Exploring the impact of the New York State repeal of nonmedical vaccination exemptions on student enrollment, absenteeism, and school workload: Perspectives from a survey of school administrators

Correira, John W.; Pettigrew, Stacy M.; Kamstra, Rhiannon; Megyeri, Perrie Rose; Silverstein, Gabriel J.; Kambrich, Susan; Ma, Julia; Doll, Margaret K.

doi:10.1080/21645515.2023.2261176

Cited by 1 publication

(1 citation statement)

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“…Fifth, we did not examine whether Senate Bill 2994A was associated with changes in school enrollment. Research in both California and NYS has suggested that students may leave traditional school systems to avoid compliance with strict immunization laws, 23 , 24 which may have implications for the spread of vaccine-preventable diseases in the broader population, despite observed increases in school immunization coverage. Sixth, the study did not evaluate the percentage of students on a pathway to immunization compliance.…”

Section: Discussionmentioning

confidence: 99%

School Vaccine Coverage and Medical Exemption Uptake After the New York State Repeal of Nonmedical Vaccination Exemptions

Correira,

Kamstra,

Zhu

et al. 2024

JAMA Netw Open

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ImportanceAlthough New York State (NYS) recently adopted legislation eliminating nonmedical vaccination exemption options from school-entry requirements, the implications of the law for school vaccine coverage and medical vaccine exemption uptake have not been examined.ObjectiveTo evaluate the implications of the repeal of school-entry nonmedical vaccination exemptions for vaccine coverage and medical exemption uptake at NYS schools outside of New York City (NYC).Design, Setting, and ParticipantsThis cohort study had an interrupted time-series design and used generalized estimating equation models to examine longitudinal school immunization compliance data from the 2012 to 2013 through 2021 to 2022 school years. The cohort comprised NYS public and nonpublic schools, excluding NYC schools, with any students enrolled in kindergarten to 12th grade. Eligible schools had enrollment and immunization data before and after the implementation of the Senate Bill 2994A legislation. Data analyses were conducted in July 2023.ExposureSenate Bill 2994A was passed in June 2019, eliminating school-entry nonmedical vaccination exemptions. Since compliance with the law was evaluated for most students during the next school year, the 2019 to 2020 school year was considered to be the law’s effective date.Main Outcomes and MeasuresThe primary outcomes were school vaccine coverage (defined as the percentage of students at each school who completed grade-appropriate requirements for all required vaccines) and medical exemption uptake (defined as the percentage of students at each school who received a medical exemption).ResultsAmong the 3821 eligible schools, 3632 (95.1%) were included in the analysis, representing 2794 (96.9% of eligible) public schools and 838 (89.2% of eligible) nonpublic schools. The implementation of Senate Bill 2994A was associated with absolute increases in mean vaccine coverage of 5.5% (95% CI, 4.5%-6.6%) among nonpublic schools and 0.9% (95% CI, 0.7%-1.1%) among public schools, with additional annual increases in vaccine coverage observed through the 2021 to 2022 school year. The law’s implementation was also associated with a 0.1% (95% CI, 0.0%-0.1%) mean absolute decrease in medical vaccination exemption uptake at both public and nonpublic schools, and small but significant mean annual decreases in medical vaccination exemptions (0.02%; 95% CI, 0.01%-0.03%) through the end of the study period.Conclusions and RelevanceResults of this cohort study suggested that repeal of school-entry nonmedical vaccination exemptions was associated with increased vaccine coverage at NYS schools outside of NYC. Coverage gains were not replaced by increases in medical vaccination exemptions.

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Section: Discussionmentioning

confidence: 99%