Challenges With Access to School Vaccination Surveillance Data to Evaluate the Impact of State-level School Vaccination Exemptions

Understanding school vaccination rates is critical to controlling disease outbreaks and assessing vaccination policies. Current US surveillance data on school vaccination coverage lack consistency across states, impairing the ability to conduct rigorous analysis on public health policy impacts. This case study describes our experience with publicly available school vaccination surveillance datasets during an attempt to conduct a quasi-experiment on how school vaccination exemption laws affect vaccination coverage. We outline the challenges observed during our attempts to analyze the relationship between policies related to nonmedical school vaccination exemptions and school vaccination coverage in states' bordering counties. Incomparable data volume, access, granularity, and collection methodology between states were identified as barriers to integrating data across states. Consistent surveillance data collection and reporting over time and among states could lead to improved analysis of public health status, more effective intervention evaluation, and more informed public health decision making.