Vaccination Coverage with Selected Vaccines and Exemption Rates Among Children in Kindergarten — United States, 2020–21 School Year

State and local school vaccination requirements serve to protect students against vaccine-preventable diseases (1). This report summarizes data collected for the 2020-21 school year by state and local immunization programs* on vaccination coverage among children in kindergarten in 47 states and the District of Columbia (DC), exemptions for kindergartners in 48 states and DC, and provisional enrollment or grace period status for kindergartners in 28 states. Vaccination coverage nationally was 93.9% for 2 doses of measles, mumps, and rubella vaccine (MMR); 93.6% for the state-required number of doses of diphtheria, tetanus, and acellular pertussis vaccine (DTaP); and 93.6% for the state-required doses of varicella vaccine. Compared with the 2019-20 school year, vaccination coverage decreased by approximately one percentage point for all vaccines. Although 2.2% of kindergartners had an exemption from at least one vaccine, an additional 3.9% * Federally funded immunization programs are located in 50 states and DC, five cities, and eight U.S territories and freely associated states (territories). Two cities reported data to CDC, which were also included in data submitted by their state. State-level data were used to calculate national estimates and medians. Immunization programs in territories reported vaccination coverage and exemptions; however, these data were not included in national calculations. National and median vaccination coverage was determined using estimates for 47 states and DC; Alaska, Illinois, and West Virginia did not report school coverage data because of the impact of COVID-19 on data collection. Data from cities were included with their state data. Data from territories were not included in national and median calculations. National and median exemption rates were determined using estimates for 48 states and DC; Colorado, Minnesota, and Missouri did not collect information on the number of kindergartners with an exemption but instead reported the number of exemptions for each vaccine, which could count some children more than once. For these states, the percentage of kindergartners exempt from the vaccine with the highest number of exemptions (the lower bound of the potential range of exemptions) was included in the national and median exemption rates. Washington was unable to deduplicate students with both religious and philosophical exemptions, so the nonmedical exemption type with the highest number of kindergartners (the lower bound of the potential range of nonmedical exemptions) was included in the national and median exemption rates for nonmedical exemptions. Illinois and West Virginia did not report school vaccine exemption data because of the impact of COVID-19 on data collection. Data from cities were included with their state data. Data from territories were not included in national estimates.