Y. Tony Yang, Sc.D., LLM, MPH, was recently awarded $150,000 from Merck to investigate "A Multimethod Examination of Conditionally Admitted Kindergartners and School Entry Vaccination Requirements." With vaccine coverage levels for school-age children in the U.S. fluctuating dramatically over the previous 15-20 years and decreasing substantially in many states and regions, along with a reemergence of vaccine-preventable diseases (VPDs), a number of states in the US are currently struggling to maintain the high levels of immunization coverage. Provisional enrollment is an important piece of this larger puzzle. Although there is some understanding of when, why, and where children are falling behind on vaccinations, our proposed research aims to advance the overall understanding of undervaccination in the US by examining provisional enrollment in school-age children.
The goal of the investigation is to determine the relationship between the level of restrictiveness of state provisional enrollment laws and state rates of provisional entrants and nonmedical exemptions. Researchers will identify and categorize all provisional enrollment regulations from 50 states and D.C., as well as analyze the relationship between provisional law restrictiveness and grace period and the proportion of provisional entrants, while controlling for the restrictiveness of non-medical exemption (NME) policies and other demographic factors.
In addition, investigators will evaluate the associations among community-level factors and provisionally enrolled kindergarteners, and determine the effect of a change in the provisional entrance grace period on provisional entrants and nonmedical exemptions. Efforts to reduce provisional entry creates a more equitable environment in which medically at-risk children are able to attend school without fear of contracting VPDs. Our findings have potential ramifications across the U.S., as many states have underappreciated provisional enrollment issues due to lack of research evidence and considerable focus on vaccine hesitancy and NME use.