Retrospective Four-year Review of Vaccination Coverage and Personal Belief Exemption in Maricopa County Kindergarten and Sixth Grade Students

A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.Introduction: In recent years, there has been an increase in personal belief exemption and a corresponding decrease in vaccination coverage for school-required vaccines among children in Maricopa County. Trends in personal belief exemption (PBE) as well as documented immunity to measles, mumps, rubella (MMR) was reviewed retrospectively for four consecutive academic years among Maricopa County kindergarten and sixth grade students. Methods: Data of immunization coverage was obtained online via the publicly available Arizona Reporting Schools Coverage Report for the represented years. Data from 1,280 schools was available for analysis from 2015-2016, 1,298 schools from 2016-2017, 1,281 schools from 2017- 2018, and 1,280 schools from 2018-2019. This data was stratified based on school type (public, charter, private) and free and reduced lunch subsidy was used as a surrogate of socioeconomic status for each participating school. Results: Overall, for every increase in academic year, there was an increase in PBE to at least one required immunization and an increase in PBE to all required immunizations by 0.43% and 0.5%, respectively. For each increase in academic year, there was a decrease in documented MMR immunity by 0.26%. Higher rates of exemption were seen in charter and private schools when compared to public schools. Additionally, parents of children attending schools utilizing less free and reduced lunch subsidy have a higher tendency to exempt their children from schoolrequired vaccinations. Conclusion: These results demonstrate a growing need to limit personal belief exemptions as the lack of vaccination coverage continues to threaten the health of Maricopa County children.This item is part of the College of Medicine - Phoenix Scholarly Projects 2020 collection. For more information, contact the Phoenix Biomedical Campus Library at pbc-library@email.arizona.edu