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School Vaccination Coverage
for Kindergarten and Middle School

 
THIS PAGE IS PROVIDED FOR INFORMATION PURPOSES ONLY. YOU CANNOT USE THIS PAGE TO SUBMIT YOUR ANNUAL SCHOOL COVERAGE REPORT. THE SCHOOL VACCINATION COVERAGE REPORT IS HOSTED ON A SECURE SITE REQUIRING A DIGITAL CERTIFICATE. IF YOU NEED INFORMATION ON HOW TO ACCESS THE SITE AND/OR OBTAIN A DIGITAL CERTIFICATE PLEASE CONTACT Robert Avey
Grantee: Your State

kindergarten enrollment

Please fill in the blank with the appropriate numbers. (You can get information on school enrollment from your department of education.)

 
12. What is the total number of schools in Your State that have kindergartens?
a. Public:
b. Private:
 

13. How many of the schools had data included in this report?
a. Public:
b. Private:
 

14. What is the total number of children enrolled in all kindergartens in Your State?
a. Public:
b. Private:
 

15. How many kindergartners did you survey? (This should include children with a missing vaccination record.)
a. Public:
b. Private:
 

16. How many surveyed kindergarten children did not have a vaccination record?
a. Public:
b. Private:
 
16a. What happens to these children?
i. Public: (Check all that apply)



 
ii. Private: (Check all that apply)



 

SDN imposes a 15 minute timeout. You must save data at least once every 15 minutes or entered/unsaved data will be lost

kindergarten exemptions

Instructions for completing the exemption section: Please report permanent exemptions and temporary exemptions separately. If you are unable to do that, please use the spaces for permanent exemptions to report total exemptions in each category. Make a note in the comment section explaining how you reported the exemption data.
           
 
Type of Exemption Is this type of exemption allowed? Do you/can you track this type of exemption? Number of surveyed children who were exempt.
Public Private
 
17. Medical
18. Religious
19. Philosophical
20. Temporary
 
 

21. Comments regarding kindergarten exemptions:


vaccine information for kindergarten (required)

  • Comments and definitions on reporting vaccine requirements and doses:
  • Up-to-date(UTD) = received the appropriate doses of each vaccine.
  • Include a vaccine in your count whether it was administered individually or through combination vaccines.
             
 
Vaccine (doses for complete series) # Doses for UTD status in your state. Number of surveyed children meeting state rqmts. Number of surveyed children UTD on complete series.
Public Private Public Private
 
22. Polio (3+)
23. Diphtheria (4+)
24. Tetanus (4+)
25. Pertussis (4+)
26. MMR (2)
27. Hepatitis B (Hep B) (3+)
28. Varicella (2)
29. Influenza
 
30. Vaccine related comments

Please select "Final" when you have completed all data entry for the Kindergarten section.
 

Click on "Save/Continue" to save data input and/or navigate to the Middle school section.

cdc contacts

Report/Content Issues:Contact CDC with questions or requests for assistance on school report content
Technical/Website Issues:Robert Avey
 
Safer, Healthier People

Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, U.S.A
Tel: (404) 639-3311 / Public Inquiries: (404) 639-3534 / (800) 311-3435
FirstGovDHHS Department of Health
and Human Services