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immunization requirements
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
middle school enrollment
Please fill in the blank with the appropriate numbers. (You can get information on school enrollment from your department of education.)
31. Please check each grade that you survey in Middle School:
a. Public:
6th Grade
7th Grade
8th Grade
None
b. Private:
6th Grade
7th Grade
8th Grade
None
32. What is the total number of schools in Your State that have any of the middle school grades listed in Q31?
a. Public:
b. Private:
33. How many of the schools had data included in this report?
a. Public:
b. Private:
34. What is the total number of children in Your State that have any of the middle school grades listed in Q31?
a. Public:
6th Grade
7th Grade
8th Grade
b. Private:
6th Grade
7th Grade
8th Grade
35. How many middle school children did you survey? (This should include children with a missing vaccination record.)
a. Public:
6th Grade
7th Grade
8th Grade
b. Private:
6th Grade
7th Grade
8th Grade
36. How many surveyed middle school children did not have a vaccination record?
a. Public:
b. Private:
36a. What happens to these children?
i. Public:
(Check all that apply)
Given an exemption
Excluded from school
Grace period starts
Other
ii. Private:
(Check all that apply)
Given an exemption
Excluded from school
Grace period starts
Other
middle school 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
37.
Medical
Yes
No
Yes
No
38.
Religious
Yes
No
Yes
No
39.
Philosophical
Yes
No
Yes
No
40.
Temporary
Yes
No
Yes
No
41. Comments regarding middle school exemptions:
SDN imposes a 15 minute timeout. You must save data at least once every 15 minutes or entered/unsaved data will be lost
vaccine information for middle school (recommended)
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.
Data for the 6th Grade
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
42a.
Hepatitis B Series
43a.
MMR
44a.
Varicella
45a.
Meningococcal (MCV-4)
46a.
Human Papillomavirus (HPV)
47a.
Booster Tdap
The coverage reported for Tdap is the number of children who received Tdap
The coverage reported for Tdap includes the number of children who received Td
Comments:
Data for the 7th Grade
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
42b.
Hepatitis B Series
43b.
MMR
44b.
Varicella
45b.
Meningococcal (MCV-4)
46b.
Human Papillomavirus (HPV)
47b.
Booster Tdap
The coverage reported for Tdap is the number of children who received Tdap
The coverage reported for Tdap includes the number of children who received Td
Comments:
Data for the 8th Grade
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
42c.
Hepatitis B Series
43c.
MMR
44c.
Varicella
45c.
Meningococcal (MCV-4)
46c.
Human Papillomavirus (HPV)
47c.
Booster Tdap
The coverage reported for Tdap is the number of children who received Tdap
The coverage reported for Tdap includes the number of children who received Td
Comments:
48.
Vaccine related comments
Please select "Final" when you have completed all data entry for the Middle School section.
In-process
Final
Click on "Save/Continue" to save data input and/or navigate to the Immunization Requirements section.
cdc contacts
Report/Content Issues:
Contact CDC with questions or requests for assistance on school report content
Technical/Website Issues:
Robert Avey
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
Department of Health
and Human Services