School Reporting Menu

School Vaccination Coverage
for Kindergarten and Middle School

demographics

Grantee Project Area
School Year
Program manager
Prepared by

scope of the report

Please check all that apply
Type of SchoolSchools Surveyed
Public
Private
Home
How were the data for this report collected?
Does the child's vaccination information at the school come directly from a provider (e.g. doctor, nurse, clinics, registry)?



What immunization information is included in the student's record?




Does the health department receive all of the above information for each child?


Do you have a grace period (i.e. 14 days) for students who are not up-to-date?

  # of days...
The information submitted in this report describes the up-to-date status of kindergarten and middle school children (pick one):





kindergarten

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

 
1. What is the total number of schools in South Dakota that have kindergartens?

 
2. How many of these schools did you survey?

 
3. What is the total number of children enrolled in all kindergartens in South Dakota ?

 
4. How many kindergartners did you survey?

 
5. How many surveyed kindergarten children did not have vaccination records available to you?

 
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 your reported the exemption data.
 
6. How many kindergarten children were exempted from one or more required vaccines for medical reasons?  

 
7. How many kindergarten children were exempted from one or more required vaccines for religious reasons?

 
8. How many kindergarten children were exempted from one or more required vaccines for philosophical reasons?

 
9. How many kindergarten children were exempted from one or more required vaccines on a temporary basis (e.g. given 30 days to become up-to-date)?

 
10. 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.
  • Please specify if you are reporting according to ACIP recommendations or your school law requirements.
  • If you are not reporting according to ACIP recommended doses, please indicate how many doses are required by your school law. Please note that from now on all grantees are encouraged to report according to ACIP recommended doses.
  • The ACIP recommended doses are shown in parentheses beside the vaccine name.
           
 
 
Vaccine Is this vaccine required for Kindergarten entry? Are you reporting based on ACIP recommended doses? If your report is not based on ACIP, indicate # of doses for UTD status. Number of surveyed children who were considered UTD.
 
11. Polio (3+)
12. Diphtheria (4+)
13. Tetanus (4+)
14. Pertussis (4+)
15. Measles (2+)
16. Mumps (2+)
17. Rubella (2+)
18. Hepatitis B (Hep B) (3+)
19. Varicella (1)
20. Hepatitis A (Hep A) (2)

middle school

Please fill in the blank with the appropriate numbers. (You can get information on school enrollment from your department of education.)
 
We conduct Middle School Assessments
 
21. What is the total number of schools in South Dakota that have middle school?

22. How many of these schools did you survey?

23. What is the total number of chldren enrolled in all middle school in South Dakota ?

24. How many middle school children did you survey?

25. How many surveyed middle school children did not have immunization records available to you?

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 your reported the exemption data.
 
26. How many middle school children were exempted from one or more required required vaccines for medical reasons?
27. How many middle school children were exempted from one or more required required vaccines for religious reasons?

28. How many middle school children were exempted from one or more required required vaccines for philosophical reasons?

29. How many middle school children were exempted from one or more required required vaccines on a temporary basis (e.g. given 30 days to become up-to-date)?

30. Comments regarding middle school exemptions:


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.
  • Please specify if you are reporting according to ACIP recommendations or your school law requirements.
  • If you are not reporting according to ACIP recommended doses, please indicate how many doses are required by your school law. Please note that from now on all grantees are encouraged to report according to ACIP recommended doses.
  • The ACIP recommended doses are shown in parentheses beside the vaccine name.
 
           
 
 
Vaccine Is this vaccine required for Middle school entry? Are you reporting based on ACIP recommended doses? If your report is not based on ACIP, indicate # of doses for UTD status. Number of surveyed children who were considered UTD.
 
31. Booster Td or Tdap (1)
32. Hepatitis B Series (3+)
33. Measles (2)
34. Mumps (2)
35. Rubella (2)
36. Varicella (1)
37. Meningococcal (MCV-4)(1)

immunization laws and requirements for school and child care entry

Who has the primary responsibility for contacting parents of non-compliant children entering school? child care? (check all that apply)
 School Child Care
Department of Education
State Health Department
Local Health Department
School/Childcare Center
Other (specify)
None
Does the law specify a penalty for parents with children who are not immunized or up-to-date?
School
Child Care

If there is a penalty, is it enforced?







Have there been any changes to the immunization requirements or laws for school or child care entry during the present school year?
 


 
Present school year Immunization requirement/law changes
 
  • Please complete/select the items below to submit an immunization requirement/law change for the present year.
  • When you have finished entering/selecting data, click the button and your data will be saved and displayed in the table beneath the entry fields.
  • You may repeat this process as often as necessary to capture all of your present year immunization requirement/law changes.
  • Once data has been saved and is displayed in the table below, you may edit and/or delete the information by selecting the appropriate link located to the right side of the data row.
 
School Type
Vaccine(s)/Antigen(s) If vaccine isn't listed, please provide vaccine 
Doses(s) Required
Exemption Change(s)
Other Change(s)
 

School Type Vaccine/Antigen New Vaccine Doses Required Exemption changes Other changes Update  
Will there be any changes to the immunization requirements or laws for school or child care entry in the upcoming school year?



 
Upcoming school year Immunization requirement/law changes
 
  • Please complete/select the items below to submit an immunization requirement/law change for the upcoming school year.
  • When you have finished entering/selecting data, click the button and your data will be saved and displayed in the table beneath the entry fields.
  • You may repeat this process as often as necessary to capture all of your upcoming school year immunization requirement/law changes.
  • Once data has been saved and is displayed in the table below, you may edit and/or delete the information by selecting the appropriate link located to the right side of the data row.
 
School Type
Vaccine(s)/Antigen(s) If vaccine isn't listed, please provide vaccine 
Doses(s) Required
Exemption Change(s)
Other Change(s)
 

School Type Vaccine/Antigen New Vaccine Doses Required Exemption changes Other changes Update  
Since CDC no longer requires a biennial childcare assessment report, do you continue to collect data on vaccination coverage in childcare centers?


Does the child's vaccination information at the childcare center come directly from a provider (e.g. doctor, nurse, clinics, registry)?



Additional Comments

Is this your final submission of data for this survey?

 
(If you answer "No", CDC's records will indicate that you have not reported.
Please remember to update this page and check "Yes" when you are done.)

cdc contacts

Report/Content Issues:Cindi Knighton | Carol Stanwyck
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