State and local school vaccination requirements protect students and communities against vaccine-preventable diseases (1). This report summarizes data collected by state and local immunization programs* on vaccination coverage and exemptions to vaccination among children in kindergarten in 49 states † and the District of Columbia and provisional enrollment or grace period status for kindergartners in 27 states § for the 2021-22 school year. Nationwide, vaccination coverage with 2 doses of measles, mumps and rubella vaccine (MMR) was 93.5% ¶ ; with the state-required number of diphtheria, tetanus, and acellular pertussis vaccine (DTaP) doses was 93.1%**; with poliovirus vaccine (polio) was 93.5% †† ; and with the state-required number of varicella vaccine doses was 92.8%. §§ Compared with the 2020-21 school year, vaccination coverage decreased 0.4-0.9 percentage points for all vaccines. Although 2.6% of kindergartners had an exemption for at least one vaccine, ¶¶ an additional 3.9% who did not have an exemption were not up to date with MMR. Although there has been a nearly complete return to in-person learning after COVID-19 pandemic-associated disruptions, immunization programs continued to report COVID-19-related impacts on vaccination assessment and coverage. Follow-up with undervaccinated students and catch-up campaigns remain important for increasing vaccination coverage to prepandemic levels to protect children and communities from vaccine-preventable diseases.
Competing Interests: All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.