TABLE 2. Estimated number and percentage* of children enrolled in kindergarten with reported type of exemption from vaccination and grace period/provisional enrollment, by immunization program† — United States and territories, 2016–17 school year.
| Immunization program | Medical exemptions, no. (%) | Nonmedical exemptions |
Any exemption |
Grace period/Provisional enrollment,§ no. (%) | |||||
|---|---|---|---|---|---|---|---|---|---|
| Religious, no. | Philosophical, no. | Total no. (%) | 2016–2017, No. | 2016–2017, % | 2015–2016, % | Percentage point difference (2015–16 to 2016–17) | |||
|
Median¶
|
(0.2)
|
—
|
—
|
(1.8)
|
—
|
2.0
|
1.9
|
0.1
|
(2.0)
|
| Alabama |
62 (0.1) |
367 |
** |
367 (0.6) |
429 |
0.7 |
0.8 |
-0.1 |
NA |
| Alaska |
149 (1.5) |
514 |
** |
514 (5.2) |
663 |
6.8 |
5.9 |
0.9 |
NA |
| Arizona |
134 (0.2) |
††
|
4,106 |
4,106 (4.9) |
4,240 |
5.1 |
4.7 |
0.4 |
NA |
| Arkansas |
24 (0.1) |
169 |
344 |
513 (1.3) |
537 |
1.4 |
1.3 |
0.1 |
3,014 (7.6) |
| California |
2,928 (0.5) |
§§
|
§§
|
3,217 (0.6) |
6,144 |
1.1 |
2.5 |
-1.4 |
10,999 (1.9) |
| Colorado¶¶ |
NA |
NA |
NA |
NA |
NA |
NA |
4.3 |
NA |
NA |
| Connecticut |
107 (0.3) |
701 |
** |
701 (1.8) |
808 |
2.1 |
2.0 |
0.1 |
NA |
| Delaware |
7 (<0.1) |
133 |
** |
133 (1.2) |
140 |
1.2 |
1.2 |
0.0 |
NA |
| District of Columbia |
47 (0.6) |
42 |
** |
42 (0.5) |
89 |
1.1 |
1.0 |
0.1 |
NA |
| Florida |
841 (0.4) |
4,725 |
** |
4,725 (2.1) |
5,566 |
2.5 |
2.2 |
0.3 |
7,293 (3.2) |
| Georgia |
198 (0.1) |
3,613 |
** |
3,613 (2.7) |
3,811 |
2.8 |
1.9 |
0.9 |
308 (0.2) |
| Hawaii |
20 (0.1) |
455 |
** |
455 (2.7) |
474 |
2.8 |
2.9 |
-0.1 |
310 (1.8) |
| Idaho |
86 (0.4) |
127 |
1,265 |
1,392 (6.2) |
1,478 |
6.5 |
6.1 |
0.4 |
444 (2.0) |
| Illinois¶¶ |
NA |
NA |
NA |
NA |
NA |
NA |
NA |
NA |
NA |
| Indiana |
112 (0.1) |
697 |
** |
697 (0.8) |
809 |
1.0 |
1.2 |
-0.2 |
NA |
| Iowa |
79 (0.2) |
622 |
** |
622 (1.6) |
701 |
1.8 |
1.8 |
0.0 |
1,478 (3.7) |
| Kansas |
115 (0.3) |
569 |
** |
569 (1.5) |
683 |
1.8 |
1.6 |
0.2 |
NA |
| Kentucky |
217 (0.4) |
366 |
** |
366 (0.7) |
583 |
1.1 |
0.9 |
0.2 |
NA |
| Louisiana |
54 (0.1) |
32 |
364 |
396 (0.7) |
450 |
0.8 |
0.8 |
0.0 |
NA |
| Maine |
32 (0.2) |
36 |
622 |
658 (4.8) |
691 |
5.0 |
4.5 |
0.5 |
154 (1.1) |
| Maryland |
391 (0.5) |
628 |
** |
628 (0.9) |
1,019 |
1.4 |
1.3 |
0.1 |
NA |
| Massachusetts |
191 (0.3) |
702 |
** |
702 (1.0) |
893 |
1.3 |
1.3 |
0.0 |
NA |
| Michigan |
213 (0.2) |
872 |
3,262 |
4,134 (3.5) |
4,347 |
3.7 |
3.6 |
0.1 |
885 (0.7) |
| Minnesota¶¶ |
NA |
NA |
NA |
NA |
NA |
NA |
NA |
NA |
NA |
| Mississippi |
31 (0.1) |
††
|
** |
††,** |
31 |
0.1 |
<0.1 |
0.1 |
210 (0.5) |
| Missouri¶¶ |
NA |
NA |
NA |
NA |
NA |
NA |
NA |
NA |
NA |
| Montana |
53 (0.4) |
391 |
** |
391 (3.3) |
444 |
3.7 |
3.8 |
-0.1 |
209 (1.7) |
| Nebraska*** |
186 (0.7) |
367 |
** |
367 (1.4) |
553 |
2.0 |
2.0 |
0.0 |
881 (3.2) |
| Nevada |
53 (0.1) |
1,585 |
** |
1,585 (4.3) |
1,638 |
4.4 |
2.0 |
2.4 |
1,042 (2.8) |
| New Hampshire |
29 (0.2) |
365 |
** |
365 (3.0) |
394 |
3.2 |
2.6 |
0.6 |
633 (5.2) |
| New Jersey |
196 (0.2) |
1,881 |
** |
1,881 (1.7) |
2,077 |
1.9 |
1.8 |
0.1 |
1,191 (1.1) |
| New Mexico |
6 (<0.1) |
604 |
** |
604 (2.2) |
610 |
2.3 |
1.3 |
1.0 |
182 (0.7) |
| New York (including New York City) |
345 (0.2) |
1,975 |
** |
1,975 (0.9) |
2,320 |
1.0 |
0.9 |
0.1 |
4,444 (2.0) |
| New York City |
78 (0.1) |
581 |
** |
581 (0.6) |
659 |
0.6 |
0.4 |
0.2 |
1,444 (1.4) |
| North Carolina |
174 (0.1) |
2,073 |
** |
2,073 (1.6) |
2,247 |
1.8 |
1.1 |
0.7 |
2,138 (1.7) |
| North Dakota |
24 (0.2) |
64 |
244 |
307 (3.1) |
332 |
3.4 |
3.3 |
0.1 |
NA |
| Ohio |
414 (0.3) |
§§
|
§§
|
2,836 (2.1) |
3,251 |
2.4 |
2.3 |
0.1 |
6,320 (4.6) |
| Oklahoma††† |
79 (0.2) |
290 |
620 |
910 (1.7) |
989 |
1.9 |
1.6 |
0.3 |
NA |
| Oregon |
55 (0.1) |
§§
|
§§
|
2,992 (6.5) |
3,047 |
6.7 |
6.3 |
0.4 |
NA |
| Pennsylvania |
537 (0.4) |
1,256 |
1,523 |
2,778 (1.9) |
3,315 |
2.3 |
2.2 |
0.1 |
11,622 (8.1) |
| Rhode Island |
22 (0.2) |
109 |
** |
109 (1.0) |
131 |
1.2 |
1.1 |
0.1 |
NA |
| South Carolina |
55 (0.1) |
1,124 |
** |
1,124 (1.9) |
1,180 |
2.0 |
1.6 |
0.4 |
385 (0.6) |
| South Dakota |
21 (0.2) |
219 |
** |
219 (1.8) |
241 |
2.0 |
1.6 |
0.4 |
NA |
| Tennessee |
103 (0.1) |
882 |
** |
882 (1.1) |
985 |
1.3 |
1.1 |
0.2 |
1,007 (1.3) |
| Texas (including Houston) |
822 (0.2) |
§§
|
§§
|
6,078 (1.6) |
6,900 |
1.8 |
1.6 |
0.2 |
NA |
| Houston |
69 (0.2) |
§§
|
§§
|
333 (0.8) |
401 |
1.0 |
0.9 |
0.1 |
NA |
| Utah |
88 (0.2) |
4 |
2,391 |
2,395 (4.9) |
2,483 |
5.1 |
4.6 |
0.5 |
1,061 (2.2) |
| Vermont |
15 (0.2) |
234 |
** |
234 (3.7) |
249 |
3.9 |
5.7 |
-1.8 |
408 (6.4) |
| Virginia |
225 (0.2) |
1,048 |
** |
1,048 (1.0) |
1,273 |
1.2 |
1.2 |
0.0 |
NA |
| Washington |
805 (0.9) |
257 |
3,187 |
3,444 (4.0) |
4,161 |
4.8 |
4.5 |
0.3 |
1,824 (2.1) |
| West Virginia |
75 (0.3) |
††
|
** |
††,** |
75 |
0.3 |
0.2 |
0.1 |
1,198 (4.2) |
| Wisconsin |
194 (0.3) |
271 |
3,238 |
3,509 (5.2) |
3,702 |
5.5 |
3.3 |
2.2 |
1,567 (2.3) |
| Wyoming |
NA |
NA |
NA |
NA |
NA |
NA |
NA |
NA |
NA |
| Guam |
0 (<0.1) |
7 |
** |
7 (0.2) |
7 |
0.2 |
<0.1 |
0.2 |
NA |
| Marshall Islands |
0 (0.0) |
0 |
** |
0 (0.0) |
0 |
0.0 |
NA |
NA |
NA |
| Federated States of Micronesia (Kosrae) |
0 (0.0) |
0 |
0 |
0 (0.0) |
0 |
0.0 |
NA |
NA |
NA |
| Federated States of Micronesia (Yap) |
0 (0.0) |
0 |
0 |
0 (0.0) |
0 |
0.0 |
NA |
NA |
NA |
| N. Mariana Islands |
0 (0.0) |
0 |
0 |
0 (0.0) |
0 |
0.0 |
0.0 |
0.0 |
NA |
| Palau*** |
0 (0.0) |
§§
|
§§
|
0 (0.0) |
0 |
0.0 |
NA |
NA |
NA |
| Puerto Rico |
43 (0.2) |
57 |
** |
57 (0.2) |
101 |
0.4 |
0.3 |
0.1 |
NA |
| U.S. Virgin Islands | 0 (<0.1) | 12 | ** | 12 (0.9) | 12 | 0.9 | 0.6 | 0.3 | NA |
Abbreviation: NA = not available (i.e., not collected or reported to CDC).
* Estimates were adjusted for nonresponse and weighted for sampling where appropriate.
† Medical exemptions, nonmedical exemptions, and grace period/provisional enrollment status might not be mutually exclusive. Some children might have both medical and nonmedical exemptions, and some enrolled under a grace period/provisional enrollment might be exempt from one or more vaccinations.
§ A grace period is a set number of days during which a student can be enrolled and attend school without proof of complete vaccination or exemption. Provisional enrollment allows a student without complete vaccination or exemption to attend school while completing a catch-up vaccination schedule. In states with one or both of these policies, the estimates represent the number of kindergartners within a grace period, provisionally enrolled, or some combination of these categories.
¶ Medians calculated from data from 45 states and District of Columbia; states/jurisdictions excluded were Colorado, Illinois, Minnesota, Missouri, and Wyoming. Houston, New York City, Guam, Marshall Islands, Federated States of Micronesia, N. Mariana Islands, Palau, Puerto Rico, and U.S. Virgin Islands were also excluded. Exemption data were reported for 3,666,870 kindergartners. Grace period/provisional enrollment median was calculated from data from 27 states; data were reported for 2,463,131 kindergartners.
** Philosophical exemptions were not allowed.
†† Religious exemptions were not allowed.
§§ Religious and philosophical exemptions were not reported separately.
¶¶ Program did not report the number of children with exemptions, but instead reported the number of exemptions for each vaccine, which could count some children more than once. Lower bounds of the percentage of children with any exemptions estimated using the individual vaccines with the highest number of exemptions are: for Colorado, 0.2% with medical exemptions, 0.3% with religious exemptions, 3.1% with philosophical exemptions, and 3.6% with any exemptions; for Illinois, 0.2% with medical exemptions, 1.2% with religious exemptions, and 1.4% for any exemptions; for Minnesota, 0.2% with medical exemptions, 3.1% with nonmedical exemptions, and 3.3% for any exemptions; and for Missouri 0.2% with medical exemptions, 2.0% with religious exemptions, and 2.2% for any exemptions.
*** For Nebraska, estimates represent exemptions among children in kindergarten and 1st grade. For Palau, estimates represent exemptions among children in 1st grade.
††† Reported public school data only.