Purpose

The Utah Department of Health and Human Services collaborates with the Utah State Board of Education (USBE) to collect immunization data each year on currently enrolled students from all public, private, and parochial schools as required by Utah Statutory Code 53G-9-305(2)(b). Each school is required to submit data regarding the immunization status of all children currently enrolled via an online reporting interface.

This report summarizes the immunization data by all school types (district school, charter school, private) on Utah’s kindergarten students from school years 2014/2015 through 2022/23. Included information examines statewide student enrollment by school type and exemption status over time. This document also reports on exemptions types (medical and non-medical), frequency of missing specific kindergarten required vaccines, and relative frequency of vaccine exemptions in each local health department (LHD). By showing trends in the immunization status of kindergartners in Utah we hope to highlight problem areas where interventions are needed to improve vaccine uptake and prevent the transmission of vaccine preventable diseases in Utah schools.

Additional information about school vaccination topics can be found on the schools immunization webpage along with a comprehensive description of the Utah School Immunization Rule. School immunization reporting requirements are found in the Immunization Guidebook.

Limitations

Although the yearly reporting of student immunization data is believed to be quite comprehensive, it is possible some private schools fail to report data in this system. Because there is no comprehensive list of Utah private schools it is impossible to know if some private schools are not reporting. With the exception of fewer than 10 private facilities that offer kindergarten, the data is complete for all district and charter schools.

In school year 2021/22 school reporting was moved into a new online data collection platform. Because of this transition, some schools reported too many or too few students in each enrollment category. The error in student counts for that school year is believed to be <5% of school reports.

Note:
Many of the graphs and tables in the report below have interactive features:

  • Tables have sorting capacity at the top of each column
  • Some graphs are layered on top of each other and can be viewed by clicking the corresponding buttons
  • Some graphs show data values if you hover over the data points
  • Within line graphs you can click or double-click lines to add or remove data from the overall graph



Kindergarten immunization data

Students by school type

The table below displays the statewide percentage of Utah’s kindergartners enrolled in each school type during the previous 9 school years. Notice enrollment in charter schools and online schools increased steadily during this time.



Enrollment in district schools decreased steadily over the period. The line graph below shows the total number of students enrolled in Utah kindergartens, and enrollment in each school type. Notice that the overall decrease in enrollment is closely tied with a decrease in district schools.



Enrollment categories: in-person kindergarten


The line graphs below show the percentage of kindergarten students in the previous 9 school years who are adequately immunized, have an exemption to any school-required vaccine, are enrolled via conditional enrollment or extended conditional enrollment, are out of compliance with vaccination requirements, or have proof of history of infection with the vaccine-preventable disease. Students who are out of compliance have provided the school with no immunization or exemption record.

You can use the onscreen buttons to toggle between the graphs and hover over each line to view the value for that data point.

Because the enrollment profiles of in-person and online schools are so different, this report displays them in their own sections with separate graphs.

The first graph below shows the percentage of in-person kindergartners who provided adequate documentation for all required vaccines. For the 7 school years leading up to the pandemic, at least 90% of kindergartners attending in-person school were adequately immunized. However, that percentage has dropped approximately 1% per year in each of the last 2 school years with only 88.2% of in-person kindergartners adequately immunized in 2022/23.

The second graph below shows all other enrollment categories for in-person kindergartners. Notably, the percentage of students with an exemption was stable at around 5% for several years. In the 2020/21 school year that decreased to almost 4%, presumably due to the pandemic disruptions and the prevalence of online schooling in that year. However, the exemption rate increased dramatically to 7.2% in the following 2 school years.


In-person kindergarten: adequately immunized

In-person kindergarten: exemptions and other categories



Enrollment categories: online kindergarten


Although online students account for just 2.4% of the total kindergarten population, it is worth noting that they have a much higher exemption rate than traditional in-person students. Because of this, and because these students do not typically congregate in a traditional educational setting, we have chosen to present their school immunization data separately.

The first graph below shows the percentage of online kindergartners who provided adequate documentation for all required vaccines. For the 7 school years leading up to the pandemic, approximately 60-70% of kindergartners who attended online school were adequately immunized. In the most recent 2 school years, that rate has plummeted to <50%.

The second graph below shows all other enrollment categories for online kindergartners. Online kindergartners have consistently had a rate of exemptions about 7 times that of in-person students. Given this, online students have typically had a exemption rate of 30-40%. However, in the most recent school year that rate has ballooned to 47.3%.

Although online students do not typically congregate in schools, it is worth noting that this population is likely very susceptible to vaccine-preventable diseases that may circulate in the community.


Online kindergarten: adequately immunized

Online kindergarten: exemptions and other categories

School types


Although online schools have a very high proportion of exempt students, it is also worth noting that charter schools typically have more exempt students and fewer adequately immunized students than district or private schools. Charter schools are the second most common type of school for kindergartners in Utah with 15% of Utah’s enrolled kindergartners. Continued growth in charter school enrollment is likely to lead to increasing exemptions for Utah students.

The 4 bar graphs below compare the 2022/23 enrollment categories of adequately immunized, exempt, conditionally/extended conditionally enrolled, and out of compliance across all school types.

Adequately immunized

Exempt

Conditionally or extended conditionally enrolled

Out of compliance

Exemption types

The state of Utah permits parents to seek a school vaccine exemption in 3 categories: medical, religious, and personal belief. The stacked bar chart below shows the relative percentage of each vaccine exemption type over time. While the vast majority of exemptions sought are personal belief exemptions, the number and relative percentage of religious exemptions has increased notably since the 2018/2019 school year.

Students missing specific vaccines

In each school, students on conditional enrollment, extended conditional enrollment, out of compliance or with an exemption may be missing documentation of any one (or multiple) of the required vaccines. The table below displays the percentage of kindergartners in each LHD who are missing documentation or have an exemption for each of these vaccines.

During an outbreak of any of these vaccine-preventable diseases, these students may need to be excluded from school if they cannot provide vaccination documentation.


Adequate immunization by LHD

The line graph below shows the percentage of in-person kindergartners in each local health district who are reported as having received all school-required vaccines for the last 9 school years. The purple line shows the average for the state of Utah (including online students). Notice that the trend is downward for nearly all LHDs and the state measure in the 3 most recent school years.

To view just 1 LHD in the graph below, double-click the LHD name in the graph legend. To add more LHD lines, use a single click in the legend to add them to the graph.


Exemptions by LHD

The line graph below shows the percentage of in-person kindergartners in each local health district who have a vaccine exemption for each of the last 9 school years. The yellow line shows the average for the state of Utah (including online students). Notice that the trend is strikingly upward for all LHDs and the state measure in the 3 most recent school years.

To view just 1 LHD in the graph below, double-click the LHD name in the graph legend. To add more LHD lines, use a single click in the legend to add them to the graph.



The dot plot below shows that while exemptions increased in nearly every LHD from the 2021/22 school year to the 2022/23 school year, the largest increases were seen in just a few LHDs. All LHDs, except Salt Lake, exceeded 5% exemptions among kindergartners in 2022/23.


Summary

Examination of kindergarten immunization and exemption data over the past 9 school years shows a few important trends.

  • While kindergarten enrollment is decreasing overall, the percentage of kindergartners enrolled in charter schools and online schools has increased.
  • Charter schools have roughly double the exemption percentage of students in district or private schools. The percentage of kindergarten vaccine exemptions is extremely high in online schools.
  • The percentage of kindergartners who have received all of the required vaccines was regularly above 90% prior to the COVID-19 pandemic, but has decreased since that time.
  • Kindergarten vaccine exemptions have dramatically increased in the last two school years. For in-person kindergarten students the exemption rate is now 7.2%.
  • Exemptions sought for religious reasons have been increasing in the last 5 school years.
  • Although exemptions have increased statewide, the highest exemption percentages and largest increases occurred in some rural LHDs.



Questions about this report can be directed to
Data update date: 09 February 2024