CDC Call to Action: What Schools Can Do to Promote Routine Vaccination Catch-Up Among School Aged Children

During the two school years following the start of the COVID-19 pandemic, routine kindergarten vaccination 

coverage dropped by two percentage points nationwide from 95% to 93% and by as much as 10% in some 

jurisdictions. This is the lowest that we’ve seen kindergarten routine vaccination coverage drop nationally in the 

last decade. Influenza vaccination coverage also dropped five percent among children 6 months to 17 years old.

Drops in vaccine coverage put students at greater risk for illness,

i absenteeism,ii,iii,iv,v and lower academic 

achievement from missing even a few days of schoolvi,vii,viii.

Routine vaccinations are a great tool to keep kids healthy, in school, and ready to learn. Vaccines can optimize 

student health by:

• Providing immunity and preventing disease outbreaks,

• Reducing the spread of disease in school thereby reducing the:

o Number of students and teachers that get sick and are absent 

o Probability of an unplanned school closure due to illness, and

• Reducing duration of disease and thereby number of school days missed due to poor health.

Path Forward: Every Student Every Day

Although coverage has declined in recent years, we can get back on track and achieve the Healthy People 2030

target of 95% routine kindergarten vaccination coverage by ensuring all kindergarteners without a documented 

exemption are vaccinated. Education partners and schools are trusted sources of information for parents and 

guardians, and they play an important role in the health of students. Schools can promote student health, 

attendance, and learning by adding routine immunizations to the back-to-school checklist. 

Here are some ways that schools can help school aged children get back on track with their vaccinations. 

Remind families about kindergarten and middle school vaccination requirements

As families begin to prepare to send their children back to school, summer is an opportune time to communicate 

with families about school vaccinations.

• Check out CDC’s Let’s RISE webpage for immunization catch-up tools and resources.

• Provide vaccine information, stress the importance of vaccination, and give information on vaccine 

requirements for school entry to parents and guardians in back-to-school communications and events.

• Consider displaying or sharing CDC’s back-to-school vaccination communication materials, such as 8.5” x 

11” flyers and social media posts, in schools or on your school websites and social media channels.

• Send reminders to families whose children do not have documentation of required school vaccinations 

upon school entry.

• Consider promoting immunization as part of September Attendance Awareness Month. This year’s 

campaign is focused on “Showing Up Together” to support positive conditions for learning previously 

affected by the pandemic that can improve attendance.

Help share the facts 

Catch-up vaccination will require efforts from healthcare systems, healthcare providers, schools, state and local 

governments, and families by sharing the facts about routine vaccines and answering families’ questions. It is 

important to strengthen awareness about all ACIP recommended childhood vaccines including those that are not 

required for school entry such as the benefits of flu, COVID-19 and HPV vaccination.
• Help share the facts about routine vaccines, including that vaccines are safe and where families can 

inquire about receiving free vaccines through CDC’s Vaccines for Children program.

• Provide parents and guardians with a specific school contact who can address questions and concerns 

about vaccinations, such as a school nurse.

• Equip school administrators and school health services staff with CDC’s frequently asked questions for 

routine immunizations.

• Alert school administrators and school health services staff to common misinformation circulating about 

routine immunizations and share resources on how to address misinformation.

Expand access to immunization services for students

Community located vaccination events held at a local health department or school campus can help remove 

logistical barriers and increase vaccine uptake. These can be open to students only or offered to teachers, families, 

and the greater community.

• Reach out to, or use relationships with, relevant immunization programs and health departments to 

determine if they can offer community vaccination days or school-located vaccination clinics during the 

week(s) prior to and after the first day of school. 

• Reach out to local pharmacies and Community Health Centers to understand their vaccine supply and 

determine whether they can offer community vaccination days or school-located vaccination clinics

during the week(s) prior to and after the first day of school.

• Expand immunization school-based services to children via school-located vaccination event or onsite 

provision of health services.

o View CDC guidance on school located vaccination clinics: CDC’s Guidance for Planning 

Vaccination Clinics Held at Satellite; SLV_information.pdf (cdc.gov); and SLV Clinics - Best 

Practices for School Districts: A Guide for School District Administrators.

o Check out Centers for Medicare and Medicaid Services and Department of Education’s new 

Comprehensive Guide to Medicaid Services and Administrative Claiming on provision of and 

payment for Medicaid-covered health services, such as vaccination, in schools.

Share and utilize data for action

• Share school vaccination coverage data with health departments, as requested and allowable by state 

law. This data is used by health departments to provide schools and education partners with resources 

and support.

• Use school data to prioritize immunization catch-up in schools that have historically low coverage rates 

and where rates have declined the most during the COVID-19 pandemic.

Help us protect your students by doing what you can to get kids caught up on recommended vaccines. 

Sincerely,

José R. Romero, MD, FAAP, FAAAS, FIDSA, FPIDS 

Director 

National Center for Immunization and Respiratory Diseases

Centers for Disease Control and Prevention

This document contains links to non-United States Government websites. We are providing these links because they contain additional 

information relevant to the topic(s) discussed in this document or that otherwise may be useful to the reader. We cannot attest to the accuracy 

of information provided on the cited third-party websites or any other linked third-party site. We are providing these links for reference only; 

linking to a non-United States Government website does not constitute an endorsement by CDC, HHS, or any of their employees.
i Sinclair, D. et al. 2019. Forecasted Size of Measles Outbreaks Associated with Vaccination Exemptions for Schoolchildren. JAMA. 2(8):e199768. 

doi:10.1001/jamanetworkopen.2019.976 

ii Hull, H. and Ambrose, C. 2010. The Impact of School-Located Influenza Vaccination Programs on Student Absenteeism: A Review of the U.S. 

Literature. The Journal of School Nursing. 27(1) https://doi.org/10.1177/10598405103891

iii Gicquelais R et al. 2016. Association of School-Based Influenza Vaccination Clinics and School Absenteeism—Arkansas, 2012-2013. Journal of 

School Health. 86(4): 235-241. https://doi.org/10.1111/josh.12372

iv King, J. et al. 2012. Direct and indirect impact of influenza vaccination of young children on school absenteeism.

Vaccine. Volume 30, Issue 2. https://doi.org/10.1016/j.vaccine.2011.10.097

v Keck, P. et al. 2013. School-Located Influenza Vaccination and Absenteeism Among Elementary School Students in a Hispanic Community. The 

Journal of School Nursing. Volume 29, Issue 4. https://doi.org/10.1177/10598405134860

vi Aucejo, E. and Romano, T. Assessing the effect of school days and absences on test score performance. Economics of Education Review.

Volume 55, 2016, Pages 70-87. https://doi.org/10.1016/j.econedurev.2016.08.007

vii Liu, J et al. 2019. The Short- and Long-Run Impacts of Secondary School Absences. Institute of Labor and Economics. The Short- and Long-Run 

Impacts of Secondary School Absences (iza.org)

viii Kraft, M., and Novicoff, S. 2022. Instructional Time in U.S. Public Schools: Wide Variation, Causal Effects, and Lost Hours. Annenberg Institute 

at Brown University. EdWorking Paper: 22-653. https://doi.org/10.26300/1xxp-9c79