Mandatory School Vaccination Policies: Highlighting or Equalizing Racial and Socioeconomic Disparities in School Children? Barriers, attitudes, and behaviors towards fulfilling requirements

Abstract

With the rise of vaccine preventable illness in the US, the importance of timely vaccinations in children remains a priority. Mandatory school vaccination requirements are effective because they are generally accepted by the public, they allow schools and immunization programs to share resources, and they serve as a safety net to ensure all school children are immunized appropriately regardless of race, socioeconomic status (SES), or access to medical care2. However, it has repeatedly been shown that low-income, urban minority children have higher rates of underimmunization11-13, 15,16. The city of Philadelphia has a disproportionately large number of undervaccinated students compared to the rest of the state36. Philadelphia also has the highest poverty rate in the 10 largest cities of the US, and the majority of those living in poverty are minorities37. Given that the majority of Philadelphia students attend Philadelphia public schools, and of those students, greater than 75% are minorities, the disparity follows established trends39. Understanding the beliefs, attitudes, and behaviors of guardians of students in the School District of Philadelphia regarding mandatory immunization requirements and their barriers to fulfilling mandatory requirements can help facilitate future compliance. Ultimately, this information can reduce the number of undervaccinated students in the city and bridge this gap dividing students along racial and SES lines.