A 5-year national study of 100,000 adolescents found that vaccination rates to protect against tetanus, diphtheria and pertussis (Tdap) and meningococcal disease improved when they were required for school entry, and could provide a spillover effect to boost the vaccination rate for the human papillomavirus (HPV).
The study, “School Entry Requirements and Coverage of Non-Targeted Adolescent Vaccines,” funded by the National Institutes of Health, will be published in the December 2016 Pediatrics.
Vaccination requirements typically increase coverage for vaccines they target and can generate smaller spillover increases in coverage for non-targeted vaccines, the study reports. By the 2015 school year, 47 states had adopted requirements for Tdap booster, 25 states for meningococcal vaccine, and three states for HPV vaccine completion. States with requirements for Tdap booster and meningococcal vaccination had 22 and 24 percentage point increases in coverage for these vaccines, respectively, compared to states without requirements. The study found that Tdap booster and meningococcal vaccination requirements were effective at increasing coverage for the targeted vaccines and were associated with larger spillover increases in HPV vaccination coverage.
The authors suggest that policymakers consider changing school entry requirements in order to increase HPV vaccination coverage, and that states consider an indirect approach of adopting Tdap booster or meningococcal vaccination requirements.
Additional studies are needed on the effects of HPV vaccination requirements and opt-out provisions, the study concludes.