Introduction
Vaccinations are among the greatest success stories of public health, having led to the global eradication of smallpox and sharp decreases in the incidence of other serious and deadly infectious diseases. The current childhood vaccination schedule recommended by public health experts provides protection against 16 diseases that once killed thousands each year in the U.S. In Kansas for the 2020-2021 school year, vaccines to protect kids from 11 of these 16 diseases are required at various grade levels for school entry. In contrast, for university students, the only statewide requirement is to protect students from meningococcal disease. Statute only requires this immunization for students at state universities who will live on campus housing.
The U.S. Centers for Disease Control and Prevention (CDC)estimated that, among children born between1994 to 2013, vaccinations will prevent 322 million illnesses, 21 million hospitalizations and 732,000deaths, and result in a net savings of $295 billion in direct costs and $1.38 trillion in total societal costs over the course of their lifetimes. In addition to these estimates, the world is currently closely watching the development of a COVID-19 vaccine. It is anticipated that this vaccine will play a critical role in ending the ongoing pandemic.
Despite these achievements, preventable outbreaks still occur. After being eliminated from the U.S. in 2000, there was a resurgence of measles in 2019, with 1,282 cases confirmed in 31 states. This is the highest number of cases in a single year since 1992. Most cases occurred among persons who had not been vaccinated. Measles outbreaks in 2019 prompted quarantines at two universities in California, affecting hundreds of students and staff.
Outbreaks of mumps also have increased in recent years. An outbreak at Temple University in Pennsylvania began in February 2019 and, by mid-April, involved 140 cases and spread to other schools in the area, including Drexel University, West Chester University and the University of Pennsylvania.
From January 2016 to June 2017, 150 mumps outbreaks, comprising 9,200 cases, were reported to the CDC. In Kansas, from December 2016 to July 2017, 166 mumps cases were reported in 26 counties. Of these cases, 133 (80 percent) occurred among 11 distinct outbreaks, including two outbreaks among university communities. In the first outbreak, at the University of Kansas in Lawrence, 20 cases were reported between December 2016 and April 2017. At a second outbreak at Kansas State University in Manhattan (Riley County), 17 cases were reported between January 2017 and April 2017. At nearby University of Missouri, a mumps outbreak across 2016-2017 involved 378 students.
Outbreaks of vaccine-preventable diseases (VPD) on college and university campuses and surrounding communities may occur due to students living in close quarters in dormitories and other group living situations and engaging in behaviors that increase risk for infection, such as sharing drinks. Some research has shown that first-year college students living in residence halls are at higher risk for meningococcal disease, which prompted vaccine recommendations for these students.
Prevention Through Policy
Vaccination policies have long been an important strategy for protecting the public against vaccine preventable diseases. All 50 states have legislation requiring certain vaccinations for childcare and school attendance. Kansas currently requires that children attending childcare facilities and school receive vaccinations for several diseases, including measles, mumps and pertussis (“whooping cough”), among others. The only allowable exemptions are for religious beliefs or medical contraindications.
However, for colleges and universities, requirements under Kansas state law are limited to vaccination against meningitis, broadly interpreted as against meningococcal disease, only for residents in student housing at the six state universities. The law does not require vaccinations against diseases other than meningitis, and does not require meningitis vaccinations for students at state universities in non-student housing or at other universities.
Given the potential risks of vaccine-preventable disease outbreaks, many colleges and universities in Kansas have instituted vaccination requirements for students. Vaccinating on campus students also has the benefit of protecting others in the university, including faculty, staff and students who cannot receive vaccinations.
