College and University Vaccination Policies

6 Min Read

Sep 14, 2020


Charles Hunt, M.P.H.,

Carlie J. Houchen, M.P.H.,

Elena Aronson, M.P.H.



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.

Current College and University Policy Landscape

KHI conducted a review of vaccination policies at 52 of the 55 universities and colleges in Kansas and found that requirements vary tremendously (Figure 1). All of the public universities — including the six state universities as well as Washburn University — require quadrivalent meningococcal vaccine (against types A, C, W and Y) or a waiver for students living in student housing. For the six state universities, meningococcal vaccination or a waiver is required by statute for those living in student housing. Three of the seven (42.9 percent) public universities require two doses of the MMR (measles, mumps and rubella) vaccine.

Among the 22 private colleges and universities, KHI was able to review vaccination policies for 19 of the schools. Of these schools, 16 (84.2 percent) require the quadrivalent meningococcal vaccine for students residing in on-campus student housing. Twelve (63.2 percent) require all students to receive two doses of the MMR vaccine and eight (42.1 percent) require the Tdap vaccine, which protects against tetanus, diphtheria and pertussis.

Figure 1 Percent of Colleges and Universities Requiring Vaccinations Among Students in Kansas by Type of Institution and

Among the 19 community colleges in Kansas, 17 (89.5 percent) require the quadrivalent meningococcal vaccine for students residing in on-campus student housing. Six (31.6 percent) require all students to receive the MMR vaccine and three (15.8 percent) require the Tdap vaccine. None of the seven technical colleges have vaccination requirements except for program-specific requirements (e.g., nursing).


Although all seven public universities (six state universities, plus Washburn University) currently have requirements for vaccination against meningitis as required by law or university policy, only 84.2 percent of private colleges and 89.5 percent of community colleges have such a requirement in place. A smaller percentage of colleges and universities require vaccination against measles, mumps and rubella (MMR) and tetanus, diphtheria and pertussis (Tdap).

As is evident from recent measles and mumps outbreaks on college campuses, risks of vaccine preventable diseases continue to be a concern. Additionally, the COVID-19 pandemic has demonstrated the extent to which academics can be interrupted by infectious disease outbreak.

Public health, college and university officials, in collaboration with health care providers, need to implement strategies to help reduce the risks. The American College Health Association provides guidelines that offer detailed vaccination recommendations for college students. These guidelines are intended to facilitate implementation of comprehensive vaccination policies on college and university campuses to help protect the health of students, faculty, staff and communities.

About Kansas Health Institute

The Kansas Health Institute supports effective policymaking through nonpartisan research, education and engagement. KHI believes evidence-based information, objective analysis and civil dialogue enable policy leaders to be champions for a healthier Kansas. Established in 1995 with a multiyear grant from the Kansas Health Foundation, KHI is a nonprofit, nonpartisan educational organization based in Topeka.

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