Immunization policies among allied health programs: Evidence of immunity and allowance of vaccination exemptions

Background: Unvaccinated or non-immune students training to become healthcare personnel (HCP) are at risk of acquiring or transmitting vaccine-preventable diseases (VPDs) among other students and to patients when they undertake clinical rotations involving patient contact. Purpose: This study aimed to characterize allied health programs (AHPs) by their immunization policies, specifically for acceptable forms of evidence of immunity, vaccination exemptions permitted, and immunization tracking methods. Significance: To determine the consistency of immunization policies at AHPs with the vaccination recommendations for HCP of the Advisory Committee on Immunization Practices (ACIP). Methodology: Data were collected between September 2011 and April 2012 using an internet-based survey emailed to a staff member at accredited AHPs. Analysis was limited to those programs requiring ≥1 vaccines recommended by the ACIP for HCP which included: MMR, hepatitis B, varicella, pertussis, and influenza. Weighted bivariate frequencies were generated using SAS 9.3. Results: Of the 2775 programs surveyed, 74.8% responded; of responding programs, 93.3% (1947) required ≥1 ACIP -recommended vaccinations. The proportion of programs accepting ≥1 non-ACIP recommended forms of evidence of immunity varied by vaccine: 9.2% for MMR, 18.2% for varicella, 21.8% for hepatitis B, 42.0% for pertussis, and 36.5% for influenza. Medical exemptions were permitted for ≥1 vaccines by 74.7% of programs, 54% permitted religious exemptions, and 34.8% permitted personal belief exemptions. Conclusions: Many programs accepted non-ACIP-recommended forms of evidence of immunity which could lead some students to believe they are protected from VPDs when they may be susceptible.