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OBJECTIVETo characterize health professional schools by their vaccination policies for acceptable forms of evidence of immunity and exemptions permitted.METHODSData were collected between September 2011 and April 2012 using an Internet-based survey e-mailed to selected types of accredited health professional programs. Schools were identified through accrediting associations for each type of health professional program. Analysis was limited to schools requiring =1 vaccine recommended by the Advisory Committee on Immunization Practices (ACIP): measles, mumps, rubella, hepatitis B, varicella, pertussis, and influenza. Weighted bivariate frequencies were generated using SAS 9.3.RESULTSOf 2,775 schools surveyed, 75% (n=2,077) responded; of responding schools, 93% (1947) required =1 ACIP-recommended vaccination. The proportion of schools accepting =1 non–ACIP-recommended form of evidence of immunity varied by vaccine: 42% for pertussis, 37% for influenza, 30% for rubella, 22% for hepatitis B, 18% for varicella, and 9% for measles and mumps. Among schools with =1 vaccination requirement, medical exemptions were permitted for =1 vaccine by 75% of schools; 54% permitted religious exemptions; 35% permitted personal belief exemptions; 58% permitted any nonmedical exemption.CONCLUSIONSMany schools accept non–ACIP-recommended forms of evidence of immunity which could lead some students to believe they are protected from vaccine preventable diseases when they may be susceptible. Additional efforts are needed to better educate school officials about current ACIP recommendations for acceptable forms of evidence of immunity so school policies can be revised as needed.Infect Control Hosp Epidemiol 2014;00(0): 1–6

Objective.To evaluate the reliability and validity of a standardized measure of healthcare personnel (HCP) influenza vaccination.Setting.Acute care hospitals, long-term care facilities, ambulatory surgery centers, physician practices, and dialysis centers from 3 US jurisdictions.Participants.Staff from 96 healthcare facilities randomly sampled from 234 facilities that completed pilot testing to assess the feasibility of the measure.Methods.Reliability was assessed by comparing agreement between facility staff and project staff on the classification of HCP numerator (vaccinated at facility, vaccinated elsewhere, contraindicated, declined) and denominator (employees, credentialed nonemployees, other nonemployees) categories. To assess validity, facility staff completed a series of case studies to evaluate how closely classification of HCP groups aligned with the measure's specifications. In a modified Delphi process, experts rated face validity of the proposed measure elements on a Likert-type scale.Results.Percent agreement was high for HCP vaccinated at the facility (99%) and elsewhere (95%) and was lower for HCP who declined vaccination (64%) or were medically contraindicated (64%). While agreement was high (more than 90%) for all denominator categories, many facilities' staff excluded nonemployees for whom numerator and denominator status was difficult to determine. Validity was lowest for credentialed and other nonemployees.Conclusions.The standardized measure of HCP influenza vaccination yields reproducible results for employees vaccinated at the facility and elsewhere. Adhering to true medical contraindications and tracking decimations should improve reliability. Difficulties in establishing denominators and determining vaccination status for credentialed and other nonemployees challenged the measure's validity and prompted revision to include a more limited group of nonemployees.