School & Child Care Audits

What are school and child care audits?

Assessments of children attending licensed child care centers or elementary or secondary school are conducted annually to ensure attendees have received the required immunizations. Local public health agencies (LPHA) perform annual assessments of immunization records for children in licensed child care centers, and students enrolled in public, private, and parochial K‐12 schools. 

Why vaccinate child care and school-aged kids?

Achieving and maintaining high vaccination rates are two of the most important safeguards to prevent the spread of vaccine-preventable diseases. Studies have found individuals claiming exemptions from immunization are at a greater risk of contracting vaccine-preventable diseases.

States with lower immunization rates have higher rates of vaccine-preventable diseases. The Iowa HHS Immunization Program continues to monitor immunization exemption rates, identify clusters of unimmunized children and provides education and information to address vaccine safety concerns. 

What are immunization requirements for school and child care?

Iowa Code, Chapter 139a.8(6) and Iowa Administrative Code, 641-7.7(139) outline immunization requirements for students attending licensed child care centers and elementary or secondary schools: Iowa Immunization Requirements Chart.

To attend school or licensed child care, the child needs to present a valid Certificate of Immunization, Provisional Certificate of Immunization, or Certificate of Immunization Exemption (Medical or Religious) to the admitting official. A brief explanation of each certificate is included below.

• Certificate of Immunization: Issued when the applicant has a record of age-appropriate immunizations that meet the requirement for licensed child care or school enrollment.
• Provisional Certificate of Immunization: Issued when the applicant has received at least one dose of each of the required vaccines but has not completed all required immunizations or is a transfer student from another U.S. school system.
• Certificate of Immunization Exemption-Medical: Iowa law allows for medical exemption to immunization when required immunizations would be injurious to the health and wellbeing of the applicant or any member of the applicant’s family or household or required vaccine would violate minimum interval spacing.
• Certificate of Immunization Exemption- Religious: Iowa law allows for religious exemption to immunization when immunizations conflict with a genuine and sincere religious belief, and is not based merely on philosophical, scientific, moral, personal or medical opposition to immunizations.

Other measures included in visualizations:

• Invalid or No Certificate: Total number of students not compliant with Iowa law (does not have a valid Certificate of Immunization, Provisional Certificate of Immunization, or Certificate of Immunization Exemption [Medical or Religious]).
• Valid Immunization Certificates: Total number of students compliant with Iowa law. This value is calculated by adding the number of valid Certificate of Immunization, Provisional Certificate of Immunization, and Certificate of Immunization Exemption [Medical or Religious]).

School Immunization Audits Data Visualization

View data visualization

2023 Data Summary: 2023-2024 School and Child Care Audit Data Summary 

While the data in this report demonstrate trends, school audit data do not provide a full picture of all children’s immunization history. Vaccination and exemption status reflects the student’s status at the time of assessment. Some students may be in the process of receiving required vaccines and final vaccination or exemption status may change after completion of the audit (Provisional Certificates, Medical Exemptions and invalid records). In addition, some students with exemptions may have received some of the required vaccines.

Measure Description:

• Number of Certificates: The number of students that have the Certificate Type selected.
• Total Enrolled: The total number of students enrolled by selected criteria (state, county or grade level).

Measure Calculations:

• Percent of Certificates: The percent of students that have the Certificate Type selected. Calculated as a percent of Certificate Type divided by the total enrollment for selected criteria.
• Valid Immunization Certificates: Total number of students compliant with Iowa law (sum of valid Certificate of Immunization, Provisional Certificate of Immunization, and Certificate of Immunization Exemption [Medical or Religious]) divided by the total enrollment for selected criteria.

Child Care Immunization Audits Data Visualization

View data visualization

2023 Data Summary: 2023-2024 School and Child Care Audit Data Summary  

While the data in this report demonstrate trends, childcare audit data do not provide a full picture of all children’s immunization history. Vaccination and exemption status reflects the child's status at the time of assessment. Some children may be in the process of receiving required vaccines and final vaccination or exemption status may change after completion of the audit (Provisional Certificates, Medical Exemptions and invalid records). In addition, some students with exemptions may have received some of the required vaccines.

Measure Description:

• Number of Certificates: The number of children that have the Certificate Type selected.
• Total Enrolled: The total number of children enrolled by selected criteria (state or county).

Measure Calculations:

• Percent of Certificates: The percent of students that have the Certificate Type selected. Calculated as a percent of Certificate Type divided by the total enrollment for selected criteria.
• Valid Immunization Certificates: Total number of students compliant with Iowa law (sum of valid Certificate of Immunization, Provisional Certificate of Immunization, and Certificate of Immunization Exemption [Medical or Religious]) divided by the total enrollment for selected criteria.