High Immunization Rates in Colorado Schools and Child Cares: Something To Strive For

May 10, 2023

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As the Public Health Emergency (PHE) for COVID-19 ends and vaccine misinformation continues to spread, we bring your attention today to the topic of school immunizations. Diseases like measles and chickenpox spread easily in schools where students are in proximity to one another. These diseases can be dangerous and even deadly. Thatā€™s why Colorado, and all other U.S. states, require that students get certain vaccines to attend school and child care. Vaccines are an essential part of keeping kids safe, healthy, and ready to learn in school! They also help protect the health of those who cannot be vaccinated due to medical conditions or because they are too young. Read on to learn about Coloradoā€™s school entry requirements and the tools Immunize Colorado has to help parents and school staff understand the level of vaccine protection in their school community.

What are the immunization requirements for schools and child care facilities in Colorado?

Colorado Board of Health rule 6 CCR 1009-2 requires all students attending Colorado schools and licensed child care centers to be vaccinated against certain diseases (including hepatitis B, diphtheria, tetanus, pertussis, polio, varicella, measles, mumps, and rubella) or to obtain an exemption, which requires consultation with a doctor or the completion of an online training module.Ā 

In October, the CDCā€™s Advisory Committee on Immunization Practices (ACIP) voted to add COVID-19 vaccinations to the routine childhood immunization schedule. Contrary to some news headlines, this does not mean that COVID-19 vaccines are mandatory for school entry. Each state individually decides which immunizations are required for school attendance. In Colorado, COVID-19 vaccines, though highly recommended for everyone 6 months and up, are not required immunizations for school or childcare entry. Flu and human papillomavirus (HPV) vaccines are also not required for entry.

What does vaccine coverage look like in Colorado schools?

Each year, Immunize Colorado publishes the Immunity Community Honor Roll to recognize Colorado school districts that achieve exceptional vaccination coverage. We also publish fact sheets which summarize school- and child care-level vaccination rates by county and school district. These tools help parents and school staff understand their communityā€™s level of protection against vaccine-preventable diseases. Schools on the Honor Roll, given ā€œGold Starā€ status, have immunization rates that meet Healthy People 2030 goals. These include coverage at 95% or higher for DTaP, HepB, MMR, Polio, and Varicella. Schools with 6th grade and higher must also have 80% coverage for Tdap. During the 2021-22 school year, only 32 Colorado school districts (out of 182) and only 37% of all schools achieved Gold Star status and made the Immunity Community Honor Roll. This means that less than half (46%) of Colorado students attend a school with adequate protection from vaccine-preventable diseases. Additionally, data from the Colorado Department of Public Health and Environment show that vaccination rates for K-12 students declined for all school-required vaccines in 2021-22.

Why are high immunization rates important for schools and child care centers?

Schools have an obligation to keep kids safe and ensure their ability to learn. This means keeping kids healthy. Itā€™s easy to think that many of the diseases vaccines prevent are a thing of the past. (Thanks, vaccines!) But the truth is vaccine-preventable diseases can spread rapidly in the school environment and it only takes a few gaps in vaccine coverage to cause an outbreak. 

In December, gaps in MMR vaccine coverage led to over 80 children contracting measles in Ohio. Measles is an extremely contagious disease. In fact, an infected person can spread it to up to 90% of the people they come into contact with. According to the CDC, the measles virus can linger in the air for up to two hours, meaning you donā€™t even have to be in the same room as an infected individual to get it. Measles can also be extremely dangerous, causing ā€œencephalitis (swelling of the brain) that can lead to convulsions and can leave the child deaf or with intellectual disability,ā€ according to the CDC. Measles was eliminated in the United States in 2000, but due to low vaccination rates, itā€™s making a comeback. More worrisome is that data released in January show that at least 250,000 kindergartners in the U.S. are not protected against measles. 

This scenario is not unique to measles. Rockland County, New York saw the resurgence of polio last summer. Vaccination rates for all routine vaccines are lagging in Colorado and across the nation. Vaccine-preventable diseases should not be a threat to our school children and communities in the year 2023. Vaccines have been hailed as one of the top public health achievements of all time. In Colorado, vaccines prevent over 8,600 hospitalizations among children each year. Worldwide, vaccines prevent 4-5 million deaths each year. Vaccines are safe! They are rigorously tested and continuously monitored for safety; in fact, theyā€™re one of the most closely-monitored products we have. We need vaccines so that our children and our communities can thrive!

In Colorado, we can all play a role in protecting schools and communities from disease. Help ensure Colorado schools are a safe place for all students, staff, and faculty by following the recommended routine vaccine schedules, and if you have questions, speak to your childā€™s medical provider.


Immunize Colorado was formed in 1991 in response to alarmingly low vaccination rates across the state. At the time, only about 50% of Coloradoā€™s children were adequately vaccinated. A group of physicians and other concerned individuals came together to strategize how to protect Coloradans from vaccine-preventable diseases and increase vaccine uptake. Much work remains. You can donate or discover other ways to get involved in supporting our commitment to healthy Colorado communities today!

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