1 2 Acknowledgements The Georgia Department of Public Health Epidemiology and Immunization Programs would like to thank the public health representatives who participated in this study for all of their hard work, support and dedication. This study could not have been completed successfully without the cooperation of the Immunization Program Consultants and State staff throughout Georgia. A profound thank you and sincere appreciation is also given to the public and private schools and their immunization staff and nurses that participated in this collaborative effort. Their cooperation and assistance throughout the study is greatly appreciated. Additional gratitude goes to Karl Soetebier for the development and maintenance of our data collection system; and LaTonya Thomas and Ben Sloat for their collaborative effort in making this study possible. "This publication was supported by the Cooperative Agreement Number 5H23IP000744-02 from the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention." 1 2 Table of Contents Contents Acknowledgements Table of Contents Section I: Project Overview Purpose of Study Methods (Sampling, Data Collection, Data Analysis) Limitations Section II: Statewide Results Contributing Staff from Georgia Department of Public Health State of Georgia Immunization Report Section III: Health District Immunization Reports District 1-1 Immunization Report (Rome District) District 1-2 Immunization Report (Dalton District) District 2-0 Immunization Report (Gainesville District) District 3-1 Immunization Report (Cobb-Douglas District) District 3-2 Immunization Report (Fulton District) District 3-3 Immunization Report (Clayton District) District 3-4 Immunization Report (Lawrenceville District) District 3-5 Immunization Report (DeKalb District) District 4-0 Immunization Report (LaGrange District) District 5-1 Immunization Report (Dublin District) District 5-2 Immunization Report (Macon District) District 6-0 Immunization Report (Augusta District) District 7-0 Immunization Report (Columbus District) District 8-1 Immunization Report (Valdosta District) District 8-2 Immunization Report (Albany District) District 9-1 Immunization Report (Savannah District) District 9-2 Immunization Report (Waycross District) District 10 Immunization Report (Athens District) Appendix Appendix A: Margins of Error for UTD Immunization Rates Appendix B: Frequency of Exemptions Appendix C: District Immunization Measures by Vaccine-Antigen Additional Resources 3 Page(s) 1 3 5--10 7 9--10 10 11--14 13 14 15--52 17--18 19--20 21--22 23--24 25--26 27--28 29--30 31--32 33--34 35--36 37--38 39--40 41--42 43--44 45--46 47--48 49--50 51--52 i-vi iii iv v vi 4 Section I Project Overview Georgia Adolescent Immunization Study, 2016 5 6 Purpose of Study The Centers for Disease Control and Prevention (CDC) and the Advisory Committee on Immunization Practices (ACIP) recommend that adolescents routinely receive Tdap, MCV4, and the 3 dose HPV series at 11 to 12 years of age1. Beginning in the 2014-2015 school year, Tdap and MCV4 were added to the list of required vaccines for Georgia students entering seventh grade who were born on or after January 1, 2002. This report summarizes the annual assessment of immunization coverage for Tdap and MCV4 as well as one and three dose coverage of HPV among seventh grade students in Georgia's 18 Public Health Districts. In addition to determining adolescent coverage rates for vaccines required for school entry, the GA Immunization Program is interested in determining whether providers are making strong, clear HPV recommendations to parents of adolescents when teens are seen in clinics for their seventh grade Tdap and MCV4 vaccinations. 1Department of Health and Human Services Centers for Disease Control and Prevention. (January 28, 2011). MMWR weekly: General Recommendations of Immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 2011; 60(RR02);1-60. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6002a1.htm 7 8 Methods Study Design The annual Georgia Adolescent Immunization Study (GAIS) employs a cross-sectional research design to ascertain the vaccine coverage rate for 7th grade children in the State of Georgia. Immunization history data for cohorts of children in the 7th grade from 18 Health Districts were analyzed to calculate these rates. Identifying information and immunization history data were obtained from school 3231 files and the Georgia Registry of Immunization Transactions and Services (GRITS). Immunization rates for Tdap, Polio, MMR, MCV4 (meningococcal), Hepatitis B, Varicella and HPV vaccines were calculated. Data collection for the 2016 GAIS study began January 15, 2016 and lasted for three months. A two-stage cluster-sampling scheme was developed to randomly select the study sample. Stage one of the cluster sampling scheme involved randomly selecting up to 30 middle schools from each of the 18 Health Districts. The number of schools sampled from each district was determined using the following factors: A) target population size per district B) estimated percent response rate C) estimate design effect D) confidence coefficient E) confidence interval width If a District had fewer than 30 schools, then all schools in that District were sampled. Stage two of the sampling scheme involved randomly selecting an established number of students from each school. This number varied by District depending on the number of schools sampled and population. Basic coverage rates were then calculated for each of the specific vaccines of interest. Target and Sample Populations The target population of the 2016 GAIS included all 7th grade children in the State of Georgia during the 2015-2016 school year. A sample of 6,191 seventh grade students, attending both private and public Georgia schools, were selected for the study. The sample design allowed for independent estimates to be calculated for each of the 18 Health Districts in the state. Data Collection An electronic web-based data collection system named "GAIS" was created to systematically collect the required information for each child. The GAIS data collection system contains three distinct sections for completion: Child, Notes and VX List (Immunization History). Data collection was carried out primarily by each Health District's Immunization Program Consultant (IPC). IPCs in each Health District participated in training at the start of the data collection period. A Training Manual was also provided and made available on the GAIS log-in screen. Data Collection Protocol Step #1: Obtain student sample Before the data collection process began, IPCs were assigned a maximum of 30 schools in their respective Districts and assigned a required number of students per school to be sampled. Once at a school, the IPC obtained an alphabetized roster of all current 7th graders attending that school. Using the total number of seventh graders, a random number generator was applied to randomly select the 13 students chosen as the 2016 GAIS sample. 9 Step #2: Collect immunization forms at public and private schools. Once the IPC selected the school sample, each specific child's 3231 form was located to obtain their immunization history. A comparison of the GRITS record and the 3231 form was conducted for each child to make sure all vaccines received matched between sources. If any dates were missing from either source, steps were taken to update the 3231 form and/or the GRITS record to match. If a 3231 was found to be expired, a new one was printed out from GRITS for school record. Step #3: Input children to data collection website A record was then created by the IPC for each child in the GAIS website. Information collected included first and last name, date of birth, county, school, exemption and waiver status and lab confirmation of immunity. A blank vaccine list was also available in the GAIS record for the IPC to either: 1) add each of the vaccine dates of interest in the table; or, 2) perform a direct upload from GRITS into the GAIS record. Step #4: Data returned to State Epidemiology office Using the GAIS system, data collectors completed adding records for all required children in their District. As the records were completed using the GAIS system, each record was reviewed by the Principal Investigator. Attempts were made to resolve any unclear information before data cleaning using SAS 9.4 software. Data Analysis Analyses were done using SAS 9.4 software and macros developed by the Principal Investigator. Data were used to determine what percentage of 7th graders were up-to-date (UTD), which was defined as having at least 3 doses of Hepatitis B, 2 doses of MMR, 2 doses of Varicella, 1 dose of Tdap and 1 dose of MCV4 vaccines. UTD immunization rates as well as individual vaccine coverage rates were assessed at both the state and District levels. Limitations When interpreting study results, the following limitations of the study should be considered: 1. Compared to other sampling methods, cluster sampling is least representative of the population. Individuals within a cluster tend to have similar characteristics and there is a chance of over- or underrepresentation of the population, leading to skewed results. The two-stage cluster sampling scheme was used because of its low-cost and efficient method of collecting a larger sample size across a wide area. 2. Some IPCs had less than 30 middle schools in their District and were forced to sample all the middle schools in the District. Larger Districts were only required to sample 30 schools, due to time and resource restraints, and therefore many schools were not sampled which may have affected the results of the study. 10 Section II Statewide Results Georgia Adolescent Immunization Study, 2016 11 12 State of Georgia 2016 Georgia Adolescent Immunization Study Report Fabio R. Machado, MPH Jessica Tuttle, MD State-Level Immunization Study Staff Immunization Study Epidemiologist, Principal Investigator & Author Medical Epidemiologist, Primary Editor Metro Atlanta Districts 13 State of Georgia 2016 Georgia Adolescent Immunization Study Report The 2016 Georgia Adolescent Immunization Study (GAIS) sampled 6,191 adolescents in seventh grade (Table 1). An adolescent was considered up-to-date (UTD) if they received at least 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4 vaccines by the time they enrolled in school. The UTD immunization rate for 7th graders in Georgia was 94.7% for 2016. Overall, females were slightly more likely to be UTD than males. Immunization rates that decreased from the previous year are bolded (Table 1). Coverage rates among male and female adolescents were similar for all vaccines except HPV. More female adolescents received 1 dose of HPV vaccine than male adolescents (47.4% vs. 41.3%). A higher number of female adolescents received 3 doses of HPV vaccine than male adolescents (16.2% vs 13.3%)(Table 1). In the overall State sample, 5 adolescents had serologic evidence of immunity-- 3 for Varicella, 1 for MMR, and 1 for Hepatitis B. Statewide, 43 students had either physician-diagnosed or a history of varicella illness (not shown). Table 1: Georgia Adolescent Immunization Coverage Rates by Vaccine Antigen and Gender, 2016 2015 2016 Overall n=6,521 (%) Overall n=6,191 (%) Male n=3,089 (%) Female n=2,971 (%) UTD rate* 90.7 0.7 94.7 0.6 95.0 0.8 96.2 0.7 3 Hepatitis B 96.9 0.4 97.7 0.4 98.7 0.4 98.7 0.4 2 MMR 96.8 0.4 97.6 0.4 98.4 0.4 98.6 0.4 2 Varicella** 94.5 0.6 96.5 0.5 97.2 0.6 97.7 0.5 1 Tdap 93.0 0.6 96.1 0.5 96.8 0.6 97.2 0.6 1 MCV4 92.5 0.6 96.0 0.5 96.5 0.6 97.2 0.6 4 Polio 95.1 0.5 96.0 0.5 96.5 0.6 97.1 0.6 1 HPV 42.5 1.2 43.8 1.2 41.3 1.7 47.4 1.8 3 HPV 14.8 0.9 14.5 0.9 13.3 1.2 16.2 1.3 * An adolescent was classified as UTD if they had received at least the follow- ing vaccine doses: 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4. ** Physician diagnosed or history of varicella illness were not included in the Varicella coverage rate. However, they were included in the UTD rate. There were 131 students that had an unknown or missing gender status. Of the 6,191 seventh graders sampled, 49.9% were male, 48.0% were female and 2.1% had missing gender information (Table 2). Transfer students with incomplete immunization records have a 30-day waiver period to meet immunization requirements. Only 15 (0.2%) of the students in the final sample were found to be in the school "waiver" period, meaning they were incomplete on their schoolrequired immunizations because they were newly enrolled (Table 2). Within the final study sample, 10 (0.2%) of the adolescents were found to have a medical exemption for one or more vaccinations and 115 (1.9%) had a religious exemption on file (Table 2). Table 2: Gender, School Waiver and Exemptions among Georgia Adolescents, 2016 (n=6,191) n Percent of sample (%) Gender Male 3,089 49.9 Female 2,971 48.0 Missing or unknown gender 131 2.1 School waiver Within waiver period 15 0.2 Not within waiver period 6,176 99.8 Medical Exemptions Medical exemption 10 0.2 No medical exemption 6,181 99.8 Religious Exemptions Religious exemption 115 1.9 No religious exemption 6,076 98.1 14 Section III Health District Adolescent Immunization Reports Georgia Adolescent Immunization Study, 2016 15 16 District 1-1 2016 Georgia Adolescent Immunization Study Report District 1-1 Data Collection Team Rick Naus Immunization Program Consultant County Bartow Catoosa Chattooga Dade Floyd Gordon Haralson Paulding Polk Walker District 1-1 District UTD Rate State of Georgia State UTD Rate Number in Final Sample 40 39 27 13 69 24 13 70 13 55 363 96.1% 6,191 94.7% 17 District 1-1 2016 Georgia Adolescent Immunization Study Report The 2016 GAIS sampled 363 adolescents in seventh grade from District 1-1 (Table 1-1-A). An adolescent was considered up-to-date (UTD) if they received at least 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4 vaccines by the time they enrolled in school. The UTD immunization rate for seventh graders in District 1-1 was 96.1% for 2016. Immunization rates that decreased from the previous year are shown bolded (Table 1-1-A). Coverage rates among male and female seventh graders were similar for all vaccines except HPV. More female adolescents received 1 dose of HPV vaccine than male adolescents (47.8% vs. 40.1%). A higher number of female adolescents received 3 doses of HPV vaccine than male adolescents (12.4% vs 7.0%) (Table 1 -1-A). Of the 363 seventh graders sampled from District 1-1, 47.4% were male and 51.2% were female. The gender for five students (1.4%) was unknown or missing (Table 1-1-B). None of the students in the sample were found to be in the school "waiver" period, meaning that no student was incomplete due to being newly enrolled in school (Table 1-1-B). None of the adolescents in the District 1-1 sample were found to have a medical exemption for one or more vaccinations. Eight adolescents (2.2%) had a religious exemption on file (Table 1-1-B). Table 1-1-A: Georgia Adolescent Immunization Coverage Rates by Vaccine Antigen and Gender--District 1-1, 2016 State District 1-1 Overall n=6,191 (%) Overall n=363 (%) Male n=172 (%) Female n=186 (%) UTD rate* 94.7 0.6 96.1 2.0 96.5 2.7 97.3 2.3 3 Hepatitis B 97.7 0.4 98.6 1.2 100 0.0 98.9 1.5 2 MMR 97.6 0.4 98.3 1.3 100 0.0 98.4 1.8 2 Varicella** 96.5 0.5 97.0 1.8 97.7 2.3 97.8 2.1 1 Tdap 96.1 0.5 97.2 1.7 98.8 1.6 97.3 2.3 1 MCV4 96.0 0.5 97.2 1.7 98.3 2.0 97.8 2.1 4 Polio 96.0 0.5 97.0 1.8 97.7 2.3 97.8 2.1 1 HPV 43.8 1.2 43.8 5.1 40.1 7.3 47.8 7.2 3 HPV 14.5 0.9 9.9 3.1 7.0 3.8 12.4 4.7 * An adolescent was classified as UTD if they had received at least the follow- ing vaccine doses: 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4. ** Physician diagnosed or history of varicella illness were not included in the Varicella coverage rate. However, they were included in the UTD rate. There were 5 students that had an unknown or missing gender status. Table 1-1-B: Gender, School Waiver and Exemptions among Georgia Adolescents--District 1-1, 2016 (n=363) n Percent of sample (%) Gender Male 172 47.4 Female 186 51.2 Missing or unknown gender 5 1.4 School waiver Within waiver period 0 0 Not within waiver period 363 100.0 Medical Exemptions Medical exemption 0 0 No medical exemption 363 Religious Exemptions 100.0 Religious exemption 8 2.2 No religious exemption 355 97.8 18 District 1-2 2016 Georgia Adolescent Immunization Study Report District 1-2 Data Collection Team Jennifer Hooker Immunization Program Consultant County Cherokee Fannin Gilmer Murray Pickens Whitfield District 1-2 District UTD Rate State of Georgia State UTD Rate Number in Final Sample 146 25 12 1 32 110 326 90.5% 6,191 94.7% 19 District 1-2 2016 Georgia Adolescent Immunization Study Report The 2016 GAIS sampled 326 adolescents in seventh grade from District 1-2 (Table 1-2-A). An adolescent was considered up-to-date (UTD) if they received at least 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4 vaccines by the time they enrolled in school. The UTD immunization rate for seventh graders in District 1-2 was 90.5% for 2016. Immunization rates that decreased from the previous year are shown bolded (Table 1-2-A). Coverage rates among male and female seventh graders were similar for all vaccines. (Table 1-2-A). Of the 326 seventh graders sampled from District 1-2, 51.5% were male and 46.9% were female. The gender for five students (1.5%) was unknown or missing (Table 1-2-B). None of the students in the sample were found to be in the school "waiver" period, meaning that no student was incomplete due to being newly enrolled in school (Table 1-2-B). None of the adolescents in the District 1-2 sample were found to have a medical exemption for one or more vaccinations. Seventeen adolescents (5.2%) had a religious exemption on file (Table 1-2-B). Table 1-2-A: Georgia Adolescent Immunization Coverage Rates by Vaccine Antigen and Gender--District 1-2, 2016 State District 1-2 Overall n=6,191 (%) 2016 n=326 (%) Male n=168 (%) Female n=153 (%) UTD rate* 94.7 0.6 90.5 3.2 89.3 4.7 94.1 3.7 3 Hepatitis B 97.7 0.4 96.0 2.1 97.0 2.6 96.7 2.8 2 MMR 97.6 0.4 95.1 2.3 95.8 3.0 96.1 3.1 2 Varicella** 96.5 0.5 93.9 2.6 94.0 3.6 95.4 3.3 1 Tdap 96.1 0.5 92.6 2.8 92.3 4.0 95.4 3.3 1 MCV4 96.0 0.5 91.4 3.0 90.5 4.4 94.8 3.5 4 Polio 96.0 0.5 92.0 2.9 91.7 4.2 94.1 3.7 1 HPV 43.8 1.2 39.9 5.3 39.3 7.4 41.8 7.8 3 HPV 14.5 0.9 14.1 3.8 13.1 5.1 15.7 5.8 * An adolescent was classified as UTD if they had received at least the follow- ing vaccine doses: 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4. ** Physician diagnosed or history of varicella illness were not included in the Varicella coverage rate. However, they were included in the UTD rate. There were 5 students that had an unknown or missing gender status. Table 1-2-B: Gender, School Waiver and Exemptions among Georgia Adolescents--District 1-2, 2016 (n=326) n Percent of sample (%) Gender Male 168 51.5 Female 153 46.9 Missing or unknown gender 5 1.5 School waiver Within waiver period 0 0 Not within waiver period 326 100.0 Medical Exemptions Medical exemption 0 0 No medical exemption 363 Religious Exemptions 100.0 Religious exemption 17 5.2 No religious exemption 309 94.8 20 District 2-0 2016 Georgia Adolescent Immunization Study Report District 2-0 Data Collection Team Jennifer Hooker Immunization Program Consultant County Banks Dawson Forsyth Franklin Habersham Hall Hart Lumpkin Rabun Stephens Towns Union White District 2-0 District UTD Rate State of Georgia State UTD Rate Number in Final Sample 0 27 105 0 39 110 8 0 13 13 13 3 13 344 94.8% 6,191 94.7% Union Lumpkin White Habersham Stephens Hall Banks Franklin Hart 21 District 2-0 2016 Georgia Adolescent Immunization Study Report The 2016 GAIS sampled 344 adolescents in seventh grade from District 2-0 (Table 2-0-A). An adolescent was considered up-to-date (UTD) if they received at least 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4 vaccines by the time they enrolled in school. The UTD immunization rate for seventh graders in District 2-0 was 94.8% for 2016. Immunization rates that decreased from the previous year are shown bolded (Table 2-0-A). Coverage rates among male and female seventh graders were similar for all vaccines except HPV. More female adolescents received 1 dose of HPV vaccine than male adolescents (40.1% vs. 29.2%) (Table 2-0-A). Of the 344 seventh graders sampled from District 2-0, 49.7% were male and 48.5% were female. The gender for six students (1.7%) was unknown or missing (Table 2-0-B). None of the students in the sample were found to be in the school "waiver" period, meaning that no student was incomplete due to being newly enrolled in school (Table 2-0-B). None of the adolescents in the District 2-0 sample were found to have a medical exemption for one or more vaccinations. Fourteen adolescents (4.1%) had a religious exemption on file (Table 2-0-B). Table 2-0-A: Georgia Adolescent Immunization Coverage Rates by Vaccine Antigen and Gender--District 2-0, 2016 State District 2-0 Overall n=6,191 (%) 2016 n=344 (%) Male n=171 (%) Female n=167 (%) UTD rate* 94.7 0.6 94.8 2.4 95.3 3.2 94.6 3.4 3 Hepatitis B 97.7 0.4 97.4 1.7 97.7 2.3 97.6 2.3 2 MMR 97.6 0.4 96.8 1.9 97.1 2.5 97.0 2.6 2 Varicella** 96.5 0.5 95.9 2.1 96.5 2.8 95.8 3.0 1 Tdap 96.1 0.5 94.8 2.4 95.3 3.2 94.6 3.4 1 MCV4 96.0 0.5 95.1 2.3 95.9 3.0 94.6 3.4 4 Polio 96.0 0.5 95.3 2.2 96.5 2.8 94.6 3.4 1 HPV 43.8 1.2 34.9 5.0 29.2 6.8 40.1 7.4 3 HPV 14.5 0.9 11.3 3.4 9.4 4.4 13.8 5.2 * An adolescent was classified as UTD if they had received at least the follow- ing vaccine doses: 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4. ** Physician diagnosed or history of varicella illness were not included in the Varicella coverage rate. However, they were included in the UTD rate. There were 6 students that had an unknown or missing gender status. Table 2-0-B: Gender, School Waiver and Exemptions among Georgia Adolescents--District 2-0, 2016 (n=344) n Percent of sample (%) Gender Male 171 49.7 Female 167 48.5 Missing or unknown gender 6 1.7 School waiver Within waiver period 0 0 Not within waiver period 344 100.0 Medical Exemptions Medical exemption 0 0 No medical exemption 344 Religious Exemptions 100.0 Religious exemption 14 4.1 No religious exemption 330 95.9 22 District 3-1 2016 Georgia Adolescent Immunization Study Report District 3-1 Data Collection Team Noreen Dahill Immunization Program Consultant County Number in Final Sample Cobb 253 Douglas 105 District 3-1 358 District UTD Rate 94.1% State of Georgia 6,191 State UTD Rate 94.7% 23 District 3-1 2016 Georgia Adolescent Immunization Study Report The 2016 GAIS sampled 358 adolescents in seventh grade from District 3-1 (Table 3-1-A). An adolescent was considered up-to-date (UTD) if they received at least 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4 vaccines by the time they enrolled in school. The UTD immunization rate for seventh graders in District 3-1 was 94.1% for 2016. Immunization rates that decreased from the previous year are shown bolded (Table 3-1-A). Coverage rates among male and female seventh graders were similar for all vaccines except HPV. More female adolescents received 1 dose of HPV vaccine than male adolescents (51.1% vs. 44.7%) (Table 3-1-A). Of the 358 seventh graders sampled from District 3-1, 50.0% were male and 49.2% were female. The gender for three students (0.8%) was unknown or missing (Table 3-1-B). None of the students in the sample were found to be in the school "waiver" period, meaning that no student was incomplete due to being newly enrolled in school (Table 3-1-B). Table 3-1-A: Georgia Adolescent Immunization Coverage Rates by Vaccine Antigen and Gender--District 3-1, 2016 State District 3-1 Overall n=6,191 (%) 2016 n=358 (%) Male n=179 (%) Female n=176 (%) UTD rate* 94.7 0.6 94.1 2.4 92.7 3.8 96.0 2.9 3 Hepatitis B 97.7 0.4 99.2 0.9 98.9 1.5 100 0.0 2 MMR 97.6 0.4 99.2 0.9 98.9 1.5 100 0.0 2 Varicella** 96.5 0.5 96.4 1.9 95.0 3.2 98.3 1.9 1 Tdap 96.1 0.5 95.3 2.2 94.4 3.4 96.6 2.7 1 MCV4 96.0 0.5 95.5 2.1 94.4 3.4 97.2 2.5 4 Polio 96.0 0.5 97.5 1.6 97.2 2.4 98.3 1.9 1 HPV 43.8 1.2 48.0 5.2 44.7 7.3 51.1 7.4 3 HPV 14.5 0.9 17.0 3.9 18.4 5.7 15.3 5.3 * An adolescent was classified as UTD if they had received at least the follow- ing vaccine doses: 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4. ** Physician diagnosed or history of varicella illness were not included in the Varicella coverage rate. However, they were included in the UTD rate. There were 3 students that had an unknown or missing gender status. None of the adolescents in the District 3-1 sample were found to have a medical exemption for one or more vaccinations. Eight adolescents (2.2%) had a religious exemption on file (Table 3-1-B). Table 3-1-B: Gender, School Waiver and Exemptions among Georgia Adolescents--District 3-1, 2016 (n=358) n Percent of sample (%) Gender Male 179 50.0 Female 176 49.2 Missing or unknown gender 3 0.8 School waiver Within waiver period 0 0 Not within waiver period 358 100.0 Medical Exemptions Medical exemption 0 0 No medical exemption 358 100.0 Religious Exemptions Religious exemption 8 2.2 No religious exemption 350 97.8 24 District 3-2 2016 Georgia Adolescent Immunization Study Report District 3-2 Data Collection Team Saron Ephraim Immunization Program Consultant County Number in Final Sample Fulton 362 District 3-2 362 District UTD Rate 95.3% State of Georgia 6,191 State UTD Rate 94.7% 25 District 3-2 2016 Georgia Adolescent Immunization Study Report The 2016 GAIS sampled 362 adolescents in seventh grade from District 3-2 (Table 3-2-A). An adolescent was considered up-to-date (UTD) if they received at least 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4 vaccines by the time they enrolled in school. The UTD immunization rate for seventh graders in District 3-2 was 95.3% for 2016. Immunization rates that decreased from the previous year are shown bolded (Table 3-2-A). Coverage rates among male and female seventh graders were similar for all vaccines (Table 3-2-A). Of the 362 seventh graders sampled from District 3-2, 47.0% were male and 51.4% were female. The gender for six students (1.7%) was unknown or missing (Table 3-2-B). One student in the sample was found to be in the school "waiver" period, meaning they were incomplete due to being newly enrolled in school (Table 3-2-B). None of the adolescents in the District 3-2 sample were found to have a medical exemption for one or more vaccinations. Seven adolescents (1.9%) had a religious exemption on file (Table 3-2-B). Table 3-2-A: Georgia Adolescent Immunization Coverage Rates by Vaccine Antigen and Gender--District 3-2, 2016 State District 3-2 Overall n=6,191 (%) 2016 n=362 (%) Male n=170 (%) Female n=186 (%) UTD rate* 94.7 0.6 95.3 2.2 96.5 2.8 95.2 3.1 3 Hepatitis B 97.7 0.4 97.5 1.6 98.8 1.6 97.3 2.3 2 MMR 97.6 0.4 97.5 1.6 98.2 2.0 97.8 2.1 2 Varicella** 96.5 0.5 96.7 1.8 97.1 2.5 97.3 2.3 1 Tdap 96.1 0.5 96.7 1.8 97.6 2.3 96.8 2.5 1 MCV4 96.0 0.5 97.0 1.8 98.2 2.0 96.8 2.5 4 Polio 96.0 0.5 96.4 1.9 97.1 2.5 96.8 2.5 1 HPV 43.8 1.2 43.1 5.1 42.4 7.4 44.6 7.2 3 HPV 14.5 0.9 11.9 3.3 11.8 4.9 12.4 4.7 * An adolescent was classified as UTD if they had received at least the follow- ing vaccine doses: 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4. ** Physician diagnosed or history of varicella illness were not included in the Varicella coverage rate. However, they were included in the UTD rate. There were 6 students that had an unknown or missing gender status. Table 3-2-B: Gender, School Waiver and Exemptions among Georgia Adolescents--District 3-2, 2016 (n=362) n Percent of sample (%) Gender Male 170 47.0 Female 186 51.4 Missing or unknown gender 6 1.7 School waiver Within waiver period 1 0.3 Not within waiver period 361 99.7 Medical Exemptions Medical exemption 0 0 No medical exemption 362 100.0 Religious Exemptions Religious exemption 7 1.9 No religious exemption 355 98.1 26 District 3-3 2016 Georgia Adolescent Immunization Study Report District 3-3 Data Collection Team Antoinette Foster Immunization Program Consultant County Clayton District 3-3 District UTD Rate State of Georgia State UTD Rate Number in Final Sample 293 293 92.8% 6,191 94.7% 27 District 3-3 2016 Georgia Adolescent Immunization Study Report The 2016 GAIS sampled 293 adolescents in seventh grade from District 3-3 (Table 3-3-A). An adolescent was considered up-to-date (UTD) if they received at least 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4 vaccines by the time they enrolled in school. The UTD immunization rate for seventh graders in District 3-3 was 92.8% for 2016. Immunization rates that decreased from the previous year are shown bolded (Table 3-3-A). Coverage rates among male and female seventh graders were similar for all vaccines (Table 3-3-A). Of the 293 seventh graders sampled from District 3-3, 54.3% were male and 39.2% were female. The gender for nineteen students (6.5%) was unknown or missing (Table 3-3-B). None of the students in the sample were found to be in the school "waiver" period, meaning that no student was incomplete due to being newly enrolled in school (Table 3-3-B). Five (1.7%) of the adolescents in the District 33 sample were found to have a medical exemption for one or more vaccinations. Three adolescents (1.0%) had a religious exemption on file (Table 3-3-B). Table 3-3-A: Georgia Adolescent Immunization Coverage Rates by Vaccine Antigen and Gender--District 3-3, 2016 State District 3-3 Overall n=6,191 (%) 2016 n=293 (%) Male n=159 (%) Female n=115 (%) UTD rate* 94.7 0.6 92.8 3.0 97.5 2.4 96.5 3.4 3 Hepatitis B 97.7 0.4 95.6 2.4 100 0.0 99.1 1.7 2 MMR 97.6 0.4 95.2 2.4 100 0.0 99.1 1.7 2 Varicella** 96.5 0.5 94.5 2.6 97.5 2.4 99.1 1.7 1 Tdap 96.1 0.5 93.9 2.8 98.1 2.1 96.5 3.4 1 MCV4 96.0 0.5 93.9 2.8 98.1 2.1 96.5 3.4 4 Polio 96.0 0.5 94.2 2.7 98.7 1.7 96.5 3.4 1 HPV 43.8 1.2 57.7 5.7 60.4 7.6 60.0 9.0 3 HPV 14.5 0.9 16.7 4.3 17.6 5.9 17.4 6.9 * An adolescent was classified as UTD if they had received at least the follow- ing vaccine doses: 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4. ** Physician diagnosed or history of varicella illness were not included in the Varicella coverage rate. However, they were included in the UTD rate. There were 19 students that had an unknown or missing gender status. Table 3-3-B: Gender, School Waiver and Exemptions among Georgia Adolescents--District 3-3, 2016 (n=293) n Percent of sample (%) Gender Male 159 54.3 Female 115 39.2 Missing or unknown gender 19 6.5 School waiver Within waiver period 0 0 Not within waiver period 293 100.0 Medical Exemptions Medical exemption 5 1.7 No medical exemption 288 98.3 Religious Exemptions Religious exemption 3 1.0 No religious exemption 290 99.0 28 District 3-4 2016 Georgia Adolescent Immunization Study Report District 3-4 Data Collection Team Valerie Pritchett Immunization Program Consultant County Gwinnett Newton Rockdale District 3-4 District UTD Rate State of Georgia State UTD Rate Number in Final Sample 284 69 0 353 92.1% 6,191 94.7% 29 District 3-4 2016 Georgia Adolescent Immunization Study Report The 2016 GAIS sampled 353 adolescents in seventh grade from District 3-4 (Table 3-4-A). An adolescent was considered up-to-date (UTD) if they received at least 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4 vaccines by the time they enrolled in school. The UTD immunization rate for seventh graders in District 3-4 was 92.1% for 2016. Immunization rates that decreased from the previous year are shown bolded (Table 3-4-A). The UTD immunization rate for female seventh graders was higher than male seventh graders (97.0% vs. 92.0%). More female adolescents received 1 dose of HPV vaccine than male adolescents (43.5% vs. 37.7%) (Table 3-4-A). Of the 353 seventh graders sampled from District 3-4, 49.6% were male and 47.6% were female. The gender for ten students (2.8%) was unknown or missing (Table 3-4-B). None of the students in the sample were found to be in the school "waiver" period, meaning that no student was incomplete due to being newly enrolled in school (Table 3-4-B). Table 3-4-A: Georgia Adolescent Immunization Coverage Rates by Vaccine Antigen and Gender--District 3-4, 2016 State District 3-4 Overall n=6,191 (%) 2016 n=353 (%) Male n=175 (%) Female n=168 (%) UTD rate* 94.7 0.6 92.1 2.8 92.0 4.0 97.0 2.6 3 Hepatitis B 97.7 0.4 96.3 2.0 98.3 1.9 99.4 1.2 2 MMR 97.6 0.4 96.0 2.0 97.7 2.2 99.4 1.2 2 Varicella** 96.5 0.5 95.5 2.2 96.6 2.7 99.4 1.2 1 Tdap 96.1 0.5 94.1 2.5 96.0 2.9 97.0 2.6 1 MCV4 96.0 0.5 93.8 2.5 94.9 3.3 97.6 2.3 4 Polio 96.0 0.5 93.2 2.6 93.7 3.6 97.6 2.3 1 HPV 43.8 1.2 39.4 5.1 37.7 7.2 43.5 7.5 3 HPV 14.5 0.9 15.6 3.8 16.6 5.5 15.5 5.5 * An adolescent was classified as UTD if they had received at least the follow- ing vaccine doses: 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4. ** Physician diagnosed or history of varicella illness were not included in the Varicella coverage rate. However, they were included in the UTD rate. There were 10 students that had an unknown or missing gender status. Two (0.6%) of the adolescents in the District 34 sample were found to have a medical exemption for one or more vaccinations. Six adolescents (1.7%) had a religious exemption on file (Table 3-4-B). Table 3-4-B: Gender, School Waiver and Exemptions among Georgia Adolescents--District 3-4, 2016 (n=353) n Percent of sample (%) Gender Male 175 49.6 Female 168 47.6 Missing or unknown gender 10 2.8 School waiver Within waiver period 0 0 Not within waiver period 353 100.0 Medical Exemptions Medical exemption 2 0.6 No medical exemption 351 99.4 Religious Exemptions Religious exemption 6 1.7 No religious exemption 347 98.3 30 District 3-5 2016 Georgia Adolescent Immunization Study Report District 3-5 Data Collection Team Janet Kelly Immunization Program Consultant County DeKalb District 3-5 District UTD Rate State of Georgia State UTD Rate Number in Final Sample 374 374 88.2% 6,191 94.7% 31 District 3-5 2016 Georgia Adolescent Immunization Study Report The 2016 GAIS sampled 374 adolescents in seventh grade from District 3-5 (Table 3-5-A). An adolescent was considered up-to-date (UTD) if they received at least 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4 vaccines by the time they enrolled in school. The UTD immunization rate for seventh graders in District 3-5 was 88.2% for 2016. Immunization rates that decreased from the previous year are shown bolded (Table 3-5-A). Coverage rates among male and female seventh graders were similar for all vaccines except HPV. A higher number of female adolescents received 3 doses of HPV vaccine than male adolescents (20.2% vs 14.9%) (Table 3-5A). Of the 374 seventh graders sampled from District 3-5, 53.7% were male and 43.6% were female. The gender for ten students (2.7%) was unknown or missing (Table 3-5-B). Eleven of the students in the sample were found to be in the school "waiver" period, meaning they were incomplete due to being newly enrolled in school (Table 3-5-B). None of the adolescents in the District 3-5 sample were found to have a medical exemption for one or more vaccinations. Nine adolescents (2.4%) had a religious exemption on file (Table 3-5-B). Table 3-5-A: Georgia Adolescent Immunization Coverage Rates by Vaccine Antigen and Gender--District 3-5, 2016 State District 3-5 Overall n=6,191 (%) 2016 n=374 (%) Male n=201 (%) Female n=163 (%) UTD rate* 94.7 0.6 88.2 3.3 88.6 4.4 91.4 4.3 3 Hepatitis B 97.7 0.4 95.7 2.1 97.0 2.4 98.2 2.1 2 MMR 97.6 0.4 96.5 1.9 98.0 1.9 98.8 1.7 2 Varicella** 96.5 0.5 96.0 2.0 98.0 1.9 97.5 2.4 1 Tdap 96.1 0.5 92.2 2.7 93.5 3.4 94.5 3.5 1 MCV4 96.0 0.5 91.7 2.8 93.0 3.5 93.9 3.7 4 Polio 96.0 0.5 90.9 2.9 90.5 4.1 95.1 3.3 1 HPV 43.8 1.2 52.7 5.1 55.2 6.9 52.8 7.7 3 HPV 14.5 0.9 16.8 3.8 14.9 4.9 20.2 6.2 * An adolescent was classified as UTD if they had received at least the follow- ing vaccine doses: 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4. ** Physician diagnosed or history of varicella illness were not included in the Varicella coverage rate. However, they were included in the UTD rate. There were 10 students that had an unknown or missing gender status. Table 3-5-B: Gender, School Waiver and Exemptions among Georgia Adolescents--District 3-5, 2016 (n=374) n Percent of sample (%) Gender Male 201 53.7 Female 163 43.6 Missing or unknown gender 10 2.7 School waiver Within waiver period 11 2.9 Not within waiver period 363 97.1 Medical Exemptions Medical exemption 0 0 No medical exemption 374 100.0 Religious Exemptions Religious exemption 9 2.4 No religious exemption 365 97.6 32 District 4-0 2016 Georgia Adolescent Immunization Study Report District 4-0 Data Collection Team Tina Dempsey Immunization Program Consultant County Butts Carroll Coweta Fayette Heard Henry Lamar Meriwether Pike Spalding Troup Upson District 4-0 District UTD Rate State of Georgia State UTD Rate Number in Final Sample 0 40 55 53 0 89 12 13 14 26 13 0 315 94.6% 6,191 94.7% 33 District 4-0 2016 Georgia Adolescent Immunization Study Report The 2016 GAIS sampled 315 adolescents in seventh grade from District 4-0 (Table 4-0-A). An adolescent was considered up-to-date (UTD) if they received at least 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4 vaccines by the time they enrolled in school. The UTD immunization rate for seventh graders in District 4-0 was 94.6% for 2016. Immunization rates that decreased from the previous year are shown bolded (Table 4-0-A). Coverage rates among male and female seventh graders were similar for all vaccines except HPV. More female adolescents received 1 dose of HPV vaccine than male adolescents (40.2% vs. 34.5%) (Table 4-0-A). Of the 315 seventh graders sampled from District 4-0, 46.0% were male and 52.1% were female. The gender for six students (1.9%) was unknown or missing (Table 4-0-B). None of the students in the sample were found to be in the school "waiver" period, meaning that no student was incomplete due to being newly enrolled in school (Table 4-0-B). None of the adolescents in the District 4-0 sample were found to have a medical exemption for one or more vaccinations. Five adolescents (1.6%) had a religious exemption on file (Table 4-0-B). Table 4-0-A: Georgia Adolescent Immunization Coverage Rates by Vaccine Antigen and Gender--District 4-0, 2016 State District 4-0 Overall n=6,191 (%) 2016 n=315 (%) Male n=145 (%) Female n=164 (%) UTD rate* 94.7 0.6 94.6 2.5 95.2 3.5 94.5 3.5 3 Hepatitis B 97.7 0.4 98.1 1.5 98.6 1.9 98.2 2.1 2 MMR 97.6 0.4 97.8 1.6 97.9 2.3 98.2 2.1 2 Varicella** 96.5 0.5 96.5 2.0 96.6 3.0 97.0 2.6 1 Tdap 96.1 0.5 96.5 2.0 96.6 3.0 97.0 2.6 1 MCV4 96.0 0.5 96.8 1.9 96.6 3.0 97.6 2.4 4 Polio 96.0 0.5 96.8 1.9 97.2 2.7 97.0 2.6 1 HPV 43.8 1.2 37.1 5.3 34.5 7.7 40.2 7.5 3 HPV 14.5 0.9 12.4 3.6 10.3 5.0 14.6 5.4 * An adolescent was classified as UTD if they had received at least the follow- ing vaccine doses: 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4. ** Physician diagnosed or history of varicella illness were not included in the Varicella coverage rate. However, they were included in the UTD rate. There were 6 students that had an unknown or missing gender status. Table 4-0-B: Gender, School Waiver and Exemptions among Georgia Adolescents--District 4-0, 2016 (n=315) n Percent of sample (%) Gender Male 145 46.0 Female 164 52.1 Missing or unknown gender 6 1.9 School waiver Within waiver period 0 0 Not within waiver period 315 100.0 Medical Exemptions Medical exemption 0 0 No medical exemption 315 100.0 Religious Exemptions Religious exemption 5 1.6 No religious exemption 310 98.4 34 District 5-1 2016 Georgia Adolescent Immunization Study Report District 5-1 Data Collection Team DeAnna Brown Immunization Program Consultant County Bleckley Dodge Johnson Laurens Montgomery Pulaski Telfair Treutlen Wheeler Wilcox District 5-1 District UTD Rate State of Georgia State UTD Rate Number in Final Sample 23 26 24 92 23 23 23 24 23 23 304 97.7% 6,191 94.7% 35 District 5-1 2016 Georgia Adolescent Immunization Study Report The 2016 GAIS sampled 304 adolescents in seventh grade from District 5-1 (Table 5-1-A). An adolescent was considered up-to-date (UTD) if they received at least 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4 vaccines by the time they enrolled in school. The UTD immunization rate for seventh graders in District 5-1 was 97.7% for 2016. Immunization rates that decreased from the previous year are shown bolded (Table 5-1-A). Coverage rates among male and female seventh graders were similar for all vaccines except HPV. More female adolescents received 1 dose of HPV vaccine than male adolescents (39.3% vs. 31.1%) (Table 5-1-A). Of the 304 seventh graders sampled from District 5-1, 53.0% were male and 46.1% were female. The gender for three students (1.0%) was unknown or missing (Table 5-1-B). Two of the students in the sample were found to be in the school "waiver" period, meaning they were incomplete due to being newly enrolled in school (Table 5-1-B). Table 5-1-A: Georgia Adolescent Immunization Coverage Rates by Vaccine Antigen and Gender--District 5-1, 2016 State District 5-1 Overall n=6,191 (%) 2016 n=304 (%) Male n=161 (%) Female n=140 (%) UTD rate* 94.7 0.6 97.7 1.7 98.1 2.1 98.6 2.0 3 Hepatitis B 97.7 0.4 99.0 1.1 100 0.0 99.3 1.4 2 MMR 97.6 0.4 99.0 1.1 100 0.0 99.3 1.4 2 Varicella** 96.5 0.5 98.4 1.4 100 0.0 97.9 2.4 1 Tdap 96.1 0.5 98.4 1.4 98.8 1.7 99.3 1.4 1 MCV4 96.0 0.5 98.0 1.6 98.1 2.1 99.3 1.4 4 Polio 96.0 0.5 98.7 1.3 99.4 1.2 99.3 1.4 1 HPV 43.8 1.2 34.5 5.4 31.1 7.2 39.3 8.1 3 HPV 14.5 0.9 12.2 3.7 10.6 4.8 14.3 5.8 * An adolescent was classified as UTD if they had received at least the follow- ing vaccine doses: 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4. ** Physician diagnosed or history of varicella illness were not included in the Varicella coverage rate. However, they were included in the UTD rate. There were 3 students that had an unknown or missing gender status. One (0.3%) of the adolescents in the District 51 sample was found to have a medical exemption for one or more vaccinations. Two adolescents (0.7%) had a religious exemption on file (Table 5-1-B). Table 5-1-B: Gender, School Waiver and Exemptions among Georgia Adolescents--District 5-1, 2016 (n=304) n Percent of sample (%) Gender Male 161 53.0 Female 140 46.1 Missing or unknown gender 3 1.0 School waiver Within waiver period 2 0.7 Not within waiver period 302 99.3 Medical Exemptions Medical exemption 1 0.3 No medical exemption 303 99.7 Religious Exemptions Religious exemption 2 0.7 No religious exemption 302 99.3 36 District 5-2 2016 Georgia Adolescent Immunization Study Report District 5-2 Data Collection Team Kelly Duke Immunization Program Consultant County Number in Final Sample Baldwin 26 Bibb 143 Crawford 0 Hancock 13 Houston 105 Jasper 0 Jones 26 Monroe 0 Peach 13 Putnam 26 Twiggs 9 Washington 27 Wilkinson 0 District 5-2 388 District UTD Rate 96.6% State of Georgia State UTD Rate 6,191 94.7% 37 District 5-2 2016 Georgia Adolescent Immunization Study Report The 2016 GAIS sampled 388 adolescents in seventh grade from District 5-2 (Table 5-2-A). An adolescent was considered up-to-date (UTD) if they received at least 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4 vaccines by the time they enrolled in school. The UTD immunization rate for seventh graders in District 5-2 was 96.6% for 2016. Immunization rates that decreased from the previous year are shown bolded (Table 5-2-A). Coverage rates among male and female seventh graders were similar for all vaccines except HPV. More female adolescents received 1 dose of HPV vaccine than male adolescents (48.1% vs. 38.5%) (Table 5-2-A). Of the 388 seventh graders sampled from District 5-2, 51.5% were male and 47.7% were female. The gender for three students (0.8%) was unknown or missing (Table 5-2-B). None of the students in the sample were found to be in the school "waiver" period, meaning that no student was incomplete due to being newly enrolled in school (Table 5-2-B). Table 5-2-A: Georgia Adolescent Immunization Coverage Rates by Vaccine Antigen and Gender--District 5-2, 2016 State District 5-2 Overall n=6,191 (%) 2016 n=388 (%) Male n=200 (%) Female n=185 (%) UTD rate* 94.7 0.6 96.6 1.8 97.5 2.2 96.8 2.6 3 Hepatitis B 97.7 0.4 98.5 1.2 99.0 1.4 98.9 1.5 2 MMR 97.6 0.4 97.9 1.4 98.5 1.7 98.4 1.8 2 Varicella** 96.5 0.5 97.9 1.4 98.5 1.7 98.4 1.8 1 Tdap 96.1 0.5 96.9 1.7 98.0 1.9 96.8 2.6 1 MCV4 96.0 0.5 96.6 1.8 97.5 2.2 96.8 2.6 4 Polio 96.0 0.5 97.4 1.6 98.5 1.7 97.3 2.3 1 HPV 43.8 1.2 42.8 4.9 38.5 6.8 48.1 7.2 3 HPV 14.5 0.9 16.8 3.7 15.0 5.0 18.9 5.7 * An adolescent was classified as UTD if they had received at least the follow- ing vaccine doses: 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4. ** Physician diagnosed or history of varicella illness were not included in the Varicella coverage rate. However, they were included in the UTD rate. There were 3 students that had an unknown or missing gender status. None of the adolescents in the District 5-2 sample were found to have a medical exemption for one or more vaccinations. Nine adolescents (2.3%) had a religious exemption on file (Table 5-2-B). Table 5-2-B: Gender, School Waiver and Exemptions among Georgia Adolescents--District 5-2, 2016 (n=388) n Percent of sample (%) Gender Male 200 51.5 Female 185 47.7 Missing or unknown gender 3 0.8 School waiver Within waiver period 0 0 Not within waiver period 388 100.0 Medical Exemptions Medical exemption 0 0 No medical exemption 388 Religious Exemptions 100.0 Religious exemption 9 2.3 No religious exemption 379 97.7 38 District 6-0 2016 Georgia Adolescent Immunization Study Report District 6-0 Data Collection Team Sheila Fultz Immunization Program Consultant County Burke Columbia Emanuel Glascock Jefferson Jenkins Lincoln McDuffie Richmond Screven Taliaferro Warren Wilkes District 6-0 District UTD Rate State of Georgia State UTD Rate Number in Final Sample 30 65 38 0 13 13 13 13 100 11 15 13 12 336 97.0% 6,191 94.7% 39 District 6-0 2016 Georgia Adolescent Immunization Study Report The 2016 GAIS sampled 336 adolescents in seventh grade from District 6-0 (Table 6-0-A). An adolescent was considered up-to-date (UTD) if they received at least 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4 vaccines by the time they enrolled in school. The UTD immunization rate for seventh graders in District 6-0 was 97.0% for 2016. Immunization rates that decreased from the previous year are shown bolded (Table 6-0-A). Coverage rates among male and female seventh graders were similar for all vaccines except HPV. More female adolescents received 1 dose of HPV vaccine than male adolescents (62.9% vs. 36.8%). A higher number of female adolescents received 3 doses of HPV vaccine than male adolescents (19.5% vs 8.8%) (Table 6 -0-A). Of the 336 seventh graders sampled from District 6-0, 50.9% were male and 47.3% were female. The gender for six students (1.8%) was unknown or missing (Table 6-0-B). None of the students in the sample were found to be in the school "waiver" period, meaning that no student was incomplete due to being newly enrolled in school (Table 6-0-B). None of the adolescents in the District 6-0 sample were found to have a medical exemption for one or more vaccinations. None adolescents had a religious exemption on file (Table 6-0-B). Table 6-0-A: Georgia Adolescent Immunization Coverage Rates by Vaccine Antigen and Gender--District 6-0, 2016 State District 6-0 Overall n=6,191 (%) 2016 n=336 (%) Male n=171 (%) Female n=159 (%) UTD rate* 94.7 0.6 97.0 1.8 97.1 2.5 99.4 1.2 3 Hepatitis B 97.7 0.4 98.8 1.2 100 0.0 100 0.0 2 MMR 97.6 0.4 98.8 1.2 99.4 1.1 100 0.0 2 Varicella** 96.5 0.5 97.6 1.6 98.2 2.0 98.7 1.7 1 Tdap 96.1 0.5 98.8 1.2 99.4 1.1 100 0.0 1 MCV4 96.0 0.5 98.8 1.2 99.4 1.1 100 0.0 4 Polio 96.0 0.5 98.2 1.4 98.2 2.0 100 0.0 1 HPV 43.8 1.2 49.1 5.4 36.8 7.2 62.9 7.5 3 HPV 14.5 0.9 14.0 3.7 8.8 4.2 19.5 6.2 * An adolescent was classified as UTD if they had received at least the follow- ing vaccine doses: 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4. ** Physician diagnosed or history of varicella illness were not included in the Varicella coverage rate. However, they were included in the UTD rate. There were 6 students that had an unknown or missing gender status. Table 6-0-B: Gender, School Waiver and Exemptions among Georgia Adolescents--District 6-0, 2016 (n=336) n Percent of sample (%) Gender Male 171 50.9 Female 159 47.3 Missing or unknown gender 6 1.8 School waiver Within waiver period 0 0 Not within waiver period 336 100.0 Medical Exemptions Medical exemption 0 0 No medical exemption 336 100.0 Religious Exemptions Religious exemption 0 0 No religious exemption 336 100.0 40 District 7-0 2016 Georgia Adolescent Immunization Study Report District 7-0 Data Collection Team Kelly Seegmuller Immunization Program Consultant County Chattahoochee Clay Crisp Dooly Harris Macon Marion Muscogee Quitman Randolph Schley Stewart Sumter Talbot Taylor Webster District 7-0 District UTD Rate State of Georgia State UTD Rate Number in Final Sample 14 12 25 26 16 17 11 139 12 0 2 11 22 0 11 0 318 89.6% 6,191 94.7% 41 District 7-0 2016 Georgia Adolescent Immunization Study Report The 2016 GAIS sampled 318 adolescents in seventh grade from District 7-0 (Table 7-0-A). An adolescent was considered up-to-date (UTD) if they received at least 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4 vaccines by the time they enrolled in school. The UTD immunization rate for seventh graders in District 7-0 was 89.6% for 2016. Immunization rates that decreased from the previous year are shown bolded (Table 7-0-A). Coverage rates among male and female seventh graders were similar for all vaccines except HPV. More female adolescents received 1 dose of HPV vaccine than male adolescents (44.2% vs. 35.7%) (Table 7-0-A). Of the 318 seventh graders sampled from District 7-0, 49.4% were male and 48.4% were female. The gender for seven students (2.2%) was unknown or missing (Table 7-0-B). One student in the sample was found to be in the school "waiver" period, meaning they were incomplete due to being newly enrolled in school (Table 7-0-B). Table 7-0-A: Georgia Adolescent Immunization Coverage Rates by Vaccine Antigen and Gender--District 7-0, 2016 State District 7-0 Overall n=6,191 (%) 2016 n=318 (%) Male n=157 (%) Female n=154 (%) UTD rate* 94.7 0.6 89.6 3.4 88.5 5.0 93.5 3.9 3 Hepatitis B 97.7 0.4 94.7 2.5 94.9 3.4 96.8 2.8 2 MMR 97.6 0.4 94.3 2.5 93.6 3.8 96.8 2.8 2 Varicella** 96.5 0.5 94.3 2.5 93.6 3.8 96.1 3.1 1 Tdap 96.1 0.5 94.0 2.6 93.0 4.0 96.1 3.1 1 MCV4 96.0 0.5 93.7 2.7 93.0 4.0 95.5 3.3 4 Polio 96.0 0.5 93.7 2.7 93.0 4.0 95.5 3.3 1 HPV 43.8 1.2 39.0 5.4 35.7 7.5 44.2 7.9 3 HPV 14.5 0.9 12.9 3.7 11.5 5.0 14.9 5.6 * An adolescent was classified as UTD if they had received at least the follow- ing vaccine doses: 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4. ** Physician diagnosed or history of varicella illness were not included in the Varicella coverage rate. However, they were included in the UTD rate. There were 7 students that had an unknown or missing gender status. One (0.3%) of the adolescents in the District 70 sample was found to have a medical exemption for one or more vaccinations. Three adolescents (0.9%) had a religious exemption on file (Table 7-0-B). Table 7-0-B: Gender, School Waiver and Exemptions among Georgia Adolescents--District 7-0, 2016 (n=318) n Percent of sample (%) Gender Male 157 49.4 Female 154 48.4 Missing or unknown gender 7 2.2 School waiver Within waiver period 1 0.3 Not within waiver period 317 99.7 Medical Exemptions Medical exemption 1 0.3 No medical exemption 317 99.7 Religious Exemptions Religious exemption 3 0.9 No religious exemption 315 99.1 42 District 8-1 2016 Georgia Adolescent Immunization Study Report District 8-1 Data Collection Team Jenny Howell Immunization Program Consultant County Ben Hill Berrien Brooks Cook Echols Irwin Lanier Lowndes Tift Turner District 8-1 District UTD Rate State of Georgia State UTD Rate Number in Final Sample 23 25 23 23 23 23 23 115 46 23 347 97.7% 6,191 94.7% 43 District 8-1 2016 Georgia Adolescent Immunization Study Report The 2016 GAIS sampled 347 adolescents in seventh grade from District 8-1 (Table 8-1-A). An adolescent was considered up-to-date (UTD) if they received at least 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4 vaccines by the time they enrolled in school. The UTD immunization rate for seventh graders in District 8-1 was 97.7% for 2016. Immunization rates that decreased from the previous year are shown bolded (Table 8-1-A). Coverage rates among male and female seventh graders were similar for all vaccines except HPV. A higher number of male adolescents received 3 doses of HPV vaccine than female adolescents (21.3% vs 15.9%) (Table 8-1 -A). Of the 347 seventh graders sampled from District 8-1, 50.1% were male and 47.3% were female. The gender for nine students (2.6%) was unknown or missing (Table 8-1-B). None of the students in the sample were found to be in the school "waiver" period, meaning that no student was incomplete due to being newly enrolled in school (Table 8-1-B). None of the adolescents in the District 8-1 sample were found to have a medical exemption for one or more vaccinations. Four adolescents (1.2%) had a religious exemption on file (Table 8-1-B). Table 8-1-A: Georgia Adolescent Immunization Coverage Rates by Vaccine Antigen and Gender--District 8-1, 2016 State District 8-1 Overall n=6,191 (%) 2016 n=347 (%) Male n=174 (%) Female n=164 (%) UTD rate* 94.7 0.6 97.7 1.6 100 0.0 97.0 2.6 3 Hepatitis B 97.7 0.4 98.8 1.1 100 0.0 98.8 1.7 2 MMR 97.6 0.4 98.6 1.3 100 0.0 98.2 2.1 2 Varicella** 96.5 0.5 98.0 1.5 100 0.0 97.6 2.4 1 Tdap 96.1 0.5 98.6 1.3 100 0.0 98.2 2.1 1 MCV4 96.0 0.5 98.6 1.3 100 0.0 98.2 2.1 4 Polio 96.0 0.5 96.0 2.1 96.6 2.7 96.3 2.9 1 HPV 43.8 1.2 43.2 5.2 43.1 7.4 43.3 7.6 3 HPV 14.5 0.9 18.4 4.1 21.3 6.1 15.9 5.6 * An adolescent was classified as UTD if they had received at least the follow- ing vaccine doses: 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4. ** Physician diagnosed or history of varicella illness were not included in the Varicella coverage rate. However, they were included in the UTD rate. There were 9 students that had an unknown or missing gender status. Table 8-1-B: Gender, School Waiver and Exemptions among Georgia Adolescents--District 8-1, 2016 (n=347) n Percent of sample (%) Gender Male 174 50.1 Female 164 47.3 Missing or unknown gender 9 2.6 School waiver Within waiver period 0 0 Not within waiver period 347 100.0 Medical Exemptions Medical exemption 0 0 No medical exemption 347 100.0 Religious Exemptions Religious exemption 4 1.2 No religious exemption 343 98.8 44 District 8-2 2016 Georgia Adolescent Immunization Study Report District 8-2 Data Collection Team Lisa Jenkins Immunization Program Consultant County Baker Calhoun Colquitt Decatur Dougherty Early Grady Lee Miller Mitchell Seminole Terrell Thomas Worth District 8-2 District UTD Rate State of Georgia State UTD Rate Number in Final Sample 12 24 13 24 60 24 36 12 12 48 12 12 40 12 341 99.1% 6,191 94.7% 45 District 8-2 2016 Georgia Adolescent Immunization Study Report The 2016 GAIS sampled 341 adolescents in seventh grade from District 8-2 (Table 8-2-A). An adolescent was considered up-to-date (UTD) if they received at least 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4 vaccines by the time they enrolled in school. The UTD immunization rate for seventh graders in District 8-2 was 99.1% for 2016. Immunization rates that decreased from the previous year are shown bolded (Table 8-2-A). Coverage rates among male and female seventh graders were similar for all vaccines except HPV. More female adolescents received 1 dose of HPV vaccine than male adolescents (60.5% vs. 49.1%) (Table 8-2-A). Of the 341 seventh graders sampled from District 8-2, 47.2% were male and 51.9% were female. The gender for three students (0.9%) was unknown or missing (Table 8-2-B). None of the students in the sample were found to be in the school "waiver" period, meaning that no student was incomplete due to being newly enrolled in school (Table 8-2-B). Table 8-2-A: Georgia Adolescent Immunization Coverage Rates by Vaccine Antigen and Gender--District 8-2, 2016 State District 8-2 Overall n=6,191 (%) 2016 n=341 (%) Male n=161 (%) Female n=177 (%) UTD rate* 94.7 0.6 99.1 1.0 98.8 1.7 99.4 1.1 3 Hepatitis B 97.7 0.4 100 0.0 100 0.0 100 0.0 2 MMR 97.6 0.4 100 0.0 100 0.0 100 0.0 2 Varicella** 96.5 0.5 99.4 0.8 99.4 1.2 99.4 1.1 1 Tdap 96.1 0.5 99.7 0.6 99.4 1.2 100 0.0 1 MCV4 96.0 0.5 100 0.0 100 0.0 100 0.0 4 Polio 96.0 0.5 100 0.0 100 0.0 100 0.0 1 HPV 43.8 1.2 55.1 5.3 49.1 7.7 60.5 7.2 3 HPV 14.5 0.9 17.3 4.0 15.5 5.6 19.2 5.8 * An adolescent was classified as UTD if they had received at least the follow- ing vaccine doses: 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4. ** Physician diagnosed or history of varicella illness were not included in the Varicella coverage rate. However, they were included in the UTD rate. There were 3 students that had an unknown or missing gender status. None of the adolescents in the District 8-2 sample were found to have a medical exemption for one or more vaccinations. None adolescents had a religious exemption on file (Table 8-2-B). Table 8-2-B: Gender, School Waiver and Exemptions among Georgia Adolescents--District 8-2, 2016 (n=341) n Percent of sample (%) Gender Male 161 47.2 Female 177 51.9 Missing or unknown gender 3 0.9 School waiver Within waiver period 0 0 Not within waiver period 341 100.0 Medical Exemptions Medical exemption 0 0 No medical exemption 341 100.0 Religious Exemptions Religious exemption 0 0 No religious exemption 341 100.0 46 District 9-1 2016 Georgia Adolescent Immunization Study Report District 9-1 Data Collection Team Kimberly Skinner Immunization Program Consultant County Bryan Camden Chatham Effingham Glynn Liberty Long McIntosh District 9-1 District UTD Rate State of Georgia State UTD Rate Number in Final Sample 0 4 237 24 41 26 12 0 344 94.8 6,191 94.7% 47 District 9-1 2016 Georgia Adolescent Immunization Study Report The 2016 GAIS sampled 344 adolescents in seventh grade from District 9-1 (Table 9-1-A). An adolescent was considered up-to-date (UTD) if they received at least 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4 vaccines by the time they enrolled in school. The UTD immunization rate for seventh graders in District 9-1 was 94.8% for 2016. Immunization rates that decreased from the previous year are shown bolded (Table 9-1-A). Coverage rates among male and female seventh graders were similar for all vaccines (Table 9-1-A). Of the 344 seventh graders sampled from District 9-1, 50.6% were male and 45.1% were female. The gender for fifteen students (4.4%) was unknown or missing (Table 9-1-B). None of the students in the sample were found to be in the school "waiver" period, meaning that no student was incomplete due to being newly enrolled in school (Table 9-1-B). None of the adolescents in the District 9-1 sample were found to have a medical exemption for one or more vaccinations. Seven adolescents (2.0%) had a religious exemption on file (Table 9-1-B). Table 9-1-A: Georgia Adolescent Immunization Coverage Rates by Vaccine Antigen and Gender--District 9-1, 2016 State District 9-1 Overall n=6,191 (%) 2016 n=344 (%) Male n=174 (%) Female n=155 (%) UTD rate* 94.7 0.6 94.8 2.4 96.0 2.9 96.1 3.0 3 Hepatitis B 97.7 0.4 97.7 1.6 99.4 1.1 98.7 1.8 2 MMR 97.6 0.4 97.7 1.6 99.4 1.1 98.7 1.8 2 Varicella** 96.5 0.5 95.1 2.3 97.1 2.5 96.8 2.8 1 Tdap 96.1 0.5 95.9 2.1 97.1 2.5 97.4 2.5 1 MCV4 96.0 0.5 95.3 2.2 96.6 2.7 96.8 2.8 4 Polio 96.0 0.5 95.3 2.2 97.1 2.5 96.1 3.0 1 HPV 43.8 1.2 43.6 5.2 46.0 7.4 43.2 7.8 3 HPV 14.5 0.9 14.5 3.7 14.9 5.3 15.5 5.7 * An adolescent was classified as UTD if they had received at least the follow- ing vaccine doses: 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4. ** Physician diagnosed or history of varicella illness were not included in the Varicella coverage rate. However, they were included in the UTD rate. There were 15 students that had an unknown or missing gender status. Table 9-1-B: Gender, School Waiver and Exemptions among Georgia Adolescents--District 9-1, 2016 (n=344) n Percent of sample (%) Gender Male 174 50.6 Female 155 45.1 Missing or unknown gender 15 4.4 School waiver Within waiver period 0 0 Not within waiver period 344 100.0 Medical Exemptions Medical exemption 0 0 No medical exemption 344 100.0 Religious Exemptions Religious exemption 7 0 No religious exemption 337 98.0 48 District 9-2 2016 Georgia Adolescent Immunization Study Report District 9-2 Data Collection Team Lorie Banks Immunization Program Consultant County Appling Atkinson Bacon Brantley Bulloch Candler Charlton Clinch Coffee Evans Jeff Davis Pierce Tattnall Toombs Ware Wayne District 9-2 District UTD Rate State of Georgia State UTD Rate Number in Final Sample 24 12 12 12 79 12 12 12 12 12 12 12 36 36 36 24 355 96.9% 6,191 94.7% 49 District 9-2 2016 Georgia Adolescent Immunization Study Report The 2016 GAIS sampled 355 adolescents in seventh grade from District 9-2 (Table 9-2-A). An adolescent was considered up-to-date (UTD) if they received at least 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4 vaccines by the time they enrolled in school. The UTD immunization rate for seventh graders in District 9-2 was 96.9% for 2016. Immunization rates that decreased from the previous year are shown bolded (Table 9-2-A). Coverage rates among male and female seventh graders were similar for all vaccines except HPV. A higher number of female adolescents received 3 doses of HPV vaccine than male adolescents (18.0% vs 11.6%) (Table 9-2A). Of the 355 seventh graders sampled from District 9-2, 48.7% were male and 48.5% were female. The gender for ten students (2.8%) was unknown or missing (Table 9-2-B). None of the students in the sample were found to be in the school "waiver" period, meaning that no student was incomplete due to being newly enrolled in school (Table 9-2-B). One (0.3%) of the adolescents in the District 92 sample was found to have a medical exemption for one or more vaccinations. Two adolescents (0.6%) had a religious exemption on file (Table 9-2-B). Table 9-2-A: Georgia Adolescent Immunization Coverage Rates by Vaccine Antigen and Gender--District 9-2, 2016 State District 9-2 Overall n=6,191 (%) 2016 n=355 (%) Male n=173 (%) Female n=172 (%) UTD rate* 94.7 0.6 96.9 1.8 97.1 2.5 98.3 2.0 3 Hepatitis B 97.7 0.4 98.6 1.2 98.8 1.6 100 0.0 2 MMR 97.6 0.4 99.2 1.0 100 0.0 100 0.0 2 Varicella** 96.5 0.5 98.3 1.3 98.8 1.6 99.4 1.1 1 Tdap 96.1 0.5 97.5 1.6 98.3 1.9 98.3 2.0 1 MCV4 96.0 0.5 98.0 1.4 98.8 1.6 98.8 1.6 4 Polio 96.0 0.5 97.7 1.5 99.4 1.1 97.7 2.3 1 HPV 43.8 1.2 44.5 5.2 45.1 7.4 45.9 7.5 3 HPV 14.5 0.9 14.6 3.7 11.6 4.8 18.0 5.8 * An adolescent was classified as UTD if they had received at least the follow- ing vaccine doses: 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4. ** Physician diagnosed or history of varicella illness were not included in the Varicella coverage rate. However, they were included in the UTD rate. There were 10 students that had an unknown or missing gender status. Table 9-2-B: Gender, School Waiver and Exemptions among Georgia Adolescents--District 9-2, 2016 (n=355) n Percent of sample (%) Gender Male 173 48.7 Female 172 48.5 Missing or unknown gender 10 2.8 School waiver Within waiver period 0 0 Not within waiver period 355 Medical Exemptions 100.0 Medical exemption 1 0.3 No medical exemption 354 99.7 Religious Exemptions Religious exemption 2 0.6 No religious exemption 353 99.4 50 District 10 2016 Georgia Adolescent Immunization Study Report District 10 Data Collection Team Angie Webster Immunization Program Consultant County Barrow Clarke Elbert Greene Jackson Madison Morgan Oconee Oglethrope Walton District 10 District UTD Rate State of Georgia State UTD Rate Number in Final Sample 70 54 1 39 43 13 65 65 13 72 370 95.7% 6,191 94.7% 51 District 10 2016 Georgia Adolescent Immunization Study Report The 2016 GAIS sampled 370 adolescents in seventh grade from District 10 (Table 10-A). An adolescent was considered up-to-date (UTD) if they received at least 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4 vaccines by the time they enrolled in school. The UTD immunization rate for seventh graders in District 10 was 95.7% for 2016. Immunization rates that decreased from the previous year are shown bolded (Table 10-A). Coverage rates among male and female seventh graders were similar for all vaccines except HPV. More female adolescents received 1 dose of HPV vaccine than male adolescents (44.9% vs. 33.1%). A higher number of female adolescents received 3 doses of HPV vaccine than male adolescents (17.6% vs 10.1%) (Table 10-A). Of the 370 seventh graders sampled from District 10, 48.1% were male and 50.5% were female. The gender for five students (1.4%) was unknown or missing (Table 10-B). None of the students in the sample were found to be in the school "waiver" period, meaning that no student was incomplete due to being newly enrolled in school (Table 10-B). None of the adolescents in the District 10 sample were found to have a medical exemption for one or more vaccinations. Eleven adolescents (3.0%) had a religious exemption on file (Table 10-B). Table 10-A: Georgia Adolescent Immunization Coverage Rates by Vaccine Antigen and Gender--District 10, 2016 State District 10 Overall n=6,191 (%) 2016 n=370 (%) Male n=178 (%) Female n=187 (%) UTD rate* 94.7 0.6 95.7 2.1 94.9 3.2 96.3 2.7 3 Hepatitis B 97.7 0.4 98.4 1.3 97.8 2.2 98.9 1.5 2 MMR 97.6 0.4 98.1 1.4 97.2 2.4 98.9 1.5 2 Varicella** 96.5 0.5 95.7 2.1 93.8 3.5 97.3 2.3 1 Tdap 96.1 0.5 96.8 1.8 96.1 2.9 97.3 2.3 1 MCV4 96.0 0.5 96.2 1.9 94.9 3.2 97.3 2.3 4 Polio 96.0 0.5 96.8 1.8 95.5 3.0 97.9 2.1 1 HPV 43.8 1.2 39.5 5.0 33.1 6.9 44.9 7.1 3 HPV 14.5 0.9 14.1 3.5 10.1 4.4 17.6 5.5 * An adolescent was classified as UTD if they had received at least the follow- ing vaccine doses: 3 Hepatitis B, 2 MMR, 2 Varicella, 1 Tdap and 1 MCV4. ** Physician diagnosed or history of varicella illness were not included in the Varicella coverage rate. However, they were included in the UTD rate. There were 5 students that had an unknown or missing gender status. Table 10-B: Gender, School Waiver and Exemptions among Georgia Adolescents--District 10, 2016 (n=370) n Percent of sample (%) Gender Male 178 48.1 Female 187 50.5 Missing or unknown gender 5 1.4 School waiver Within waiver period 0 0 Not within waiver period 370 100.0 Medical Exemptions Medical exemption 0 0 No medical exemption 370 100.0 Religious Exemptions Religious exemption 11 3.0 No religious exemption 359 97.0 52 Appendices Georgia Adolescent Immunization Study, 2016 i ii Appendix A: Margins of Error Appendix Table A: Margin of Error for UTD Immunization Rates by District, Georgia, 2016 District Final Sample (n) Immunization 1-Immunization Margin of Rate Rate Error* (%) (%) (%) 95% Confidence Interval (%) 1-1 Northwest (Rome) 1-2 North Georgia (Dalton) 2-0 North (Gainesville) 3-1 Cobb-Douglas 3-2 Fulton 3-3 Clayton 363 96.1 326 90.5 344 94.8 358 94.1 362 95.3 293 92.8 3.9 2.0 94.2 - 98.1 9.5 3.2 87.3 - 93.7 5.2 2.4 92.4 - 97.1 5.9 2.4 91.7 - 96.6 4.7 2.2 93.1 - 97.5 7.2 3.0 89.9 - 95.8 3-4 Gwinnett, Newton, Rockdale 353 92.1 7.9 2.8 89.2 - 94.9 3-5 DeKalb 374 88.2 11.8 3.3 85.0 - 91.5 4-0 LaGrange 315 94.6 5-1 South Central (Dublin) 304 97.7 5-2 North Central (Macon) 388 96.6 6-0 East Central (Augusta) 336 97.0 7-0 West Central (Columbus) 318 89.6 8-1 South (Valdosta) 347 97.7 5.4 2.5 92.1 - 97.1 2.3 1.7 96.0 - 99.4 3.4 1.8 94.9 - 98.4 3.0 1.8 95.2 - 98.9 10.4 3.4 86.3 - 93.0 2.3 1.6 96.1 - 99.3 8-2 Southwest (Albany) 341 99.1 0.9 1.0 98.1 - 100.0 9-1 Coastal (Savannah) 344 94.8 5.2 2.4 92.4 - 97.1 9-2 Southeast (Waycross) 355 96.9 3.1 1.8 95.1 - 98.7 10-0 Northeast (Athens) 370 95.7 4.3 2.1 93.6 - 97.8 Georgia 6,191 94.7 5.3 0.6 94.1 - 95.3 *The margin of error (MOE) is a sta s c conveying the amount of random sampling error in a survey's results. It expresses the maximum expected difference between the true popula on parameter and a sample es mate of that parameter. The larger the MOE around an es mated value, the less accurate the es mated value is. iii Appendix B: Frequency of Exemptions Appendix Table B: Frequency of Exemptions and Within School Waiver Period Status by District, Georgia, 2016 District Final Religious Medical Within School Sample Exemption Exemption Waiver Period Total 1-1 Northwest (Rome) 363 8 0 0 8 1-2 North Georgia (Dalton) 326 17 0 0 17 2-0 North (Gainesville) 344 14 0 0 14 3-1 Cobb-Douglas 358 8 0 0 8 3-2 Fulton 362 7 0 1 8 3-3 Clayton 293 3 5 0 8 3-4 Gwinnett, Newton, Rockdale 353 6 2 0 8 3-5 DeKalb 374 9 0 11 20 4-0 LaGrange 315 5 0 0 5 5-1 South Central (Dublin) 304 2 1 2 5 5-2 North Central (Macon) 388 9 0 0 9 6-0 East Central (Augusta) 336 0 0 0 0 7-0 West Central (Columbus) 318 3 1 1 5 8-1 South (Valdosta) 347 4 0 0 4 8-2 Southwest (Albany) 341 0 0 0 0 9-1 Coastal (Savannah) 344 7 0 0 7 9-2 Southeast (Waycross) 355 2 1 0 3 10-0 Northeast (Athens) 370 11 0 0 11 Georgia 6,191 115 10 15 129 iv Appendix C: District Immunization Measures by Vaccine-Antigen Appendix Table C: Vaccine Antigen-Specific Immunization Measures by District, Georgia 2016 Highest Rate District 3 2 2 1 1 4 1 3 Hep B MMR Varicella Tdap MCV4 Polio HPV HPV (%) (%) (%) (%) (%) (%) (%) (%) 1-1 Northwest (Rome) 98.6 98.3 97.0 97.2 97.2 97.0 43.8 9.9 1-2 North Georgia (Dalton) 96.0 95.1 93.9 92.6 91.4 92.0 39.9 14.1 2-0 North (Gainesville) 97.4 96.8 95.9 94.8 95.1 95.3 34.9 11.3 3-1 Cobb-Douglas 99.2 99.2 96.4 95.3 95.5 97.5 48.0 17.0 3-2 Fulton 97.5 97.5 96.7 96.7 97.0 96.4 43.1 11.9 3-3 Clayton 95.6 95.2 94.5 93.9 93.9 94.2 57.7 16.7 3-4 East Metro (Lawrenceville 96.3 96.0 95.5 94.1 93.8 93.2 39.4 15.6 3-5 DeKalb 95.7 96.5 96.0 92.2 91.7 90.9 52.7 16.8 4-0 LaGrange 98.1 97.8 96.5 96.5 96.8 96.8 37.1 12.4 5-1 South Central (Dublin) 99.0 99.0 98.4 98.4 98.0 98.7 34.5 12.2 5-2 North Central (Macon) 98.5 97.9 97.9 96.9 96.6 97.4 42.8 16.8 6-0 East Central (Augusta) 98.8 98.8 97.6 98.8 98.8 98.2 49.1 14.0 7-0 West Central (Columbus) 94.7 94.3 94.3 94.0 93.7 93.7 39.0 12.9 8-1 South (Valdosta) 98.8 98.6 98.0 98.6 98.6 96.0 43.2 18.4 8-2 Southwest (Albany) 100.0 100.0 99.4 99.7 100.0 100.0 55.1 17.3 9-1 Coastal (Savannah) 97.7 97.7 95.1 95.9 95.3 95.3 43.6 14.5 9-2 Southeast (Waycross) 98.6 99.2 98.3 97.5 98.0 97.7 44.5 14.6 10-0 Northeast (Athens) 98.4 98.1 95.7 96.8 96.2 96.8 39.5 14.1 Georgia 97.7 97.6 96.5 96.1 90.6 96.0 43.8 14.5 v Additional Resources For more information about the Georgia Department of Public Health Immunization Program, please visit the following website: http://dph.georgia.gov/immunization-section For past Georgia Immunization Study Final Reports, please visit the following website: http://dph.georgia.gov/immunization-publications For more information about the Georgia Department of Public Health Acute Disease Epidemiology Unit, please visit the following website: http://dph.georgia.gov/acute-disease-epidemiology For more information about the Centers for Disease Control and Prevention's (CDC) National Immunization Survey (NIS), please visit the following website: http://www.cdc.gov/nchs/nis.htm To access current vaccine schedules, vaccine information sheets and other immunization materials, please visit the Immunization Action Coalition website: http://www.immunize.org For ques ons rela ng to this document, please email the author at Fabio.Machado@dph.ga.gov vi vii viii