Clinicians who are counseling vaccine-hesitant parents about vaccination may want to consider adding immunization requirements of universities to their armamentarium, recommended Allison Noesekabel, a medical student at Wayne State University, Detroit, and Ada M. Fenick, MD , a pediatrician at Yale University, New Haven, Conn.

After identifying the 200 top-ranked U.S. universities in the US News and World Report 2014 National University rankings and sending a survey on university prematriculation immunization requirements (PIRs), the responding 124 universities spanned 44 states and the District of Columbia. Of those who responded, 94% had at least one PIR, 84% had at least two, 63% had at least three, and 16% required all the vaccines as required by any jurisdictional law for attendance at universities (hepatitis B, meningococcus, MMR, TdaP, and varicella). Only 6% of the universities had no immunization requirements.

Of the 121 universities with PIRs, 2% did not allow medical exemptions, 2% did not allow religious exemptions, and 46% did not allow philosophical belief exemptions. Medical exemptions were hardest to obtain for 24% of the 121 universities with PIRs, religious exemptions were the most difficult to obtain at 40%, and philosophical belief exemptions were hardest to obtain at 60% of the universities with PIRs. The most common administrative responses to lack of immunization were “the placement of a hold on registration of classes (89% of universities), additional registration fees (13%), and a hold on student housing (11%),” Ms. Noesekabel and Dr. Frenik reported.

Ms. Noesekabel and Dr. Frenik said they chose highly ranked universities for their study because these were likely to be desirable to vaccine-hesitant families, who tend to be highly educated and affluent. Therefore, the findings of this study may not be representative of all 4-year U.S. colleges, they said.

Read more at Vaccine ( 2017. doi: 10.1016/j.vaccine.2017.05.038 ).