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Francisco Averhoff, MD, MPH, Leslie Linton, JD, MPH, K. Michael Peddecord, DrPH, Christine Edwards, MPH, Wendy Wang, MPH and Daniel Fishbein, MD

Francisco Averhoff and Daniel Fishbein are with the National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Ga. Leslie Linton, K. Michael Peddecord, and Christine Edwards are with the Graduate School of Public Health, San Diego State University, San Diego, Calif. Leslie Linton is also with, and Wendy Wang is with, the Health and Human Services Agency, County of San Diego, San Diego, Calif.

Correspondence: Requests for reprints should be sent to Francisco Averhoff, MD, MPH, National Immunization Program, MS E-61, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333 (e-mail: fma0{at}cdc.gov).

Objectives. This study assessed the effectiveness of a middle school vaccination requirement for raising second-dose measles, mumps, and rubella vaccine and hepatitis B vaccine coverage among adolescents.

Methods. Random-digit-dialed telephone surveys were conducted before (1998) and after (1999) the implementation of a vaccination requirement for entry into the seventh grade in San Diego, Calif.

Results. Vaccination coverage was higher among children subject to the vaccination requirement (seventh-grade students; 60%) than among fifth- and sixth-grade students 1 year before the requirement (13%, P < .001), and 8th- through 12th-grade students not subject to the requirement (27%, P < .0001).

Conclusions. Middle school–entry vaccination requirements can rapidly and substantially raise vaccination coverage among students subject to the law.

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