Pediatrics
November 2013, VOLUME 132 / ISSUE 5
http://pediatrics.aappublications.org/current.shtml
[Reviewed earlier]

Online
Case Report
Vaccine-Preventable Disease Among Homeschooled Children: Two Cases of Tetanus in Oklahoma
Matthew G. Johnson, MDa, Kristy K. Bradley, DVMb, Susan Mendus, MPHc, Laurence Burnsed, MPHd, Rachel Clinton, MSd, and Tejpratap Tiwari, MDe

Abstract
Homeschooled children represent an increasing proportion of school-aged children in the United States. Immunization rates among homeschooled children are largely unknown because they are usually not subject to state-based school-entry vaccination requirements. Geographic foci of underimmunized children can increase the risk for outbreaks of vaccine-preventable diseases. In 2012, 2 cases of tetanus were reported in Oklahoma; both cases involved homeschooled children without documentation of diphtheria-tetanus-acellular pertussis vaccination. We describe the characteristics of both patients and outline innovative outreach measures with the potential to increase vaccination access and coverage among homeschooled children.