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Preschool/Child Care Immunization Requirements Trang Kuss, RN, MN, MPH Department of Health Office of Immunization and Child Profile January 18, 2013. Implementing WA New State Exemption Requirements - Training for Schools and Child Cares/Preschools August XX, 2011. Contact Information.

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slide1

Preschool/Child Care Immunization Requirements

Trang Kuss, RN, MN, MPH

Department of Health Office of Immunization and Child Profile

January 18, 2013

Implementing WA New State Exemption Requirements -

Training for Schools and Child Cares/Preschools

August XX, 2011

contact information
Contact Information

Dept. of Health Office of Immunization and Child Profile

Trang Kuss, RN, MN, MPH

School and Child Care Coordinator

trang.kuss@doh.wa.gov; 360-236-3760

topics to be covered
Topics to be Covered
  • What are the child care and preschool immunization requirements in Washington State?
  • Complete, Conditional, Out of Compliance: What do they mean?
  • How can I use the Washington State Immunization Information System to help determine if a child is complete? 
immunization requirements
Immunization Requirements
  • Children attending licensed child care must comply with immunization requirements to protect the health of the public and individuals
  • Children must be vaccinated against certain vaccine-preventable diseases at ages and intervals according to the national immunization schedule
  • Parent must submit completed Certificate of Immunization (or Certificate of Exemption)
  • www.doh.wa.gov/CommunityandEnvironment/Schools/Immunization/Regulations.aspx
examples of those not required to comply
Examples of those not required to comply
  • Facilities not required to have a DEL license
  • Coop preschool
  • Birth to Three Program
required immunizations for preschool or child care attendance
Required Immunizations for Preschool or Child Care Attendance
  • DTaP
  • Hepatitis B
  • Hib
  • IPV
  • MMR
  • PCV
  • Varicella
recommended but not required
Recommended, but Not Required
  • Hepatitis A
  • Rotavirus
  • Flu
immunization status
Immunization Status
  • Complete/Fully Immunized
  • Conditional
    • Temporary status to allow child to get fully immunized
  • Out of Compliance
  • Exempt
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www.doh.wa.gov/Portals/1/Documents/Pubs/348-051-ChildcareChart2013-2014.pdfwww.doh.wa.gov/Portals/1/Documents/Pubs/348-051-ChildcareChart2013-2014.pdf

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www.doh.wa.gov/Portals/1/Documents/Pubs/348-284-IndividualVaccineRequirements.pdfwww.doh.wa.gov/Portals/1/Documents/Pubs/348-284-IndividualVaccineRequirements.pdf

dtap details
DTaP Details
  • Routine schedule: 2, 4, 6, 15-18 months, and booster dose at 4-6 years
  • 6 months interval recommended between dose 3 and 4, but 4 months or more is acceptable
  • DTaP given to children less than 7 years of age; Td and Tdap given to children 7 years of age or older
what to do if
What to do if:
  • If Tdap given for dose 1, 2, or 3 instead of DTaP Repeat with DTaP
  • If Tdap given for dose 4 or dose 5 instead of DTaP Acceptable
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Note red X because Dose 4 given too early

Dose 4 past due

DTaP Example

hepatitis b details
Hepatitis B Details
  • Routine schedule: birth, 1 month, and 6 months
  • Pay attention to min age for dose 3 and minimum intervals between doses
hib details
Hib Details
  • Routine schedule: 2, 4, 6, and 12-15 months
  • Not recommended for children 5 years or older
  • The recommended immunization schedule for Hib vaccines:
hib details1
Hib Details
  • Unvaccinated children 7 months of age and older may not require full series. Total number of doses depends on child’s current age.
  • Final booster dose should be given at 12 months or older and a min of 8 weeks after previous dose.
hib details2
Hib Details
  • One total dose for unvaccinated child 15-59 months of age.
  • Two doses total if Dose 1 given >12 months and Dose 2 given >15 months of age.
  • Three doses total if 2 doses given before 12 months and Dose 3 given >12 months.
ipv details
IPV Details
  • Routine schedule: 2, 4, 6-18 months, and booster at 4-6 years.
  • IPV used routinely in US for polio vaccination, but students coming from a foreign country may get OPV
  • Any combination of IPV or OPV valid
mmr details
MMR Details
  • Routine schedule: 12-15 months and 4-6 years
  • Dose 1 given <12 months of age must be repeated (4 day grace applies)
  • MMR or MMRV can be used
  • If not given on same day, minimum interval between MMR and varicella is >28 days
    • The second vaccine given is not valid and should be repeated
pneumococcal conjugate pcv requirement
Pneumococcal Conjugate (PCV) Requirement

*Some children may get 5 total doses. A single supplemental dose of PCV13 is recommended, but not required, for all children aged 14–59 months who got 4 doses of PCV7.

pcv details
PCV Details
  • Routine schedule: 2, 4, 6, and 12-15 months
  • A single supplemental dose of PCV13 is recommended, but not required, for all children aged 14–59 months who got 4 doses of PCV7
    • PCV13 replaced PCV7 in 2010
pcv details1
PCV Details
  • 1 total dose only on or after 24 months unless high risk.
  • Two doses total if both received between 12-24 months, given >8 weeks apart.
  • Three doses total if 2 doses given <12 months and Dose 3 given at >12 months.
varicella details
Varicella Details
  • Routine schedule: 12-15 months and 4-6 years of age
  • If not given on same day, minimum interval between varicella and MMR is >28 days
4 day grace period
4 Day Grace Period
  • Vaccines given <4 days before the minimum interval or age are valid
  • Applies to all inactivated vaccines before minimum intervals OR ages
  • Grace period applies if live vaccines given at the same visit
resources
Resources
  • Individual Vaccine Requirements Summary: www.doh.wa.gov/Portals/1/Documents/Pubs/348-284-IndividualVaccineRequirements.pdf
  • Vaccines Required for Preschool/Child Care Attendance chart: www.doh.wa.gov/CommunityandEnvironment/Schools/Immunization/VaccineRequirements.aspx
  • Immunization Manual for Schools and Child Cares: www.doh.wa.gov/CommunityandEnvironment/Schools/Immunization/SchoolManual.aspx
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Thank you for all you do!

Implementing WA New State Exemption Requirements -

Training for Schools and Child Cares/Preschools

August XX, 2011

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