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School Immunization Requirements: Part 3 August, 2012. Implementing WA New State Exemption Requirements - Training for Schools and Child Cares/Preschools August XX, 2011. Objectives. For each required vaccine: Describe detailed rules and exceptions to the rules

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slide1

School Immunization Requirements: Part 3

August, 2012

Implementing WA New State Exemption Requirements -

Training for Schools and Child Cares/Preschools

August XX, 2011

objectives
Objectives

For each required vaccine:

  • Describe detailed rules and exceptions to the rules
  • Show how the WA State Immunization Information System can help determine valid doses
required school immunizations
Required School Immunizations
  • Hep B
  • DTaP
  • Tdap
  • IPV
  • MMR
  • Varicella
slide5

Hepatitis B Example

Red X shows Dose 3 is invalid

Forecast shows Dose 3 should be repeated and is now past due

dtap rules
DTaP Rules
  • DTaP given to students 7-10 years of age counts for the Tdap dose
  • Catch-up schedule for >7 years of age without any DTaP doses:
    • One dose of Tdap followed by 2 doses of Td (>4 weeks between doses 1 & 2, and >6 months between doses 2 & 3)
slide7

DTaP Example

Note red X because Dose 5 given too early

Dose 5 due now according to vaccination forecast

tdap and td rules
Tdap (and Td) Rules
  • No need to wait 5 years between DTaP/Td and Tdap
  • Students 7-10 years of age not fully vaccinated with DTaP required to get dose of Tdap
    • Off-label use of Tdap vaccine, but providers follow ACIP recommendations as best medical practice
slide9

Tdap Example 1

Way to go! Rebekah is complete with 5 doses of DTaP

Rebekah also got Tdap at age 8

Rebekah is up to date until 2018

slide11

Tdap Example 2

Td is past due

Tdap given to kids 7 and older are given as a catch-up dose

what to do if
What to do if:
  • If Tdap given for dose 1, 2, or 3 instead of DTaPRepeat with DTaP
  • If Tdap given for dose 4 or dose 5 instead of DTaPCounts for 6th grade
  • If Tdap given between 7-10 years

of age Counts for 6th grade

slide13
IPV
  • For K-1st grade only for 2012-2013:
    • Dose 4, if given on or after Aug 7, 2009, must have been given >4 years of age and separated from dose 3 by >6 months
  • Students with 4 valid doses before Aug 7, 2009 don’t need more doses
    • >4 week interval must separate IPV doses
    • Dose 4 must be given >18 weeks of age
slide14

IPV Example 1

IPV Dose 4 marked with a red X

IPV dose 4 needs to be repeated and is due now

slide15

IPV Example 2

IPV Dose 4 valid at age 24 months since given before 8/7/09

mmr rules
MMR Rules
  • Dose 1 given <12 months of age must be repeated (4 day grace applies)
  • 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
  • 4 day grace DOES NOT apply between live vaccines not given at the same time
slide17

MMR Example

Note red X. Varicella not given same day as MMR

varicella rules
Varicella Rules
  • If not given on same day, minimum interval between varicella and MMR is >28 days
  • 4 day grace DOES NOT apply between live vaccines not given at the same time
  • Minimum interval between dose 1 & 2 = 3 months.
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 DOES NOT apply between two different live vaccines not given at the same visit
  • Grace period DOES apply between the same live vaccines
slide20

4 Day Grace Example 1

Hep B Dose 3 given 4 days earlier than 6 months of age

Dose 3 is valid and doesn’t need to be repeated

slide21

4 Day Grace Example 2

Varicella Dose 2 given 5 days before it was due

resources
Resources
  • Individual Vaccine Requirements Summary: www.doh.wa.gov/Portals/1/Documents/Pubs/348-284-IndividualVaccineRequirements.pdf
  • Vaccines Required for School Attendance chart: www.doh.wa.gov/CommunityandEnvironment/Schools/Immunization/VaccineRequirements.aspx
  • Centers for Disease Control and Prevention “Pink Book” http://www.cdc.gov/vaccines/pubs/pinkbook/index.html
  • Immunization Manual for Schools and Child Cares: www.doh.wa.gov/CommunityandEnvironment/Schools/Immunization/SchoolManual.aspx
slide23

Thank you for watching this training!

Send clinical questions to: [email protected]

Please complete an evaluation at:

School Immunization Requirements Evaluation

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