Implementing WA New State Exemption Requirements -

1. School Immunization Requirements: For Private Schools Department of Health Office of Immunization and Child Profile April 2014 Implementing WA New State Exemption Requirements - Training for Schools and Child Cares/Preschools August XX, 2011

2. Topics to be Covered • What are the vaccine requirements in Washington State? • How do I review a CIS? • Complete, conditional, out of compliance, exempt status–what do they mean?

3. Why Do We Need Immunizations? • We don’t see diseasesonce common. Vaccines successfully prevent disease. • However, diseases and outbreaks still occur. • Children are at increased risk in the school setting.

4. Immunization Requirementswww.doh.wa.gov/CommunityandEnvironment/Schools/Immunization/Regulations.aspx • Students attending school and child care/preschool 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 Status (or Certificate of Exemption).

6. Washington State Immunization Information System • Public and private schools are eligible to use the system if they: • Serve any grades between K and 12 • Have a school nurse on staff or under contract to track and report immunizations. • The school nurse may be a volunteer. • An information sharing agreement needs to be in place. • Email sherri.spezze@doh.wa.gov.

8. Changes to the Exemption Lawwww.doh.wa.gov/CommunityandEnvironment/Schools/Immunization/Exemptions.aspx • Sample Certificates of Exemption • Training video • Frequently Asked Questions

9. Immunization Requirements • Responsibilities of schools: • Check each student to determine if they’re fully immunized, conditional, out of compliance, or exempt. • Follow-up with students not fully immunized. • Maintain a CIS or COE. • Keep list of students not fully immunized, exempt, or in conditional status in case of an outbreak.

10. Immunization Status • Complete/fully immunized • Conditional: • Temporary status to allow a child to get fully immunized • Out of compliance • Exempt

11. Conditional Status • Students not fully immunized may attend school under a conditional status if making satisfactory progress: • 30 days from the first day of attendance to get vaccinated or get needed paperwork. • If getting a series of vaccines, in conditional status 30 days after the next scheduled dose in the series. • Sample letters: • www.doh.wa.gov/Portals/1/Documents/Pubs/348-277-ConditionImmunStatus.doc • www.doh.wa.gov/Portals/1/Documents/Pubs/348-278-ExclusionLetterPrivate.doc

12. Vaccines Required for School Attendance • DTaP • Tdap • Hepatitis B • IPV • MMR • Varicella

13. Recommended, but not Required • Flu • Hepatitis A • HPV • Meningococcal

14. www.doh.wa.gov/CommunityandEnvironment/Schools/Immunization/VaccineRequirements.aspxwww.doh.wa.gov/CommunityandEnvironment/Schools/Immunization/VaccineRequirements.aspx

16. www.doh.wa.gov/CommunityandEnvironment/Schools/Immunization/VaccineRequirements.aspxwww.doh.wa.gov/CommunityandEnvironment/Schools/Immunization/VaccineRequirements.aspx

18. DTaP and Tdap Vaccine Requirement

19. Tdap Vaccine • No need to wait five years to get Tdap after getting DTaP or Td. • Students 7-10 years of age not fully vaccinated with DTaP required to get dose of Tdap.

21. Hepatitis B Vaccine Requirement

23. IPV Details • IPV used routinely in U.S. • Children coming from a foreign country may get OPV. • Any combination of IPV or OPV is valid.

24. IPV Requirement

26. MMR Vaccine Requirement

27. MMR Vaccine Details • Dose 1 given <12 months of age must be repeated. • 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.

29. Varicella Vaccine Requirement

30. Varicella Vaccine Details • If not given on same day, minimum interval between varicella and MMR is >28 days.

31. 4 Day Grace Period • Vaccines given 4 days or less before the minimum interval or age are valid. • Applies to all vaccines. • Example: MMR vaccine given 3 days before 12 months of age is valid.

32. Reporting Requirement • All public and private schools are required to report the immunization status of their students (RCW 28A.210.110). • After you review the CIS and determine the status of each student, use the IIS to report OR • Email export from student information system to oicpschools@doh.wa.gov (NO paper forms unless no computer access).

33. Reporting • For more instructions to report in the IIS, click on the link below: www.doh.wa.gov/CommunityandEnvironment/Schools/Immunization/SchoolStatusReporting.aspx

34. Resources • Main school and child care web page: www.doh.wa.gov/CommunityandEnvironment/Schools/Immunization.aspx • Vaccines Required for School Attendance chart: www.doh.wa.gov/CommunityandEnvironment/Schools/Immunization/VaccineRequirements.aspx • Vaccines Required for Child Care/Preschool Attendance chart: www.doh.wa.gov/CommunityandEnvironment/Schools/Immunization/VaccineRequirements.aspx

35. Resources • Individual Vaccine Requirements Summary: 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 • Kindergarten CIS overlay (print out on transparency paper): www.doh.wa.gov/Portals/1/Documents/Pubs/348-275_CertificateImmunizationStatusKinderOverlay.pdf • For clinical questions, please send an email to immunenurses@doh.wa.gov

36. Implementing WA New State Exemption Requirements - Training for Schools and Child Cares/Preschools August XX, 2011