Welcome to the Immunization Requirements Webinar for Clinic Staff! For technical difficulties, call , press 1. During this webinar, everyone will be placed on mute. Please type in any questions in the question box. We will answer questions at the end of the presentation. The webinar will be recorded. The presentation and recording will be available after today’s webinar here: ncement.pdf ncement.pdf

Child Care and School Immunization Requirements Department of Health Office of Immunization and Child Profile April 28, 2016

Why do we need immunizations and immunization laws? Which vaccines are required for child care and school? What are some of the common rules and exceptions to the rules? What is the change to the varicella requirement for school? Exemptions Washington State Department of Health Topics to be covered

We don’t see diseases once common. Vaccines successfully prevent disease However, diseases and outbreaks still occur Children are at increased risk in the school and child care setting School and child care immunization requirements effective in reducing disease Washington State Department of Health Why do we need immunizations and an immunization law?

Students attending school and child care/preschool must comply with immunization requirements to protect against diseases. 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).Certificate of Immunization Status Certificate of Exemption Washington State Department of Health What are the immunization laws?

Washington State Department of Health

Recommended vs required Recommended Hepatitis B DTaP Tdap IPV MMR Varicella PCV Hib Hepatitis A HPV Meningococcal Flu Rotavirus Required Hepatitis B DTaP Tdap IPV MMR Varicella PCV (for child care) Hib (for child care)

Vaccine Requirements

ents/Pubs/ IndividualVaccineReqs pdf IVRS: Individual Vaccine Requirements Summary

Washington State Department of Health

Vaccine Requirements – Hep B K-9 th grade Dose 3 must be given min age of 24 weeks 10 th -12 th grade Dose 3 must be given min age of 4 months

Case Example – Hep B Washington State Department of Health Does this patient need more hep B doses?

Washington State Department of Health

Vaccine Requirements – DTaP Washington State Department of Health For children up to 7 years of age If dose 4 was given on or after the 4 th birthday, dose 5 is NOT required Patients 7-10 years of age not fully immunized with DTaP should get one Tdap followed by additional doses of Td if needed DTaP given after age 7 counts for the Tdap dose; no Tdap required at years of age

Vaccine Requirements – Tdap Washington State Department of Health For children 7 years of age and older Students without any DTaP should get one Tdap followed by 2 Td. Then Td is recommended every 10 years If incomplete series of DTaP, Tdap should be given Tdap given between 7-10 years of age meet the 6 th grade requirement; no Tdap required at 11 years of age

Case Example – DTaP and Tdap Washington State Department of Health Td was given. What additional vaccines, if any, does this patient need?

Washington State Department of Health

Vaccine Requirements – IPV Washington State Department of Health Dose 4, if given on or after Aug 7, 2009Must be given >4 years of ageSeparated from dose 3 by >6 months K-5 th Grade

Case Example – IPV Washington State Department of Health Does this patient need more IPV?

Washington State Department of Health

Vaccine Requirements – MMR Washington State Department of Health 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 If MMR and varicella not given on the same day, the second vaccine given is not valid and should be repeated

Case Example - MMR Washington State Department of Health Does this patient need any vaccines?

Washington State Department of Health

Vaccine Requirements – Varicella Washington State Department of Health 2 doses required for K-12 th grade in the fallDose 1 must be given minimum of 1 year of age 3 months is recommended between dose 1 and 2; however, if at least 4 weeks separates doses, this is valid

Immunization Requirements - Varicella Option 1 History of varicella disease Option 2 Blood test showing titer for immunity Option 3 Exemption

Chickenpox Verification on the CIS

Varicella Flyer

Exemptions

Washington State Department of Health

 Main school and child care web page:  Vaccines Required for School chart: SchoolChart pdf SchoolChart pdf  Vaccines Required for Child Care/Preschool chart: ChildCareChart pdf ChildCareChart pdf  Immunization web page:  Immunization Action Coalition: Resources Washington State Department of Health

 Individual Vaccine Requirements Summary: IndividualVaccineReqs pdf IndividualVaccineReqs pdf  CDC job aids for DTaP/Tdap/Td, Hib, and PCV: adolescent.html adolescent.html  For clinical questions, contact your local health department or send an to DOH nurses at  For school requirement questions, send an to Resources Washington State Department of Health

Please take a few minutes to complete an evaluation after the webinar. A certificate of completion is available after you complete the evaluation: Announcement.pdf Announcement.pdf