School Immunization Update FAMIS Conference, Tallahassee, FL June 12, 2012 FAMIS Conference, Tallahassee, FL June 12, 2012

2 Presenters  Dianne Mennitt, School Nurse Consultant, USF Student Support Services Project, Bureau of Exceptional Education and Student Services  Beth Cox, Training Consultant, Florida Department of Health, Bureau of Immunization, Florida SHOTS  Dianne Mennitt, School Nurse Consultant, USF Student Support Services Project, Bureau of Exceptional Education and Student Services  Beth Cox, Training Consultant, Florida Department of Health, Bureau of Immunization, Florida SHOTS 2

3 Objectives  Review immunization data for school year  Understand immunization requirements for school year  Discuss Florida SHOTS updates  Review immunization data for school year  Understand immunization requirements for school year  Discuss Florida SHOTS updates 3

4 Legal Authority Legal Authority  Section , Florida Statutes  Required immunizations shall be available at no cost from the county health departments (CHD)  Each district school board and the governing authority of each private school shall …  Certification of immunization shall …  Section , Florida Statutes  Required immunizations shall be available at no cost from the county health departments (CHD)  Each district school board and the governing authority of each private school shall …  Certification of immunization shall … 4

5 Florida Administrative Code Florida Administrative Code  Rule 64D-3.046, F.A.C., Immunization Requirements: Public and Nonpublic Schools, Grades Preschool, Kindergarten Through 12, Adult Education Classes.  Annual statewide compliance reporting requirement for all students attending kindergarten and seventh grade in Florida  Florida SHOTS (State Health Online Tracking System) authorization for access (  Rule 64D-3.046, F.A.C., Immunization Requirements: Public and Nonpublic Schools, Grades Preschool, Kindergarten Through 12, Adult Education Classes.  Annual statewide compliance reporting requirement for all students attending kindergarten and seventh grade in Florida  Florida SHOTS (State Health Online Tracking System) authorization for access ( 5

6 Immunization Guidelines  Florida Schools, Child Care Facilities, and Family Day Care Homes (July 2011)  Available online at mmune/resources/announcements/inde x.html#schoolguide mmune/resources/announcements/inde x.html#schoolguide  Florida Schools, Child Care Facilities, and Family Day Care Homes (July 2011)  Available online at mmune/resources/announcements/inde x.html#schoolguide mmune/resources/announcements/inde x.html#schoolguide 6

7 Certificate of Immunization DH 680 Form 7

8 Electronic Certificate of Immunization DH 680 Form 8

9 Kindergarten & Seventh Grade Immunization Status Report,  une/resources/surveys/state-surveys.html une/resources/surveys/state-surveys.html  Validation Assessment  une/resources/surveys/state-surveys.html une/resources/surveys/state-surveys.html  Validation Assessment 9

Immunization Requirements: Kindergarten  Four or 5 doses of diphtheria, tetanus, and pertussis (DtaP) vaccine;  Three, four, or five doses of polio vaccine: If the fourth dose was administered prior to the 4 th birthday, a fifth dose is required for kindergarten entry  Two doses of measles, mumps, rubella (MMR) vaccine;  Three doses of hepatitis B vaccine; and  Two doses of varicella (chicken pox) vac cine  Four or 5 doses of diphtheria, tetanus, and pertussis (DtaP) vaccine;  Three, four, or five doses of polio vaccine: If the fourth dose was administered prior to the 4 th birthday, a fifth dose is required for kindergarten entry  Two doses of measles, mumps, rubella (MMR) vaccine;  Three doses of hepatitis B vaccine; and  Two doses of varicella (chicken pox) vac cine 10

Immunization Results: Kindergarten (Public Schools)  Statewide Data: 92% of kindergarteners had all required immunizations (DH 680: Part A, DOE Code 1).  Of Florida’s 67 counties, 33, or 49.3% achieved/exceeded the goal that 95% or greater have received all required immunizations upon kindergarten entry/attendance.  Statewide Data: 92% of kindergarteners had all required immunizations (DH 680: Part A, DOE Code 1).  Of Florida’s 67 counties, 33, or 49.3% achieved/exceeded the goal that 95% or greater have received all required immunizations upon kindergarten entry/attendance. 11

Immunization Exemptions: Kindergarten Statewide Data: Students with exemptions from immunizations accounted for 7.2% of the total kindergarten population:  9,758 Temporary Medical Exemptions, or 4.3%  724 Permanent Medical Exemptions, or 0.3%  2,771 Religious Exemptions, or 1.2%  3, day Exemptions, or 1.4% Statewide Data: Students with exemptions from immunizations accounted for 7.2% of the total kindergarten population:  9,758 Temporary Medical Exemptions, or 4.3%  724 Permanent Medical Exemptions, or 0.3%  2,771 Religious Exemptions, or 1.2%  3, day Exemptions, or 1.4% 12

Immunization Requirements: 7th Grade  Completion of the hepatitis B series;  Two doses of measles, mumps, rubella (preferably MMR) vaccine;  One dose of varicella (chicken pox) vaccine; and  One dose of tetanus, diphtheria, and pertussis (Tdap) vaccine  Completion of the hepatitis B series;  Two doses of measles, mumps, rubella (preferably MMR) vaccine;  One dose of varicella (chicken pox) vaccine; and  One dose of tetanus, diphtheria, and pertussis (Tdap) vaccine 13

Immunization Requirements: 7th Grade  Statewide Data: 95.4% of seventh grade students were reported complete for required immunizations (DH 680: Part A, DOE Code 8).  Of Florida’s 67 counties, 66, or 98.5%, achieved the goal that 90% or greater receive all required immunizations for 7 th grade entry/attendance.  Statewide Data: 95.4% of seventh grade students were reported complete for required immunizations (DH 680: Part A, DOE Code 8).  Of Florida’s 67 counties, 66, or 98.5%, achieved the goal that 90% or greater receive all required immunizations for 7 th grade entry/attendance. 14

Immunization Exemptions: 7th Grade Statewide Data: Students with exemptions from immunizations accounted for 4% of the total 7 th grade population:  5,837 Temporary Medical Exemptions, or 2.6%  622 Permanent Medical Exemptions, or 0.3%  1,738 Religious Exemptions, or 0.8%  day Exemptions, or 0.3% Statewide Data: Students with exemptions from immunizations accounted for 4% of the total 7 th grade population:  5,837 Temporary Medical Exemptions, or 2.6%  622 Permanent Medical Exemptions, or 0.3%  1,738 Religious Exemptions, or 0.8%  day Exemptions, or 0.3% 15

16 Temporary Medical Exemption  For K – 12 students with incomplete immunizations (DH 680: Part B, DOE Code 2)  Temporary Medical Exemption (TME) requires a valid Expiration Date  For K – 12 students with incomplete immunizations (DH 680: Part B, DOE Code 2)  Temporary Medical Exemption (TME) requires a valid Expiration Date 16

17 Permanent Medical Exemption  DH 680: Part C, DOE Code 3  For medically contraindicated immunizations  List each vaccine with coded valid clinical reason for exemption  DH 680: Part C, DOE Code 3  For medically contraindicated immunizations  List each vaccine with coded valid clinical reason for exemption 17

Validation Assessment Results  Kindergarten: 96.7% of students were fully immunized, which is significantly higher than 92.6% reported during Survey 2 (Target: 95%)  Seventh Grade: 94.5% of students were fully immunized compared to 95.4% reported during Survey 2 (Target: 90%)  Concern: 12% of students in kindergarten and 8.2% of students in 7 th grade had improper or no documentation of immunizations.  Kindergarten: 96.7% of students were fully immunized, which is significantly higher than 92.6% reported during Survey 2 (Target: 95%)  Seventh Grade: 94.5% of students were fully immunized compared to 95.4% reported during Survey 2 (Target: 90%)  Concern: 12% of students in kindergarten and 8.2% of students in 7 th grade had improper or no documentation of immunizations. 18

IMMUNIZATION GUIDELINES SCHOOL YEAR 2012/2013 Vaccine ↓ Childcare / Family Daycare Preschool / Pre-K Entry Kindergarten through 12th DTap√√√ TdapNo requirement 7 th through 10 th IPV√√√ MMR1 – 2 doses 2 doses Varicella√1 – 2 doses 2 doses Kg – 4 1 dose Hepatitis BNo requirement√√ Hib√√No requirement PCV√No requirement

Seventh Grade Requirement Students entering, attending, or transferring to 7 th grade in Florida schools:  One tetanus-diphtheria-pertussis (Tdap)  DH 680: Part A, DOE Code 8: Immunizations are complete for 7th grade Students entering, attending, or transferring to 7 th grade in Florida schools:  One tetanus-diphtheria-pertussis (Tdap)  DH 680: Part A, DOE Code 8: Immunizations are complete for 7th grade 20

21 Immunization Flyers available at s/flyers.html s/flyers.html 21

22 What Is New In FLORIDA SHOTS!

23 Updates to Immunization Forms in Florida SHOTS Parents may need different forms for different children to meet Florida school immunization requirements. Changes were made to Florida SHOTS in how providers can create and produce some of these forms. These are the:  DH 681 Religious Exemption.  DH 680 Part B Temporary Medical Exemption (TME). Parents may need different forms for different children to meet Florida school immunization requirements. Changes were made to Florida SHOTS in how providers can create and produce some of these forms. These are the:  DH 681 Religious Exemption.  DH 680 Part B Temporary Medical Exemption (TME).

24 Religious Exemptions in Florida SHOTS  Religious Exemptions DH 681can now be e- signed and created in Florida SHOTS.  Only available at Florida County Health Departments  E-signed only by the CHD Administrator or that individual’s designee who uses Florida SHOTS.  A DH 681 can be created by a CHD individual that uses Florida SHOTS and has been determined an appropriate creator by that county.  Schools that have Florida SHOTS accounts can view and print an e-signed DH 681 that is in the system.  Religious Exemptions DH 681can now be e- signed and created in Florida SHOTS.  Only available at Florida County Health Departments  E-signed only by the CHD Administrator or that individual’s designee who uses Florida SHOTS.  A DH 681 can be created by a CHD individual that uses Florida SHOTS and has been determined an appropriate creator by that county.  Schools that have Florida SHOTS accounts can view and print an e-signed DH 681 that is in the system.

Religious Exemption DH 681 E-Signed Form 25

Providing a DH 680 Part B  Florida SHOTS users are blocked from creating an electronic DH 680 Part B (TME) for children entering kindergarten with the following immunization status:  All series but DTaP are complete.  DTaP series is up-to-date and required doses for kindergarten entry are correct--there is only ONE dose left to receive--the seventh grade Tdap.  The recommended due date + 15 days for the one remaining Tdap dose is more than one year in the future. These individuals are up-to-date for the kindergarten vaccination requirements and should be provided a DH 680 Part A. 26

27 What the Florida SHOTS User Sees

When Can A DH 680 Part B (TME) Be Created? When children have an immunization status of incomplete BUT up-to-date for any series required for child care or school attendance.  In these cases, if Florida SHOTS calculates an expiration date based on the next recommended due date for the individual and that date is greater than 1 year in the future, the date field will be left blank for user entry. 28

How Can Schools Enroll in Florida SHOTS? Use the following link to complete the application process.  If you have any questions, contact the Florida SHOTS Training Consultant, Beth Cox at ext Use the following link to complete the application process.  If you have any questions, contact the Florida SHOTS Training Consultant, Beth Cox at ext

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