1. 2017 Student Vaccine Requirements in Nevada and the New HPV Vaccine Schedule
Pamela Forest MD
Provider Quality Assurance Manager
Nevada State Immunization Program or

2. Objectives
Name the six vaccine series required for Kindergarten enrollment in NV
Name the seven vaccine series required for 7th grade enrollment in NV
Name the vaccines required for university enrollment in NV
Name the acceptable vaccine exemptions in Nevada and how to document them
Discuss the recent ACIP vaccine schedule change for the HPV vaccine

3. Public and Private School Vaccine Requirements
Public Schools – NRS and NAC
Private Schools – NRS and NAC

4. NRS and
Unless excused because of religious belief or medical condition …,a child may not be enrolled in a public school within this State unless the child’s parents or guardian submit … a certificate stating that the child has been immunized and has received proper boosters for that immunization or is complying with the schedules established by regulation pursuant to NRS  for the following diseases:

5. NRS 392.435 and 394.192 (a) Diphtheria; (b) Tetanus;
      (c) Pertussis if the child is under 6 years of age;
      (d) Poliomyelitis;
      (e) Rubella;
      (f) Rubeola; and
      (g) Such other diseases as the local board of health or the State Board of Health may determine

6. NAC and NAC
 1.  The State Board of Health hereby declares the diseases of:
     (a) Mumps;
     (b) Hepatitis A;
     (c) Hepatitis B;
     (d) Varicella; and
     (e) Bordetella pertussis if a child is 6 years of age or older; and
(f) Neisseria meningitidis,
 to be communicable diseases.

7. Kindergarten Required Vaccines
DTaP
Polio
MMR
Varicella
Hepatitis A
Hepatitis B

8. Advisory Committee on Immunization Practices

9. DTaP Schedule

10. Polio Vaccine Schedule

11. MMR Vaccine Schedule

12. Varicella Vaccine

13. Hepatitis B Vaccine

14. Hepatitis A Vaccine

15. Can this child be enrolled in school?
Birth Date
Vaccine
Dose 1
Dose 2
Dose 3
Dose 4
10/16/2010
DTaP,DTP
12/15/2010
3/18/2011
8/14/2014
2/25/2015
Polio
MMR
11/4/2011
8/25/2015
Hep B
11/16/2010
Varicella
Hep A

16. Can this child be enrolled in kindergarten?
Birthdate
Vaccine
Dose 1
Dose 2
Dose 3
Dose 4
3/21/2011
DTaP,DTP
5/17/2011
8/1/2016
9/16/2016
Polio
MMR
7/25/2012
Hep B
Varicella
11/1/2016
Hep A

17. Can this child be enrolled in kindergarten?
Birth Date
Vaccine
Dose 1
Dose 2
Dose 3
Dose 4
Dose 5
9/20/2010
DTaP,DTP
12/3/2010
4/1/2011
8/30/2011
2/24/2012
6/15/2015
Polio
MMR
11/3/2011
Hep B
2/1/2011
Varicella
Hep A
8/6/2012

18. Can this child be enrolled in kindergarten?
Birth Date
Vaccine
Dose 1
Dose 2
Dose 3
Dose 4
Dose 5
9/20/2010
DTaP,DTP
12/3/2010
4/1/2011
8/30/2011
2/24/2012
6/15/2015
Polio
MMR
9/10/2011
Hep B
3/20/2011
Varicella
Hep A
11/3/2011
8/6/2012

19. Conditional Enrollment
Vaccination series is not complete but booster doses cannot be administered because the minimum interval has not passed.
Example:
Hepatitis A dose #1 administered 6/1/17. Dose #2 cannot be administered until 12/1/17.
IF ALL REQUIRED VACCINE DOSES CAN BE PROVIDED IN ONE VISIT, THEN CONDITIONAL ENROLLMENT DOES NOT APPLY!!!

20. 7TH Grade Vaccine Requirements
All vaccines required for kindergarten enrollment
Tdap – Adacel or Boostrix
MCV4 – Menactra or Menveo
- On or after the 10th birthday
Varicella – 2 dose requirement for those students who entered the school district 2011 – 2012 school year and all subsequent years.

21. MCV 4 Vaccine

22. Can this 7th grader enroll in school?
Birth date
Vaccine
Dose #1
Dose #2
Dose #3
Dose #4
5/16/2004
DTaP-DTP
9/21/2007
2/5/2008
8/16/2008
4/23/2010
Polio
MMR
HepB
Varicella
2/11/2013
HepA
Tdap
6/13/2016
MCV4

23. Can this 7th grader enroll in school?
Birth date
Vaccine
Dose #1
Dose #2
Dose #3
Dose #4
Dose #5
Dose #6
6/16/2004
DTaP-DTP
8/19/2004
10/21/2004
12/16/2004
1/17/2005
7/14/2009
8/11/2014
Polio
6/30/2005
MMR
HepB
7/16/2004
3/17/2005
Varicella
HepA
7/19/2007
4/24/2008
MCV4

24. Can this 7th grader enroll in school?
Birth date
Vaccine
Dose #1
Dose #2
Dose #3
Dose #4
1/13/2004
DTaP-DTP
5/14/2010
6/14/2010
7/14/2010
Polio
12/14/2010
MMR
8/14/2010
HepB
11/14/2010
Varicella
HepA
Tdap
1/14/2011
MCV4
5/20/2015

25. University Vaccine Requirements
NAC 441A.755 Except as otherwise provided in subsection 10 or unless excused because of religious belief or medical condition, a person shall not attend a university until he or she submits to the university proof of immunity to tetanus, diphtheria, measles, mumps, rubella and any other disease specified by the State Board of Health. The Division shall establish the immunization schedule required for admission of the student.

26. University Vaccine Requirements
Except as otherwise provided in subsection 10 or unless excused because of religious belief or medical condition, a person who: (a) Is less than 23 years of age; and (b) Is enrolled as a freshman; shall not attend a university until he or she submits to the university proof of immunity to Neisseria meningitidis.

27. University Vaccine Requirements
Tdap or Td
MMR
MVC4 - Menactra or Menveo

28. Medical Exemptions
If the medical condition of a child will not permit the child to be immunized to the extent required …, a written statement of this fact signed by a licensed physician and presented to the governing body by the parents or guardian of such child shall exempt such child from all or part of the provisions ….., for enrollment purposes.

29. Religious Exemptions
A private school shall not refuse to enroll a child as a pupil because such child has not been immunized pursuant to NRS  if the parents or guardian of such child have submitted to the governing body a written statement indicating that their religious belief prohibits immunization of such child or ward.
A public school shall not refuse to enroll a child as a pupil because the child has not been immunized pursuant to NRS  if the parents or guardian of the child has submitted to the board of trustees of the school district or the governing body of a charter school in which the child has been accepted for enrollment a written statement indicating that their religious belief prohibits immunization of such child or ward.

30. Religious Exemption - example

31. New HPV Vaccine Administration Schedule
October 2016 – the ACIP voted to recommend a 2 dose vaccination schedule for HPV vaccine for those patients who initiate the HPV vaccine series prior to the 15th birthday.
Two doses of HPV vaccine are administered 6 months apart
For patients who started the vaccine series prior to the 15th birthday and have 2 doses of HPV vaccine at least 5 months apart, they have completed the series!
During 11 and 12 year olds’ wellness visit – recommend “the same way, the same day” for Tdap, MCV4 and HPV vaccines.

32. New HPV Vaccine Administration Schedule
HPV infection is very common
31,000 men and women in USA are diagnosed every year with cancer caused by HPV infection
Preventing HPV infection prevents cancer
HPV vaccine is safe
HPV vaccine is effective
Protect your patients against HPV infection

33. Nevada WebIZ School Officials may have “View Only” access
WebIZ Recommender is a great tool for school staff to use
WebIZ Help Desk –

34. Referring students for vaccination
Insured students – private insurance and Medicaid
Their health care provider
Pharmacy
Local public health clinic
Uninsured students
Their health care provider who is enrolled in the VFC program

35. Contact information
Pam Forest
Nevada State Immunization Program
Thank you for your interest in school required vaccines!