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Adolescent/Adult Immunization Program: Update for School Nurses, January 2009 Vaccinate for Life. The Texas Department of State Health Services Immunization.

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Presentation on theme: "Adolescent/Adult Immunization Program: Update for School Nurses, January 2009 Vaccinate for Life. The Texas Department of State Health Services Immunization."— Presentation transcript:

1 Adolescent/Adult Immunization Program: Update for School Nurses, January 2009 Vaccinate for Life. The Texas Department of State Health Services Immunization Branch Adolescent/Adult Immunization Program www.ImmunizeTexas.com

2 Presentation Objectives Describe the Texas Adolescent/Adult Immunization (AAI) Program Describe the Texas Adolescent/Adult Immunization (AAI) Program Describe changes to the Recommended Immunization Schedules for Persons Aged 0 Through 18 Years – U.S Describe changes to the Recommended Immunization Schedules for Persons Aged 0 Through 18 Years – U.S Describe changes to the Recommended Adult Immunization Schedule – U.S Describe changes to the Recommended Adult Immunization Schedule – U.S Identify adolescent & adult vaccines, indications and use Identify adolescent & adult vaccines, indications and use Discuss HPV vaccine and communication challenges Discuss HPV vaccine and communication challenges Identify vaccine myths and describe vaccine facts Identify vaccine myths and describe vaccine facts Describe proposed school rules for 2009 and beyond Describe proposed school rules for 2009 and beyond

3 Presentation Overview Adolescent/Adult Immunization (AAI) Program Adolescent/Adult Immunization (AAI) Program Changes to CDC Recommendations for Adolescent and Adult Immunization Schedules Changes to CDC Recommendations for Adolescent and Adult Immunization Schedules Adolescent and Adult Vaccines Adolescent and Adult Vaccines Vaccines and Healthcare Workers Vaccines and Healthcare Workers HPV vaccine communication challenges HPV vaccine communication challenges Vaccine myths vs. facts Vaccine myths vs. facts School rules for 2009 and beyond School rules for 2009 and beyond

4 The AAI Program: Basic Goals Increase adolescent and adult vaccine coverage levels in the State of Texas. Increase adolescent and adult vaccine coverage levels in the State of Texas. Increase knowledge and awareness among providers and the public concerning age appropriate vaccination. Increase knowledge and awareness among providers and the public concerning age appropriate vaccination. Identify, facilitate, coordinate, and support the efforts of Texas-based adolescent and adult immunization stakeholders where possible. Identify, facilitate, coordinate, and support the efforts of Texas-based adolescent and adult immunization stakeholders where possible. Increase access to/availability of resources such as free vaccines made available through the Texas Vaccines for Children (TVFC), the Texas Adult Safety-Net Vaccine Program, and other services such as ImmTrac (immunization registry) for adolescent and adult populations. Increase access to/availability of resources such as free vaccines made available through the Texas Vaccines for Children (TVFC), the Texas Adult Safety-Net Vaccine Program, and other services such as ImmTrac (immunization registry) for adolescent and adult populations.

5 The AAI Program: Background Early Focus on Children Early Focus on Children New Vaccines and Recommendations New Vaccines and Recommendations Increased Funding Increased Funding Personnel Personnel

6 Vaccines Work! Vaccines are recognized as one of the top 10 most effective public health interventions Vaccines are recognized as one of the top 10 most effective public health interventions

7 10 Greatest Public Health Achievements Healthier moms and babies Safer workplace Safer and healthier foods Tobacco as a health hazard Decline in deaths from coronary heart disease Fluoridation of drinking water Motor-vehicle safetyFamily Planning Vaccinations & Control of Infectious Disease Vaccines Work!

8 Polio >21,000 cases of paralytic polio in the U.S. Polio >21,000 cases of paralytic polio in the U.S. Polio vaccine licensed in 1955 Polio vaccine licensed in 1955 Incidence of disease: In 1960, a total of 2,525 paralytic cases were reported, compared with 61 in 1965 Incidence of disease: In 1960, a total of 2,525 paralytic cases were reported, compared with 61 in 1965 Last case of wild-virus polio acquired in the U.S. was in 1979 Last case of wild-virus polio acquired in the U.S. was in 1979 Polio is not eradicated from the world Polio is not eradicated from the world Disease has no border! ** Disease has no border! ** Vaccines Work! Photo: Courtesy of World Health Organization Photo: Helen Comer/AP Photo: Encyclopædia Britannica; © Steve Raymer/Corbis

9 Nigeria India Pakistan Retrieved January 7, 2009 from

10 Vaccines Arent Just for Kids Sometimes vaccines do not provide lifelong protection Sometimes vaccines do not provide lifelong protection Sometimes the virus or bacteria changes through time Sometimes the virus or bacteria changes through time Sometimes the aging immune system becomes susceptible to diseases that were less of a threat at an earlier age Sometimes the aging immune system becomes susceptible to diseases that were less of a threat at an earlier age

11 Changes to Recommended Immunization Schedules for Persons Aged 0 Through 18 Years – United States, 2009 Recommendations for rotavirus vaccines include changes for the maximum age for the first dose (14 weeks 6 days) and the maximum age for the final dose of the series (8 months 0 days). Recommendations for rotavirus vaccines include changes for the maximum age for the first dose (14 weeks 6 days) and the maximum age for the final dose of the series (8 months 0 days). Routine annual influenza vaccination is recommended for all children aged 6 months through 18 years. Children aged younger than 9 years who are receiving influenza vaccine for the first time or who were vaccinated for the first time during the previous season but only received 1 dose should receive 2 doses of influenza vaccine at least 4 weeks apart. Healthy non-pregnant persons aged 2 through 49 years may receive either live attenuated influenza vaccine or inactivated influenza vaccine. Routine annual influenza vaccination is recommended for all children aged 6 months through 18 years. Children aged younger than 9 years who are receiving influenza vaccine for the first time or who were vaccinated for the first time during the previous season but only received 1 dose should receive 2 doses of influenza vaccine at least 4 weeks apart. Healthy non-pregnant persons aged 2 through 49 years may receive either live attenuated influenza vaccine or inactivated influenza vaccine.

12 The minimum interval between tetanus and diphtheria toxoids (Td) and tetanus and diphtheria toxoids and acellular pertussis vaccine (Tdap) for persons aged 10 through 18 years is addressed. An interval less than 5 years may be used if pertussis immunity is needed. The minimum interval between tetanus and diphtheria toxoids (Td) and tetanus and diphtheria toxoids and acellular pertussis vaccine (Tdap) for persons aged 10 through 18 years is addressed. An interval less than 5 years may be used if pertussis immunity is needed. Information about the use of Haemophilus influenzae type b (Hib) conjugate vaccine among persons aged 5 years and older at increased risk for invasive Hib disease has been added. Use of Hib vaccine for these persons is not contraindicated. Information about the use of Haemophilus influenzae type b (Hib) conjugate vaccine among persons aged 5 years and older at increased risk for invasive Hib disease has been added. Use of Hib vaccine for these persons is not contraindicated. Changes to Recommended Immunization Schedules for Persons Aged 0 Through 18 Years – United States, 2009

13 Catch-up vaccination with human papillomavirus (HPV) vaccine is clarified. Routine dosing intervals should be used for series catch-up (i.e., the second and third doses should be administered 2 and 6 months after the first dose). The third dose should be given at least 24 weeks after the first dose. Catch-up vaccination with human papillomavirus (HPV) vaccine is clarified. Routine dosing intervals should be used for series catch-up (i.e., the second and third doses should be administered 2 and 6 months after the first dose). The third dose should be given at least 24 weeks after the first dose. Abbreviation changes for: Abbreviation changes for: rotavirus (now RV), rotavirus (now RV), pneumococcal polysaccharide (now PPSV), pneumococcal polysaccharide (now PPSV), pneumococcal conjugate vaccine (still PCV), pneumococcal conjugate vaccine (still PCV), meningococcal polysaccharide vaccine (now MPSV) meningococcal polysaccharide vaccine (now MPSV) meningococcal conjugate vaccine (still MCV) meningococcal conjugate vaccine (still MCV) Changes to Recommended Immunization Schedules for Persons Aged 0 Through 18 Years – United States, 2009

14 Recommended Adolescent Immunization Schedule by Age, 2009

15 Recommended Adolescent Immunization Schedule Footnotes

16 Catch-Up Schedule for Persons Aged 7 Through 18 Years

17 Recommended Adult Immunization Schedule by Age

18 Recommended Adult Immunization Schedule by Medical Indication

19 Recommended Adult Immunization Schedule Footnotes Due to the length and complexity of the footnotes please consult the following CDC web site for the Recommended Adult Immunization Schedule, United States –

20 Vaccines for Adolescents & Adults VaccineAdolescentAdult Tetanus, diphtheria, pertussis (Td/Tdap) XX Human papillomavirus (HPV)XX VaricellaXX ZosterN/A X Measles, mumps, rubella (MMR)XX InfluenzaXX Pneumococcal (polysaccharide)XX Hepatitis AXX Hepatitis BXX MeningococcalXX Inactivated PoliovirusXN/A

21 Td or Tdap Tetanus-diphtheria-pertussis (Td or Tdap) Tetanus-diphtheria-pertussis (Td or Tdap) Tetanus – bacterium that causes severe and painful muscle spasms, including the muscles of the jaw lock-jaw Tetanus – bacterium that causes severe and painful muscle spasms, including the muscles of the jaw lock-jaw Diphtheria – bacterium that causes a thick coating on the back of the throat making it difficult to swallow and breath Diphtheria – bacterium that causes a thick coating on the back of the throat making it difficult to swallow and breath Pertussis – bacterium that causes thick, sticky mucus that clogs the windpipe, also known as whooping cough in children Pertussis – bacterium that causes thick, sticky mucus that clogs the windpipe, also known as whooping cough in children

22 Td or Tdap Tdap should replace a single dose of Td for adolescents and adults aged 64 years and younger who have not previously received a dose of Tdap Tdap should replace a single dose of Td for adolescents and adults aged 64 years and younger who have not previously received a dose of Tdap There are two Tdap products. There are two Tdap products. Adacel ® manufactured by Sanofi Pasteur for ages Adacel ® manufactured by Sanofi Pasteur for ages Boostrix ® manufactured by GlaxoSmithKline for ages Boostrix ® manufactured by GlaxoSmithKline for ages One dose of Tdap (substitute for Td) One dose of Tdap (substitute for Td) Three dose series if never vaccinated at 0 and 4 weeks, the third 6-12 months after second Three dose series if never vaccinated at 0 and 4 weeks, the third 6-12 months after second One dose booster of Td every 10 years One dose booster of Td every 10 years An interval of less than 5 years may be used if pertussis immunity is needed. An interval of less than 5 years may be used if pertussis immunity is needed. ** Consult package insert, schedule, ** Consult package insert, schedule, and provider and provider Intramuscular (IM) Injection Technique

23 Human Papillomavirus (HPV) A virus that infects the genitals and the lining of the cervix A virus that infects the genitals and the lining of the cervix There are many different types of HPV – some cause cervical cancer There are many different types of HPV – some cause cervical cancer HPV vaccine is the second vaccine to prevent a form of cancer (cervical) HPV vaccine is the second vaccine to prevent a form of cancer (cervical) C E R V I C A L C A N C E R

24 Human Papillomavirus (HPV) Recommended for females Recommended for females ages 9 – 26 ages 9 – 26 Ideally, vaccine should be given before potential exposure to HPV through sexual activity; however, females who are sexually active should still receive the vaccine Ideally, vaccine should be given before potential exposure to HPV through sexual activity; however, females who are sexually active should still receive the vaccine Three dose series – second dose two months after the first and third dose administered six months after the first (at least 24 weeks after first dose) Three dose series – second dose two months after the first and third dose administered six months after the first (at least 24 weeks after first dose) IM

25 Measles, mumps, rubella (MMR) Measles – Infects the lining of the back of the throat and nose; can infect lungs and brain causing permanent damage or death Measles – Infects the lining of the back of the throat and nose; can infect lungs and brain causing permanent damage or death Mumps – Painful swelling of the parotid glands; infects lining of brain/spinal cord Mumps – Painful swelling of the parotid glands; infects lining of brain/spinal cord Rubella – Causes swelling of glands, rash, and fever; can cause permanent and severe birth defects Rubella – Causes swelling of glands, rash, and fever; can cause permanent and severe birth defects

26 Measles, mumps, rubella (MMR) People born during or after 1957 who have not had measles, mumps, or rubella or the MMR vaccine should get the MMR vaccine People born during or after 1957 who have not had measles, mumps, or rubella or the MMR vaccine should get the MMR vaccine People entering college People entering college Healthcare workers Healthcare workers International travelers International travelers Specific guidelines from the schedule should be followed Specific guidelines from the schedule should be followed Two doses (consult provider) Two doses (consult provider) Subcutaneous (SC) Injection Technique

27 Varicella (chickenpox) Very contagious coughing/sneezing Very contagious coughing/sneezing Fever and many small blisters Fever and many small blisters Complications include pneumonia, brain swelling, and severe skin infections Complications include pneumonia, brain swelling, and severe skin infections Approximately 35 of every 100 deaths from chickenpox are in adults Approximately 35 of every 100 deaths from chickenpox are in adults

28 Varicella (chickenpox) All adults without evidence of immunity to varicella should receive 2 doses of single- antigen varicella vaccine unless they have a medical contraindication. All adults without evidence of immunity to varicella should receive 2 doses of single- antigen varicella vaccine unless they have a medical contraindication. What constitutes evidence of immunity? What constitutes evidence of immunity? Two doses at 0 then 4-8 weeks Two doses at 0 then 4-8 weeks SC

29 Influenza (flu) Infects the respiratory system Infects the respiratory system Complications include pneumonia, fever, croup, and bronchitis Complications include pneumonia, fever, croup, and bronchitis People with asthma, chronic diseases of the lungs, heart, or kidneys are at greater risk People with asthma, chronic diseases of the lungs, heart, or kidneys are at greater risk Most deaths from flu occur in people 65 or older Most deaths from flu occur in people 65 or older

30 Influenza (flu) Annual vaccine Annual vaccine Recommended for children 6 months through 18 years Recommended for children 6 months through 18 years Chronic disease of cardiovascular or pulmonary systems, renal dysfunction Chronic disease of cardiovascular or pulmonary systems, renal dysfunction Healthcare personnel Healthcare personnel Residents of long-term care facilities Residents of long-term care facilities Anyone wanting to decrease their chance of catching the flu Anyone wanting to decrease their chance of catching the flu Some benefit should a Pandemic flu outbreak occur Some benefit should a Pandemic flu outbreak occur Annual dose Annual dose IM

31 Pneumococcal (polysaccharide) Several types of pneumococcal disease; pneumonia, bacteremia, and meningitis Several types of pneumococcal disease; pneumonia, bacteremia, and meningitis Pneumonia most common; high fever, cough, rapid, difficult breathing Pneumonia most common; high fever, cough, rapid, difficult breathing People with asthma, chronic diseases of the lungs, heart, or kidneys are at risk People with asthma, chronic diseases of the lungs, heart, or kidneys are at risk People without a spleen, undergoing chemotherapy, infected with AIDS virus, or organ transplantation are also at greater risk People without a spleen, undergoing chemotherapy, infected with AIDS virus, or organ transplantation are also at greater risk Approximately 175,000 people are hospitalized each year with pneumonia Approximately 175,000 people are hospitalized each year with pneumonia

32 Pneumococcal (polysaccharide) Adults 65 years of age and older Adults 65 years of age and older High risk; chronic cardiovascular and pulmonary disease (including asthma), cigarette smokers and diabetes High risk; chronic cardiovascular and pulmonary disease (including asthma), cigarette smokers and diabetes People without a spleen, undergoing chemotherapy, infected with the AIDS virus People without a spleen, undergoing chemotherapy, infected with the AIDS virus There may be occasions where a second dose is given (consult provider) There may be occasions where a second dose is given (consult provider) One dose One dose SCIM or

33 Hepatitis A Virus infects the liver Virus infects the liver Symptoms include loss of appetite, vomiting, nausea, fatigue and jaundice Symptoms include loss of appetite, vomiting, nausea, fatigue and jaundice Can cause rapid overwhelming infection of the liver and death Can cause rapid overwhelming infection of the liver and death Spread person to person or by contaminated food and water Spread person to person or by contaminated food and water

34 Hepatitis A Persons with chronic liver disease and persons who receive clotting factor concentrates Persons with chronic liver disease and persons who receive clotting factor concentrates Persons traveling to or working in countries that have high or intermediate endemicity of hepatitis A Persons traveling to or working in countries that have high or intermediate endemicity of hepatitis A Men who have sex with men and persons who use illegal drugs Men who have sex with men and persons who use illegal drugs Two doses 6-12 months apart Two doses 6-12 months apart IM

35 Hepatitis B Virus infects the liver Virus infects the liver Spread by sexual contact, blood, saliva, or other body fluids Spread by sexual contact, blood, saliva, or other body fluids About 100,000 people catch hepatitis B each year in the U.S. About 100,000 people catch hepatitis B each year in the U.S. High risk populations most at risk High risk populations most at risk First vaccine to prevent cancer (liver) First vaccine to prevent cancer (liver)

36 Hepatitis B First vaccine to prevent cancer First vaccine to prevent cancer Persons with end-stage renal disease, including patients receiving hemodialysis; persons seeking evaluation or treatment for a sexually transmitted disease (STD); persons with HIV infection; and persons with chronic liver disease Persons with end-stage renal disease, including patients receiving hemodialysis; persons seeking evaluation or treatment for a sexually transmitted disease (STD); persons with HIV infection; and persons with chronic liver disease Occupational indications: Health-care personnel and public-safety workers who are exposed to blood or other potentially infectious body fluids Occupational indications: Health-care personnel and public-safety workers who are exposed to blood or other potentially infectious body fluids Behavioral indications: Sexually active persons who are not in a long-term, mutually monogamous relationship (e.g., persons with more than 1 sex partner during the previous 6 months); current or recent injection-drug users; and men who Behavioral indications: Sexually active persons who are not in a long-term, mutually monogamous relationship (e.g., persons with more than 1 sex partner during the previous 6 months); current or recent injection-drug users; and men who have sex with men Three doses at 0, 1-2, 4-6 months apart Three doses at 0, 1-2, 4-6 months apart IM

37 Meningococcal Bacterium that lives on the lining of the nose and throat of some people Bacterium that lives on the lining of the nose and throat of some people Approximately 2,500 people in the U.S. get this disease each year; some 300 die Approximately 2,500 people in the U.S. get this disease each year; some 300 die Approximately 400 people a year who survive have permanent disabilities such as seizures, loss of limbs, deafness, and mental retardation Approximately 400 people a year who survive have permanent disabilities such as seizures, loss of limbs, deafness, and mental retardation

38 Meningococcal Adults with anatomic or functional asplenia, or terminal complement component deficiencies. Adults with anatomic or functional asplenia, or terminal complement component deficiencies. First-year college students living in dormitories; First-year college students living in dormitories; Persons who travel to or live in countries in which meningococcal disease is hyperendemic or epidemic (e.g., portions of Africa during the dry season) Persons who travel to or live in countries in which meningococcal disease is hyperendemic or epidemic (e.g., portions of Africa during the dry season) Meningococcal conjugate vaccine is preferred for adults with any of the preceding indications who are aged <55 years, although meningococcal polysaccharide vaccine (MPSV4) is an acceptable alternative. Meningococcal conjugate vaccine is preferred for adults with any of the preceding indications who are aged <55 years, although meningococcal polysaccharide vaccine (MPSV4) is an acceptable alternative. Revaccination after 3–5 years might be indicated for adults previously vaccinated with MPSV4 who remain at increased risk for infection Revaccination after 3–5 years might be indicated for adults previously vaccinated with MPSV4 who remain at increased risk for infection One or more doses (consult with provider) One or more doses (consult with provider) IM

39 Herpes zoster (shingles) Shingles is caused by a reawakening of the chickenpox virus Shingles is caused by a reawakening of the chickenpox virus Symptoms – rash usually along nerve pathways Symptoms – rash usually along nerve pathways Very painful and debilitating Very painful and debilitating of every 100 people can expect to get shingles in their lifetime of every 100 people can expect to get shingles in their lifetime

40 Herpes zoster (shingles) Recommended for adults aged >60 years regardless of whether they report a prior episode of herpes zoster Recommended for adults aged >60 years regardless of whether they report a prior episode of herpes zoster Persons with chronic medical conditions may be vaccinated unless a contraindication or precaution exists for their condition Persons with chronic medical conditions may be vaccinated unless a contraindication or precaution exists for their condition Single dose Single dose SC

41 Recommended Vaccines for Healthcare Workers Healthcare workers should maintain an immunization history for: Healthcare workers should maintain an immunization history for: Hepatitis B Hepatitis B Influenza * Influenza * MMR MMR Varicella (chickenpox) Varicella (chickenpox) Tetanus, diphtheria, pertussis Tetanus, diphtheria, pertussis Meningococcal** Meningococcal** * Receive annually ** For specific healthcare personnel

42 Vaccine Handling and Storage Maintain cold chain – check temperatures twice daily Maintain cold chain – check temperatures twice daily Know where vaccines go – refrigerator/freezer Know where vaccines go – refrigerator/freezer Rotate stock – expiration dates Rotate stock – expiration dates Follow all manufacturer guidelines for storage and handling Follow all manufacturer guidelines for storage and handling Consult TVFC Tool Kit Consult TVFC Tool Kit

43 Screening Patients for Vaccines Screen every patient regardless of reason for visit Screen every patient regardless of reason for visit Utilize screening tools; H-A-L-O Utilize screening tools; H-A-L-O Health condition Health condition Age Age Lifestyle Lifestyle Occupation Occupation

44 Document Provide copy of Vaccine Information Statement (VIS) from CDC to patient Provide copy of Vaccine Information Statement (VIS) from CDC to patient Document: date vaccine given, vaccine manufacturer, lot number, date of VIS, date VIS was given to patient, site vaccine was given, vaccinators initials Document: date vaccine given, vaccine manufacturer, lot number, date of VIS, date VIS was given to patient, site vaccine was given, vaccinators initials Required by law Required by law

45 Vaccine Administration Ensure you are properly trained Ensure you are properly trained Always prepare and check the following for every injection or medication you give: Always prepare and check the following for every injection or medication you give: Right Patient Right Patient Right Drug (vaccine) Right Drug (vaccine) Right Dose Right Dose Right Route (intramuscular, intradermal) Right Route (intramuscular, intradermal) Right Time (is scheduling correct) Right Time (is scheduling correct)

46 HPV Vaccine; the Communication Challenges Vaccine recommendations (minimum age 9) Vaccine recommendations (minimum age 9) Administer the first dose to females at age 11 or 12 years. Administer the second dose 2 months after the first dose and the third dose 6 months after the first dose (at least 24 weeks after the first dose). Administer the series to females at age 13 through 26 years if not previously vaccinated.

47 Basic Facts: Basic Facts: HPV vaccine does not appear to cause any serious side effects. However, a vaccine, like any medicine, could possibly cause serious problems, such as severe allergic reactions. The risk of any vaccine causing serious harm, or death, is extremely small. HPV vaccine does not appear to cause any serious side effects. However, a vaccine, like any medicine, could possibly cause serious problems, such as severe allergic reactions. The risk of any vaccine causing serious harm, or death, is extremely small. Several mild problems may occur with HPV vaccine: Several mild problems may occur with HPV vaccine: Pain at the injection site (about 8 people in 10) Pain at the injection site (about 8 people in 10) Redness or swelling at the injection site (about 1 person in 4) Redness or swelling at the injection site (about 1 person in 4) Mild fever (100 degrees Fahrenheit) (about 1 person in 10) Mild fever (100 degrees Fahrenheit) (about 1 person in 10) Itching at the injection site (about 1 person in 30) Itching at the injection site (about 1 person in 30) Moderate fever (102 degrees Fahrenheit) (about 1 person in 65) Moderate fever (102 degrees Fahrenheit) (about 1 person in 65) These symptoms do not last long and go away on their own. These symptoms do not last long and go away on their own. Life-threatening allergic reactions from vaccines are very rare. If they do occur, it would be within a few minutes to a few hours after the vaccination. Life-threatening allergic reactions from vaccines are very rare. If they do occur, it would be within a few minutes to a few hours after the vaccination. Like all vaccines, HPV vaccine will continue to be monitored for unusual or severe problems. Like all vaccines, HPV vaccine will continue to be monitored for unusual or severe problems. HPV Vaccine; the Communication Challenges

48 Proposed School Rules Proposed changes to school rules were originally published in the Texas Register August 22, 2008 Proposed changes to school rules were originally published in the Texas Register August 22, 2008 Proposed changes have not been approved or adopted (anticipate January or February 2009) Proposed changes have not been approved or adopted (anticipate January or February 2009) When adopted the proposed changes will not take effect until August 1, 2009 When adopted the proposed changes will not take effect until August 1, 2009 Changes synchronize school rules with the Advisory Committee on Immunization Practices (ACIP) age appropriate immunization schedules Changes synchronize school rules with the Advisory Committee on Immunization Practices (ACIP) age appropriate immunization schedules

49 Proposed School Rules Meningococcal Vaccine* Beginning School Year (SY) , 7th grade requirement Meningococcal Vaccine* Beginning School Year (SY) , 7th grade requirement Varicella Vaccine Beginning (SY) , 2 dose requirement for kindergarten and 7th grade entry Varicella Vaccine Beginning (SY) , 2 dose requirement for kindergarten and 7th grade entry Tdap Vaccine Beginning SY , a booster dose requirement for Tdap for 7th grade Tdap Vaccine Beginning SY , a booster dose requirement for Tdap for 7th grade MMR Vaccine Beginning SY , 2 dose requirement of MMR vaccine for kindergarten entry MMR Vaccine Beginning SY , 2 dose requirement of MMR vaccine for kindergarten entry Hepatitis A Vaccine Beginning SY , 2 dose requirement for kindergarten entry statewide Hepatitis A Vaccine Beginning SY , 2 dose requirement for kindergarten entry statewide General revisions incorporated that clarify or simplify language throughout the rules relating to the school and child care requirements. General revisions incorporated that clarify or simplify language throughout the rules relating to the school and child care requirements.

50 Vaccinate for Life! Presented by: Presented by: John Gemar Adolescent/Adult Immunization Coordinator For more information contact: Texas Department of State Health Services


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