1. Welcome to the Immunization Requirements Webinar for Public Schools! For technical difficulties, call 1-888-259-8414, 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 recording and PowerPoint presentation will be available after today’s webinar here: www.doh.wa.gov/Portals/1/Documents/Pubs/May27WebinarAnnou ncement.pdf www.doh.wa.gov/Portals/1/Documents/Pubs/May27WebinarAnnou ncement.pdf

2. School Immunization Requirements Washington Department of Health Office of Immunization and Child Profile May 27, 2015

3. School year 2014-15 school immunization data School year 2015-16 school immunization requirements Change to the varicella requirement for school Changes to the Certificate of Immunization Status and the Certificate of Exemption Washington State Department of Health Topics to be covered

4. 2014-15 School Year Immunization Data

5. Immunization status of kindergarteners, 1998 - 2015 The percentage of kindergartners complete for required immunizations has dropped during each of the last two years. Students with completed immunizations are better protected from getting and spreading vaccine-preventable diseases. HP2020 goal: 95%

6. Medical exemptions 1.2% (unchanged from last year) School immunization exemptions among kindergarteners, 2005 - 2015 Exemption rates have remained stable over the last four school years. Washington State has one of the highest exemption rates in the country. While most exemptions are for personal and religious reasons, Washington’s medical exemption rate is 6 times higher than the national average of 0.2% Separate Certificate of Exemption required Healthcare provider signature required on Certificate of Exemption 7.6% Exemption type data were not collected for kindergartners prior to 2012-13.

13. School Year Number of reports received # Kinder- gartners reported Non- reporting schools % Kinder- gartners complete % Kinder- gartners OOC 2011-20121,93475,870 32% (N = 907) 85%9% 2012-2013*2,43079,624 9% (N=249) 86%8% 2013-2014*2,32783,495 12% (N=308) 83%10% 2014-20152,44785,887 7% (N=182) 83%11% School reporting is improving but the number of kids who are not complete is increasing. Each year ~9,000 kindergartners are out-of-compliance with state immunization law, leaving them and their communities vulnerable to vaccine preventable diseases. 13 *Data are weighted to account for schools that did not report. Data source: WA DOH OICP school immunization data through 2014-2015.

14. http://www.doh.wa.gov/DataandStatisticalReports/ HealthBehaviors/Immunization/SchoolReports

15. Data for kindergartners, 6 th graders, and all students in K – 12 – State – County – Public/private schools – Educational Service District – District – School Available Data Tables

16. Vaccine Requirements

19.  1 dose required for 6-12 th grade IF student is 11 years of age or older Washington State Department of Health Immunization Requirements - Tdap Exception: Tdap given between 7-10 years of age counts for the 6 th grade requirement

20.  DTaP: 6 years of age and younger  Tdap and Td: 7 years of age and older  Tdap is recommended once, then switch to Td every 10 years Washington State Department of Health Immunization Requirements – DTaP/TdaP/Td

21. Tdap for catch- up Less than 5 doses of DTaP Tdap followed by 2 Td No DTaP <7 years of age Students 7 years of age or older

22.  K-8 th grade: Dose 3 must be given min age of 24 weeks  9 th -12 th grade: Dose 3 must be given min age of 4 months Immunization Requirements – Hepatitis B

23. Immunization Requirements - IPV Dose 4, if given on or after Aug 7, 2009Must be given >4 years of ageSeparated from dose 3 by >6 months K-4 th Grade

24.  2 doses required for K-8 th grade for upcoming school year  At least 4 weeks must separates doses Exception: 3 doses required if 4 th dose given >4 th birthday Washington State Department of Health Immunization Requirements - Varicella

25. Printing the CIS Printing instructions: www.doh.wa.gov/Portals/1/Documents/Pubs/348-389-CIS- PrintingInstructions.pdfwww.doh.wa.gov/Portals/1/Documents/Pubs/348-389-CIS- PrintingInstructions.pdf

26. Printing the CIS

28. IIS Forecasting Tool

29. Change in Varicella Requirement for School Year 2015-16

30. Immunization Requirements - Varicella Option 1 Blood test showing titer for immunity Option 2 Documentation in IIS or CIS printout Option 3 Letter from provider (out of state valid) Option 4 Provider documents on CIS hard copy 2 doses of varicella vaccine required for K-8 th grade

31. Current K-7th grade No provider or parent verification Get provider verification Got provider verification No further action Got parent verification in previous school year Not allowed, get provider verification No need to do retrospective review All new students from out of state must get provider verification Parent vs. Provider Verification K-7 th Grade School Year 2015-16

32. 8th grade No provider or parent verification Get provider verification Got provider verification No further action Got parent verification before school year 2014-15 Allowed, no further action All new students from out of state must get provider verification Parent vs. Provider Verification 8 th Grade School Year 2015-16

33. 2 doses of varicella vaccine required for K-12 th grade Varicella Requirement By school year 2016-17 Washington State Department of Health

34. www.doh.wa.gov/YouandYourFamily/Immunization/FormsandPublications/Forms Varicella Flyer

35. Changes to the Certificate of Immunization Status

36. Washington State Department of Health

37. New Certificate of Exemption

38. 2011

39. Washington State Department of Health 2015 Side A

40. 2015 Side B

41.  Main school and child care web page: www.doh.wa.gov/CommunityandEnvironment/Schools/Immunization.aspx www.doh.wa.gov/CommunityandEnvironment/Schools/Immunization.aspx  Vaccines Required for School Attendance chart: www.doh.wa.gov/CommunityandEnvironment/Schools/Immunization /VaccineRequirements.aspx 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 www.doh.wa.gov/CommunityandEnvironment/Schools/Immunization /VaccineRequirements.aspx  Individual Vaccine Requirements Summary (IVRS): www.doh.wa.gov/Portals/1/Documents/Pubs/348-284- IndividualVaccineReqs2015-16.pdf www.doh.wa.gov/Portals/1/Documents/Pubs/348-284- IndividualVaccineReqs2015-16.pdf  School Immunization Manual: www.doh.wa.gov/CommunityandEnvironment/Schools/Immunization /SchoolManual www.doh.wa.gov/CommunityandEnvironment/Schools/Immunization /SchoolManual Resources Washington State Department of Health

42.  For clinical questions about compliance, send an email to DOH nurses at immunenurses@doh.wa.govimmunenurses@doh.wa.gov  For school requirement or reporting questions, send an email to oicpschools@doh.wa.govoicpschools@doh.wa.gov Resources Washington State Department of Health

43. Please take a few minutes to complete an evaluation that will be emailed to you after the webinar. A certificate of completion is available after you complete the evaluation: www.doh.wa.gov/Portals/1/Documents/Pubs/ May27WebinarAnnouncement.pdf www.doh.wa.gov/Portals/1/Documents/Pubs/ May27WebinarAnnouncement.pdf

44.  Thank you for attending the webinar!  Please type in your questions.