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

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

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

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

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

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

Certificate of Immunization DH 680 Form 7

Electronic Certificate of Immunization DH 680 Form 8

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) vaccine  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) vaccine 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

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. 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 17

Permanent Medical Exemption  DH 680: Part C, DOE Code 3  For medically contraindicated immunizations  List each vaccine with valid clinical reason for exemption  DH 680: Part C, DOE Code 3  For medically contraindicated immunizations  List each vaccine with valid clinical reason for exemption 18

Religious Exemption DH 681 Form, 7/08 19

Immunization Flyers available at s/flyers.html s/flyers.html 20

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 22

Comments/Questions 23