implementing wa new state exemption requirements -
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Preschool/Child Care Immunization Requirements Department of Health Office of Immunization and Child Profile May 2013. Implementing WA New State Exemption Requirements - Training for Schools and Child Cares/Preschools August XX, 2011. Topics to be Covered. - PowerPoint PPT PresentationTRANSCRIPT
Implementing WA New State Exemption Requirements - Training for Schools and Child Cares/Preschools
August XX, 2011
Preschool/Child Care Immunization RequirementsDepartment of Health Office of Immunization and Child Profile
May 2013
Topics to be Covered• What are the child care and preschool vaccine requirements in
Washington State?• Complete, Conditional, Out of Compliance: What do they
mean?• How can I use the Washington State Immunization Information
System (IIS) to find out if a child is complete?
Why Do We Need Immunizations?
We don’t see diseases once common. Vaccines successfully prevent disease
However, diseases and outbreaks still occurChildren are at risk in the child care and preschool
setting
Immunization RequirementsChildren attending licensed child care must comply
with immunization requirements to protect the health of the public and individuals
Children must be vaccinated against certain diseases at ages and intervals according to the national immunization schedule
Parents must turn in completed Certificate of Immunization Status (or Certificate of Exemption)
www.doh.wa.gov/CommunityandEnvironment/Schools/Immunization/Regulations.aspx
Immunization Requirements
Comply with State Board of Health immunization requirements
Required to report to DOH
Licensed child care center (and preschool) √ √
Licensed family home child care
Must comply with DEL rules --
Licensed child care for school age children √ --
Head Start, ECEAP √ √Any preschool in school setting √ √
Changes to Exemption Lawwww.doh.wa.gov/CommunityandEnvironment/Schools
/Immunization/Exemptions.aspx
Sample Certificates of ExemptionTraining videoFrequently Asked Questions
Vaccines Required for Preschool or Child Care Attendance
DTaPHepatitis BHibIPVMMRPCVVaricella
Recommended, but Not Required
FluHepatitis ARotavirus
Immunization Status
Complete/Fully ImmunizedConditional
Temporary status to allow child to get fully immunized
Out of ComplianceExempt
www.doh.wa.gov/Portals/1/Documents/Pubs/348-051-ChildcareChart2013-2014.pdf
www.doh.wa.gov/Portals/1/Documents/Pubs/348-284-IndividualVaccineRequirements.pdf
www.doh.wa.gov/Portals/1/Documents/Pubs/348-051-SchoolChart2013-2014.pdf
4 Day Grace PeriodVaccines given 4 days or fewer before the
minimum interval or age are validVaccines given more than 4 days before the
minimum interval or age are NOT valid and need to be repeated
Applies to all vaccines before minimum intervals OR ages
Patient Name: Katey SIIS Patient ID:
Date of Birth: 02/15/2011 Age: 99 weeks, 22 months, 1 yrs
Vaccination Summary
Does not include all vaccination types. Vaccinations outside the ACIP schedule are marked with an 'X'.
Vaccine Family 1 2 3 4 5 6 7 8
OPV/IPV 04/15/2011 8 weeks
06/18/2012 4 months
08/12/2011 5 months
Invalid Vaccinations
Invalid Vaccinations Date Reason Vaccination Forecast
The forecast automatically switches to the accelerated schedule when a patient is behind schedule.
Vaccine Family Dose Recommended
Date Minimum Valid Date
Overdue Date
Status
Polio 4 02/15/2015 02/15/2015 02/15/2018 Up to Date
4 Day Grace Example
Dose 3 valid given 3 days
before 6 months of age
DTaP RequirementVACCINE By 3 Months
(on or before last day of mo 2)
By 5 Months(on or before last
day of mo 4)
By 7 Months(on or before last
day of mo 6)
By 16 Months(on or before last
day of mo 15)
By 19 Months(on or before last
day of mo 18)
Diphtheria, Tetanus, Pertussis(DTaP/DT)
1 dose 2 doses 3 dosesMay get as early as 6 months.
4 dosesMay get 4th dose as early as 12 months as long as 6 months separate dose 3 and
dose 4.
DTaP Minimum Age and Intervals
Dose # Minimum Age Minimum Interval Between Doses
1 6 weeks 4 weeks between Dose 1 & 2
2 10 weeks 4 weeks between Dose 2 & 3
3 14 weeks 6 months between Dose 3 & 4
4 12 months 6 months between Dose 4 & 5
DTaP DetailsRoutine schedule: 2, 4, 6, 15-18 months, and
booster dose at 4-6 years6 months interval recommended between dose
3 and 4, but 4 months or more is acceptableDTaP given to children less than 7 years of
age; Tdap and Td given to children 7 years of age or older
Patient Name: Isabella SIIS Patient ID:
Date of Birth: 04/17/2008 Age: 246 weeks, 56 months, 4 yrs
Vaccination Summary
Does not include all vaccination types. Vaccinations outside the ACIP schedule are marked with an 'X'.
Vaccine Family 1 2 3 4 5 6 7 8
DTaP/DTP/Td 06/17/2008 8 weeks
07/18/2008 3 months
08/18/2008 4 months
X 12/19/2008 8 months
Invalid Vaccinations
Invalid Vaccinations Date Reason DTaP/DT/Td 12/19/2008 Minimum age for this dose not met.
Vaccination Forecast The forecast automatically switches to the accelerated schedule when a patient is behind schedule.
Vaccine Family Dose Recommended
Date Minimum
Valid Date Overdue
Date Status
DTaP/DT/Td 4 06/19/2009 06/19/2009 11/17/2009 Past Due
Note red X because Dose
4 given too early
DTaP Example
Dose 4 past due
Hepatitis B Requirement
VACCINEBy 3 Months
(on or before last day of mo 2)
By 5 Months(on or before last
day of mo 4)
By 7 Months(on or before last
day of mo 6)
By 16 Months(on or before last
day of mo 15)
By 19 Months(on or before last
day of mo 18)
Hepatitis B1 dose
May get dose 1at birth.
2 dosesMay get dose 2 as early as 1 month. 3 doses
Hepatitis B Minimum Age and Intervals
Dose # Minimum Age Minimum Interval Between Doses
1 Birth 4 weeks between Dose 1 & 2
2 4 weeks 8 weeks between Dose 2 & 3
3 24 weeks 16 weeks between Dose 1 & 3
Hepatitis B DetailsRoutine schedule: birth, 1 month, and 6 monthsPay attention to min age for dose 3 and
minimum intervals between doses
Hib Requirement
VACCINE By 3 Months(on or before last day of mo
2)
By 5 Months(on or before last day of mo
4)
By 7 Months(on or before last day of mo
6)
By 16 Months(on or before
last day of mo 15)
By 19 Months(on or before last
day of mo 18)
Haemophilus influenzae type B(Hib)
1 dose 2 doses 3 doses 4 doses
Hib Minimum Age and Intervals
Dose # Minimum Age Minimum Interval Between Doses
1 6 weeks 4 weeks between Dose 1 & 2
2 10 weeks 4 weeks between Dose 2 & 3
3 14 weeks 8 weeks between Dose 3 & 4
4 12 months -
Hib DetailsRoutine schedule: 2, 4, 6, and 12-15 monthsNot recommended for children 5 years or olderThe recommended immunization schedule for Hib
vaccines:
Vaccine 2 Months 4 Months 6 Months 12-15 Months
PRP-T* (ActHib)Dose 1 Dose 2 Dose 3 Booster
PRP-OMP (PedvaxHib)
Dose 1 Dose 2 Booster
Hib Details• One total dose for unvaccinated child 15-59 months of
age.• Two doses total if Dose 1 given >12 months and Dose 2
given >15 months of age.• Three doses total if 2 doses given before 12 months
and Dose 3 given >12 months.
Doses beforeage 12 months
Doses on or afterage 12 months Status
3 1 Complete
2 1 Complete
1 1 Needs 1 Booster Dose(If Last Dose Given Before 15 Months)
0 1 Needs 1 Booster Dose(If Last Dose Given Before 15 Months)
4 0 Needs 1 Booster Dose
3 0 Needs 1 Booster Dose
2 0 Needs 1 Booster Dose
1 0 Needs 1 Booster Dose
0 0 Needs 1 Dose
Hib Doses Required Chartwww.doh.wa.gov/Portals/1/Documents/Pubs/348-284-IndividualVaccineRequirements.pdf
Patient Name: Isabella SIIS Patient ID:
Date of Birth: 04/17/2008 Age: 246 weeks, 56 months, 4 yrs
Vaccination Summary
Does not include all vaccination types. Vaccinations outside the ACIP schedule are marked with an 'X'.
Vaccine Family 1 2 3 4 5 6 7 8
Hib 06/18/2008 8 weeks
05/17/2009 13 months
Vaccination Forecast The forecast automatically switches to the accelerated schedule when a patient is behind schedule.
Vaccine Family Dose Recommended
Date Minimum Valid Date
Overdue Date
Status
Hib 3 07/12/2009 07/12/2009 8/17/2009 Past Due
Hib Example
IPV Requirement
VACCINE
By 3 Months(on or before
last day of mo 2)
By 5 Months(on or before last
day of mo 4)
By 7 Months(on or before
last day of mo 6)
By 16 Months(on or before last day of mo
15)
By 19 Months(on or before last day of mo
18)
Polio(IPV or OPV)
1 dose 2 dosesMay get as early as 4 months.
3 doses
IPV Minimum Age and Intervals
Dose # Minimum Age Minimum Interval Between Doses
1 6 weeks 4 weeks between Dose 1 & 2
2 10 weeks 4 weeks between Dose 2 & 3
3 14 weeks 6 months between Dose 3 & 4
IPV DetailsRoutine schedule: 2, 4, 6-18 months, and
booster at 4-6 yearsIPV used routinely in US for polio vaccination,
but children coming from a foreign country may get OPV
Any combination of IPV or OPV valid
MMR RequirementVACCINE
By 3 Months(on or before last
day of mo 2)
By 5 Months(on or before last
day of mo 4)
By 7 Months(on or before last
day of mo 6)
By 16 Months(on or before last
day of mo 15)
By 19 Months(on or before last
day of mo 18)
Measles, Mumps, Rubella (MMR)
Not given before 12 months of age. 1 dose
MMR Minimum Age and Intervals
Dose # Minimum Age Minimum Interval Between Doses
1 12 months 4 weeks between Dose 1 & 2
MMR Details
Routine schedule: 12-15 months and 4-6 yearsDose 1 given <12 months of age must be
repeated (4 day grace applies)MMR or MMRV can be usedIf not given on same day, minimum interval
between MMR and varicella is >28 dayso The second vaccine given is not valid and
should be repeated
Patient Name: Katey SIIS Patient ID:
Date of Birth: 02/15/2011 Age: 99 weeks, 22 months, 1 yrs
Vaccination Summary
Does not include all vaccination types. Vaccinations outside the ACIP schedule are marked with an 'X'.
Vaccine Family 1 2 3 4 5 6 7 8
MMR X 02/10/2012 11 months
Invalid Vaccinations
Invalid Vaccinations Date Reason MMR 02/10/20012 Minimum age for this dose not met.
Vaccination Forecast The forecast automatically switches to the accelerated schedule when a patient is behind schedule.
Vaccine Family Dose Recommended
Date Minimum
Valid Date Overdue
Date Status
MMR 1 03/09/2012 03/09/2012 06/15/2012 Past Due
MMR Example
Note red X – MMR given 5
days too early
Pneumococcal Conjugate Vaccine (PCV) Requirement
VACCINE By 3 Months(on or before last day of mo
2)
By 5 Months(on or before last day of mo
4)
By 7 Months(on or before last day of mo
6)
By 16 Months(on or before
last day of mo 15)
By 19 Months(on or before
last day of mo 18)
Pneumococcal Conjugate(PCV7 or PCV13)
1 dose 2 doses 3 doses 4 doses
PCV Minimum Age and Intervals
Dose # Minimum Age Minimum Interval Between Doses
1 6 weeks 4 weeks between Dose 1 & 2
2 10 weeks 4 weeks between Dose 2 & 3
3 14 weeks 8 weeks between Dose 3 & 4
4 12 months -
PCV Details
Routine schedule: 2, 4, 6, and 12-15 monthsPCV is not recommended for children 5 and olderA single supplemental dose of PCV13 is
recommended, but not required, for all children aged 14–59 months who got 4 doses of PCV7o PCV13 replaced PCV7 in 2010
PCV Details• 1 total dose only on or after 24 months unless
high risk.• Two doses total if both received between 12-24
months, given >8 weeks apart. • Three doses total if 2 doses given <12 months
and Dose 3 given at >12 months.
PCV Doses Required Chart
Doses before Age 12 months
Doses on or after Age 12 months Status
3 1 Complete(If PCV7 given, needs one additional dose of PCV13)
21 (8 weeks after
# 2)Complete
0 2 Complete1 2 Complete1 1 Needs 1 dose 8 weeks after Dose 2
0 1 Needs 1 dose 8 weeks after Dose 1 if # 1 received at age ≤ 24 months
4 0 Needs 1 dose 8 weeks after Dose 4
3 0 Needs 1 dose 8 weeks after Dose 3
2 0 Needs 1 dose 8 weeks after Dose 2
1 0 Needs 2 doses (8 weeks apart) if age 12 - 24 monthsNeeds 1 dose if age ≥ 24 - 59 months
0 0 Needs 2 doses (8 weeks apart) if age 12 - 24 monthsNeeds 1 dose if age ≥ 24 - 59 months
Patient Name: Katey SIIS Patient ID:
Date of Birth: 02/15/2011 Age: 99 weeks, 22 months, 1 yrs
Vaccination Summary
Does not include all vaccination types. Vaccinations outside the ACIP schedule are marked with an 'X'.
Vaccine Family 1 2 3 4 5 6 7 8
Pneumococcal, PCV-13 (Prevnar13®) 04/15/2011 8 weeks
06/15/2012 4 months
02/16/2012 12 months
Invalid Vaccinations
Invalid Vaccinations Date Reason
Vaccination Forecast The forecast automatically switches to the accelerated schedule when a patient is behind schedule.
Vaccine Family Dose Recommended
Date Minimum
Valid Date Overdue
Date Status
PCV Example
Katey is complete
with 3 doses!
Varicella Requirement
VACCINE
By 3 Months(on or before
last day of mo 2)
By 5 Months(on or before last day of mo
4)
By 7 Months(on or before last
day of mo 6)
By 16 Months(on or before
last day of mo 15)
By 19 Months(on or before
last day of mo 18)
Varicella Not given before 12 months of age.1 dose
Required: if unvaccinated, health care provider must verify
disease.
Varicella Minimum Age and Intervals
Dose # Minimum Age Minimum Interval Between Doses
1 12 months 3 months between Dose 1 & 2
Varicella Details
Routine schedule: 12-15 months and 4-6 years of age
If not given on same day, minimum interval between varicella and MMR is >28 days
Patient Name: Isabella SIIS Patient ID:
Date of Birth: 04/17/2008 Age: 246 weeks, 56 months, 4 yrs
Vaccination Summary
Does not include all vaccination types. Vaccinations outside the ACIP schedule are marked with an 'X'.
Vaccine Family 1 2 3 4 5 6 7 8
MMR 02/17/2012 12 months
Varicella X 02/27/2012
12 months
Invalid Vaccinations Invalid Vaccinations Date Reason
Varicella 02/27/2012 Live vaccines not administered on same date must be separated by 28 days.
Vaccination Forecast The forecast automatically switches to the accelerated schedule when a patient is behind schedule.
Vaccine Family Dose Recommended
Date Minimum
Valid Date Overdue
Date Status
Varicella 1 03/26/2012 03/26/2012 06/15/2012 Past Due
Varicella Example
Note red X – Varicella not given same day as MMR
Resources www.doh.wa.gov/immunization/schoolandchildcare
Individual Vaccine Requirements Summary: www.doh.wa.gov/Portals/1/Documents/Pubs/348-284-IndividualVaccineRequirements.pdf
Vaccines Required for Preschool/Child Care Attendance chart: www.doh.wa.gov/CommunityandEnvironment/Schools/Immunization/VaccineRequirements.aspx
Immunization Manual for Schools and Child Cares: www.doh.wa.gov/CommunityandEnvironment/Schools/Immunization/SchoolManual.aspx
Implementing WA New State Exemption Requirements - Training for Schools and Child Cares/Preschools
August XX, 2011