health services

Immunizations

Healthy Kids Are Better Students

For information on the location and times for Good Samaritan Hospital's Mobile Immunization Clinic call (253)-697-8160.

Vaccines Required For School Attendance
September 2007 - June 2008
WAC 246-100-166

¹Refer to 2005 Recommended Childhood Immunization Schedule:
http://www.cdc.gov/nip/recs/child-schedule.htm#Printable

²The attendance of every child at every public and private school in the state and licensed day care center shall be conditioned upon the presentation before or on each child's first day of attendance of proof of either 1) full immunization*, 2) the initiation of...a schedule of immunization, or 3) a certificate of exemption as provided for in RCW28A.210.090.

EXEMPTIONS:

MEDICAL exemption requires the signature of a licensed health care provider
PERSONAL/RELIGIOUS exemptions require the signature of a parent/guardian

* “Full immunization” or “fully immunized” is an immunization status where a child has been vaccinated at ages and intervals consistent with the national immunization guidelines, with immunizing agents against: Diphtheria; Tetanus; Pertussis (whooping cough):, Poliomyelitis; Measles (rubeola); Mumps; Rubella; Hepatitis B; Haemophilus influenzae type B disease; and Varicella for children under thirteen years of age, admitted to school or child care after July 1, 2006.” (WAC 246-100-166)

Ages/Intervals:
• There is no maximum interval between doses. A vaccine series does not need to be restarted if there is an interval longer than the usual recommended interval.
• Minimum ages and intervals are an essential part of vaccine administration and apply to all vaccines and doses.
• The General Recommendations on Immunizations recommends that vaccine doses administered < 4 days before the minimum interval or age be counted as valid. Washington State Immunization Program allows the use of the 4-day “grace period” ONLY for assessment of records and record review.

³Minimum acceptable doses are for children who were not fully immunized as infants or preschoolers and are exceptions to the recommended schedule for full immunization.

⁴Varicella (Chickenpox):
• Recommendation is for vaccine to be given on or after the 1st birthday (4 day grace applies).
• There is no varicella requirement for children 13 years of age or older regardless of grade in school.
• Children vaccinated on or after the 13th birthday need to receive 2 doses at least 28 days apart (4 day grace does not apply).
• Parental documentation of disease history is acceptable (Yes/No is required – approximate date or age of disease is recommended).
• Laboratory evidence of immunity to varicella may be substituted for the varicella vaccine.

⁵DTaP/DT:
• Recommendation is for children to receive dose # 5 at 4-6 years of age (Kindergarten entry).
• Dose # 4 given on or after a child’s 4th birthday is acceptable.
• Pertussis-containing vaccine is required for children attending Kindergarten (ages 4-6).
• Children who are past their 7th birthday should not be given DTP/DTaP vaccine. Such children can fulfill this requirement with 3 doses of Td or 2 doses of TD and 1dose of Tdap.

⁶Polio:
• Recommendation is for children to receive dose # 4 at 4-6 years of age (Kindergarten entry).
• 4 doses received before age 4 is acceptable.
• Dose # 3 given on or after a child’s 4th birthday is acceptable.
• Routine vaccination of persons ≥ 18 years of age is not recommended.

⁷MMR:
• Recommendation is for children to receive dose # 1 on or after the first birthday (4 day grace applies) and dose # 2 at 4-6 years of age
(Kindergarten entry).
• 2 doses of MMR vaccine is recommended and preferred but students can be considered fully immunized with 2 doses of measlescontaining
vaccine both given on or after the first birthday and at least 28 days apart (4 day grace does not apply).
• Laboratory evidence of immunity to measles, mumps and rubella may be substituted for the MMR vaccine. Immunity to one disease does not necessarily mean immunity to the other two diseases

⁸Hepatitis B: Recommended Hepatitis B Vaccine Schedule

• Minimum ages/intervals IF dose # 1 given on or before 2 months of age:

The minimum interval between dose # 1 & dose # 2 is 24 days (28 day month minus 4 day grace).
The minimum interval between dose # 2 and dose # 3 is 52 days (8 weeks minus 4 day grace).
The minimum age for dose # 3 is 24 weeks (6 calendar months minus 16 days – includes 4 day grace).

• Minimum ages/intervals for children not vaccinated as infants:

The minimum interval between dose # 1 and dose # 2 is 24 days (28 day month minus 4 day grace).
The minimum interval between dose # 2 and dose #3 is 52 days (8 weeks minus 4 day grace).
The minimum interval between dose # 1 and dose #3 is 108 days (16 weeks minus 4 day grace).

DOH 348-051 (Rev 1/06)