North Dakota Dakota School School Immunization Immunization GuideGuide€¦ · Introduction to...

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North North North Dakota Dakota School School Immunization Immunization Guide Guide Updated 02/2014

Transcript of North Dakota Dakota School School Immunization Immunization GuideGuide€¦ · Introduction to...

Page 1: North Dakota Dakota School School Immunization Immunization GuideGuide€¦ · Introduction to NDIIS Brief Overview The North Dakota Immunization Information System (NDIIS) is a confidential,

NorthNorthNorth Dakota Dakota

School School

Immunization Immunization

GuideGuide

Updated 02/2014

Page 2: North Dakota Dakota School School Immunization Immunization GuideGuide€¦ · Introduction to NDIIS Brief Overview The North Dakota Immunization Information System (NDIIS) is a confidential,

TABLE OF CONTENTS

Cover Letter.……………………………………………………...……………..………………...1

Information

Vaccine Abbreviation List………………………………………………………………...………2

The North Dakota Immunization Information System……………………………………………4

School Immunization Survey

Timeline for survey……………………………………………………………………………..…5

School Immunization Survey…………………………………………………………………..….6

Letters and Materials to Determine Compliance

FAQ Letter for Tdap and Meningococcal Vaccines………………………..……………………..7

Letter about Tdap and Meningococcal Vaccines……………………………………………….....9

Algorithm for Exclusion…………………………………………………………………………10

Non-Compliance Letter………………………………………………………………………….11

Notice of Exclusion Letter…………………………………………………………………….…12

Certificate of Immunization………..………………………………………………………….…13

Additional Information

Directory of Local Public Health Units………………………………………………………….14

Laws Requiring Immunization of Students….…………………………………………………..16

Rules Requiring Immunization of Students.…………………………………………………….17

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Disease Control Medical Examiner 701.328.2378 701.328.6138 701.328.2499 (fax) 701.328.6145 (fax)

DIVISION OF DISEASE CONTROL 2635 East Main Avenue

P.O. Box 5520 Bismarck, ND 58506-5520

www.ndhealth.gov

School Administrators and Nurses:

The following packet contains information and materials regarding the North Dakota school

immunization requirements. This document is intended to make the immunization compliance

process easier by providing templates and detailed information concerning immunization

requirements, school immunization laws, and criteria for exclusion.

Additionally, information regarding the yearly school immunization survey is included.

The school immunization survey is required by North Dakota state law and allows the health

department to assess the vaccination and exemption rates of school-aged children. The school

immunization survey is due mid-November every year.

This packet also includes information about the North Dakota Immunization Information

System (NDIIS), a list of vaccine abbreviations, and Meningococcal and Tdap vaccination FAQs

for parents. Please take a moment to review the packet and evaluate its contents and let us know

if you have any questions.

Thank you,

Amy Schwartz

Immunization Surveillance Coordinator

[email protected]

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Relevant Vaccines Abbreviation List

DPT

Replaced by use of DTP. See DTP for description.

DT

Diphtheria and tetanus toxoids, pediatric formulation

DTaP

Diphtheria and tetanus toxoids and acellular pertussis vaccine, pediatric formulation

DTP

Diphtheria and tetanus toxoids and whole-cell pertussis vaccine, pediatric formulation

HAV

Hepatitis A Virus

HBV

Hepatitis B Virus

HepA

Hepatitis A Vaccine

HepB

Hepatitis B Vaccine

Hib

Haemophilus influenzae type b

HPV

Human Papillomavirus

HPV2

Human Papillomavirus vaccine, bivalent (Cervarix®)

HPV4

Human Papillomavirus vaccine, quadrivalent (Gardasil®)

IIV3

Trivalent Inactivated Influenza Vaccine

IIV4

Quadrivalent Inactivated Influenza Vaccine

IPV

Inactivated Poliovirus Vaccine

LAIV4

Quadrivalent Live, Attenuated Influenza Vaccine (Nasal Spray)

MCV4 Meningococcal Conjugate Vaccine (Quadravalent)

MMR

Measles, Mumps & Rubella Vaccine

MMRV

Measles, Mumps, Rubella & Varicella Vaccine

MPSV4

Meningococcal Polysaccharide Vaccine (Quadravalent)

OPV

Oral Polio Vaccine

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Td

Tetanus & diphtheria Vaccine, adult/adolescent formulation

Tdap

Tetanus, diphtheria & acellular pertussis vaccine, adult/adolescent formulation

TIV

Trivalent (Inactivated) Influenza Vaccine

TT

Tetanus Toxoid

VAR

Chickenpox Vaccine

VZV

Varicella Zoster Virus (causes chickenpox and shingles)

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Introduction to NDIIS

Brief Overview

The North Dakota Immunization Information System (NDIIS) is a confidential, population-based,

computerized information system that attempts to collect vaccination data about all North Dakotans.

The NDIIS is an important tool to increase and sustain high vaccination coverage by consolidating

vaccination records of children from multiple providers and providing official vaccination forms.

Children are entered into the NDIIS at birth through a linkage with electronic birth records. An

NDIIS vaccination record also can be initiated by a health-care provider at the time of the child's first

immunization. The NDIIS has the capability of collecting vaccination data on adults as well as

children. Schools have the option of having read-only access to NDIIS. This means that schools can

access the immunization records of their students, but they cannot enter information into the system.

If your institution would like to gain access to NDIIS, contact a member of the Immunization

Program at 701.328.3386 or toll-free at 800.472.2180. For more information about NDIIS, please

visit our website at www.ndhealth.gov/Immunize.

NDIIS Forecaster

NDIIS contains a tool that allows users to determine whether or not a child is up to date on

immunizations. Schools can use this tool to determine if the child meets the school immunization

requirements. The vaccine forecaster will generate a list of vaccines the child is due for or will be

due for in the future.

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School Immunization Survey Timeline and Due Dates

Event Date Useful Materials

Schools notify parents of the school immunization

requirements for the next school year.

Spring of previous

school Year and

Summer

School

Immunization

Requirements

School Year Begins August

Students not up to date with school immunization

requirements should be given a letter detailing required

vaccinations.

First day of School

Non-compliance

letter

Students who have not received required immunizations

or are not in the process of receiving them must be given

an exclusion letter and be excluded from school.

30 days after the

start of school

Algorithm for

Exclusion

Notice of

Exclusion

School Immunization Survey is distributed to all schools

in North Dakota. If you do not receive any information

about the survey, contact your administrator or the

Immunization Program.

First week of

October School Survey

Materials

The School Immunization Survey is due to the North

Dakota Department of Health. Survey should have been

submitted online.

Mid-November Instructions for

school survey

The Centers for Disease Control and Prevention (CDC)

will choose a sample of schools who must participate in

the validation study. Because the annual School

Immunization Survey is self-reported by schools,

NDDoH is required to validate the immunization rates

by reviewing a sample of records from select schools. If

the self-reported results do not fall within confidence

intervals for the validation results, NDDoH must report

the validated results as our statewide immunization

rates. NDDoH will be contacting the chosen schools for

copies of their kindergarten immunization records.

January

Results of the study will be reported to CDC April

Schools will be able to see results of survey on the

school survey website. May

www.ndhealth.gov/i

mmunize/rates/

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Dear Parent or Guardian,

Tdap and Meningococcal vaccines are required upon entry into the seventh grade. Tdap is a

vaccine that protects against tetanus, diphtheria and pertussis or whooping cough.

Meningococcal vaccine (MCV4) protects against four common strains of meningococcal disease.

Adolescents are recommended and required to receive both of these vaccines. To ensure

compliance with school vaccination requirements, it is essential that your child receives these

vaccinations before entering the seventh grade. You must provide proof of immunization or

claim an exemption.

1. What grades are affected and what vaccines are required?

Both Tdap and the meningococcal vaccine are required for entry into the seventh grade.

2. How many vaccinations are required?

Only one dose of Tdap vaccine and one dose of meningococcal vaccine are required;

however, a second dose of meningococcal vaccine is recommended at age 16-18 years. In

addition, your child may need additional vaccines to meet school requirements, such as

the chickenpox (varicella) vaccine if he/she has not yet been vaccinated or had

chickenpox.

3. Are there any exceptions?

If your child has already been vaccinated with one dose of Tdap and Meningococcal

vaccine, they do not need to receive another dose in order to be compliant. Proof of

vaccination should be submitted to your child’s school. Vaccination with Td will not

satisfy the Tdap requirement.

4. Is prior illness with pertussis/whooping cough an exception to the Tdap

requirement?

No, anyone who has had pertussis should still be vaccinated. The length of immunity is

unknown following illness. Additionally, it is sometimes difficult to confirm a pertussis

diagnosis.

5. Are Tdap and meningococal vaccines readily available?

Yes, most doctor’s offices, pharmacies and local public health units have a supply of

Tdap and meningococcal vaccines.

6. Why are these vaccines required?

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Pertussis and meningococcal disease are both very serious illnesses that can be prevented

by vaccination. Pertussis is still very common in North Dakota and the United States.

Although most children have been vaccinated with DTaP before entering kindergarten;

immunity lessens after a few years. Tdap vaccination provides renewed protection against

the disease. Meningococcal disease, although significantly less common than pertussis,

has a high fatality rate. Incidence is higher among adolescents and teenagers,

necessitating the vaccination requirement.

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Algorithm for Students not Fully Immunized with Required Vaccines

*** Exclude child from school

Record on File

Yes

Meets School Requirements for

Immunizations

Yes

Up to date with valid doses, no further action

required.

No

Philosophical, Moral, Religious, Medical, or Historical Exemption

claimed by submitting a signed form.

Yes

No further action required.

No

Student has received required vaccines, has

started receiving needed doses or has

claimed an exemption by 30th school day.

Yes

Student has fulfilled all needed vaccine requirements

Yes

No further action required.

No

Required subsequent doses received by 90th

school day

Yes

Continue to follow student until all

required vaccines have been received.

No

Behind Schdule***

No

Behind Schedule***

No

Check NDIIS

No Record on file or in NDIIS***

Immunization record in NDIIS

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Page 12: North Dakota Dakota School School Immunization Immunization GuideGuide€¦ · Introduction to NDIIS Brief Overview The North Dakota Immunization Information System (NDIIS) is a confidential,

To the Parent, Guardian or Legal Custodian of __________________ in Grade___:

Section 23-07-17.1 section of North Dakota State Law entitled Inoculation Required before

Admission to School mandates that all students through grade 12 meet a minimum number of

required immunizations prior to school entrance. These requirements can be waived only for

medical, philosophical, moral or religious reasons. Our records show that your child is not

compliant with the requirements. Non-compliance may be due to absence of immunization

record or because your child is in need of an immunization. The reason for your child’s non-

compliance is noted below. In order to meet the requirements, please complete the form attached

or submit an official certificate of immunization. If vaccinations are added or if you are claiming

a medical exemption, the form must be signed by a medical professional. If you are claiming a

moral, philosophical or religious exemption, the form must be signed by a parent or guardian.

Failure to comply with requirements may result in exclusion of your child from school.

Reason for noncompliance:

The school does not have a copy of your child’s immunization record.

Your child needs the following checked vaccines:

1 If your child has had chickenpox disease, please enter the date of illness on the attached

form in the history of disease section.

Thank you so much for your cooperation.

___________________________ __________________

Date

DTaP Polio MMR Hepatitis B Varicella1 Tdap Meningococcal

1st dose 1

st dose 1

st dose 1

st dose 1

st dose 1

st dose 1

st dose

2nd

dose 2nd

dose 2nd

dose 2nd

dose 2nd

dose

3rd

dose 3rd

dose 3rd

dose

4th

dose 4th

dose

5th

dose

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Page 13: North Dakota Dakota School School Immunization Immunization GuideGuide€¦ · Introduction to NDIIS Brief Overview The North Dakota Immunization Information System (NDIIS) is a confidential,

NOTICE OF EXCLUSION

Dear Parent or Guardian:

Your child has failed to meet the school immunization requirements as mandated by state law.

As a result, your child will be excluded from school starting on _________. To re-enter school

your child must meet one of the following requirements:

1) Provide proof of required immunizations by completing the attached form and providing

the signature of a medical professional. If you are claiming history of disease of

chickenpox, date of illness must be indicated in the history of disease portion of the

attached form.

2) Claim an exemption and complete the attached form indicating the exemption.

Exemptions that may be claimed include philosophical, moral, religious or medical. If

claiming a medical exemption, the form must be signed by a medical professional.

Your cooperation is much appreciated.

___________________________________ ___________________

Date

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Page 14: North Dakota Dakota School School Immunization Immunization GuideGuide€¦ · Introduction to NDIIS Brief Overview The North Dakota Immunization Information System (NDIIS) is a confidential,

North Dakota law requires this form be completed* and provided to the childcare facility or school. Child’s Name (Last, First, Middle Initial):

Date of Birth:

Parent’s Name:

Telephone Number:

Vaccine Type Exemption

Check type below€

Enter Month/Day/Year for Each Immunization Given

Hepatitis B Hepatitis B

Rotavirus Rotavirus

Hib Haemophilus influenzae type B

PCV Pneumococcal conjugate

DTP/DTaP/DT Diphtheria-Tetanus-Pertussis

OPV/IPV Polio

MMR Measles-Mumps-Rubella

Varicella Chickenpox History of Disease Date:

Hepatitis A Hepatitis A

Td/Tdap Tetanus-Diphtheria (and Pertussis)

MCV4 Meningococcal

HPV Human Papillomavirus

Other

To the best of my knowledge, this person has received the above-indicated immunizations on the above dates. Physician, Nurse, Local/State Health Title Date

If additional doses are added after initial signature, please initial dose and sign below. Update signature #1: Physician, Nurse, Local/State Health: Title: Date:

Update signature #2: Physician, Nurse, Local/State Health: Title: Date:

My child has not met the minimum requirements for his/her age. I agree to resume immunizations within 30 days from the date I was notified (today’s date noted below) that my child’s immunizations are incomplete and to submit a signed Certificate of Immunization.

Parent/Guardian Signature: Date:

Statement of Exemption to Immunization Law

In the event of an outbreak, exempted persons may be subject to exclusion from school or childcare facility.

Medical Exemption: The physical condition of the above-named person is such that immunization would endanger life or health or is medically contraindicated due to other medical conditions.

Physician Signature: Date:

€Exemption: (Indicate vaccine above)

(Please check one) □ Religious □ Philosophical □ Moral □ History of Disease

Parent/Guardian Signature Date

CERTIFICATE OF IMMUNIZATION NORTH DAKOTA DEPARTMENT OF HEALTH SFN 16038 (Revised 05-2012)

Division of Disease Control 2635 East Main Ave. PO Box 5520

Bismarck, ND 58506-5520 800.472.2180 or 701.328.3386

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