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Review of childhood immunizations and school requirements

By JAMES LOMAX, M.D.
Posted 8/10/22

Parents are aware of the many issues involved in getting their infants, toddlers and school-aged children immunized in order to attend pre-K through 12 grade. The number of required vaccines keeps …

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Back to school

Review of childhood immunizations and school requirements

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Parents are aware of the many issues involved in getting their infants, toddlers and school-aged children immunized in order to attend pre-K through 12 grade. The number of required vaccines keeps growing for a preschool child—up to five years in age. Boosters and preventative vaccines for the teenager continue to be developed as young people move into high school, college or begin working full-time.

In the last two-plus years, COVID vaccines were added to the list of recommended immunizations for adults, and then finally for children of all ages.

Unfortunately there continues to be resistance to receiving these types of vaccines. For this reason, school systems may encourage completing the series and boosters for staff and students, but may or may not require it.

Other vaccines, however, are required to attend school. Here is a general list.

Some guidelines for pre-kindergarten (day care, Head Start, nursery school or pre-K)

Diphtheria, tetanus and pertussis (DTaP)—four doses

Polio vaccine—three doses

Measles, mumps and rubella (MMR)—one dose

Hepatitis B vaccine—three doses

Varicella (chickenpox) vaccine or evidence of immunity—two doses

Hib influenza vaccine—one to four doses

Pneumococcal conjugate vaccine (PVC)—one to four doses

The timing and exact schedule depends on many factors, such as the age of the child when the series is started. Also, if a vaccine is given too early, it will not count in terms of school requirements, and the child may require an extra shot. The family doctor or pediatrician will discuss this with the parents.

Kindergarten and Grades 1 to 5

DTaP—Completion of series, depending on timing of prior vaccination

Polio vaccine—Completion of series, depending on timing of prior vaccinations

2nd MMR vaccine during this period

Hepatitis B—Completion of series, but child may need extra vaccinations if there was a delay in completing the vaccine series.

Varicella (chickenpox) vaccine—2 doses during this period, or evidence of immunity

Grades 6 to 12

DTaP booster during this period

Meningococcal (MenACWY) vaccine—one dose during Grades 7 to 11, and a second dose at the start of Grade 12

Influenza annually recommended

In reviewing the above, it is easy to see why parents struggle with these requirements. Depending on the state where the child is attending school, there can be some minor difference in schedules. Some states like Pennsylvania allow for medical, religious or philosophical exemptions, while others will have other restrictions of activities in the school if the parents are opting out of some or all vaccines.

For college attendance, especially for students who live on campus, vaccine requirements will vary. Many schools require meningococcal immunization. The state of New York mandates that all students who intend to engage in-person at a SUNY campus or facility receive a COVID-19 vaccination. Other private state colleges do not require this. It is important that you explore this when looking at schools to attend.

The fact is that there are always new infections spreading around the world. Eventually, they will find their way to our area. All individuals and families need to stay current with these issues and carefully follow the recommendations of international, national, state and local departments of health in remaining fully immunized and protected.

vaccination, school, attendance, mandate

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