2014 CCDPH Annual School Nurse Update Thursday, April 24, IMMUNIZATION UPDATE IMMUNIZATION PROGRAM ILLINOIS DEPARTMENT OF PUBLIC HEALTH

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1 2014 CCDPH Annual School Nurse Update Thursday, April 24, IMMUNIZATION UPDATE IMMUNIZATION PROGRAM ILLINOIS DEPARTMENT OF PUBLIC HEALTH

2 CONFLICT OF INTEREST THE PRESENTER HAS NO RELEVANT, FINANCIAL, PROFESSIONAL OR PERSONAL RELATIONSHIP WITH A COMMERICAL INTEREST PRODUCING HEALTH CARE GOODS/SERVICES RELATED TO THIS EDUCATIONAL ACTIVITY

3 April 2, 2014 at 4:52 PM Measles exposure reported in Seattle, Tacoma, elsewhere Ohio mumps outbreak grows to 116 cases, mainly at Ohio State Measles Case in International Traveler to Illinois California Measles Outbreak Highest Since It Was Declared Eradicated, And It's Only April Measles Cases in Illinois UPDATE and attendance at McDonough County Junior School Volleyball Game on February 25 th, 2014 More whooping cough cases reported by California, counties

4 CCDPH Reported VPD Cases Haemophilus Influenzae Invasive Disease Hepatitis B Acute Hepatitis B Chronic Hepatitis Delta 1 3 Influenza with ICU Hospitalization Measles 5 Mumps 4 4 Pediatric Influenza Death Pertussis Streptococcus Pneumoniae - Drug Resistant Invasive Disease 2 5 Streptococcus Pneumoniae - Non Drug Resistant Invasive Disease (< 5 years) 5 3 Tetanus 1 Varicella (Chicken Pox) Sum:

5 2013 MEASLES COOK COUNTY all cases were imported with travel history outside of the country; age range from 6-months to 8 years old, with regard to MMR vaccination status only the 8-year- old had 1 MMR, and the 6 -month-old was too young to be vaccinated.

6 2014 MEASLES ILLINOIS Index case child traveling with family to U.S. arriving in Macomb, IL During period of communicability was at, area restaurants, physician office, local E/R and at Regional Hospital for emergency room visit and in patient Additional case exposed to index case New case attended a county s junior high volleyball game during infectious period.

7 SCHOOL YEAR VACCINATION REQUIREMENT CHANGES Preschool and Day Care Adding Pneumococcal Age at 1 st dose (Months) Pneumococcal Primary Series doses, 2 months apart doses, 2 months apart doses, 2 months apart (healthy children) (children at high risk Booster months months Total Doses Require d dose doses, 2 months apart Grades Kindergarten - 12 All K-12 th graders: 2 doses Rubella and Mumps Hep B requirement moves to 6 th grade Two dose Varicella for Kindergarten, 6 th and 9 th graders

8 PROGRESS ON ROLL-OUT ON 1 VARICELLA REQUIREMENT Preschool and Kindergarten (K) Preschool K Preschool K Preschool K Preschool K Preschool K Preschool K Preschool K Preschool K Preschool K Preschool K Preschool K Preschool K

9 ROLL-OUT FOR 2 VARICELLA REQUIREMENT Kindergarten, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, Kindergarten, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, Kindergarten, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, Kindergarten, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, Kindergarten, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, Kindergarten, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 Or physician documented history of varicella disease

10 SCHOOL YEAR VACCINATION REQUIREMENT CHANGES Meningococcal Requirement (MCV4) for 6 th and 12 th graders 6 TH graders must show 1 dose of MCV4 at school entry 12 TH graders must show 2 doses of MCV4 at school entry; second dose must be administered on or after 16 th birthday If first dose of MCV4 administered > 16 th birthday; then only one dose required for entry to 12 TH grade. Child Health Examination Form revisions will occur to accommodate the Meningococcal Requirement

11 SCHOOL COMPLIANCE Mandated Intervals Between Shots 1 Month = 4 Weeks / 28 Days 2 Months = 8 Weeks / 56 Days 4 Months = 16 Weeks/112 Days One year of age = On or after the first birthday. For Preschool hepatitis B only: 6 months of age = 24 weeks = 168 days When interval is < 28 DAYS for live virus vaccines, the vaccine administered second should not be counted as valid and must be repeated. A 4 day grace period can only be allowed with a provider note; counts as a medical exemption. The 4 day grace period not accepted on 28 day interval between 2 live-virus vaccines (i.e. MMR, Varicella or FluMist). Laboratory Evidence of Immunity + IgG or titers accepted for measles, rubella, mumps and varicella. Hepatitis B infection: HBsAg, anti- HBc and/or anti-hbs. Lab evidence of immunity is not allowed for Hib, pneumo, diphtheria, tetanus, pertussis and polio vaccines. Students Affected Public AND Private Schools Rules Target Students by Grade. Students attending ungraded school programs (including special education), must comply in accordance with grade equivalent: * Kindergarten =5 years of age * 6 th graders = 11 years of age * 9 th graders = 15 years of age

12 TDAP An inadvertent dose of DTaP vaccine administered to children aged 7 through 10 years can count as part of the catch-up series. This dose can count as the adolescent Tdap dose, or the child can later receive a Tdap booster dose at age years. Tdap vaccine given on or after the 7th birthday would meet the new school requirement, though it is not routinely recommended. This dose can count as the adolescent Tdap dose. Testing for pertussis immunity is not reliable AND WILL NOT MEET THE REQUIREMENT

13 SCHOOL COMPLIANCE ONLY TWO TYPES OF EXEMPTIONS: MEDICAL AND RELIGIOUS MEDICAL OBJECTION Medical objection must indicate what the medical condition is that contraindicates the specific immunization Must be written by a M.D., D.O., APN or P.A. RELIGIOUS OBJECTION NO LEGAL FORM for religious objection PERSONAL RELIGIOUS BELIEF, LOCAL SCHOOL AUTHORITY ACCEPTS OR DENIES Must detail specific religious belief which conflicts with the specific immunization and or exam. Local school authority is responsible for determining whether written statement constitutes a valid religious objection.

14 I-CARE ILLINOIS COMPREHENSIVE AUTOMATED IMMUNIZATION REGISTRY EXCHANGE Schools can now access immunization records from the State Immunization Registry, I-CARE. Allows view and print immunization records. Must register for I-CARE by completing the memorandum of agreement, then going on line to sign on through the web portal To register for I-CARE either or call BY MID 2014 ALL VFC PROVIDERS WILL BE REQUIRED TO ENTER ALL IMMUNIZATIONS INTO I-CARE

15 Rockford Region 1 ILLINOIS DEPARTMENT OF PUBLIC HEALTH IMMUNIZATION SECTION Regional Contacts for Medical Exemption Reviews West Chicago Region 7 Updated 9/4/13 1 ROCKFORD REGION Covered by: Carol Gibson Finley 525 W. Jefferson St. Springfield, IL Fax carol.finley@illinois.gov Chicago/Cook County Region 8 2 PEORIA REGION Mark Andreasen 5415 N. University St. Peoria, IL Fax mark.andreasen@illinois.gov Peoria Region 2 Champaign Region 6 4 EDWARDSVILLE REGION Marla Jentsch 22 Kettle River Dr. Glen Carbon, IL Fax marla.jentsch@illinois.gov 5 MARION REGION Covered by: Carol Gibson Finley 525 W. Jefferson St. Springfield, IL Fax carol.finley@illinois.gov 6 CHAMPAIGN REGION Debbie Reynolds 2125 S. First St. Champaign, IL Fax debbie.reynolds@illinois.gov Edwardsville Region 4 If you have questions concerning immunizations, please call TTY (hearing impaired use only) Marion Region 5 7 WEST CHICAGO REGION Janet Daniels 245 W. Roosevelt Road, Bldg #5 West Chicago, IL Fax janet.daniels@illinois.gov CHICAGO/COOK CO REGION Covered by: Bill Moran W. Jefferson St. Springfield, IL Fax william.moran@illinois.gov

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