Presentation Objectives Describe the rationale for updating school entry immunization regulations Give a summary of the regulation update and how it will impact immunization requirements Describe how schools can access and use the New York State Immunization Information System (NYSIIS) and Citywide Immunization Registry y( (CIR) to help them review immunization records Describe where educational materials can be accessed Describe who to contact for further information 2 1
Rationale for Updating Regulations Updates made to make New York State (NYS) school immunization entry and attendance requirements consistent with Advisory Committee on Immunization Practices (ACIP) recommendations ACIP develops recommendations for use of vaccines Reduceincidenceof vaccinepreventable diseases Increase safe use of vaccines Effective July 1, 2014 3 School Entry and Attendance Immunization Requirements No change to the required vaccines Revised the number of required doses and intervals between doses of vaccines to be consistent with the ACIP schedules Recommendedchildhood childhood andadolescentimmunization adolescent schedule Catch up schedule 4 2
Assessment of Immunization History All required vaccines, except poliomyelitis and varicella Annual assessment of doses required upon entry or attendance Poliomyelitis and varicella vaccines Assessed upon entry to kindergarten and grade 6 for the 2014 15 school year 5 Assessment of Immunization History (Poliomyelitis and Varicella Vaccines) As students in kindergarten and grade 6 move up a grade, students enrolling in those higher grades required to be immunized: School year 2014 2015 (Year 1): K, 6 School year 2015 2016 (Year 2): K, 1, 6, 7 School year 2016 2017 (Year 3): K, 1, 2, 6, 7, 8 School year 2017 2018 (Year 4): K, 1, 2, 3, 6, 7, 8, 9 School year 2018 2019 (Year 5): K, 1, 2, 3, 4, 6, 7, 8, 9, 10 School year 2019 2020 (Year 6): K, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11 School year 2020 2021 (Year 7): K, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 6 3
7 Diagnosis of Disease as Evidence of Immunity Only allowed for varicella No longer allowed for measles or mumps Must be diagnosed by physician, nurse practitioner, or physician assistant 8 4
Serological Evidence of Immunity Allowed for measles, mumps, rubella, bll varicella (chickenpox), hepatitis B and poliomyelitus (all three serotypes must be positive) Must be laboratory evidence of immunity Equivocal results not acceptable proof of immunity 9 In Process Definition: received at least first dose of each immunization series and has age appropriate appointments to complete the immunization series ACIP catch up schedule used to determine appropriate spacing of appointments Alternative vaccine schedules will no longer be acceptable 10 5
In Process (cont.) 30days allowed for results of serologic testing If results negative, appointment dates must be provided School may not refuse admission to a child who meets the definition of in process to complete the required immunizations 11 Medical Exemptions Must be reissued annually Must contain sufficient i information i to identify if medical contraindication to specific immunization Must specify length of time immunization contraindicated Medical exemption form available at: http://www.health.ny.gov/prevention/immunization/sc h h / /i i i / hools 12 6
Religious Exemption Sample form titled: Request for Religious Exemption created tdby the New York kstate t Education Department t (SED) OR Written and signed statement from parent or guardian Philosophical exemptions not allowed 13 Exclusion in the Event of an Outbreak Vaccine preventable diseases for which a child may be excluded from school expanded to include all the diseases listed in PHL Section 2164 Children in process, or with medical or religious exemptions, may be excluded in the event of an outbreak Schools required to maintain a current list of susceptible children at all times 14 7
Definition of Health Practitioner Any person authorized by law to administer an immunization i i which h includes: Physician Nurse practitioner Nurse midwife caring for pregnant student Registered nurse (RN) Licensed practical nurse under direction of RN Physician i assistant 15 Certificate of Immunization Healthcare practitionerrecord record Signed by practitioner NYSIIS or CIR record 16 8
Grace Period Vaccine doses administered within 4 calendar days of the recommended minimum age or interval to be considered valid 17 Definition of Day Care Agency Day cares outside New York City (NYC) Licensed day care center Licensed group family day care Operate for at least 3 hours a day Day cares in NYC Definition remains the same 18 9
Annual School Immunization Survey Regulations now state schools required to submit immunization data in the form of the annual school immunization survey conducted by NYSDOH Except public schools in NYC 19 NYSIIS and CIR Provide immunization records that clearly show vaccinations and dates of administration Recommend schools use NYSIIS or CIR to determine validity of spacing between doses of vaccine Reports whether doses of vaccine are age appropriate Reports whether intervals between doses are correct 20 10
NYSIIS Schools must have a Health Commerce System (HCS) account to access NYSIIS To request an HCS account, send an email to osas@health.state.ny.us For more information on NYSIIS Call (518) 473 2839 Email nysiis@health.state.ny.us 21 CIR For information about accessing CIR, and to set up an Online Registry account, call the New York City Department of Health and Mental Hygiene: (347) 396 2400 22 11
Educational Materials NYSDOH Frequently Asked Questions Revised NYS Immunization Requirements for School Entrance and Attendance #2370 Letter to schools (provided by State Education Department) Letter to medical providers Revised Pneumococcal Vaccine Schedule Mt Materials il posted tdat NYSDOH Child Care Programs, Schools Sh and Post Secondary Institutions www.health.ny.gov/prevention/immunization/schools ACIP Birth 18 Years & "Catch up" Immunization Schedules www.cdc.gov/vaccines/schedules/hcp/child adolescent.html 23 Contact Information NYSDOH, Bureau of Immunization (518) 474 1944 osas@health.state.ny.us Schools in New York City (347) 396 2433 24 12