IMPORTANT IMMUNIZATION INFORMATION

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1 IMPORTANT IMMUNIZATION INFORMATION The Pennsylvania Department of Health is reminding parents and guardians in all school districts of an upcoming May 1, 2012 deadline. The purpose of this communication is to provide our parents and guardians with important information of the required immunization documentation in the interest of health, safety, and welfare of all our students. Some children were granted provisional status to attend school for a period of eight months, due to incomplete immunization records, in accordance to Pennsylvania School Health regulations. If you are a parent/guardian of a New Hope-Solebury student missing this documentation, your child is out of compliance. You have already received several letters from the school nurse, as well as a personal telephone call from our staff, requesting that you provide the school district with the required vaccination documentation that will enable your child to continue to attend school after May 1. This requires your immediate attention as all children without proper documentation of immunizations are to be excluded from school as of May 1. In addition to the immunization requirements below, I have attached information on free vaccination clinics as well as a "Frequently Asked Questions" sheet from the Pennsylvania Board of Health. Please understand that we do not desire to exclude students on May 1, However, we have carefully investigated all aspects of these requirements and confirmed that we have no choice but to exclude students who do not have the required vaccination documentation. If you have not been contacted, then your child s records are up to date, and you need not take any action. Please feel welcome to contact me or our Director of Pupil Services, Mr. David Lieberman, at or , with any questions or concerns. Thank you for your prompt attention to this matter. Sincerely, Dr. Raymond J. Boccuti Superintendent PENNSYLVANIA SCHOOL IMMUNIZATION REQUIREMENTS Children in ALL GRADES (K-12) need the following vaccines: 4 doses of tetanus* (1 dose on or after the 4 th birthday) 4 doses of diphtheria* (1 dose on or after the 4 th birthday) 3 doses of polio 2 doses of measles** 2 dose of mumps** 1 dose of rubella (German measles)** 3 doses of hepatitis B 2 doses of varicella (chickenpox) vaccine or history of disease Children ENTERING 7TH GRADE, in addition to the above, will need: 1 dose TDap- tetanus, diphtheria, acellular pertussis (if at least 5 years have elapsed since the last dose of tetanus & diphtheria) 1 Dose MCV (Meningococcal Conjugate Vaccine) *Usually given as DTP or DTaP or DT or ** Usually given as MMR

2 FREE Vaccine Clinics for School-age Children Do your children need vaccinations to meet school requirements for May 1, 2012? Varicella, Tdap, Meningococcal, MMR vaccinations available MUST bring child s vaccination records! No Appointment Needed Saturday, April 21, am 1pm Bucks County Department of Health: Doylestown Office 1282 Almshouse Rd, Doylestown PA For more information: Saturday, April 28, am 1pm Bucks County Department of Health: Levittown Office 7321 New Falls Rd, Levittown PA For more information call: Robert G. Loughery: Commissioner Chairman Charles H. Martin: Commissioner Vice Chairman Diane M. Ellis-Marseglia: Commissioner

3 Pa. Department of Health FAQ regarding exclusion The following information is being provided by the Department of Health Division of Immunizations and Division of School Health as well as the Department of Education in response to questions received by schools on the end of the 8 month immunization provisional period. 1. Under what authority do schools have the right to exclude students? The Pennsylvania Public School Code, Section (a) states: It shall be the duty of all school directors, superintendents, principals, or other persons in charge of any public, private, parochial, or other school including kindergarten, to ascertain that every child, prior to admission to school for the first time has been immunized, as the Secretary of Health may direct, against such diseases as shall appear on a list to be made and from time to time reviewed by the Advisory Health Board. Additionally, 28 PA Code, Responsibilities of schools and school administrators, states: (d) A child not previously admitted to or not allowed to continue attendance at school because the child has not had the required immunizations shall be admitted to or permitted to continue attendance at school only upon presentation to the school administrator or school administrator s designee of a completed certificate of immunization or immunization record, upon submission of information sufficient for an exemption under 23.84, or upon compliance with subsection (e). (3) Completion of required immunizations Immunization requirements described in shall be completed within 8 months of the date of provisional admission to school. If the requirements are not met, the school administrator may not admit the child to school or permit continued attendance after that 8 month provisional period. (emphasis mine) The same requirements are outlined in Department of Education regulations, 22 PA Code, Non- immunized Children. 2. Are students to be excluded at the end of 8 months or can we wait until the end of the school year? Students are to be excluded at the end of the 8- month provisional period. 28 PA Code, Responsibilities of schools and school administrators, states (3) Completion of required immunizations. The plan for completion of the required immunizations shall be reviewed every 60 days by the school administrator or the school administrator s designee. Subsequent immunizations shall be entered on the certificate of immunization or entered in the school s computer database. Immunization requirements described in shall be completed within 8 months of the date of provisional admission to school. If the requirements are not met, the school administrator may not admit the child to school or permit continued attendance after that 8- month provisional period.

4 The regulations require that plans for completion of required immunizations are reviewed every 60 days. This would be difficult to track over the summer, since Certified School Nurses are not in the office and families could be less available, due to vacations. 3. May we renew the provisional period for an additional 8 months? There is no provision in law or regulation to allow renewal of the provisional period. Even if a student transfers to another building or district, the 8- month provisional period transfers with them, and when that time has lapsed, the student may not continue attendance. 4. The Immunization Manual, under Provisional Enrollment on page 12, says that students are to be suspended. I thought students were excluded. Suspensions pertain to disciplinary action. Students excluded for non- compliance with immunization mandates are not being disciplined, but are excluded. The online version of the manual, which can be found at 41/school_children_immunizations/557995, has been updated to read: If the requirements are not met, the school administrator may not admit the child to school or permit continued attendance after that 8- month provisional period. 5. How do we mark these students for attendance? The Department of Education has verified that schools may consider days missed due to exclusion for non- compliance with immunization requirements as an unexcused absence. 6. Do we need to provide them with homebound instruction? 22 PA Code, Section is a general statement about when students may be excluded from school on a temporary basis for a variety of reasons. The provision does not distinguish among the various possible circumstances, nor does it draw a distinction between excusals at the request of the parents or at the mandate of the district. In all circumstances the provision of education during the period of exclusion is discretionary. Thus, schools should be advised to consult with their solicitor, but indicate that according to the Department of Education, the district is not required to provide homebound instruction. On the other hand, the district may certainly opt to provide homebound instruction. 7. May I exclude any of the following groups: a. students with IEPs and 504s? Pennsylvania Public School Code, a. Immunization required; penalty states: (a) It shall be the duty of all school directors, superintendents, principals, or other persons in charge of any public, private, parochial, or other school including kindergarten, to ascertain

5 that every child, prior to admission to school for the first time has been immunized, 28 PA Code, Definitions states: The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise: Attendance at school (i) The attendance at a grade, or special classes, kindergarten through 12th grade, including public, private, parochial, vocational, intermediate unit and home education students and students of cyber and charter schools. The same requirements are outlined in Department of Education regulations, 22 PA Code, Non- immunized Children. All students are required to comply with the same immunization requirements and may be excluded at the end of the provisional period. b. Children younger than 8 years of age? Children are not required to attend school until they are 8 years of age. However, parents have chosen to enroll these students in school. One condition of enrollment is to comply with the immunization requirements. Therefore, these students are to be excluded at the end of the 8- month provisional period if their immunizations are not complete. c. Homeschooled students Homeschooled students are enrolled in the school district and must provide evidence that they are in compliance with the immunization requirements. Submission of the affidavit alone is not sufficient evidence. Refer to the answer in 7a. d. Private Tutored Students The Department of Education s position is that a student who is privately tutored should be subjected to the same requirements to submit evidence of medical exams and immunizations to the school districts as homeschooled students. Chapter 14 of the Public School Code requires each child of school age to meet certain health requirements. Additionally, health regulations use the same terminology in the regulations dealing with examinations and immunizations. Child of school age is defined as any child who attends or should attend a school in the commonwealth. Our interpretation is that this applies to all students, including students being taught by a private tutor. There is no basis to distinguish between students who have a private tutor vs. students who are homeschooled. e. Immigrant and refugee students Refer to the answer in 7a. f. Homeless students

6 The educating district should immediately enroll and begin to provide instruction. The receiving school district may contact the district of origin for oral confirmation that the child has been immunized. Oral confirmation between professionals is a sufficient basis to verify immunization with written confirmation to follow within 30 days. The instructional program should begin as soon as possible after the enrollment process is initiated and should not be delayed until the procedure is completed. According to federal law, "(iii) If the child or youth needs to obtain immunizations, or immunization or medical records, the enrolling school shall immediately refer the parent or guardian of the child or youth to the local educational agency liaison designated under paragraph (1)(J)(ii), shall assist in obtaining necessary immunizations, or immunization or medical records, in accordance with subparagraph (D)." 42 USCA 11432(g)(c)(iii). 8. For school year , will the same immunizations be required? Yes. The immunization requirements for school- age children will not change. For example, students currently in 6th grade will be required to have the meningococcal vaccine and Tdap for school year for entry into 7th grade. 9. Will the Department of Health be offering vaccine to schools to assist in getting these students up to date? The department will only be offering vaccines through the School Immunization Catch- up Program, which is for Vaccines for Children- eligible persons (on medical assistance, Alaskan Native/American Indian, uninsured). The Department cannot supply vaccine for insured students. 10. How should we handle exemption requests (e.g., for religious reasons)? PA Public School Code, a. Immunization required; penalty (c) The provisions of this section shall not apply in the case of any child deemed to have a medical contraindication which may contraindicate immunization and so certified by a physician. Such certificates may be accepted in lieu of a certificate of immunization. (d) The provisions of this section shall not apply in the case of any child whose parent or guardian objects in writing to such immunization on religious grounds. 28 PA Code, Exemption from immunization. (a) Medical exemption. Children need not be immunized if a physician or the physician s designee provides a written statement that immunization may be detrimental to the health of the child. When the physician determines that immunization is no longer detrimental to the health of the child, the child shall be immunized according to this subchapter. (b) Religious exemption. Children need not be immunized if the parent, guardian or emancipated child objects in writing to the immunization on

7 religious grounds or on the basis of a strong moral or ethical conviction similar to a religious belief. Only licensed health care professionals (physicians, nurse practitioners and physician assistants), and designated Health Department personnel (for children that do not have a medical doctor) can sign for medical exemptions. Chiropractors' certifications for medical exemptions are not acceptable. A medical exemption for a specific antigen(s) should be documented in the statement of exemption. All other immunizations are still required. If a physician provides written documentation that the child is adequately immunized when there are inappropriate intervals between doses or a dose is given too early for the age (or any other spacing issues), the instance should be considered a medical exemption. In the event of a disease outbreak, the Division of Immunizations (DOI) will recommend exclusion of the student or may make other recommendations based on the disease outbreak and the immunity history. Statements of religious or strong moral or ethical conviction opposing immunization must be submitted in writing and signed by the parent, guardian or emancipated child. A space on the back of the Certificate of Immunization (the immunization card) is provided for this purpose. This exemption does not need to be renewed yearly. School officials must use their discretion in accepting the statements of exemption. The reason(s) for exemption must be reasonable, as judged by the school official. In difficult cases, State Health Department representatives are available to consult with school personnel as to the intent of the exemption regulations, but the final decision is up to the school official. School officials should consult with their own legal counsel prior to a final decision regarding a questionable exemption. For further questions or clarification, contact the Immunization Nurse Consultant in your Department of Health District Office or County/Municipal Health Department.

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