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School Immunization Requirements

Back To School

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Updated June 10, 2014

Children (8-9) raising hands in classroom
Tetra Images - Jamie Grill/Brand X Pictures/Getty Images
Are your kid's shots up-to-date?

New vaccine laws in some states, like California and Massachusetts, which now requires students who are going into 7th through 12th grade to get a Tdap vaccine, may mean that some kids need to get shots before going back to school.

The many new vaccine requirements of the last few years can also make it difficult to keep your child's shots up to date.

Among the vaccines that were introduced and regularly used over the last five to six years are Tdap, the meningococcal vaccine, and the chickenpox booster shot. While most children are getting these shots with their regular immunizations, older children may not have received them yet.

Another shot that your older child may not have received yet is hepatitis A, which is now routinely given to toddlers when they are 12 to 23 months old. But since it is only required for older children in certain areas of the United States that are considered to be high risk, your child may not actually need it to go to school.

There are other new vaccines and vaccine recommendations that may mean your child needs shots this year before going back to school, including:

  • a chickenpox booster shot
  • Menactra or Menveo, shots that provides protection against meningococcal meningitis
  • Gardasil or Cervarix, the HPV vaccines for older school age girls, although they are not required for attending school
To be considered fully immunized, most schools require the following immunizations (keep in mind that vaccine requirements for school entry vary from state to state):

DTaP (Diphtheria, Tetanus, Pertussis)

  • most children have five dosages by the time they start school, including one after their fourth birthday
  • remember that children also need a tetanus booster when they are around 11 to 12 years old
  • the Tdap vaccine (Boostrix or Adacel) is recommended for teens and adults to protect them from pertussis in 2006 and replaces the previous Td vaccine that only worked against tetanus and diphtheria

MMR (Measles, Mumps, Rubella)

  • two doses of MMR are usually required by school entry. In the past, the second dose was given when a child was either 4 to 6 years old or 12 years old. Now, it is usually given earlier, but some older children may not have gotten two doses yet.
  • having two doses of MMR is important in this age of measles outbreaks

IPV (Polio)

  • most children have four or five dosages by the time they start school, including one after their fourth birthday

Varivax (Varicella, or the Chickenpox vaccine)

  • Your older child will need the chickenpox shot if he has not already had chickenpox in the past. Most younger children receive it when they are 12 to 18 months old. Although younger children used to be given just one dose, it is now required that kids get a chickenpox booster shot when they are 4 to 6 years old. Older kids should get their booster at their next well child visit or as soon as they can so that they don't get chickenpox.

Hepatitis B

  • a series of three shots that is now started in infancy. Older children are usually caught up by 12 years of age if they haven't received this vaccine yet.

Hepatitis A

  • a set of two shots for children over 12 months years of age. All infants and toddlers are now getting this shot as a part of the routine childhood immunization schedule, but there is currently no plan for routine catch-up immunization of all unimmunized 2- to 18-year-old children, unless they live in a high-risk area with an existing hepatitis A immunization program or if the kids are themselves high risk. Kids are high risk for example, if they travel to developing countries, abuse drugs, have clotting-factor disorders, or chronic liver disease, etc.
  • Hepatitis A vaccine is required to attend preschool in many parts of the United States

Hib

  • while required for school entry, children do not usually receive this shot after they are five years of age, so children who have missed this shot don't usually need to get caught up before school starts if they are older than 5 years old.

Prevnar

  • a vaccine that can help to prevent infections by the pneumococcal bacteria, which is a common cause of blood infections, meningitis and ear infections in children.
  • Prevnar is typically given between the ages of two months and five years, and isn't approved for most older kids, so your older child wouldn't need this shot if he didn't get it when he was younger. It is often required to attend preschool though.
  • A newer version of Prevnar, which can provide coverage against 13 strains of the pneumococcal bacteria, is approved and replaces the older version (Prevnar 7) in 2010, which means that many older children in preschool may need another dose of Prevnar 13, even if they finished the Prevnar 7 series.
  • Another version of this vaccine is available for certain older high-risk children though, including kids with immune system problems, although that wouldn't be required for school.

Meningococcal vaccine

  • Menactra and Menveo, the newest versions of the meningococcal vaccine, is now recommended for children who are 11 to 12 years old, with a booster dose when they are 15 to 18 years old.

More Back to School Articles



Sources:

CDC. Recommended Immunization Schedules for Persons Aged 0 Through 18 Years --- United States, 2011. MMWR. February 11, 2011 / 60(05);1-4

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