Question: Why do school nurses want to have NYSIIS Access User Training? Answer: Once school nurses have participated in the training (which is a recorded webinar training & takes 39 minutes to complete) they may search for student records, generate immunization history reports and create student lists. Please see SN Tool of the Week for directions to access this training. Question: Can a college can accept a cumulative health record card from a school as proof of immunization? Answer: We have received this clarification from a representative of the Western Regional Immunization Field Office: According to PHL 2165 (the college law), it IS acceptable. Question: Can you get pertussis more than once? If a student has a documented case of Pertussis, should he/she still receive the Tdap? Answer: “Reinfection appears to be uncommon but does occur. With natural infection, immunity to pertussis will likely wane as soon as seven years following disease; reinfection may present as a persistent cough, rather than typical pertussis. Unfortunately, it is difficult to verify pertussis infection with existing laboratory methods. If someone has a recent culture-documented case of pertussis, he or she may not need immediate immunization against pertussis; however, a vaccine containing pertussis antigen will not be harmful, and they should continue on the routine immunization schedule for future protection against tetanus, diphtheria, and pertussis. If culture is lacking, even with a history of pertussis, do NOT withhold a dose of pertussis vaccine, if it is recommended per the routine schedule” Tdap vaccine continues to be required for students entering Grade 6. For the 2010 - 2011 school year, all students in Grades 6, 7, 8 and 9 will be required to have this mandated vaccine. Adacel is licensed for students ages 11 through 64 yrs. Boostrix is licensed for ages 10 - 64 yrs. Students are required to have the Tdap, but their private provider may choose which brand of the vaccine to adminster. If the provider chooses to administer Adacel, the student may wait until their 11th birthday to be required to have the Tdap. The parents need to provide proof of immunization or provide the date that the vaccine will be given within 14 days of the student's 11th birthday. Question: What is the nurse’s responsibility with regards to the Immunization Audits? Answer: Audits of immunization records have changed in the last year. The auditor may no longer sit down and look through the health records due to the confidential nature of the information on the health record. Last year, the State Education Department let us know that while the Health Department may still audit records, that all personally identifiable information must be redacted from the record that they can review according to the Family Education Rights and Privacy Act (FERPA - information on this is highlighted on our SN Tool Kit page this week). This will likely require that the school provide some clerical assistance to the school nurse. The school nurse would need to train the clerical staff in the importance of respecting the confidentiality of health information. Personally identifiable information is defined as: ? Student’s name ? Social Security number ? Student number ? Personal characteristics- hair color, age, or other information that would allow a reasonable person in the school community to identify the student with reasonable certainty ? Parent or family names ? Address ? Place of birth ? Mother’s maiden name ? Biometric records- one or more biological or behavioral characteristic that can be used for automated recognition: fingerprints, retina & iris patterns, voiceprints, DNA sequence, and handwriting. Records will likely need to be photocopied with the personally identifiable information cut off or completely blacked out. For the purpose of Immunization Audits, the State Education Department has determined that the student’s birth date may remain on the record so that it can be determined if the MMR and Varicella immunizations were given at the appropriate ages. We anticipate that there will be some issues and concerns as the transition to this new process occurs. Please don’t hesitate to call us if you need additional guidance. Question: Is a physician's diagnosis of disease acceptable proof of immunization for school enrollment? Answer: A physician's diagnosis of only mumps, measles, or varicella disease is acceptable proof of immunization for school enrollment. Question: If a student has a religious exemption to immunizations granted by the school district in Kindergarten, is the exemption still valid for high school in the same district? Answer: If a school district grants a religious exemption, it is valid for the period of time that the student attends school in that district. If the student leaves the district for another school in New York State, the process would need to be repeated.
Question: We have been advised to obtain an original provider’s immunization record for our school records when a student enters our district, but what do we do if the sending school does not have an original record to send? Answer: When a student transfers from one school to another, it is incumbent upon the school that is accepting the transferee to request from the school the student last attended, a copy of the student’s cumulative immunization record and a copy of the health care providers immunization record of such student. If the school that the student last attended does not have such a copy of the health care provider’s immunization record, then the accepting school should document this. A record from the Immunization Registry is a valid original record. Question: Where do I go for advice when I have a specialized immunization question? Answer: The NYSDOH has Immunization Field Offices in every region of the state. For a complete listing with contact information look under “I” in our A-Z Index. Question: If a student is enrolled in a BOCES program, who is responsible for obtaining immunization records and enforcing compliance, the district or the BOCES? Answer: According to the State Education Department, both are responsible. When the student enrolls in the public district, it is the district's responsiblity to obtain proof of immunization. When the student is transferred to the BOCES program, authorities at the center should require proof of immunization from the sending school as part of the placement process. Question: If a student is enrolled in a partial day BOCES program, who is responsible for including the student in the mandated annual immunization school survey form? Answer: The home school district is responsible for counting the student on the form. If student attends BOCES for the full day, then BOCES and the home school district should decide which one will submit the survey data on the student. Most BOCES do send a separate form, but the DOH reports that a number of local school districts send the information. It's important that the school nurse be sure that the student is counted on one survey or the other. Question: What time duration is recommended between 1st and 2nd varicella immunization booster? Answer: The recommended schedule for varicella immunization includes the 1st dose at 12-15 months of age and the 2nd dose at 4-6 years of age. The minimum interval between doses of varicella vaccine for children younger than 13 years of age is 3 months. However, if the child receives the 2nd dose at an interval less than 3 months but at least 28 days, a repeat dose is not necessary. It is recommended that children 13 years of age and older, and adults should receive 2 doses of varicella vaccine separated by at least 4 weeks - but this is not a school requirment at this time. Question: When a child moves to a new district, when sending health information to the new school, we send cumulative health records. Do we also send the Doctor documented immunization certificate or does the new school nurse ask that of the parent/physician? Answer: Please forward copies of the certificate with the cumulative health records to the new school the child will attend. Question: In NYC, a medical exemption must be renewed annually for immunizations, eg. allergies to gelatin. Is it the same in NYS? Answer: The New York City Board of Education, which oversees all public schools in the City of New York, requires that the medical exemptions of public school students must be renewed each year. Non-public schools in the City of New York are not regulated by the New York City Board of Education and therefore are not required to renew medical exemptions annually. For the rest of New York State- If the medical exemption is for a permanent condition, such as an anaphylactic reaction to a vaccine or component of a vaccine, then the student wouldn't need another exemption. If the medical exemption is based on a temporary condition, such as pregnancy or severe acute illness, then the medical exemption would be valid for the duration of the pregnancy or illness. Question: Where can a school health professional find a current, inclusive listing of vaccine names - inlcuding vaccines that are given in combination with other vaccines? Answer: The Centers for Disease Control has an excellent resource for vaccines with information including the name, route, manufacturer and additional comments at: http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/B/us-vaccines.pdf We recommend printing this out as a Health Office reference. Question: If a foreign exchange students is going to be at your school for less than 30 days, must he/she present an immunization record? Answer: A child from another country may be granted a grace period to produce immunizations not to exceed 30 days. Your local school can decide whether or not pursue immunizations in stays shorter than 30 days. Question: Is there a difference between a DTaP and a Tdap immunization? Answer: Yes, the amounts of diphtheria and pertussis in these vaccines are different. Upper-case letters in these abbreviations denote full-strength doses of diphtheria (D) and tetanus (T) toxoids and pertussis (P) vaccines. Lower-case "d" and "p" denote reduced doses of diphtheria and pertussis. DTaP is given to children younger than 7 years of age. Tdap is given to older children and adults. Question: If a child receives a dose of Adacel at age 10 instead of Boostrix, is the dose acceptable for school entry/attendance? Should the student receive another dose in 2 years? Answer: Yes, the dose of Adacel will meet the requirements for school entry/attendance, however, off-license use of Adacel is not recommended. Adacel is licensed for only one dose, so the student should not receive a second dose in 2 years. - New York State Department of Health
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