Host of immunizations long-required for school children & child care workers

While getting a COVID19 vaccine is a new recommendation for school students, getting a vaccination is not unusual or new to go to school in Rhode Island – and most likely every state in the United States.

Required from Kindergarten to Grade 12 in Rhode Island, according to the RI Dept. of Education:

Currently, students must receive the following immunizations prior to their enrollment:

• Hepatitis B (series)
• DIPTHERIA, Tetanus and Pertussis (DTAP) (series)
• TDAP vaccine (7th grade)
• Inactivated Polio Vaccine (series)
• Varicella (VAR) (commonly known as Chicken Pox) (two doses are required for all grades)
• Meningitis (7th – 12th grade)
• Measles, Mumps and Rubella (two doses are required for all grades)
• Tuberculosis Skin Test (P.P.D) – (all children who were born or traveled outside the contiguous United States for longer than 90 days must have a test for Tuberculosis)
• Lead Screening (required for Pre-Kindergarten and Kindergarten students)
• Four doses of Polio vaccine (final dose after 4 years old) (Kindergarten students)
• One dose of the HPV vaccine series (Grade 7)
• Booster dose of Meningococcal vaccine (MCV) (Grade 12)

More information on Immunizations for Schools and Child Care Workers from the RI Department of Health:

Immunization Information for Schools and Child Care Workers

Students and child care workers are required to be vaccinated against certain diseases in Rhode Island. These requirements are based on recommendations from the Center for Disease Control and Prevention (CDC), the American Academy of Pediatrics, and healthcare providers in Rhode Island.

More information about these diseases is available online.

Sharing data with KIDSNET: The Family Educational Rights and Privacy Act (FERPA) allows the release of immunization data from schools only with signed consent. A parent/guardian or student (if 18+ years) must fill out this consent form before you can share their immunization data with KIDSNET.

Required immunizations for students

Requirements for students entering licensed DHS center-based and in-home child care facilities

• 4 doses of DTaP (diphtheria, tetanus, pertussis) vaccine
• 1 dose of Flu vaccine each year
• 2 doses of Hepatitis A vaccine
• 3 doses of Hepatitis B vaccine
• 3 doses of Hib (Haemophilus influenzae type b) vaccine
• 1 dose of MMR (measles, mumps, rubella) vaccine
• 4 doses of Pneumococcal Conjugate vaccine (not routinely given to healthy children 5 years of age and older)
• 3 doses of Polio vaccine
• 2 doses of Rotavirus vaccine
• 1 dose of Varicella (chickenpox) vaccine

Requirements for students entering kindergarten

A student entering kindergarten must have met the pre-kindergarten immunization requirements, plus:

• 1 dose of DTaP (diphtheria, tetanus, pertussis) vaccine
• 1 dose of MMR (measles, mumps, rubella) vaccine
• 1 dose of Polio vaccine
• 1 dose of Varicella (chickenpox) vaccine

Requirements for students entering 7th grade

A student entering 7th grade must have met the pre-kindergarten and kindergarten immunization requirements, plus:

• 1 dose of HPV (human papillomavirus) vaccine
• 1 dose of Meningococcal Conjugate (MCV4) vaccine
• 1 dose of Tdap (tetanus, diphtheria, pertussis) vaccine

Requirements for students entering 8th grade

A student entering 8th grade must have met the 7th grade immunization requirements, plus:

• 2 doses of HPV (human papillomavirus) vaccine

Requirements for students entering 9th grade

A student entering 9th grade must have met the 8th grade immunization requirements, plus:

• 3 doses of HPV (human papillomavirus) vaccine
• *Note: Per current ACIP recommendations, 2 doses of HPV (human papillomavirus) vaccine (if series is started at age 14 or younger)

Requirement for students entering 12th grade

A student entering 12th grade must have met the 9th grade immunization requirements, plus:

• 1 dose of Meningococcal Conjugate (MCV4) vaccine – booster dose

Required immunizations for child care workers

• 1 dose of Flu vaccine every year
• 2 doses of MMR (measles, mumps, rubella) vaccine
• 1 dose of Tdap (tetanus, diphtheria, pertussis) vaccine
• 2 doses of Varicella (chickenpox) vaccine

Exemptions

Students and children in child care (day care) and pre-kindergarten facilities can be exempted from required immunizations for religious, medical, or temporary reasons. A medical exemption certificate must be signed by a medical provider.

• Religious exemption
• Medical exemption
• Temporary exemption

The Religious exemption form is a self-attestation, can be revisited at any time, and includes wording that notes if an outbreak of a vaccine-preventable disease should occur, the student could be excluded from school.

Child care workers can be exempted from required immunizations for medical reasons. A medical exemption certificate must be signed by a medical provider.

• Medical exemption (child care workers)

Other ways to meet the immunization requirements

• Students and child care workers do not need to get the immunizations listed above if they have already received them. This can be demonstrated with an immunization record, a medical passport, or any other official record that shows the month, day, and year of the vaccinations.
• Students and child care workers do not need to get the immunizations listed above if they cannot receive them for medical reasons. A healthcare provider can provide paperwork stating that someone cannot be vaccinated against a particular disease for medical reasons.
• Child care workers do not need to get varicella (chickenpox) vaccine if they had varicella (chickenpox or shingles) in the past. This can be demonstrated with a signed statement from a licensed healthcare provider acting within his/her scope of practice (physician, physician assistant, nurse practitioner).
• If a child care worker is already immune to a disease, vaccination against that disease is not required. Immunity must be demonstrated with laboratory evidence (also called a titer).
• Child care workers born before 1957 are not required to get MMR vaccine.
• Child care workers born before 1980 are not required to get varicella (chickenpox) vaccine.

HPV vaccination

A 3-dose HPV immunization requirement is being phased in. For fall 2015, 1 dose will be required for 7th graders. For fall 2016, one dose will be required for 7th graders and 2 doses will be required for 8th graders. For fall 2017, 1 dose will be required for 7th graders, 2 doses will be required for 8th graders, and 3 doses will be required for 9th graders.

Note: No student should be excluded from school if he/she is not vaccinated against HPV.

Per current ACIP recommendations, adolescents 9 – 14 years of age need 2 doses of HPV vaccine for series completion, and adolescents 15 – 26 years of age need 3 doses for series completion.

Impact on schools: School nurses will only have to assess for 2 doses of vaccine rather than 3 doses, for 9th graders who start the series before age 15.

Colleges & Universities

Minimum Standards for Immunization and Communicable Disease Testing for Students Entering Colleges or Universities

A. Each student, upon entering any college or university in Rhode Island, shall furnish evidence to the administrative head of the college or university (pursuant to the requirements of § 3.6.2 of this Part) that the student has been immunized, as required in § 3.6.1 of this Part, unless the student is in an exempt category (e.g., documented evidence of immunity).

B. For the immunization requirements stipulated in § 3.6.1 of this Part, a student who is not in compliance with these requirements shall be excluded from attending college or universityclasses until the requirements are met, unless the student belongs in an exemption category or is in a waiting period between doses as described in § 3.6.3(B) or § 3.6.3(C) of this Part.

3.6.1 College or University Entry: Immunization Requirements

A. Each student, upon entering any college or university, shall furnish evidence as required in § 3.6.2 of this Part of having received the vaccines described below:

1. Tetanus, Diphtheria, Pertussis Vaccine.  Evidence of having received a single dose of Tdap vaccine.

2. Measles, Mumps, and Rubella Vaccines.  Two (2) doses of live measles, mumps and rubella vaccine given at least four (4) weeks apart beginning on or after twelve (12) months of age.

3. Hepatitis B Vaccine.  Three (3) doses of hepatitis B vaccine administered in accordance with ACIP recommendations.

4. Varicella (Chickenpox) Vaccine.  Two (2) doses of varicella vaccine given at least four (4) weeks apart beginning on or after twelve (12) months of age.

5. Meningococcal Vaccine.  Beginning August 1, 2015, one (1) dose of meningococcal conjugate (MCV4) vaccine in the last 5 years is required for previously unvaccinated newly enrolled full-time undergraduate and graduate students (under twenty-two (22) years of age) in a degree program at a college or university who will live in a dormitory or comparable congregate living arrangement approved by the institution.