School laws change
Immunization requirements for school entry in Utah now include the hepatitis A and chickenpox vaccines. Beginning July 1, two doses of the hepatitis A vaccine and one dose of the chickenpox vaccine will be required for all kindergartners to protect children against preventable diseases.
The Utah Department of Health adopted these changes into school law after receiving the latest recommendations from the National Advisory Committee on Immunization Practices and the Utah Scientific Vaccine Advisory Committee. "As new and improved vaccines are licensed, we must continue to implement strategies that will reduce the diseases these vaccines can prevent," says Linda Abel, Immunization Program Manager, Utah Department of Health.
The ACIP recommends routine hepatitis A vaccination for children living in communities with high rates of hepatitis A. Based on a ten-year average from 1987-1997, Utah was identified as one of 11 high-risk states in the U.S. where hepatitis A rates are nearly two times the national average (10 cases per 100,000 population). Children 5-14 years are more likely to get hepatitis A and nearly one-third of all reported cases occur among children under 15. Despite the approval of the vaccine in 1995, hepatitis A continues to be one of the most frequently reported vaccine-preventable diseases in the U.S.
Hepatitis A infection is spread by either person-to-person contact or by eating and drinking contaminated food or water. The most common symptoms include sudden onset of fever, nausea, abdominal discomfort, dark urine and jaundice (yellowing of the skin and eyes). Most infections among children less than 6 years of age do not have symptoms Ã¯Â¿Â½ therefore making transmission easier.
Chickenpox is a highly contagious viral disease that spreads by direct contact with the lesions of an infected person or through respiratory secretions from coughing and sneezing. Symptoms include fever, itching and a generalized rash of 250-500 lesions. Before chickenpox vaccine was available, the disease was responsible for an estimated 4 million cases, 11,000 hospitalizations, and 100 deaths each year in the United States (CDC, unpublished data, 1999). Approximately 90 percent of cases occur in children. A vaccine was licensed in the United States in 1995, and the ACIP issued recommendations for prevention of varicella in July 1996.
Because chickenpox occurs more often among children aged 1-6 years, the ACIP recommends that all states require children entering elementary schools either receive the chickenpox vaccine or have other evidence of immunity to chickenpox. Utah law allows parents to sign the child's immunization record documenting the child has previously had the chickenpox disease and does not need the vaccine. This type of parental verification applies only to the chickenpox vaccine.
Other school entry requirements include: Five doses of Diphtheria, Tetanus and Pertussis (DTaP); four doses of Polio; two doses of Measles, Mumps, Rubella (MMR); and three doses of Hepatitis B.
The UDOH also revised the school rule dealing with exemptions. Medical, religious, and personal exemptions to immunizations may be claimed. However, the appropriate UDOH exemption form must now accompany each exemption claimed. The personal and religious exemption forms are available at all local health departments. The medical exemption form is available to physicians through the Utah Immunization Program.
Although disease levels are at all-time lows and immunization levels are higher than ever before, the potential for outbreaks still exists. For more information about immunizations, call the Utah Immunization Hotline at 1-800-275-0659.