Jeb Bush
    M. Rony François, M.D., M.S.P.H., Ph.D.
    ?
    Governor
    Secretary
    ?
    INTEROFFICE MEMORANDUM
    DATE:
    February 13, 2006
    TO:
    County Health Department Directors/Administrators
    FROM:
    Bonita J. Sorensen, M.D., M.B.A.
    Deputy State Health Officer
    SUBJECT:
    Kindergarten and Seventh Grade Immunization Status Report 2005–2006
    INFORMATION ONLY
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    Each October, all public and private schools and schools with a kindergarten and/or seventh
    grade are required to submit reports indicating the immunization status of their kindergarten
    and/or seventh grade students. This information is compiled and sent to the Bureau of
    Immunization for tabulation. Attachments 1 through 4 are summaries of kindergarten data, and
    attachments 5 through 8 represent seventh grade data for the 2005-2006 school year. This
    information was submitted by 3,215 schools with 229,445 kindergarten students enrolled, and
    2,224 schools with 231,392 seventh grade students enrolled.
    Purpose:
    •
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    To assist in elimination of diphtheria, hepatitis B, pertussis (whooping cough), polio,
    measles, mumps, rubella, tetanus, and varicella disease in Florida by increasing school
    children’s immunization levels.
    •
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    To ensure the enforcement of section 1003.22 (previously 232.032
    ), Florida Statutes
    ,
    Florida School Immunization Law, and Chapter 64D-3,
    Florida Administrative Code
    ,
    regarding immunization.
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    To identify those counties needing assistance in raising their immunization coverage
    levels in kindergarten and seventh grade to at least 95 percent.
    Results – Kindergarten:
    Statewide, 94.1 percent of kindergarten students were reported as receiving all immunizations
    required for school entry/attendance:
    •
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    Five doses of diphtheria, tetanus, pertussis (DTaP) vaccine
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    Four doses of polio vaccine
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    Two doses of measles, and one dose each of mumps and rubella vaccines
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    (preferably as two MMR)
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    •
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    Three doses of hepatitis B vaccine
    •
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    One dose of varicella vaccine
    Office of the Secretary
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    4052 Bald Cypress Way, Bin A00
    •
    Tallahassee, FL 32399-1701
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    County Health Department Directors/Administrators
    Page Two
    February 13, 2006
    Students with exemptions from immunization accounted for 5.7 percent of the total kindergarten
    population, as reflected in the following:
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    1,180 religious exemptions, or 0.5 percent
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    527 permanent medical exemptions, or 0.2 percent
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    3,440 30-day exemptions, or 1.5 percent
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    8,126 temporary medical exemptions, or 3.5 percent
    Forty of the 67 counties, or 59.7 percent, reported that 95 percent or more of public and private
    students had received all required immunizations.
    Concerns – Kindergarten:
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    This year, 65 selected counties were allowed to submit their public kindergarten data
    electronically to the Department of Education. While electronic data remained within the
    acceptable range for most of these counties, several still had an excess of students in
    the temporary medical exemption, 30-day exemption, or out-of-compliance categories.
    •
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    Section
    1003.22(10a),
    Florida Statutes
    , does not allow students without proper
    documentation to attend school; however, 23 counties reported a total of 227 students,
    or 0.1 percent, with inadequate documentation of immunizations. These schools are in
    violation of the law and these students should be excluded from school until adequate
    documentation is provided.
    Results – Seventh Grade:
    Statewide, 91.8 percent of seventh grade students were reported as receiving all immunizations
    required for school attendance:
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    Completion of the hepatitis B series
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    Two doses of measles vaccine (preferably MMR)
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    Tetanus-diphtheria booster (Td)
    Students with exemptions from immunization accounted for 6.4 percent of the total seventh
    grade population, as reflected in the following:
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    745 religious exemptions, or 0.3 percent
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    499 permanent medical exemptions, or 0.2 percent
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    1,768 30-day exemptions, or 0.8 percent
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    11,748 temporary medical exemptions, or 5.1 percent
    Concerns – Seventh Grade:
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    Section
    1003.22(10a),
    Florida Statutes
    , does not allow school attendance for students
    with incomplete immunization documentation. However, given this requirement, 30
    counties still reported that 4,316 students, or 1.9 percent, were allowed school
    admission without adequate documentation of their immunizations. These schools are
    in violation of the state law, and these students should be excluded from school until
    adequate documentation is provided.
    County Health Department Directors/Administrators
    Page Three
    February 13, 2006
    The number of temporary exemptions could be significantly reduced, if all healthcare providers
    implemented the “Recommended Childhood Immunization Schedule, United States, 2006,”
    approved by the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on
    Immunization Practices, the American Academy of Pediatrics, and the American Academy of
    Family Physicians, and implemented clinical practices outlined in the
    Standards for Pediatric
    Immunization Practices
    . A copy of the schedule can be found on the CDC’s web site at:
    http://www.cdc.gov/nip/recs/child-schedule-color-print.pdf. We encourage county health
    departments to work with local community partners to promote implementation.
    The school health nurse or authorized public or non-public school official is responsible for
    follow-up on children with temporary medical exemptions or 30-day exemptions to ensure
    children complete the immunization series. In addition, cooperative efforts between the school
    health nurse and school administration to update the electronic submission of immunization
    data will benefit both the health and education system. Using a reminder system to recall
    students still needing immunizations has been shown to increase the completion of the
    hepatitis B series.
    High immunization coverage rates are a result of cooperative efforts by dedicated school
    and county health department officials. These efforts protect Florida's children from vaccine-
    preventable diseases. The Bureau of Immunization supports your local efforts to improve
    immunization coverage and is available to assist in any effort to reduce the threat of vaccine-
    preventable diseases to our children's lives. If you have any questions, you may call
    Ms. Sarah Samuel in the Bureau of Immunization at (850) 245-4342 or SUNCOM 205-4342,
    extension 2395.
    BJS/cha/ss
    Attachments
    cc:
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    Bambi J. Lockman, Bureau Chief
    Bureau of Exceptional Education and Student Services
    Department of Education
    Michele Polland, Educational Policy Analyst
    Bureau of Exceptional Education and Student Services
    Department of Education
    Lavan Dukes, Data Base Management
    Department of Education
    Nancy Humbert, A.R.N.P., M.S.N.
    Deputy Secretary for Health
    Russell W. Eggert, M.D., M.P.H., Director
    Division of Disease Control
    Annette Phelps, A.R.N.P., M.S.N., Director
    Division of Family Health Services
    Shannon B. Lease, M.S., Director
    Office of Performance Improvement
    Charles H. Alexander, Chief
    Bureau of Immunization
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    County Health Department Nursing Directors
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    Bureau of Immunization Field Staff
    ?

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