Note From the Nurse Dear Parent

Theresa Oja, RN, MSN

District Nurse

c/o Estes Park High School

1600 Manford Avenue

Estes Park, CO 80517

Telephone: 970.586.5321 ext 3322

Facsimile: 970.586.1102

E-mail: Theresa_Oja@psdr3.k12.co.us

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Note from the Nurse

Dear Parents of Students in Colorado Schools, K through 12th Grades,

Immunizations are an important part of our children’s health care and Colorado law requires that children going to school be vaccinated to prevent vaccine preventable disease. The purpose of this letter is to let you know which vaccines your student will be required to have in order to attend a Colorado school in the 2010-11 school year. Included in the following list are websites where you can go to find out more about the diseases and the vaccines.

Required Vaccines

Hepatitis B (Hep B) – Three doses are required for all students K through 12th grades to protect against a serious liver disease that can lead to liver damage, liver cancer and death: http://www.immunize.org/hepb/

Tetanus/Diphtheria/Pertussis (DTaP/Tdap/DT/Td) – Five doses of DTaP or DT are required for children under 7 years of age and one dose of Tdap is required for students in 6th through 12th grades. Td is required for children 7 to 10 years of age who have not completed the DTaP or DT series. DTaP, DT, Td & Tdap are the vaccines that protect against tetanus (a disease that causes painful muscle stiffness, convulsions and death) and diphtheria (a disease that can cause suffocation, paralysis, heart failure and death). The pertussis portion of the vaccine protects against whooping cough which can lead to pneumonia, seizures and death. Tdap vaccine will protect adolescents from the whooping cough or pertussis disease and it will prevent them from infecting infants and smaller children in the family:

http://www.immunize.org/tetanus/ http://www.immunize.org/pertussis/ http://www.immunize.org/diphtheria/

Polio (IPV) – Up to 4 doses of the vaccine are required and protects against paralysis, typically of the legs, as well as the muscles that help us breathe: http://www.immunize.org/polio/

Measles/Mumps/Rubella (MMR) – Two doses of this vaccine are required to protect against three diseases. Measles can cause ear infection, pneumonia, seizures, inflammation of the brain and death. Mumps can lead to deafness, meningitis and painful swelling of the testicles or ovaries and occasionally, death. Rubella in pregnant women can cause miscarriage or serious birth defects to the unborn child:

http://www.immunize.org/measles/ http://www.immunize.org/rubella/

Varicella or Chickenpox (Var) – Two doses are required for children in kindergarten through 3rd grade and one dose is required for children in 4th through 10th grades. This vaccine protects against chickenpox disease, a rash illness that can lead to skin infections, pneumonia, swelling of the brain and on occasion, death: http://www.immunize.org/varicella/

Included with this letter is the document entitled: "Minimum Number of Immunization Doses Required- Kindergarten through Grade 12, 2010-11." The chart in this document should help you figure out which required vaccines your child will need for school as well as the number of doses needed for protection. Exemption information is also included at the end of this document.

Recommended Vaccines for the best protection against vaccine preventable diseases

As a parent, it is important to know that in addition to the vaccines required by the state of Colorado Board of Health for school entry, there are vaccines that are recommended by the Advisory Committee on Immunization Practices (ACIP). This is the immunization schedule that will best protect your child from even more vaccine preventable diseases.

Influenza (Flu) – Recommended for children 6 months to 18 years of age to prevent respiratory illness caused by the flu that can cause illness and sometimes death: http://www.immunize.org/influenza/

Meningococcal Meningitis (MCV) - Adolescents 11 -18 years of age should receive one dose of the vaccine which helps prevent meningitis that can cause hearing loss, damage to the nervous system, loss of arms or legs and possibly death: http://www.immunize.org/mening/ http://voicesofmeningitis.org/#/psa

Human Papillomavirus (HPV) - Three doses of this vaccine is recommended for females 11-12 years of age and this vaccine prevents HPV-type related cervical cancer: http://www.immunize.org/hpv/

Hepatitis A (Hep A) – 2 doses of this vaccine prevent the disease that can affect the liver causing fever, fatigue, loss of appetite, stomach pain, vomiting and in rare cases, death: http://www.immunize.org/hepa/

Parents often have concerns or want more information on the safety of vaccines. The Colorado Immunization Program has a web page for parents (under the "Resources" section) with several parent-friendly links that will provide the most accurate information on vaccines: http://www.cdphe.state.co.us/dc/immunization/family.html

Schools work hard to ensure compliance with the immunization laws and your help in providing updated immunization records at school registration is greatly appreciated. Please discuss your child's vaccination needs with your child's doctor or local public health agency. (to find your local public health department's contact information or to locate low cost vaccines contact the Family Health Line at 1-303-692-2229 or 1-800-688-7777). Please bring your child's updated immunization records to the school each time your child receives an immunization.

MINIMUM NUMBER OF DOSES REQUIRED FOR CERTIFICATE OF IMMUNIZATION

Kindergarten through Grade 12, 2010-11

VACCINE	Number of Doses	Grades K-12 (5-18 Years of Age)
VACCINE	Vaccines administered ≤ 4 days before the minimum age are valid
Pertussis	5 to 6	5 DTaP or if dose 4 was administered at or after the 4th birthday, the requirement is met. (DTaP is only licensed for children under 7 years of age). 1 Tdap for students entering 6th through 12th grades. (Tdap is only licensed for students 10 or 11 years of age and older).
Tetanus/Diphtheria	3 to 5	5 DT or if dose 4 was administered at or after the 4th birthday, the requirement is met. A student 7 to 9 years old who has had only a 2 doses of DTaP or DT (before the age of 7 years) can meet the tetanus/diphtheria requirement by receiving a dose of Td if it is given 6 months after the 2nd dose. (Tdap should be given to students at 10 or 11 years of age to complete the tetanus/diphtheria requirement if possible).
Polio A laboratory test showing immunity is acceptable.	4	If the 3rd dose was administered ≥ 4th birthday, only 3 doses are required.
Measles/Mumps/Rubella (MMR) A laboratory test showing immunity is acceptable.	2	For school certification, the 1st dose cannot be administered more than 4 days before the 1st birthday. The minimum interval between dose 1 and dose 2 is at least 28 days.
Varicella (Chickenpox) Documentation of disease from a health care provider(physician, RN or PA) is required or a laboratory test showing immunity is acceptable.	1 or 2	For school certification, the vaccine cannot be administered more than 4 days before the 1st birthday. 2 doses are required for children entering K, through 3rd grades. 1 dose is required for 4th through 10th grades.
Hepatitis B A laboratory test showing immunity is acceptable.	3	The second dose should be administered at least 4 weeks after the first dose. The third dose should be administered at least 16 weeks after the first dose and at least 8 weeks after the second dose. The final dose is to be administered no sooner than 24 wks or 6 months of age. The 2-dose series is acceptable for ages 11-15. 2 doses can only be accepted using the approved vaccine for the 2-dose series with proper documentation (name of the vaccine, dosage, dates, and interval).

You must provide one of the following to your child's school in order to comply with the law:

1. A completed Certificate of Immunization certifying that the student has received minimum immunizations as indicated above.

2. If a student’s Certificate of Immunization is not up to date, the parent, guardian, or emancipated student has 14 days after notification to provide documentation that the next required immunization was administered and submit a written plan for completion of any additional required immunizations. If the plan is not completed, the student shall be expelled or suspended from school for non-compliance. Exception to this is a shortage of vaccine.

3. Statement of Exemption to Immunization Law printed on the reverse side of the Colorado Department of Public Health and Environment Certificate of Immunization:

a) a medical exemption signed by licensed physician stating that the student's physical condition is such that immunizations would endanger life or health or is otherwise medically contraindicated; or

b) a religious exemption signed by the parent, guardian, or emancipated student that the student adheres to a religious belief opposed to immunizations; or

c) a personal exemption signed by the parent, guardian, or emancipated student that the student adheres to a personal belief opposed to immunizations.

Immunization requirements will be strictly enforced for all students. Students who do not meet the requirements will be denied attendance according to Colorado Revised Statutes 25-4-902.

To learn where to obtain immunizations free or at low cost call the Family Health Line at 303-692-2229 or 1-800-688-7777.

Park School District policies that address immunizations and reference the state law are JLCB-R and JLCB.