LAMAR—August is back to school time for area children and as parents scramble to make sure their young students have all the supplies needed to start the school year off right, Colorado Department of Public Health and Environment officials and the Prowers County Department of Public Health are working to make sure kids and adults are protected against a number of preventable diseases.

Prowers County Public Health Nurse Pat Bates said area school districts began notifying parents at the end of the last school year of immunizations that would be required for students before the beginning of this school year. Parents and guardians need to make certain their children have had all the immunizations required for their age group before they are enrolled in preschool or school. Bates said children entering kindergarten must be immunized with all applicable vaccines before the start of school and other students have 14 days from the start of the school year to be in compliance with the requirements.

In January 2007, the CDPHE Board of Health approved three additional vaccine requirements for children in child care and school settings. The three vaccines are for pneumococcal disease, a second dose for chickenpox, and for tetanus/diphtheria/pertussis (Tdap) - which is different from the already required DTaP (diphtheria/tetanus/pertussis).

Joni Reynolds, program manager for the Colorado Immunization Program at the department said, “Pertussis, also called whooping cough, is a highly contagious cough illness that can easily be spread from one child to another. It is critical we protect infants from pertussis. Many infected adolescents and adults may be the primary carriers of this disease to infants and other children, where the illness is much more serious, even life threatening.

Prowers County Public Health Director Jacqueline Brown agrees, commenting that while older children and adults may not get as sick, “this is a disease than can be fatal for infants and very young children.” In addition, Brown said pregnant mothers can pass the illness along to their newborns with tragic results, so doctors are now being urged to make sure their pregnant patients receive the vaccine. Brown said even those adults who received the vaccine as youngsters may not have immunity any longer, as evidenced by the unexpected cases of pertussis in recent years among adults.

“The Tdap vaccine provides good protection against pertussis and can help reduce the spread of this disease,” added Reynolds. “Teens need a booster dose of pertussis vaccine (Tdap) to provide protection against whooping cough. Young children also receive pertussis vaccine (DTaP) but the protection begins to wane over time and most teens are now susceptible to pertussis. This new vaccine will boost their antibodies and provide new protection for the teens.”

Brown said the meningococcal disease vaccine which protects against meningitis infection, also a potentially fatal disease, is now being recommended for young children as well. Initially, the vaccine was recommended for college age students, but Brown said as research information improves and funding becomes available many of the vaccines, including the pneumococcal disease vaccine are being recommended for younger children.

As for chickenpox, both Brown and Bates agree that this too can be a serious illness. Although some may remember not having too much trouble with a childhood bout with the illness, it can be very serious, with complications for older children and adults. In addition, Bates pointed out that reducing the spread of the disease can greatly reduce the risk of shingles, a serious, painful disease which afflicts older adults. Shingles is caused by the same virus that causes chickenpox and can last for months and can return again since one episode does not result in immunity to the illness. Although a vaccine has recently been developed for shingles, it is currently only recommended for those over the age of 65 leaving other older adults at risk for the disease.

Jim Martin, executive director of the Department of Public Health and Environment, said, “Parents will help give their children a healthy start to the new school year by making certain they are up to date on their immunizations.”

It is recommended that Colorado children have immunizations to protect them from these childhood diseases by the time they enter kindergarten or first grade: diphtheria, tetanus and pertussis or whooping cough (DTaP); haemophilus influenzae type b (HIB); hepatitis A; hepatitis B; influenza; measles; mumps; pneumococcal disease; polio; rotavirus; rubella; and varicella or chickenpox.

Immunizations specified for the child’s age are required for enrollment at a child-care center, beginning at two months of age, in addition to being required for school entry.

The 11 required vaccinations are described by the CDPHE as follows: Chickenpox (varicella): The requirement for this vaccine, which first became mandatory in Colorado on July 1, 2000, is being gradually phased in, although health officials recommend that the vaccine be administered to all children and youth up to the age of 18 who have not had the disease. For the 2008-09 school year, one dose of the varicella or chickenpox vaccination is currently required for second through seventh grade. With the new school entry requirement, children entering kindergarten and first grade are required to have a second dose of varicella or chickenpox vaccination. Previously, if a parent or guardian confirmed the child already had chickenpox, the immunization would not be required. But the new requirement for the 2008-09 school year requires the vaccine unless there is documentation by a health care provider that the child has had chickenpox.

• Diphtheria/tetanus/pertussis (DTaP): In general, a total of five doses of diphtheria, tetanus and pertussis (whooping cough) vaccine are required for students entering a Colorado school for the first time.

Only four doses of the vaccine are required if the fourth dose was administered on or after the fourth birthday. Children who are 7 years of age or older no longer receive the DtaP vaccine. Children between 7 though 9 years of age instead receive Td vaccine if they need to complete the requirement for tetanus and diptheria. Children 10 years of

age or older receive the Tdap vaccine to complete the requirement for tetanus and diphtheria and to provide protection from pertussis.

• Hepatitis B: A total of three doses of this vaccine are required for preschool and all grades.

• Haemophilus influenzae Type B (Hib): This vaccine is a preschool requirement for children 4 years of age or younger but is not required for children 5 years of age or older. One, two or three doses of this vaccine are required, depending on both the child’s current age and the age when the vaccine was administered.

• Measles, mumps and rubella (MMR): Two doses of this vaccine are required for kindergarten through 12th grades. One dose is required for preschool children.

• Polio: In general, three doses of this vaccine are required for children in preschool. Grade school, middle school and high school students entering a Colorado school for the first time are required to have four doses of this vaccine. The exception to this rule is if a child received his or her third polio vaccine at or after the age of 4.

• Pneumococcal disease (Prevnar/PCV7): Pneumonia is a contagious disease that can have serious effects in infants and young children. The vaccine, Prevnar (PCV7), is an effective immunization administered in a series to children to prevent pneumonia. The Centers for Disease Control and Prevention recommends the routine vaccination of preschool children with the PCV7 vaccine. It now will be required for children in licensed child-care through 23 months of age, and the number of doses depends on when the vaccine was initially administered.

• Tetanus/diphtheria/pertussis (Tdap): CDC recommends all 11- to 2-year olds receive a dose of Tdap. In Colorado, Tdap vaccine will be required for all incoming sixth, seventh, tenth and eleventh graders this upcoming school year (SY 2008-09), and in subsequent years that schedule will incorporate other grades as well.

The Health Department advised parents and guardians to take immunization records with them when enrolling a child in a Colorado school for the first time.

Reynolds said that if the school determines that a child’s immunizations are incomplete, parents have only 14 days after receiving notification from the school for their child to receive the first recommended immunization and to present to the school a written plan for completion of the remaining immunizations.

Reynolds added that Colorado law permits schools to suspend students until receiving proof that the immunization requirements have been completed, are in process, or that a parent has chosen to file a request for exemption. The state’s schools are to deny admittance of students who do not present an immunization record at the beginning of school.

Under Colorado law, parents may choose to have their children exempted from immunization requirements for medical, religious or personal reasons. Exemption forms, which are required in lieu of the certificate of immunization for those parents who choose exemption, are on the reverse side of the state’s Certificate of Immunization and can be obtained from doctors’ offices and at schools.

Area residents who still need to obtain immunizations for their children should contact their family’s health care provider or their county’s public health service for information or to arrange for vaccination.