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Required for all children 11 - 18 years changing school
districts or enrolled in 6th grade:
• One dose of meningococcal (MCV4 or MPSV4)
vaccine.
• One dose of tetanus/diphtheria/acellular pertussis
(Tdap) vaccine (if 5 years have passed since last
dose of tetanus/diphtheria vaccine – DTaP, Td or
DT).
Required for all children entering kindergarten, all 6th
grade students, and all children changing school
districts:
• Two doses of varicella vaccine or history of
chickenpox disease.
Providers are encouraged to assess for these new
requirements. Reduce the influx of children needing
these requirements in the fall by immunizing NOW.
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The 2010-2011 trivalent influenza vaccine will contain
A/California/7/2009 (H1N1)-like, A; Perth/16/2009
(H3N2)-like,and B/Brisbane/60/2008-like antigens.
Both A strains have changed for this season, the
A/California/7/2009 (H1N1)-like strain is the same
strain that was included in the pandemic influenza
monovalent vaccine in 2009. Another change is
“who will need two doses of upcoming 2010-2011
seasonal flu vaccine”. The following outlines ACIP
th
recommendations voted on June 24 , 2010:
•
•
•
All children ages 6 months through 8 years
who receive a seasonal influenza vaccine for
the first time should be given 2 doses.
Children ages 6 months through 8 years who
did not receive at least 1 dose of an influenza
A(H1N1) 2009 monovalent vaccine should
receive 2 doses of a 2010-2011 seasonal
influenza vaccine, regardless of previous
influenza vaccination history.
A child with an unknown or uncertain history
of seasonal influenza vaccine should get 2
doses.
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The Advisory Committee on Immunization Practices
(ACIP) voted to replace the 7 valent pneumococcal
conjugate vaccine (PCV7) with a 13 valent pneumococcal
conjugate vaccine (PCV13). Based on their age and
previous history, children will receive from 1 to 4 doses
of PCV13.
• Children 2 through 59 months, previously
unvaccinated should begin receiving and
complete their series with PCV13.
• Children through 59 months who began
vaccination with PCV7 and remain incomplete
should finish the series with PCV13.
• Children 14 through 59 months who were
completely vaccinated with PCV7 will need a
single supplemental dose of PCV13.
• Children
who
have
underlying
medical
conditions, a single supplemental dose is
recommended through 71 months including
children who previously received the 23 valent
pneumococcal polysaccharide vaccine (PPSV23).
• A single dose of PCV13 may be administered for
children 6 through 18 years of age who are at
increased risk for invasive pneumococcal
disease because of sickle cell disease, HIV
infection
or
other
immunocompromising
condition, cochlear implant or cerebrospinal fluid
leaks, regardless of weather they have previously
received PCV7 or PPSV23.
Details
of
routine
pneumococcal
vaccination schedule are available at:
conjugate
http://www.cdc.gov/vaccines/recs/schedules/default.htm
#child
JUST A REMINDER…
MICHIGAN
CARE
IMPROVEMENT
REGISTRY (MCIR) ENCOURAGES ALL
PHYSICIAN OFFICES TO REPORT ADULT
AS WELL AS CHILDHOOD IMMUNIZATIONS.
PLEASE
REMEMBER,
TO
REPORT
IMMUNIZATIONS FROM BIRTH TO DEATH.
0 +-
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6
Dr. Annette
Mercatante is
Medical
Director and
Health Officer
of St. Clair
County Health
Department.
A recent case of confirmed mumps provided a
useful examination of our strengths and
weaknesses in managing communicable
diseases in our community. A local student
was sent back to school after developing
symptoms of mumps despite the provider’s
suspicion and appropriate specimen collection
for diagnosis. This was primarily because of
language barriers (mother misunderstood
what her child was being tested for). Once the
child was identified, MCIR records were pulled
for everyone in the classroom and on the bus
(the
identified
contacts).
Forty-five
susceptible students were identified as being
under vaccinated and subsequently excluded
from school. This met with an expectable
outcry by parents who were dismayed at their
children missing all the end-of year school
activities. Their options were to present proof
of updated vaccination for MMR, receive a
booster vaccine offered in a clinic we provided
at the school within that week, or keep their
child out of school. Some questioned our
authority to do this and were referred to the
community disease rules promulgated under
the authority conferred on the Department of
Community Health by section 5111 of Act No.
368 of the Public Acts of 1978, as amended,
being 333.5111 of the Michigan Compiled
Laws. (a real mouthful, but essentially gives
the Local Health Department full legal
authority to control a communicable disease
outbreak). Of the 45 students identified as
being at risk, 24 of them actually had adequate
immunization that needed updating in the
MCIR system.
This is a compelling
commentary on how woefully lacking this data
entry is for the older child, adolescent and
adult population. MCIR is intended to be a
birth through death registry, and will be a
useful tool in assessing vaccination status
regardless of the patient’s point of entry in to
the health care system.
SCCHD:CJC:cc
S:\COMMUNITY NURSING\The Blue Water Current\July 2010
FROM THE DOCTOR’S CORNER cont’d…
2
However, it’s only as good as our ability to update
the system. Imagine the confusion, inefficiency,
and outright adverse outcomes, if this
communicable disease develops into a more
widespread outbreak! It took the staff at the
health department many hours to investigate the
authenticity of these wayward vaccination
records, and to enter them properly into MCIR. If
the need were overwhelming, or the staff had
more pressing matters to attend to (as might be
the case in a widespread outbreak), many
students would be excluded or receive
unnecessary vaccines.
This event clearly
demonstrates our need as healthcare providers to
utilize the MCIR system more comprehensively,
both in using the system to review immunization
status and to enter all vaccine information
throughout a patient’s life. The benefits of this
system being fully functional are quite apparent.
If you or your staff would like a review or training
session on how to use MCIR, please contact
Preventive Health & Immunizations at 987-5300.
We are eager to help you get the most out of this
system, and it may save us all a lot of grief with
the next epidemic or outbreak!
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Animal Bite
Campylobacter
Chickenpox
Chlamydia (Genital)
Cryptosporidiosis
E. Coli 0157:H7
Flu Like Disease
Giardia
Gonorrhea
Hepatitis B Chronic
Hepatitis C Acute
Hepatitis C Chronic
Legionella
Meningitis Aseptic
Meningitis Bacterial Other
Pertussis
Rabies Animal
Salmonellosis
28
6
7
217
3
1
2685
8
46
3
1
42
1
4
1
5
1
7
Strep pneumoniae Invasive
4