Policy Details

5141.3 REGULATION Health Assessments and Immunizations

5141.3

Administrative Regulation


STUDENTS

HEALTH ASSESSMENTS AND IMMUNIZATIONS

In accordance with Connecticut General Statutes 10-206, as amended, 10-204a, and 10-214, the following health assessment procedures are established for students in the district:

1) Proof of immunization shall be required prior to school entry. A "school-aged child" also includes any student enrolled in an adult education program that leads to a high school diploma. This immunization verification is mandatory for all new school enterers and must include complete documentation of those immunizations requiring a full series. A required immunization record includes:

Preschool

(Children entering between 24-59 months of age)

DTaP/DT: 4 doses

Polio: 3 doses

MMR: 1 dose on or after the 1st birthday

Hep B: 3 doses, last one on or after 24 weeks of age

Varicella: 1 dose on or after the 1st birthday or verification of disease

Hib: 1 dose on or after the 1st birthday

Pneumococcal: 1 dose on or after the 1st birthday

Influenza: 1 dose administered each year between August 1-December 31st (2 doses separated by at least 28 days required for those receiving flu for the first time)

Hepatitis A: 2 doses given six calendar months apart, 1st dose on or after 1st birthday

Kindergarten

DTaP/DT: At least 4 doses. The last dose must be given on or after 4th birthday

Polio: At least 3 doses. The last dose must be given on or after 4th birthday

MMR: 2 doses separated by at least 28 days, 1st dose on or after the 1st birthday

Hep B: 3 doses, last one on or after 24 weeks of age

Varicella: 2 doses separated by at least 3 months – 1st does on or after 1st birthday; or verification of disease

Hib: 1 dose on or after the 1st birthday for children less than 5 years old

Pneumococcal: 1 dose on or after the 1st birthday for children less than 5 years old

Hepatitis A 2 doses given six calendar months apart, 1st dose on or after 1st birthday

Grade 1

DTaP/DT: At least 4 doses. The last dose must be given on or after 4th birthday

Polio: At least 3 doses. The last dose must be given on or after 4th birthday

MMR: 2 doses separated by at least 28 days, 1st dose on or after the 1st birthday

Hep B: 3 doses, last one on or after 24 weeks of age

Varicella: 2 doses separated by at least 3 months – 1st does on or after 1st birthday; or verification of disease

Hepatitis A: 2 doses given six calendar months apart, 1st dose on or after 1st birthday

Grade 2

DTaP/DT: At least 4 doses. The last dose must be given on or after 4th birthday. Students who start the series at age 7 or older only need a total of 3 doses.

Polio: At least 3 doses. The last dose must be given on or after 4th birthday

MMR: 2 doses separated by at least 28 days, 1st dose on or after the 1st birthday

Hep B: 3 doses, last one on or after 24 weeks of age

Varicella: 2 doses separated by at least 3 months – 1st does on or after 1st birthday; or verification of disease

Grades 3-6

DTaP/Td/Tdap: At least 4 doses. The last dose must be given on or after 4th birthday. Students who start the series at age 7 or older only need a total of 3 doses.

Polio: At least 3 doses. The last dose must be given on or after 4th birthday

MMR: 2 doses separated by at least 28 days, 1st dose on or after the 1st birthday

Hep B: 3 doses, last one on or after 24 weeks of age

Varicella: 1 dose on or after 1st birthday; or verification of disease

Grades 7-9

Tdap/Td: 1 dose for students who have completed their primary DTaP/DT series. Students who start the series at age 7 or older only need a total of 3 doses of tetanus-diphtheria containing vaccine, one of which must be Tdap

Polio: At least 3 doses. The last dose must be given on or after 4th birthday

MMR: 2 doses separated by at least 28 days, 1st dose on or after the 1st birthday

Meningococcal 1 dose

Hep B: 3 doses, last one on or after 24 weeks of age

Varicella: 2 doses separated by at least 3 months – 1st dose on or after the 1st birthday; or verification of disease

Grades 10-12

Td/Tdap: At least 3 doses. The last dose must be given on or after 4th birthday. Students who start the series at age 7 or older only need a total of 3 doses one of which should be Tdap.

Polio: At least 3 doses. The last dose must be given on or after 4th birthday

MMR: 2 doses separated by at least 28 days, 1st dose on or after the 1st birthday

Hep B: 3 doses, last one on or after 24 weeks of age

Varicella: For students <13 years of age, 1 dose given on or after the 1st birthday; for unvaccinated students 13 years of age or older, 2 doses given at least 4 weeks apart; or verification of disease

Important Reminders:

DTaP/DT vaccine is not given on or after the 7th birthday and may be given for all doses in the primary series.

Tdap can be given in lieu of Td vaccine for children 7 years and older unless contraindicated. Tdap is only licensed for one dose.

Hib is not required for children 5 years of age or older.

Pneumococcal is required for all Pre-K and K students born on or after 1/1/2007 and less than 5 years of age.

Hepatitis A is required for all Pre-K and K students born on or after 1/1/2007.

Hep B requirement for school year 2012-2013 applies to all students in grades K-12. Spacing intervals for a valid Hep B series; at least 4 weeks between doses 1 and 2; 8 weeks between doses 2 and 3; at least 16 weeks between doses 1 and 3; dose 3 should not be given before 24 weeks of age.

Second MMR for school year 2012-2013 applies to all students in grades K-12.

Lab confirmation of immunity is only acceptable for Hep B, Hep A, Measles, Mumps, Rubella and Varicella.

VERIFICATION OF VARICELLA DISEASE: Confirmation in writing by a MD, PA or APRN that the child has a previous history of disease, based on family or medical history.

For the full legal requirements for school entry visit www.ct.gov/dph/cwp/view.asp?a=3136&Q=467374&PM=1

New Entrant Definition:

*New entrants are any students who are new to the school district, including preschoolers and all students coming in from Connecticut private, parochial and charter schools located in the same or another community. All students entering kindergarten, including those moving from any public or private pre-school program, even in the same school district, are considered new entrants. The one exception is students returning from private approved special education placements – they are not considered new entrants.

Commonly Administered Combination Vaccines:

Vaccine:

Brand Name:

Vaccine:

Brand Name:

DTaP/DT-IPV-Hib

Pentacel

MMRV

ProQuad

DTAP/DT-HIB

TriHibit

PCV7

Prevnar

HIB-Hep B

Comvax

PCV13

Prevnar 13

DTaP/DT-IPV-Hep B

Pediarix

DTaP/DT-IPV

Kinrix

Immunization requirements are satisfied if a student:

i) presents verification of the above mentioned required immunizations;

ii) presents a certificate from a physician, physician assistant, advanced practice registered nurse or a local health agency stating that initial immunizations have been administered to the child and additional immunizations are in process;

iii) Presents a certificate from a physician stating that in the opinion of the physician immunization is medically contraindicated because of the physical condition of the child;

iv) Presents a statement from the parents or guardian of the child that such immunization would be contrary to religious beliefs of the child;

v) he/she has had a natural infection confirmed in writing by a physician, physician assistant, advanced practice registered nurse or laboratory.

Health assessment and health screening requirements are waived if the parent or legal guardian of the student or the student (if he or she is an emancipated minor or is eighteen years of age or older) notifies the school personnel in writing that the parent, guardian or student objects on religious grounds. (CGS 10-204a)

Students failing to meet the above requirements shall not be allowed to attend school.

2) A physical examination including blood pressure, height, weight, hematocrit or hemoglobin, and a chronic disease assessment which shall include, but not be limited to, asthma and which must include public health related screening questions for parents to answer and other screening questions for providers and screenings for hearing, vision, speech, gross dental and posture shall be required for all new school enterers, and students in grade 6 and grade 10. This health assessment must be completed either prior to school entry or 30 calendar days after the beginning of school for new school enterers. This assessment must be conducted within the school year for students in grade 6 or 10.Parents of students in grade 6 or 10 shall be notified, in writing, of the requirement of a health assessment and shall be offered an opportunity to be present at the time of assessment.

The assessment shall also include tests for tuberculosis, sickle cell anemia or Cooley's anemia and test for lead levels in the blood when the Board of Education, after consultation with the school medical advisor and the local health department, determine such tests are necessary.

A test for tuberculosis, as indicated above, is not mandatory, but should be performed if any of the following risk factors prevail:

a. birth in a high risk country of the world (to include all countries in Africa, Asia, the former Soviet Union, Central and South America, Dominican Republic and Haiti);

b. travel to a high risk country since the previously required examination;

c.extensive contact with persons who have recently come to the United State since the previously required examination;

d.contact with person suspected to have tuberculosis;

e. have been incarcerated;

f. have been living in a homeless shelter, or

g. have HIV infection.

Health assessments completed within one calendar year of new school entry or grades 6 or 10 will be accepted by the school system. Failure of students to satisfy the above mentioned health assessment timeliness and/or requirements shall result in exclusion from school.

The District shall annually report to the Department of Public Health and to the local Health Director the asthma data pertaining to the total number of students per school and in the district obtained through school assessments, including student demographics. Such required asthma diagnosis shall occur at the time of mandated health assessment at the time of enrollment, in either grade six or seven, and in either grade ten or eleven (effective July 1, 2008: grade 9 or 10.) Such asthma diagnosis shall be reported whether or not it is recorded on the health assessment form at the aforementioned intervals.

3) Parents or guardians of students being excluded from school due to failure to meet health assessment requirements shall be given a thirty calendar day notice in writing, prior to any effective date of school exclusion. Failure to complete required health assessment components within this thirty day grace period shall result in school exclusion. This exclusion shall be verified, in writing, by the Superintendent of Schools or his/her designee. Parents of excluded students may request administrative hearing of a health assessment-related exclusion within five days of final exclusion notice. An administrative hearing shall be conducted and a decision rendered within fifteen calendar days after receipt of request. A subcommittee of the Board of Education shall conduct an administrative hearing and will consider written and/or oral testimony offered by parents and/or school officials.

4) Health screenings shall be required for all students according to the following schedule:

Vision Screening

Grades K-6, 9

Audiometric Screening

Grades K-3, 5, 8

Postural Screening

Grades 5, 6, 7, 8, 9


The school system shall provide these screening to students at no cost to parents. Parents shall be provided an annual written notification of screenings to be conducted. Parents wishing to have these screenings to be conducted by their private physician shall be required to report screening results to the school nurse. (Health assessments may be conducted by a licensed physician, advanced practice registered nurse, registered nurse, physician assistant or by the School Medical Advisor.)

5) Parents of students failing to meet standards of screening or deemed in need of further testing shall be notified by the Superintendent of Schools.

Students eligible for free and reduced lunch may have free health assessments provided by the health services staff upon request. Parents of these students choosing to have a health assessment conducted by medical personnel outside of the school system shall do so at no cost to the school system.

6) Health records shall be maintained in accordance with Policy #5125.

7) All candidates for all athletic teams shall be examined annually by a physician.

No candidate will be permitted to engage in either a practice or a contest unless this requirement has been met, and he or she has been declared medically fit for athletics.

An athlete need not be re-examined upon entering another sport unless the coach requests it. If a student is injured, either in practice, a contest, or from an incident outside of school activities that requires him or her to forego either a practice session or contest, that student will not be permitted to return to athletic activity until a physician examines the student and pronounces him/her medically fit for athletics.

Litchfield Public Schools

Regulation Implemented: January 6, 2010
Regulation Amended: June 17, 2013

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