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Q:
Where do I get blue cards?
A:
Public Schools: You can obtain blue cards (free of charge) from
your school district office.
Private
schools: You can obtain blue cards (free of charge) from
the County of San Diego Immunization Branch by calling our Yellow
and Blue Card Hotline at (619) 692-8402. Please leave a
detailed message with the school's name, mailing address, contact
phone number, and how many blue cards you need.
Q:
Is a TB skin test required for children to enter school and child
care?
A: The TB skin test is not a vaccine, therefore,
it is not part of the California School Immunization Law. Please
ask your school administrator about your school's policy regarding
TB skin testing. Diana Lobo with the County of San Diego Tuberculosis
Control Program at (619) 692-8245 can answer specific school questions
or visit their website at http://www.sandiegotbcontrol.org.
To view or download more information on TB screening guidelines,
click on the link below:
FAQs for Tuberculosis (TB) Screening
Guidelines for Schools and Child Care Facilities in San Diego County
Q:
Are CHDP (Child Health and Disability Prevention Program) and other
California physical exam forms acceptable records of immunization
history?
A: Yes. A child needs to have a provider-documented immunization
record with the name of the vaccine and the date each dose was given.
Q:
What if a parent says they can't find their child's shot record?
A: If the child’s healthcare provider is a member
of the San Diego Regional Immunization
Registry (SDIR), the child’s immunization record
may be available in the (SDIR) database. Public Health Centers and
private clinics throughout San Diego County regularly use the registry.
Many school districts now have access to the SDIR. If you
have access to the immunization registry, look to see if the child’s
information is available. If a child’s information is found
in the registry, a blue card can be printed off of the registry
using this information. If you do not have access to the registry,
refer the family to the child’s healthcare provider to obtain
an official immunization record.
There
may be situations when the child’s immunization record is
not in the registry, is incomplete, or cannot be verified; refer
the child’s parents to their doctor or clinic to receive more
shots and/or obtain another copy of the immunization record. If
a child does not have a pediatrician, the child can go to a regional
Public Health Center for his/her shots. No appointment is needed
and all shots given at one visit
are only $10! Click below to locate a clinic near you.
Baby Shots Clinic List in English
- iz120.pdf (3/07)
HHSA Immunization Clinic List in Eng
- iz9e.pdf (1/07)
HHSA Immunization Clinic List in Span
- iz9s.pdf (1/07)
For more information about how your school can use the San Diego Regional Immunization Registry (SDIR), click here.
Remind parents that the shot record is an important document, and
they need to keep it safe and have it available for child care and
school entry, doctor visits, etc.
Q:
What type of documentation is accepted for chickenpox disease?
A: If a child has already had chickenpox disease, a doctor
will need to note that on the child's California immunization record.
A letter on the doctor's letterhead stating that the child had the
disease is also acceptable. You cannot accept a verbal
or written statement from the parent. (Click here to see an example
in English or Spanish)
Q: What
do we know about the varicella (chickenpox) vaccine?
A: The vaccine was licensed in 1995. It is 85% effective in
preventing chickenpox. It almost always protects against severe
chickenpox disease.
Before chickenpox vaccine was available, about 11,000 persons with
chickenpox had to go to the hospital each year. From 1990 through
1996, about 103 deaths from chickenpox were reported each year.
In June 2006, the Advisory Committee on Immunization Practices (ACIP)
recommended routine vaccination of all children with two doses of
varicella, the first dose of varicella vaccine administered at age
12-18 months, the second dose administered at 4-6 years of age.
A second catch-up dose is recommended for all children, adolescents
and adults who have received only one dose. Varicella vaccination
with two doses is now recommended for anyone 13 and older without
evidence of immunity.
Click
here to read ACIP recommendation details.
For more information on the vaccine, visit the Centers for Disease
Control and Prevention at:
http://www.cdc.gov/nip/diseases/varicella/default.htm
Q: How long does the vaccine protect someone against chickenpox?
A: Research has shown that protection has lasted as long
as the vaccinated persons have been studied so far (25 years in
Japan, 10 years in the U.S.) More studies are being done.
Q: Can you still get chickenpox disease if you have had the
shot?
A: After vaccination, about 1 in 10 persons do not develop
enough protection to completely prevent them from getting chickenpox
disease. If they come in close contact with a person with chickenpox,
they may develop a mild case of chickenpox with less than 50 blisters.
(This kind of chickenpox is called breakthrough disease.) It will
usually last only a few days, with no or low fever and few other
symptoms. They may miss no school or 1-2 days of school
(these children should stay home until the blisters have formed scabs
or if there are no blisters present, until no new spots or bumps
are forming). The number of children with breakthrough disease should diminish as they receive a second dose.
Q:
How do we document chickenpox disease on the blue card?
A: Write the words "had disease" in the varicella
section of the blue card, specifically where the date of the shot
would normally be written. (Click here to see an example in English
or Spanish)
Q:
Can the 2-dose hepatitis B vaccine schedule be used for kindergarten?
A: No. Younger children must get the 3-dose hepatitis B series.
The special 2-dose series has only been approved for children
11-15 years old. When used on 11-15 year olds, this special
2-dose hepatitis B series must be appropriately noted by the physician
in the child's immunization record.
Q:
Can a child be exempted from California School Immunization Law
requirements for child care?
A:
There are two situations where the law allows a child to be
exempted from the immunization requirements. These are known as
Medical Exemptions and Personal Beliefs Exemptions.
Medical Exemptions: A medical exemption is granted when
a child should not get some or all shots for temporary or permanent
medical reasons. To grant a Temporary Medical Exemption (TME),
ask the parent to bring in an official doctor's note, on letterhead.
This official letter must state which vaccine(s) the child cannot
have at this time, and indicate a future date when the vaccine(s)
will be given. Attach the letter to the blue card (CSIR) and note
the follow-up date on your calendar. It's the school's responsibility
to remind the parent before the exemption expires (the next
shot is due). The parent must then either:
- Present another official letter extending the Temporary Medical Exemption (TME)
or
- Provide proof (usually on a yellow card) that the child received the needed shot(s)
To grant a Permanent
Medical Exemption (PME), ask the parent to bring in an official
doctor's note, on letterhead stating which vaccines the child is
permanently unable to receive. Attach this letter to the blue card
and then note the exemption on the front of the blue card.
Personal Beliefs
Exemptions: Although it is strongly advised that children be
immunized, the final decision to immunize or not is that of the
parent or guardian. They may choose not to immunize in accordance
with religious or personal beliefs. The Personal Beliefs Exemption
is to be granted to parents/guardians only for reasons of personal/religious
belief, and not as a matter of convenience! Not finding the immunization
record, or not having time to take the child to get the shots are
not personal or religious beliefs so the waiver cannot be signed
in these instances. If parents oppose some, or all immunizations,
they must sign the Personal Beliefs Affidavit on the back
of the blue card. By signing this waiver, parents acknowledge that
if there is an outbreak of any disease the child is not protected
against, the County Health Officer may issue an order excluding
those unimmunized children from attending school. These intentionally
unimmunized children will not be able to return to school until
the Health Officer determines that the outbreak is over or if the
parent/guardian decides to immunize the child and thus presents
acceptable proof (usually in the form of a Yellow Card).
Q:
Whom can I contact for more information about school immunization
requirements?
A: For more information about immunizations contact Health Educator
Kimberly Ralston by email at: Kimberly.Ralston@sdcounty.ca.gov or by calling
(619) 692-8601.
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