New York State Immunization Requirements for School Entrance/Attendance1 Vaccines Pre-kindergarten School (k-12) (Day Care, Nursery, Head Start, or Pre-K)2 Diphtheria Toxoid-Containing Vaccine 3 doses (New York City Schools – 4 doses)3 3 doses (New York City schools – 4 doses – required for kindergarten only) Tetanus Toxoid-Containing Vaccine and Pertussis 3 doses if born on or after 1/1/2005 3 doses if born on or after 1/1/2005 Vaccine (DTaP, DTP)4 Tetanus, Diphtheria, and Pertussis Booster (Tdap) Not applicable Born on or after 1/1/1994 and enrolling in grades 6 through 11 for the 2012-2013 school year 5 1 dose Polio (IPV or OPV) 3 doses3 3 doses Measles, Mumps and Rubella (MMR)6 1 dose 2 doses of measles-containing vaccine and 1 dose each of mumps and rubella (preferably as MMR) Hepatitis B 3 doses 3 doses7 Haemophilus influenzae type b (Hib) 3 doses if less than 15 months of age or 1 dose Not applicable administered on or after 15 months of age8 Pneumococcal Conjugate Vaccine (PCV) Born on or after 1/1/2008 Not applicable 4 doses by 15 months of age, given at age-appropriate times and intervals9 Varicella (Chickenpox)6 Born on or after 1/1/2000 Born on or after 1/1/1998 or born on or after 1 dose 1/1/1994 and enrolling in grades 6 through 12 for the 2012-2013 school year10 1 dose Revised 2/12 1 Demonstrated serologic evidence of either measles, mumps, rubella, hepatitis B or varicella antibodies is acceptable proof of immunity to these diseases. Diagnosis by a physician, physician assistant or nurse practitioner that a child/student has had measles, mumps, or varicella diseases is acceptable proof of immunity to those diseases. 2 Children in a Pre-kindergarten setting should be age appropriately immunized. The number of doses depends on the schedule recommended by the Advisory Committee on Immunization Practices (ACIP). 3 Please note at this time that New York State requires 3 doses of diphtheria toxoid-containing vaccine (New York City requires 4 doses for pre-kindergarten and kindergarten only) and three doses of polio vaccine for entry into kindergarten and for any student entering a school in New York State for the first time. However, ACIP recommends 4 doses of diphtheria toxoid-containing vaccine by age 18 months and 5 doses by age 4-6 years of age. Children 4-6 years of age should receive 4 doses of polio vaccine unless the 3rd dose is given after 4 years of age. 4 DTaP is the vaccine currently recommended for diphtheria, tetanus and pertussis. 5 Students enrolling in grades 6 through 11 includes students who are entering, repeating or transferring into grades 6 through 11 and students who are enrolling in gradeless classes and are the age equivalent of grades 6 through 11. Children ages 7-10 who have not been adequately vaccinated with DTP/DTaP, and for whom no contraindications exist, should receive a single dose of Tdap. 6 The New York State Department of Health Immunization Program concurs with the ACIP which recommends that vaccine doses administered up to 4 days before the minimum interval or 12 months of age for measles, mumps, rubella and varicella be counted as valid. 7 Hepatitis B – For students in grades 7-12, 3 doses of Recombivax HB or Engerix-B are required, except for those students who received 2 doses of adult hepatitis B vaccine (Recombivax) which are recommended for children 11-15 years old. 8 Four doses of Haemophilus influenzae type b (Hib) are recommended by 15 months or more of age, however only 3 doses are required for day-care entry. If a child enters a day care on or after 15 months of age, and has not received 3 doses of Hib vaccine, only one dose on or after 15 months of age is required. 9 Unvaccinated children 7-11 months of age should receive 2 doses, at least 4 weeks apart, followed by a 3rd dose at age 12-15 months. Unvaccinated children 12-23 months of age should receive 2 doses of vaccine at least 8 weeks apart. Previously unvaccinated children 24-59 months of age should receive only 1 dose. PCV13 is the preferred vaccine for use in healthy unvaccinated/partially vaccinated children 2-71 months of age. A single supplemental dose of PCV13 is recommended for children 14-59 months who have already completed the age appropriate series of PCV7. 10 Students enrolling in grades 6 through 12 includes students who are entering, repeating or transferring into grades 6 through 12 and students who are enrolling in gradeless classes and are the age equivalent of grades 6 through 12. Two (2) doses of varicella vaccine are recommended for all students, but not required for school entry. For further information contact: New York State Department of Health, Bureau of Immunization, Room 649, Corning Tower ESP, Albany, NY 12237, (518) 473-4437. New York City Department of Health and Mental Hygiene, Program Support Unit, Bureau of Immunization, 42-09 28th Street, 5th floor, Long Island City, NY 11101, (347) 396-2433, fax (347) 396-2559. New York State Department of Health/Bureau of Immunization 2370 health.ny.gov/immunization Revised 2/12 FIGURE 1: Recommended immunization schedule for persons aged 0 through 6 years—United States, 2012 (for those who fall behind or start late, see the catch-up schedule [Figure 3]) 1 2 4 6 9 12 15 18 19–23 2–3 4–6 Vaccine ▼ Age ► Birth month months months months months months months months months years years Range of Hepatitis B1 Hep B HepB HepB recommended ages for all Rotavirus2 RV RV RV2 children Diphtheria, tetanus, pertussis3 DTaP DTaP DTaP see footnote3 DTaP DTaP Haemophilus influenzae type b4 4 Hib Hib Hib Hib Range of 5 recommended Pneumococcal PCV PCV PCV PCV PPSV ages for certain high-risk 6 Inactivated poliovirus IPV IPV IPV IPV groups Influenza7 Influenza (Yearly) Measles, mumps, rubella8 MMR see footnote8 MMR Range of Varicella9 Varicella see footnote9 Varicella recommended ages for all 10 10 children and Hepatitis A Dose 1 HepA Series certain high- risk groups Meningococcal11 MCV4 — see footnote 11 This schedule includes recommendations in effect as of December 23, 2011. Any dose not administered at the recommended age should be administered at a subsequent visit, when indicated and feasible. The use of a combination vaccine generally is preferred over separate injections of its equivalent component vaccines. Vaccination providers should consult the relevant Advisory Committee on Immunization Practices (ACIP) statement for detailed recommendations, available online at http://www.cdc.gov/vaccines/pubs/acip-list.htm. Clinically significant adverse events that follow vaccination should be reported to the Vaccine Adverse Event Reporting System (VAERS) online (http://www.vaers.hhs.gov) or by telephone (800-822-7967). 1. Hepatitis B (HepB) vaccine. (Minimum age: birth) 7. Influenza vaccines. (Minimum age: 6 months for trivalent inactivated influenza At birth: vaccine [TIV]; 2 years for live, attenuated influenza vaccine [LAIV]) • Administer monovalent HepB vaccine to all newborns before hospital discharge. • For most healthy children aged 2 years and older, either LAIV or TIV may be • For infants born to hepatitis B surface antigen (HBsAg)–positive mothers, used. However, LAIV should not be administered to some children, including administer HepB vaccine and 0.5 mL of hepatitis B immune globulin (HBIG) 1) children with asthma, 2) children 2 through 4 years who had wheezing in within 12 hours of birth. These infants should be tested for HBsAg and antibody the past 12 months, or 3) children who have any other underlying medical to HBsAg (anti-HBs) 1 to 2 months after completion of at least 3 doses of the conditions that predispose them to influenza complications. For all other HepB series, at age 9 through 18 months (generally at the next well-child visit). contraindications to use of LAIV, see MMWR 2010;59(No. RR-8), available at • If mother’s HBsAg status is unknown, within 12 hours of birth administer http://www.cdc.gov/mmwr/pdf/rr/rr5908.pdf. HepB vaccine for infants weighing ≥2,000 grams, and HepB vaccine plus • For children aged 6 months through 8 years: HBIG for infants weighing <2,000 grams. Determine mother’s HBsAg status — For the 2011–12 season, administer 2 doses (separated by at least as soon as possible and, if she is HBsAg-positive, administer HBIG for 4 weeks) to those who did not receive at least 1 dose of the 2010–11 infants weighing ≥2,000 grams (no later than age 1 week). vaccine. Those who received at least 1 dose of the 2010–11 vaccine Doses after the birth dose: require 1 dose for the 2011–12 season. • The second dose should be administered at age 1 to 2 months. Monovalent — For the 2012–13 season, follow dosing guidelines in the 2012 ACIP HepB vaccine should be used for doses administered before age 6 weeks. influenza vaccine recommendations. • Administration of a total of 4 doses of HepB vaccine is permissible when a 8. Measles, mumps, and rubella (MMR) vaccine. (Minimum age: 12 months) combination vaccine containing HepB is administered after the birth dose. • The second dose may be administered before age 4 years, provided at least • Infants who did not receive a birth dose should receive 3 doses of a HepB- 4 weeks have elapsed since the first dose. containing vaccine starting as soon as feasible (Figure 3). • Administer MMR vaccine to infants aged 6 through 11 months who are • The minimum interval between dose 1 and dose 2 is 4 weeks, and between traveling internationally.