School Immunization
Update
FAMIS Conference,
Tallahassee, FL
June 12, 2012
Presenters
 Dianne Mennitt, School Nurse Consultant,
USF Student Support Services Project,
Bureau of Exceptional Education and Student
Services Dianne.Mennitt@fldoe.org
 Beth Cox, Training Consultant, Florida
Department of Health, Bureau of
Immunization, Florida SHOTS
Beth_Cox@doh.state.fl.us
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Objectives
 Review immunization data for 2011-12
school year
 Understand immunization requirements
for 2012-13 school year
 Discuss Florida SHOTS updates
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Legal Authority
www.leg.state.fl.us
 Section 1003.22, Florida Statutes
 Required immunizations shall be available
at no cost from the county health
departments (CHD)
 Each district school board and the
governing authority of each private school
shall …
 Certification of immunization shall …
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Florida Administrative Code
www.flrules.org
 Rule 64D-3.046, F.A.C., Immunization
Requirements: Public and Nonpublic Schools,
Grades Preschool, Kindergarten Through 12,
Adult Education Classes.
 Annual statewide compliance reporting
requirement for all students attending kindergarten
and seventh grade in Florida
 Florida SHOTS (State Health Online Tracking
System) authorization for access
(http://www.flshots.com)
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Immunization Guidelines
 Florida Schools, Child Care Facilities,
and Family Day Care Homes (July
2011)
 Available online at
http://www.doh.state.fl.us/Disease_ctrl/i
mmune/resources/announcements/inde
x.html#schoolguide
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Certificate of Immunization
DH 680 Form
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Electronic Certificate of
Immunization
DH 680 Form
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Kindergarten & Seventh
Grade Immunization Status
Report, 2011-2012
 http://www.doh.state.fl.us/Disease_ctrl/imm
une/resources/surveys/state-surveys.html
 Validation Assessment
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2011-12 Immunization
Requirements: Kindergarten
 Four or 5 doses of diphtheria, tetanus, and pertussis
(DtaP) vaccine;
 Three, four, or five doses of polio vaccine: If the
fourth dose was administered prior to the 4th birthday,
a fifth dose is required for kindergarten entry
 Two doses of measles, mumps, rubella (MMR)
vaccine;
 Three doses of hepatitis B vaccine; and
 Two doses of varicella (chicken pox) vaccine
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2011-12 Immunization
Results: Kindergarten
(Public Schools)
 Statewide Data: 92% of kindergarteners
had all required immunizations (DH 680:
Part A, DOE Code 1).
 Of Florida’s 67 counties, 33, or 49.3%
achieved/exceeded the goal that 95% or
greater have received all required
immunizations upon kindergarten
entry/attendance.
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2011-12 Immunization
Exemptions: Kindergarten
Statewide Data: Students with
exemptions from immunizations
accounted for 7.2% of the total
kindergarten population:
 9,758 Temporary Medical Exemptions, or
4.3%
 724 Permanent Medical Exemptions, or 0.3%
 2,771 Religious Exemptions, or 1.2%
 3,098 30-day Exemptions, or 1.4%
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2011-12 Immunization
Requirements: 7th Grade
 Completion of the hepatitis B series;
 Two doses of measles, mumps, rubella
(preferably MMR) vaccine;
 One dose of varicella (chicken pox)
vaccine; and
 One dose of tetanus, diphtheria, and
pertussis (Tdap) vaccine
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2011-12 Immunization
Requirements: 7th Grade
 Statewide Data: 95.4% of seventh
grade students were reported complete
for required immunizations (DH 680:
Part A, DOE Code 8).
 Of Florida’s 67 counties, 66, or 98.5%,
achieved the goal that 90% or greater
receive all required immunizations for
7th grade entry/attendance.
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2011-12 Immunization
Exemptions: 7th Grade
Statewide Data: Students with
exemptions from immunizations
accounted for 4% of the total 7th grade
population:




5,837 Temporary Medical Exemptions, or 2.6%
622 Permanent Medical Exemptions, or 0.3%
1,738 Religious Exemptions, or 0.8%
783 30-day Exemptions, or 0.3%
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Temporary Medical
Exemption
 For K – 12 students with incomplete
immunizations (DH 680: Part B, DOE Code 2)
 Temporary Medical Exemption (TME)
requires a valid Expiration Date
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Permanent Medical
Exemption
 DH 680: Part C, DOE Code 3
 For medically contraindicated
immunizations
 List each vaccine with coded valid
clinical reason for exemption
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2011-12 Validation
Assessment Results
 Kindergarten: 96.7% of students were fully
immunized, which is significantly higher than
92.6% reported during Survey 2 (Target:
95%)
 Seventh Grade: 94.5% of students were fully
immunized compared to 95.4% reported
during Survey 2 (Target: 90%)
 Concern: 12% of students in kindergarten
and 8.2% of students in 7th grade had
improper or no documentation of
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immunizations.
IMMUNIZATION GUIDELINES
SCHOOL YEAR 2012/2013
Vaccine ↓
Childcare /
Family Daycare
Preschool /
Pre-K Entry
Kindergarten
through 12th
DTap
√
√
√
Tdap
No requirement
No requirement
7th through 10th
IPV
√
√
√
MMR
1 – 2 doses
1 – 2 doses
2 doses
Varicella
√
1 – 2 doses
2 doses Kg – 4
1 dose 5 - 11
Hepatitis B
No requirement
√
√
Hib
√
√
No requirement
PCV
√
No requirement
No requirement
2012-13 Seventh Grade
Requirement
Students entering, attending, or
transferring to 7th grade in Florida
schools:
 One tetanus-diphtheria-pertussis (Tdap)
 DH 680: Part A, DOE Code 8:
Immunizations are complete for 7th
grade
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Immunization Flyers available at
http://www.doh.state.fl.us/Disease_ctrl/immune/resources/publication
s/flyers.html
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What Is New In
FLORIDA SHOTS!
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Updates to Immunization
Forms in Florida SHOTS
Parents may need different forms for
different children to meet Florida school
immunization requirements. Changes
were made to Florida SHOTS in how
providers can create and produce some of
these forms. These are the:
 DH 681 Religious Exemption.
 DH 680 Part B Temporary Medical
Exemption (TME).
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Religious Exemptions in
Florida SHOTS
 Religious Exemptions DH 681can now be esigned and created in Florida SHOTS.
 Only available at Florida County Health
Departments
 E-signed only by the CHD Administrator or that
individual’s designee who uses Florida SHOTS.
 A DH 681 can be created by a CHD individual that
uses Florida SHOTS and has been determined an
appropriate creator by that county.
 Schools that have Florida SHOTS accounts
can view and print an e-signed DH 681 that
is in the system.
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Religious Exemption
DH 681 E-Signed Form
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Providing a DH 680 Part B
 Florida SHOTS users are blocked from
creating an electronic DH 680 Part B (TME)
for children entering kindergarten with the
following immunization status:
 All series but DTaP are complete.
 DTaP series is up-to-date and required doses for
kindergarten entry are correct--there is only ONE
dose left to receive--the seventh grade Tdap.
 The recommended due date + 15 days for the one
remaining Tdap dose is more than one year in the
future.
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What the Florida SHOTS
User Sees
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When Can A DH 680 Part B
(TME) Be Created?
When children have an immunization status of
incomplete BUT up-to-date for any series
required for child care or school attendance.
 In these cases, if Florida SHOTS calculates an
expiration date based on the next recommended due
date for the individual and that date is greater than 1
year in the future, the date field will be left blank for
user entry.
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How Can Schools Enroll in
Florida SHOTS?
Use the following link to complete the application
process.
 http://www.flshots.com/enrollment/school.html
If you have any questions, contact the Florida
SHOTS Training Consultant, Beth Cox at
850-245-4342 ext. 2342.
Comments/Questions
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