School Year 2015-2016
Enrollment and Immunization Primer
Please take note of the following:
1. OUT OF COMPLIANCE CALCULATION: For all vaccines given as a series (requires more than
one dose (“shot”) to be compliant), students become out of compliance once the minimum
interval between doses has passed. See page 12 for full details of vaccine dose
requirements.
2. NEW IMMUNIZATION REQUIREMENTS:
a. 2 doses of Varicella vaccine for entry into KINDERGARTEN and 1ST GRADE
b. 1 dose of Tdap vaccine for entry into 7th and 8th GRADES
c. 1 dose of Meningococcal for entry into 7th and 8th GRADES
3. IMMUNIZATION EXEMPTIONS: The entry and definitions for immunization exemptions are
the same as they were last year. Review the primer for new definitions and entry
procedures (Appendices 4 and 5).
4. REPORTS: Reports are in SMS, and are intended to be real-time but could take up to 20
minutes to refresh. Principal Dashboard reports update daily overnight. Data Cleansing
Report #122 identifies Immunization Out of Compliance students and vaccinations.
5. EXCLUSION: Exclusion begins on Monday, September 21st this year.
6. ASSISTANCE:
Louise Fink, Ph.D.- Director, Home and Hospital/Health Services- LLFink@bcps.k12.md.us
John Lamoureux- Baltimore City Health Department-john.lamoureux@baltimorecity.gov
Judith DeBose, MD – Medical Director, Baltimore City Health Department –
judith.debose@baltimorecity.gov
Baltimore City Public Schools (City Schools)
August 2015
Table of Contents
Introduction
3
Key Immunization Campaign Dates
3
Key Immunization Contacts
3
Introduction to SMS and SMS Tutorials
4
Accessing Enrollment and Immunization Reports
 Immunization Non-Compliance Report in SMS
 No Records Report in SMS
 T-10 Report on Principal’s Dashboard
 No Show Kids Report on Principal’s Dashboard
 Attending in September, not in October
5-10
Implementation Tools
10
Immunization Regulations
 Maryland State Regulations
 City Schools and City Health Department Out of Compliance Policy
11-13
Immunization Resources
14
Appendices:
1. Sample Letter to Parents
 English
 Spanish
2. Sample Non-Compliance Report
3. Entering Required Immunization Dosage Information
4. Entering Immunization Exemptions
5. Defining Immunization Exemptions
6. Frequently Asked Questions: For schools, for parents, about SMS
15-17
18
19-20
21-22
23
24-27
2
School Year 2015-2016 Immunization Primer
Before the start of each school year, City Schools embarks on a multi-agency effort to ensure that all
students are immunized and ready to attend school on the first day, and remain in compliance for the
remainder of the school year. Every year, immunization requirements extend from Pre-K through the 12th
grade in Baltimore City, and thousands of students are non-compliant. This primer is intended to serve as a
comprehensive resource for school-level staff and administrators.
Use this as your reference guide and toolkit for reaching the system-wide goal of 99.7% compliance in
ALL schools by September 30, 2015. All immunization information should be entered promptly into SMS
when it is received from families.
2015 Key Dates
-
By Friday, August 28th:
o SCHOOLSOnline Training Completed by Immunization Project Managers
o CENTRALNon-compliance calls made to students
-
Monday, August 31st: Start of School. First day of exclusion for non-compliant students, unless one
of the following documents is provided: 1) DHMH Form 896 (MARYLAND DEPARTMENT OF HEALTH
AND MENTAL HYGIENE IMMUNIZATION CERTIFICATE) or other immunization record; 2) An
appointment slip documenting that the student will receive the required vaccine(s) before
September 21st; 3) A verbal or written statement from the parent/guardian that the student has an
appointment (date required) with a health care provider or the Health Department before
September 21st.
o SCHOOLSInformation Sent Home with Non-compliant students on first day of school,
followed by on-going monitoring and communications (phone calls, letters, conferences)
with families.
o CENTRALParent Link calls before start of school
-
Friday, September 4th:
o SCHOOLSSend letters home with all non-compliant students who submitted
appointment information informing their parents that students must bring documentation
to school by Monday, September 21st or they will be excluded from attending school.
Letters will be made available in Principal’s Dashboard from September 4th.
o CENTRALExclusion guidance sent to Principals via City Schools Inside. Parent Link calls
sent to students regarding exclusion.
-
Monday, September 21st: First day of exclusion for non-compliant students who provided
documentation that they were scheduled to receive the required vaccines, but did not return
documentation of the required vaccines (DHMH Form 896 or other immunization record).
-
September 30th: Students who are not in compliance by September 30 will NOT be counted as
enrolled students for funding purposes.
o SCHOOLSPhone calls and home visits to students.
o CENTRALParent Link calls to students.
3
Key Immunization Contacts
Contact your School Support Liaison and/or your School Nurse for direct support.
Baltimore City Health Department: 410-396-4454 or www.baltimorehealth.org
City Schools Office of School Support – Health Services: 410-396-8904 or
http://www.baltimorecityschools.org/Page/25226
SMS
SMS is the data system that houses all City Schools immunization records electronically. School staff
members are the only personnel who are authorized to make changes or additions to student records in
SMS. Therefore, it is important to enter all immunization records in a timely and accurate manner.
Students can become non-compliant because of simple data entry errors, and families can be burdened
with multiple letters, phone calls and house visits if their students are considered non-compliant because
schools have not entered their documentation into SMS.
If you have questions at any time, call the City Schools Help Desk at 443-984-2000 and ask to speak with
ITD.
SMS Tutorials
City Schools created a tutorial for how to enter:
- Immunization dosage information
- Immunizations exemptions (including the new definitions for immunization exemptions)
Please see Appendices 3, 4, and 5 for step by step instructions and definitions.
These tutorials are step-by-step, screen-by-screen instructions on the correct way to enter this data. Please
familiarize yourself with how to enter exemptions. The importance of entering data correctly cannot be
overstated. Your students will become non-compliant if you do not enter these exemptions correctly.
Remember to look for possible data entry errors when a student is non-compliant without an obvious
reason. Check the cumulative folder to make sure that shot dates in SMS match the written records.
4
Enrollment and Immunization Reports
SMS Reports are the best tool for keeping students in compliance for immunizations.
These reports can be accessed any time:
- SMS reports are real-time and automatically updated
- Principal Dashboard reports are updated nightly
- Data Cleansing Reports are updated nightly
Principal Dashboard
The principal’s dashboard now includes key measures for immunization, so that the principal can directly
and easily monitor the progress of the initiative at their school site. Access the dashboard via the “tree”
icon on your desktop -- only principals have access to this dashboard. Under “Student Information”, click
on “Immunizations”. To see just Non-compliant students, click on “Out-of-Compliance”.
Report: Non-Compliance in SMS
This report is real time and is accessed via SMS. It will list by name all students who are currently out-ofcompliance at your school. The report indicates which shot(s) each student needs to receive or provide
documentation of having received. A sample Non-Compliance report is available in Appendix 2 of this
primer.
Directions to access the report detail level of students (student names)
1. Log in to SMS.
2. Click on Admin > Reports
3. Under “City Schools – Immunization Reports”, click on “Immunization Out of Compliance”
4. Enter three digit school number and click “Run Report”
5
Report: Data Cleansing in EWEB
The Data Cleansing Reports now includes immunizations, so that all staff with data cleansing access can
directly and easily monitor the progress of the initiative at their school site. Access eweb at http://eweb –
only staff who have been granted access to data cleansing reports will be able to view this report. Under
“Reports”, click on “Data Cleansing Reports.” To see your out-of-compliance students, click on “Student
with Immunization out of Compliance” – this is Report #122.
6
Primary Reasons for Non-Compliance*
Common Reasons for OOC
1. Invalid shot - under age 1 year
Applicable Shot(s)
MMR
Varicella
2. Two or more doses required- over age 13
Varicella
years
Hep-B (3 doses required)
3. Data Entry Error or Omission
Wrong Date of Birth
Wrong Date of Vaccine Dose
4. New Requirements
7th Grade and 8th Grade: Tdap and Meningococcal
Kindergarten and 1st Grade: 2nd dose of Varicella
*Refer to the full descriptions of immunization requirements for more information.
7
Common Names for Vaccines
Vaccine Name
DTaP/DTP/DT/Td
Tdap
MCV
Polio
Mumps
Measles
Rubella
Varicella
Hep B
HIB
PCV
Common Names
Diphtheria
Tetanus
Pertussis
Tetanus, Diphtheria, acellular Pertussis
Meningococcal
Polio
Measles, Mumps, Rubella (MMR), MMR-4
German Measles
Measles, Mumps, Rubella (MMR), MMR-4
Measles, Mumps, Rubella (MMR), MMR-4
Chicken pox vaccine
Hepatitis-B
Hemophilus influenza type B
Pneumococcal conjugate vaccine
Prevnar
Report: No Records
This report is real-time and will show students who have no records entered for immunizations in SMS.
Typically, these students are new enrollees, and their immunization information was not entered at the
time of initial entry into SMS.
Directions to access the report  detail level of students (student names)
1. Log in to SMS.
2. School based immunization contacts must switch their role to SCCHP to have SMS Immunization and
Entry Access.
3. Click on Admin > Reports
4. Under “City Schools – Immunization Reports”, click on “Immunization No Records”
5. Enter three digit school number and click “Run Report”
Report: Missing Students- T-10 Status
This report is real-time and will show students who are missing from City Schools records. Students will be
listed under the last school they attended, with their last available contact information and their number of
days absent. “Leaving schools” must attempt to contact their missing students to determine if they are
enrolled in another city school. Once that determination is made, student records should be transferred to
the current school and SMS should be updated to reflect the new information.
Directions to access the report  overview number of students
1. Log in to Principal Dashboard.
2. Click on “Student Information” tab
3. Make sure you are on “Enrollment Overview”
4. See T-10 Student data on right hand side
8
Directions to access the report  detail level of students (student names)
1. Log in to SMS.
2. Click on Admin > Reports
3. Under “City Schools – Data Validation Reports”, click on “Aging T10 report”
4. Enter three digit school number and click “Run Report”
9
Report: No Show Kids (helps with attendance and T-10)
This report identifies students who are in T-10 status and students who have yet to attend school for the
current year. This is a target list for principals and staff for phone calls and home visits to determine
enrollment status of students.
Directions to access the report  detail level of students (student names)
1. Log in to SMS.
2. Click on Admin > Reports
3. Under “City Schools – September 30th Enrollment Reports”, click on “No Show List”
4. Enter three digit school number and click “Run Report”
Report: Attending in September, but not in October
This report is real time and will list by name all students who attended school in September, but have not
attended yet in October.
Directions to access the report  detail level of students (student names)
1. Log in to SMS.
2. Click on Admin > Reports
3. Under “City Schools – September 30th Enrollment Reports”, click on “Students Absent on Sept. 30th
and no atten in Oct”
4. Enter three digit school number and click “Run Report”
10
City Schools Implementation Tools
Tool: Web-based Access to Student Health Records of BCHD
The Baltimore City Health Department is again offering services to help ensure that City
public school students are in compliance with their required immunizations (“shots”). These
services include:
(1) TIKE free shot clinics [see the attached schedule for August];
(2) Health Department staff will search for and then fax back to schools the shot
records of students who may have a “lost” or “incomplete” vaccination history
(please call 410-545-3048 for assistance); and,
(3) School immunization managers have direct access to Maryland’s BIRPImmuNET immunization registry. To access ImmuNET, point your Internet browser
to https://www.mdimmunet.org then log in with the same user name and password as
you used last year.
(4) Medical review of immunization records to determine if vaccines have been
inappropriately administered (contact your school nurse, or Judith DeBose, MD –
Medical Director for the Bureau of School Health at
judith.debose@baltimorecity.gov)
11
Please call or e-mail John Lamoureux (410-545-3048; john.lamoureux@baltimorecity.gov)
for BIRP-ImmuNET questions and other assistance.
12
2015-2016 Immunization Regulations
The following two documents give a description of vaccine requirements in the State of Maryland for school
year 2015-2016.
State of Maryland Vaccine Requirements
Explains State of Maryland immunization requirements.
City Schools Immunization Compliance Logic
Details how the City Schools and the Baltimore City Health Department determine out-ofcompliance students (based upon Maryland State law). Each required vaccine has unique minimum
intervals, age requirements and required dosages. Familiarizing yourself with this document will
enable you to answer parent questions quickly and efficiently.
Highlights of 2015-2016 Immunization Requirements
1) Students have a 20-day grace period beyond their first date of entry into City Schools (or the first day of
school) to get the next required dose, only if there is documentation of the date of an appointment for
vaccines within the 20 day grace period, with either their health care provider or the Health Department.
Students must be excluded on the first day of school if no documentation of an appointment date is
provided.
2) Students become out of compliance when the minimum interval between doses of shot has passed. For
example, there is a 4 week minimum between Hep-B doses one and two. If a student receives their first
Hep-B dose on September 1st, then the student will not become out of compliance until that 4 week
window has passed on September 29th. In addition, any shots given within that 4 week window will not be
counted as valid in SMS. So it is important that students wait those minimum time periods before getting
their next dose. See page 12 for more detailed information on shot intervals. If there are any questions
about minimum intervals, please contact your school nurse.
2) You must enter a date, including month and year, into the ‘Comments’ field on the Immunizations
Exemption dialog page. This date should either be the student’s disease date or date of titer that
determined history of the disease, if disease date is unknown. See Appendix 4 for this important tutorial.
3) Temporary Medical Exemptions should not be used in lieu of an immunization. The temporary medical
exemptions should be used with discretion and can be granted for medical situations such as pregnancies
and either student or family illness, as documented by a physician. For example, if either a student or family
member is receiving chemotherapy, a physician may choose to exempt a student from receiving vaccines
that contain live pathogens and could be a threat to the immune system. To appropriately enter this
exemption into SMS, remember to put an end date, as dictated by a physician, into the ‘Expiry Date’ field
on the Immunizations Exemption dialog page. See Appendix 4 for this important tutorial.
4) Permanent Medical Exemptions for illness can also be granted at the discretion of a physician, and must
be documented. There is no end date for these exemptions, so you do not need to enter an Expiry date.
5) Religious Exemptions: Parents must sign the bottom of DHMH form 896 confirming that their bona fide
religious beliefs exempt them from immunizations. This is the ONLY documentation that is needed for a
religious exemption to be granted. Students do not need physician approval for a religious exemption.
Simply select ‘Religious Exemption’ from the Immunization Exemption list. See Appendix 4 for this
important tutorial. If you experience difficulty with entering a religious exemption for a 7th or 8th grade
student, please contact Louise Fink by email, llfink@bcps.k12.md.us
13
6) Students may not be excluded from registering or enrolling in school due to a lack of immunization
documentation. Guidelines for this can be found from the Department of Health and Mental Hygiene at
http://phpa.dhmh.maryland.gov/OIDEOR/IMMUN/Shared%20Documents/Min_Vacc_Req%2015_16_FINA
L.pdf
14
16
Additional Immunizations Resources
Baltimore City Health Department (BCHD)
The Baltimore City Health Department offers free immunizations for students through its Community
Health Clinics, TIKE van, and school-based health suites. Students will need to either be accompanied by
a parent or guardian to provide the necessary informed consent. Students should also bring their past
shot records with them whenever possible.
BCHD Health Clinics
Students can be immunized for FREE without an appointment at Baltimore City’s Eastern District and
Druid Health Clinics at the following addresses. Clinic hours vary, so contact the BCHD at 410-396-4454.
Eastern
620 North Caroline St.
Baltimore, MD 21205
Phone: 410-396-4454
Metro: Johns Hopkins Station
MTA buses: No. 5 (Monument and Central Ave.)
Druid
1515 North Ave.
Baltimore, MD 21217
Phone: 410-396-4454
Metro Subway: Penn North Station
MTA buses: No. 13 (Pennsylvania and North Ave.)
TIKE Clinics
The Baltimore City Health Department offers FREE immunizations for students through its TIKE clinics,
which are located in different locations around Baltimore each week. Appointments are not necessary
to be immunized through the TIKE clinics. Updated schedules are available online each month at:
http://health.baltimorecity.gov/node/107
or
http://health.baltimorecity.gov/sites/default/files/TIKE%20Clinic%20Schedule_5.pdf
17
Appendix 1: Sample Letter to Parents
Appendix 1 is a sample letter that schools can send to parents of non-compliance students throughout
the year. Letters are an important method of communicating with parents and ensuring that the
addresses in student files are correct. If a letter is returned to you in the mail, be sure to track down that
student’s correct mailing address and enter it into SMS.
If you are viewing the letter electronically and would like to copy and paste the text, use the ‘select’ tool
(cursor) in Adobe Reader. It is found in the upper left corner of your screen. Highlight all the text, and
then choose ‘copy’ under the ‘edit’ menu.
Exclusion Letters Printed from SMS (anticipated availability by mid-September)
In addition to this letter, the intent is for schools to be able to print the exclusion letter to send to
families directly from SMS. This functionality should be available mid-September. A communication will
be sent to project managers regarding this option.
The instructions for printing these letters will likely be:
1 . Log-in to SMS.
2 . Click on Admin > Reports
3 . Scroll down to Health Reports and click ‘Immunization Delinquency Letter.’
4 . Enter three digit school number
5 . Click “Run Report”
18
Placeholder: Sample Letter to Parents (English)
<<month>> <<day>>, 2015
To the parents/guardians of <<student’s name>>, school number <<school number>>
Dear Parents/Guardians:
The State of Maryland requires that all students enrolled in preschool through 12th grade be upto-date with age-appropriate immunizations at the start of the new school year. Our records show
that your child does not have the required immunizations, or that your child’s immunizations will
soon be out of date. Specifically, your child requires immunizations against the following
disease(s):
<<disease names>>
Please provide your child’s school with proof of the immunization(s) on or before the first day of
school on Monday, August 31, 2015. If your child does not have proof of the required
immunizations, you must provide either: 1) An appointment slip from a doctor’s office or the
Health Department with the date that your child will receive the immunization(s); or 2) a written
statement from you, stating the date that your child will receive the required immunization(s).
The appointment must be before September 21st, 2015. Your child cannot attend school if
these documents are not provided in the first week of school. If your child does not receive
the required immunizations and the records are not current before September 21st, they will not
be permitted to attend school.
If your child does need immunizations, please make arrangements with your doctor, clinic or the
Baltimore City Health Department to get the necessary vaccination shots. The Baltimore City
Health Department offers free vaccinations; please call 410-396-4454 for information about this
service. When you take your child for vaccinations, please bring your immunization record with
you for completion by the medical staff.
Please direct questions about immunization requirements and your child’s immunization record
to the principal of your child’s school at <<school phone number>>. You can also call City
Schools’ Health Services division at 410-396-8904.
Thank you for all that you do to support our students and our schools.
Sincerely,
Karl E. Perry, Sr.
Chief School Supports Officer
19
Placeholder: Sample Letter to Parents (Spanish)
<<date>>
A los padres de: <Student’s Name> <school number>
Queridos padres y tutores:
Todos los niños matriculados en programas pre-escolares hasta el duodécimo grado deben estar
totalmente inmunizados contra ciertas enfermedades transmisibles para poder asistir a la escuela
en el año nuevo escolar. Nuestros expedientes indican que actualmente su niño no cumple o está
aproximando no cumplir con las vacunas siguientes:
Por favor provee a la escuela de su niño prueba de las vacunas antes de empezar la escuela el
lunes, 31 de agosto de 2015. Los estudiantes podrán asistir a la escuela hasta el 20 de septiembre
sin tener el registro de vacunas más corriente. Pero a partir del viernes, 21 de septiembre, no
podrán asistir la escuela si no han recibido las vacunas requeridas y sus registros no están
corrientes.
Si su niño necesita vacunas, por favor haz una cita con su doctor, organización de seguros
médicos, o el Departamento de Salud de la Ciudad de Baltimore para recibir las vacunas
necesarias. Si usted tiene preguntas sobre cómo obtener vacunas gratis, por favor llame al
Departamento de Salud de la Ciudad de Baltimore al 410-396-4454. Cuando tomando aprovecho
de estas oportunidades, por favor traiga el registro de vacunas más corriente de su niño para que
los empleados médicos lo puedan completar.
Preguntas sobre las vacunas de su niño se deben dirigir al director/a de la escuela de su niño
llamando al <<school phone number>>. También puede llamar al la Oficina de Servicios de
Apoyo para Estudiantes al 410-396-8904.
Gracias por todo lo que hace para apoyar a nuestros estudiantes y a nuestras escuelas.
Atentamente,
Karl E. Perry, Sr.
Chief School Supports Officer
20
APPENDIX 2: Sample Out of Compliance Report
21
APPENDIX 3: Entering Required Immunization Dosage Information
1. Log in to SMS.
2. Switch Role in the upper right hand corner and make sure that SCHHP is selected to have SMS
Immunization and Entry Access
3. On the Student Search page, enter last name or first name of your student (or student ID
number).
4. Select the student’s name.
On the control bar to the left, click Health Tracking, then click Dose Quick Entry. Any required
immunizations assigned to this student appear in the Immunization column.
5. Simply add any required dosage information by entering a date in the past (mm/dd/yyyy). You
can enter multiple doses for any of the required immunizations while on this page.
6. Click Apply to save the dose information and remain on the Dose Quick Entry page.
22
7. To check the Immunization status for a student after you have entered dose information, click
Immunizations, located on the control bar. The required immunization tab appears.
8. On the Required tab, the students’ Immunization Status for any immunization is listed directly to
the right of each Required Immunization name. Additional dosages may be required in order for
the student to be compliant for the immunizations listed. If this is the case, then return to Dose
Quick Entry to enter additional doses.
23
Appendix 4: Entering an Immunization Exemption
1.
2.
3.
4.
Log into SMS
On the Quick Search page, enter last name or first name of your student (or student ID number).
Click Search.
Select the student’s name.
5. On the control bar to the left, click Health Tracking, then click Immunizations.
6. Click the name of the required immunization for which you wish to enter an exemption.
7. Once you have selected the required immunization, the Immunization Exemption dialog page
will appear.
8. From the Immunization Exemption drop-down list, select the appropriate exemption.
9. If you select a Temporary Exemption or Medical Exemption, then you must enter an Expiry
date.
24
10. If you have a Religious Exemption for students in 7th or 8th grade, please contact Louise Fink at
llfink@bcps.k12.md.us.
11. If you select the “Varicella-Disease Date and Blood Test Date” exemption, then you must enter
the Disease and Blood Test Date in the Comments box.
12. Click OK to save the immunization exemption.
13. The required immunization name now displays an exclamation point! The Immunization Status
now displays Status to be calculated.
14. Click Apply to recalculate the student’s Immunization Status.
15. The Dose 1 Due Date will display the Expiry Date for Temporary and Medical Exemptions.
16. The Immunization Status now displays Compliant—XXXXXX Exempt.
25
26
Appendix 5: Immunization Exemptions Defined
Name of Exemption
Hep-B Blood Test
Hep-B Merck Exemption
Medical Exemption
MMR-Blood Test
Permanent Exemption
Polio-Blood Test
Purpose of Exemption
If a student is immune to Hep-B and can
verify this with blood test documentation
from a health care provider, then they can
be exempted from this immunization
requirement.
Two doses of Hep-B vaccine is acceptable
only if the student was vaccinated with the
Merck & Co. brand vaccine Recombivax HB
Adult Formulation and this vaccine for use in
adults 11-15 years of age as a two-dose
series.
If a student has a medical condition (such as
allergies to an immunization), then they can
be exempted with verification from a health
care professional.
If a student is immune to MMR and can
verify this with blood test documentation
from a health care provider, then they can
be exempted from this immunization
requirement.
Permanent Medical Exemptions for illness
can only be granted at the discretion of a
physician.
If a student is immune to polio and can
verify this with blood test documentation
from a health care provider, then they can
be exempted from this immunization
requirement.
Expiry Date of Exemption
No expiry date needed
Enter blood test date in the
Comments field on the
Immunizations Exemption dialog
page.
No expiry date is needed
Enter the vaccine date in the
comment field.
If the condition is permanent, then
no expiry date is needed.
Enter the reason for exemption in
the comments field.
No expiry date is needed.
Enter the Blood test date in the
comment field.
These are permanent—no expiry
date is needed.
Enter the reason in the comment
field.
No expiry date is needed.
Enter the Blood test date in the
comment field.
Religious Exemption
Parent’s bona fide religious beliefs exempt
them from immunizations.
No expiry date needed
Temporary Exemption
Temporary Medical Exemptions can be
granted for pregnancies and either student
or family illness, as documented by a doctor
Dictated by doctor. By default, these
exemptions will expire after one day
if you do NOT enter an expiry date.
Varicella-Disease Date &
Blood Test Date
If a student has had varicella (chickenpox)
prior to immunization and this is verified by
a health care provider, school health
professional or health official, then the
student can be exempted from this
immunization
Enter the reason in the comment
field.
No expiry date need be entered.
Enter the Disease Date & Blood Test
Date in the Comments field on the
Immunizations Exemption dialog
page.
27
Immunizations FAQ – Schools
All students must meet certain immunization requirements in order to attend schools in Maryland.
Families are given a 20-day grace period to provide documentation of vaccinations according to the
schedule on page 12.
Please also see the attached guidance from the Baltimore City Health Department on addressing
vaccinations marked in SMS as incorrectly administered. Reports are available in SMS detailing the
students and immunizations that are currently outstanding. For more detailed information and
instructions, please contact your Student Support Liaison.
For more information, please refer to the Immunization Requirements website at:
http://www.baltimorecityschools.org/Page/24371
What steps do I take when a student’s vaccine has been administered incorrectly?

Please click on “guidance” link above
Can I enroll a student even if they do not have their complete immunizations?

Yes. All students must be enrolled but families must provide an appointment date that is within a
20-day grace period. Any student who does not receive their vaccines by the documented date
must then be excluded.
How long do enrollment officials have to enter immunization information into SMS?

Immediately upon receipt of information.
What if parents/guardians voice a religious objection?

City Schools recognizes the rights of parents and guardians to exempt their child from
vaccinations based on religious beliefs. Parents/Guardians must complete the “Religious
Objection” section of the MARYLAND DEPARTMENT OF HEALTH AND MENTAL
HYGIENE IMMUNIZATION CERTIFICATE (Form 896), located at the bottom of page 1.
Form can be found at: https://www.mdimmunet.org/ir_docs/896_School_Certificate.pdf
When will students be excluded from school if they have not received full immunizations?

Students will be excluded on the first day of school if they have not provided an updated
immunization record or evidence of an appointment for vaccines. If the student has a documented
appointment, there is a 20 calendar-day period after the first day of school to provide
documentation of the required immunizations. September 21, 2015 is 21 days after the start of the
school year. Students who have not provided the required documentation will be excluded from
school starting September 21, 2015.
When will exclusion letters be available for distribution?

Exclusion letters will be available no later than September 11, 2015. Each school will be
responsible for mailing the letters to the families.
What if they have an appointment but no shot?

Appointment dates do count towards compliance if it is documented on an appointment slip, by
the parent or guardian (signed), or by the school enrollment official (signed). Please do not enter
as medical exemptions.
Where can students receive shots?
28
Students are encouraged to see their primary physician to receive their required immunizations. If they
are not able to see their primary physician, the Baltimore City Health Department provides free
immunizations through its TIKE clinics. Appointments are not necessary to be immunized through the
TIKE clinics. Updated schedules are available online each month at:
http://health.baltimorecity.gov/node/107
or http://health.baltimorecity.gov/sites/default/files/TIKE%20Clinic%20Schedule_5.pdf
Additional information can be found by calling BCHD at 410-396-4454 or www.baltimorehealth.org
How much do vaccines cost?

In most cases, vaccinations are free of charge for children 18 years of age and under,
specifically for families who receive medical assistance, or are un-insured or under-insured.
What if I still have students who are not immunized?

Consider common engagement strategies including, but not limited to: phone calls, letters,
ParentLink outreach, home visits, and incentive strategies. Your Back-to-School Night also
provides an opportunity to address and engage your families about the importance of
immunizations.
How do unimmunized students impact my school?


Unimmunized students potentially put the school community at risk of exposure to contagious,
vaccine-preventable illnesses. The risk is especially high for those individuals with weakened
immune systems, or individuals who are not able to receive a vaccine for medical reasons.
Students excluded due to immunizations could impact District- and school-level funding from
the state. Out of compliance students will not count in the 9/30 enrollment numbers.
 Students excluded from school due to immunization miss valuable time learning and engaging in
your school. They are at an increased risk of being Chronically Absent.
29
Immunizations FAQs for Families
1. What happens if my student is not immunized?
They can be enrolled in school as long as you provide evidence of an appointment. However, they
will not be able to return to school after September 21 if they are not immunized.
2. If my student has an appointment after September 20 will they be removed from
school?
Yes, if it is for a non-compliant shot.
No, if it is for a series that must be continued at a later date.
3. Do I have to bring a note if I am not immunizing my child for religious reasons?
No. However, the immunization form at the school will require your signature stating that you
have a religious objection to immunizations.
4. Why does my 7th or 8th grader need to be immunized?
Seventh grade students are now required to have Tdap and Meningococcal Vaccines. These
vaccines are recommended by the American Academy of Pediatrics (AAP) and the Advisory
Committee on Immunization Practices (ACIP).
5. How do I find out if my child needs immunizations?
Please contact your child’s doctor or clinic where you have received vaccinations.
The Baltimore City Health Department (410-396-4454 or www.baltimorehealth.org) as well your
child’s most recently attended school should be able to provide some information as well.
6. What do I do if my child is not immunized or needs shots?
Please contact your child’s doctor and make an appointment to receive the required vaccines.
7. Where do I find the health clinic schedules?
The Baltimore City Health Department Immunization Clinic schedule can be found at
http://health.baltimorecity.gov/node/107
or
http://health.baltimorecity.gov/sites/default/files/TIKE%20Clinic%20Schedule_5.pdf
30
Immunizations FAQs for SMS
Issue 1: Non-7th/8th grade students are being flagged as Out of Compliance (OOC) for Tdap and
Meningococcal vaccines
Resolution: SMS Immunization module tracks out of compliance by age and not by grade. ITD
placed a fix to change the OOC status to Compliant for non-7th graders.
 Fix will run every 15 minutes. So please check again to see the change.
Issue 2: 7th/8th grade students are flagged as OOC even after entering dose dates for Tdap and
Meningococcal.
Resolution: ITD placed a fix for this issue and will run every 15 minutes to change the status
from OOC to Compliant
Immunization Reports:
 In SMS: Immunization Reports are available under City Schools – Immunization Reports
and also under Health Reports.

Immunization Out of Compliance Reports are also available in Data Cleansing Report
#122 on http://eweb
Back to School Immunization Links:
http://phpa.dhmh.maryland.gov/OIDEOR/IMMUN/SitePages/back-to-school-immunizationrequirements.aspx
31