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AVAILABILITY OF NEW FLORIDA CERTIFICATION OF IMMUNIZATION (DH 680) The Bureau of Immunization is pleased to announce the availability of the new manual version of the Florida Certification of Immunization DH 680: 04/09) in the Distribution Center. A sample is attached for your information. Providers using Florida SHOTS should electronically sign and certify DH 680s. These forms are then available to other health care providers, schools, and childcare centers who participate in Florida SHOTS. If training is needed on how to electronically sign the DH 680, please contact the Florida SHOTS help desk at: 1-877-888-7468. The Florida Department of Health Bureau of Immunization would also like to remind all immunization partners of the school immunization requirement effective for the 2009/2010 school year for students entering 7th grade. Students entering, repeating or transferring into 7th grade will need to provide documentation for the Tdap vaccine. This requirement is in addition to the previous immunization requirements that are grade-appropriate. A "grandfather" clause was not an option for this vaccine requirement. The Tdap vaccine has been the routine recommendation since 2006 for adolescents age 10 and above. ***There have been many questions regarding the interval for Temporary Medical Exemptions (TMEs) after the last Td dose. The Bureau of Immunization in collaboration with the CDC is recommending that a Tdap be administered after a two year interval from the last Td---or provide a TME for 2 years from the previous Td. One of the most rapidly rising incidence rates of pertussis is among adolescents, which is transmissible in school and other settings. Students who received a dose of Td vaccine prior to entering 7th grade should be given a Temporary Medical Exemption (TME) and immunized at the appropriate time. The timeline for the TME must be no longer than 5 years from the last tetanus-diphtheria containing vaccine. The Tdap can be administered to students 10 years of age and above if prior Td booster was given at least 2 years ago. The updated Form 680 provides fields to document the Tdap vaccine as a DOE Code P. Space has also been allotted for Td vaccine as Code Q. It is important to note that the DH Form 680 provides a selection for either Code 1 (K to 12) or Code 8 (7th Grade requirement). Only the 4/09 version has the P and Q Codes. Students who have completed the immunization requirements for Kindergarten should be documented as complete (Code 1) and not be given a Temporary Medical Exemption (TME) until 7th grade. The updated version of the DH 680 (manual) Florida Certification of

Immunization has been printed and stocked in quantity at the State Distribution Center. Though forms on-hand may still be used, only the newer forms are available in bulk. The sample can be viewed at: http://www.immunizeflorida.org/publications/forms.htm <http://www.immunizeflorida.org/publications/forms.htm>. The DH 680 computer paper, for use with the Florida State Health Online Tracking System (SHOTS), is shrink-wrapped at 200/pack and is stock number 5740-099-0680-0. The manually completed "blue" card is form DH 680, stock #5740-000-0680-6, and packaged 200/pack. Healthcare providers may elect to order their supply of forms directly from the State Distribution Center. Forms are available to Florida providers for a nominal shipping and handling fee. The State Distribution Center contact information is: 850-414-8086. Additional materials and forms are presented on our publications page at: http://www.immunizeflorida.org/publications/index.htm <http://www.immunizeflorida.org/publications/index.htm>. Please distribute this information to colleagues, members, coalitions, and partners. Place this information prominently on your website. Contact Phyllis Yambor at 850-245-4342 for questions regarding the vaccine recommendations.

Charles H. Alexander, Chief Florida Dept. of Health/Bureau of Immunization 4052 Bald Cypress Way, Bin A-11 Tallahassee, FL 32399 Phone: (850) 245-4331 Fax: (850) 922-4195 E-mail: [email protected]

Mission: Promote, protect and improve the health of all people in Florida. ***********************************************************

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