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Immunization Tool Kit: For Preschool and Child Care Centers

August, 2010

NAME OF CHILD (Last, First, MI) NAME OF PARENT/GUARDIAN ADDRESS ADDRESS 1ST DOSE MO/DAY/YR 2ND DOSE MO/DAY/YR 3RD DOSE MO/DAY/YR 4TH DOSE MO/DAY/YR

DATE OF BIRTH (Mo./Day/Yr.) TELEPHONE NUMBER(S)

SEX

M F

IMMUNIZATION REGISTRY NUMBER 5TH DOSE MO/DAY/YR LEAD SCREENING

(Not Required)

VACCINE TYPE DIPHTHERIA, TETANUS, PERTUSSIS . (DTaP) or any combination . (if Td or DT(1) Indicate in corner box) POLIO-INACTIVATED POLIO VACCINE (IPV) . (if oral vaccine, indicate OPV in corner box) MEASLES, MUMPS, RUBELLA (MMR) HAEMOPHILUS B (HIB) HEPATITIS B (3) VARICELLA (4)

(2)

TEST DATE

RESULT

.

PNEUMOCOCCAL CONJUGATE (2) INFLUENZA (6) OTHER, SPECIFY:

IMMUNIZATION TOOL KIT

(5)

Document below single antigen vaccine receipt, serology titers, or Varicella disease history

DATE: TITER:

Hepatitis B Varicella Measles Mumps

DATE:

TITER:

DATE:

TITER:

DATE:

TITER:

Preschool and Child Care Centers

Provisional Admission Attached - Date Granted:________________

(1) (2) (3) (4)

DATE:

TITER:

Rubella

Medical Exemption Attached

Religious Exemption Attached

REQUIRES MEDICAL EXEMPTION REQUIRED FOR CHILD CARE/PRESCHOOL ENROLLEES (2 Months - 5th Birthday Only) REQUIRED FOR K-GRADE 1 (whichever is first). GRADE 6 BEGINNING 9-1-01, AND GRADES 9-12, EFFECTIVE 9-1-04 REQUIRED FOR DAY/CHILD CARE ENROLLED (19 Months and older) AND GRADE K-GRADE 1 (whichever is first) EFFECTIVE 9-1-04 MMR single antigen receipt requries MO/DAY/YR, serologies require titers, and varicella disease history requires MO/YR. REQUIRED FOR CHILD CARE/PRESCHOOL ENROLLEES (6 Months - 59 Months)

IMM-8 OCT 08

(5) (6)

I M M U N I Z A T I O N T O O L K I T

Preschool and Child Care Centers

530 Newark-Pompton Turnpike Pompton Plains, NJ 17444-1799 www.morrispublichealth.org August 2010

This Tool Kit was designed to help preschool and child care center directors improve the recording of required vaccinations for the children in their centers. Vaccination is the best way to prevent communicable diseases. This Tool Kit was created in response to the observation by the public health nurses that far too many children in some of Morris County, New Jersey's preschools and child care centers had not been immunized in a timely way, or at all, for seasonal influenza. After interviewing several very cooperative child care settings, some of the barriers were identified. To improve the recording of seasonal vaccination, the development of this Tool Kit will educate and guide preschool and child care center directors on how to record all required immunizations.

Carlo DiLizia, Health Officer, President, Morris Regional Public Health Partnership Marc Caputo, Health Officer, Vice President, Morris Regional Public Health Partnership Peter Correale, Health Officer, Chairperson Program Committee, Morris Regional Health Partnership Robert Schermer, Manager, Morris Regional Public Health Partnership Frank Wilpert, Health Officer, Mount Olive Township, Immunization Quality Improvement Project Leader

Funding for the project is provided by the NJ Health Officers Association, through the Multi-State Learning Collaborative (MLC-3) grant awarded to Morris Regional Public Health Partnership acting as project manager. The MLC-3 is managed by the Network of Public Health Institutes with support from the Robert Wood Johnson Foundation.

Acknowledgements

This Tool Kit has been developed by five municipal health departments that are members of the Morris Regional Public Health Partnership as part of a project for public health quality improvement.

East Hanover Township Health Department Morris County Office of Health Management Mount Olive Township Health Department Pequannock Township Health Department Randolph Township Health Department

The Immunization Tool Kit Development Committee, consisting of Public Health Nurses and a Health Educator, applied their exceptional knowledge of immunizations to emphasize the importance of vaccinations of children in the preschool and child care centers. We are pleased to acknowledge:

Helen Giles, R.N., B.A. - Mount Olive Township Health Department, Immunization Committee Chairperson Cindie Bella, R.N., B.S. N. - Morris County Office of Health Management Susan DeGraw, R.N. - Pequannock Township Health Department Kathy Gonzalez, R.N., B.S.N. - East Hanover Township Health Department Colleen Hintz, R.N., B.S.N. - Randolph Township Health Department Ginny Maico, R.N., B.S.N. - Randolph Township Health Department Arlene Stoller, M.P.H., C.H.E.S. - Morris County Office of Health Management Joan Swanson, R.N., B.S.N. - East Hanover Township Health Department

TABLE OF CONTENTS

· Record of updates

I. Yellow Section: Immunization Guidelines ­ 10 pages

NJ required immunizations by age:

· 2 months · 4 months · 6 months · 15 months · 18 months · 19 months · kindergarten · compiled NJ required immunizations ­ ages 2 months to kindergarten · Vaccine names by type · Vaccine names by brand

II. Red Section: Letters/Forms to be completed and/or copied ­ 9 pages

Immunization card templates (IMM8) in:

· Yellow · White

Director letter

· flu vaccination letter to directors

Parent letters:

· flu vaccination letter for parents · letter to parents from Health Department · due/overdue vaccine checklist by type · due/overdue vaccine by age · Religious exemption acknowledgement letter (use with "Why get vaccinated?" next page) · "Why get vaccinated?" (always use with religious exemption)

III. Blue Section: Resources ­ 19 pages

· NJ document: minimal immunization requirements for school attendance in NJ · CDC document: vaccine recommendations for children ages 0 through 6 years · "Need help responding to vaccinehesitant parents?" · "Common questions parents ask about infant immunizations" · "What if you don't immunize your child?" pamphlet ­ 1 page (front & back) · CDC document: Your Baby's First Vaccines; What you need to know ­ 2 pages (front & back = 4 pages)

*Vaccine Information Statements (VIS) ­ 10 pages: 1 page each: front & back

· Diphtheria, Tetanus & Pertussis · Polio · Measles, Mumps & Rubella (MMR) · Measles, Mumps, Rubella & Varicella (MMRV) · Haemophilus Influenzae type b (Hib) · Hepatitis B · Chickenpox (Varicella) · Pneumococcal Conjugate Flu: · Inactivated Influenza · Live, Intranasal Influenza · Web addresses used in tool kit · Reportable Disease list ­ April 2010 *Each bullet indicates a separate page unless indicated otherwise

IMMUNIZATION TOOL KIT UPDATES DATE OF CHANGE SECTION PAGE COMPLETED BY DATE COMPLETED

.

I. Yellow Section: Immunization Guidelines ­ 10 pages

New Jersey Department of Health and Senior Services STANDARD SCHOOL / CHILD CARE CENTER IMMUNIZATION RECORD

Required Immunizations - by age

NAME OF CHILD (Last, First, MI) NAME OF PARENT/GUARDIAN ADDRESS ADDRESS 1ST DOSE MO/DAY/YR 2ND DOSE MO/DAY/YR 3RD DOSE MO/DAY/YR 4TH DOSE MO/DAY/YR DATE OF BIRTH (Mo./Day/Yr.) SEX

2 MONTHS

required required

M F

TELEPHONE NUMBER(S)

IMMUNIZATION REGISTRY NUMBER 5TH DOSE MO/DAY/YR LEAD SCREENING

(Not Required)

VACCINE TYPE DIPHTHERIA, TETANUS, PERTUSSIS . (DTaP) or any combination . (if Td or DT(1) Indicate in corner box) POLIO-INACTIVATED POLIO . VACCINE (IPV) . (if oral vaccine, indicate OPV in corner box) MEASLES, MUMPS, RUBELLA (MMR) HAEMOPHILUS B (HIB) (2) HEPATITIS B (3) VARICELLA (4) PNEUMOCOCCAL CONJUGATE (2) INFLUENZA (6) OTHER, SPECIFY:

TEST DATE

RESULT

(5)

required

recommended recommended

Document below single antigen vaccine receipt, serology titers, or Varicella disease history

DATE: TITER:

Hepatitis B

DATE: TITER:

Varicella

DATE: TITER:

required

Measles

DATE: TITER:

Mumps

DATE: rotavirus TITER:

Rubella

Provisional Admission Attached - Date Granted:________________

(1) (2) (3) (4)

Medical Exemption Attached

Religious Exemption Attached

IMM-8 OCT 08

(5) (6)

REQUIRES MEDICAL EXEMPTION REQUIRED FOR CHILD CARE/PRESCHOOL ENROLLEES (2 Months - 5th Birthday Only) REQUIRED FOR K-GRADE 1 (whichever is first). GRADE 6 BEGINNING 9-1-01, AND GRADES 9-12, EFFECTIVE 9-1-04 REQUIRED FOR DAY/CHILD CARE ENROLLED (19 Months and older) AND GRADE K-GRADE 1 (whichever is first) EFFECTIVE 9-1-04 MMR single antigen receipt requries MO/DAY/YR, serologies require titers, and varicella disease history requires MO/YR. REQUIRED FOR CHILD CARE/PRESCHOOL ENROLLEES (6 Months - 59 Months) June 2010

New Jersey Department of Health and Senior Services STANDARD SCHOOL / CHILD CARE CENTER IMMUNIZATION RECORD

Required Immunizations - by age

NAME OF CHILD (Last, First, MI) NAME OF PARENT/GUARDIAN ADDRESS ADDRESS 1ST DOSE MO/DAY/YR 2ND DOSE MO/DAY/YR 3RD DOSE MO/DAY/YR 4TH DOSE MO/DAY/YR DATE OF BIRTH (Mo./Day/Yr.) SEX

4 MONTHS

required required required required

M F

TELEPHONE NUMBER(S)

IMMUNIZATION REGISTRY NUMBER 5TH DOSE MO/DAY/YR LEAD SCREENING

(Not Required)

VACCINE TYPE DIPHTHERIA, TETANUS, PERTUSSIS . (DTaP) or any combination . (if Td or DT(1) Indicate in corner box) POLIO-INACTIVATED POLIO . VACCINE (IPV) . (if oral vaccine, indicate OPV in corner box) MEASLES, MUMPS, RUBELLA (MMR) HAEMOPHILUS B (HIB) HEPATITIS B (3) VARICELLA (4) PNEUMOCOCCAL CONJUGATE (2) INFLUENZA (6) OTHER, SPECIFY:

(2)

TEST DATE

RESULT

(5)

required

recommended

required

recommended

Document below single antigen vaccine receipt, serology titers, or Varicella disease history

DATE: TITER:

Hepatitis B

DATE: TITER:

Varicella

DATE: TITER:

required

required

Measles

DATE: TITER:

Mumps

DATE: rotavirus rotavirus TITER:

Rubella

Provisional Admission Attached - Date Granted:________________

(1) (2) (3) (4)

Medical Exemption Attached

Religious Exemption Attached

IMM-8 OCT 08

(5) (6)

REQUIRES MEDICAL EXEMPTION REQUIRED FOR CHILD CARE/PRESCHOOL ENROLLEES (2 Months - 5th Birthday Only) REQUIRED FOR K-GRADE 1 (whichever is first). GRADE 6 BEGINNING 9-1-01, AND GRADES 9-12, EFFECTIVE 9-1-04 REQUIRED FOR DAY/CHILD CARE ENROLLED (19 Months and older) AND GRADE K-GRADE 1 (whichever is first) EFFECTIVE 9-1-04 MMR single antigen receipt requries MO/DAY/YR, serologies require titers, and varicella disease history requires MO/YR. REQUIRED FOR CHILD CARE/PRESCHOOL ENROLLEES (6 Months - 59 Months)

required at a younger age

required by this age

June 2010

New Jersey Department of Health and Senior Services STANDARD SCHOOL / CHILD CARE CENTER IMMUNIZATION RECORD

Required Immunizations - by age

NAME OF CHILD (Last, First, MI) NAME OF PARENT/GUARDIAN ADDRESS ADDRESS 1ST DOSE MO/DAY/YR 2ND DOSE MO/DAY/YR 3RD DOSE MO/DAY/YR 4TH DOSE MO/DAY/YR DATE OF BIRTH (Mo./Day/Yr.) SEX

6 MONTHS

required required required required required

M F

TELEPHONE NUMBER(S)

IMMUNIZATION REGISTRY NUMBER 5TH DOSE MO/DAY/YR LEAD SCREENING

(Not Required)

VACCINE TYPE DIPHTHERIA, TETANUS, PERTUSSIS . (DTaP) or any combination . (if Td or DT(1) Indicate in corner box) POLIO-INACTIVATED POLIO . VACCINE (IPV) . (if oral vaccine, indicate OPV in corner box) MEASLES, MUMPS, RUBELLA (MMR) HAEMOPHILUS B (HIB) HEPATITIS B (3) VARICELLA (4) PNEUMOCOCCAL CONJUGATE (2) INFLUENZA (6) OTHER, SPECIFY:

by 12/31 during 9/1-3/31 flu season

(2)

TEST DATE

RESULT

(5)

required

recommended

required

recommended

may be required*

recommended

Document below single antigen vaccine receipt, serology titers, or Varicella disease history

DATE: TITER:

Hepatitis B

DATE: TITER:

Varicella

DATE: TITER:

required required

rotavirus

required

recommended

Measles

DATE: TITER:

Mumps

DATE: rotavirus rotavirus TITER:

Rubella

Provisional Admission Attached - Date Granted:________________

(1) (2) (3) (4)

Medical Exemption Attached

Religious Exemption Attached

IMM-8 OCT 08

(5) (6)

REQUIRES MEDICAL EXEMPTION REQUIRED FOR CHILD CARE/PRESCHOOL ENROLLEES (2 Months - 5th Birthday Only) REQUIRED FOR K-GRADE 1 (whichever is first). GRADE 6 BEGINNING 9-1-01, AND GRADES 9-12, EFFECTIVE 9-1-04 REQUIRED FOR DAY/CHILD CARE ENROLLED (19 Months and older) AND GRADE K-GRADE 1 (whichever is first) EFFECTIVE 9-1-04 MMR single antigen receipt requries MO/DAY/YR, serologies require titers, and varicella disease history requires MO/YR. REQUIRED FOR CHILD CARE/PRESCHOOL ENROLLEES (6 Months - 59 Months)

® ® * A 3rd DOSE OF HIB IS REQUIRED UNLESS PedvaxHIB OR ComVax ARE KNOWN TO HAVE BEEN USED FOR THE FIRST 2 DOSES

required at a younger age

required by this age

June 2010

New Jersey Department of Health and Senior Services STANDARD SCHOOL / CHILD CARE CENTER IMMUNIZATION RECORD

Required Immunizations - by age

NAME OF CHILD (Last, First, MI) NAME OF PARENT/GUARDIAN ADDRESS ADDRESS 1ST DOSE MO/DAY/YR 2ND DOSE MO/DAY/YR 3RD DOSE MO/DAY/YR 4TH DOSE MO/DAY/YR DATE OF BIRTH (Mo./Day/Yr.) SEX

15 MONTHS

required required required required required 1 dose required after 1st birthday

recommended recommended recommended

M F

TELEPHONE NUMBER(S)

IMMUNIZATION REGISTRY NUMBER 5TH DOSE MO/DAY/YR LEAD SCREENING

(Not Required)

VACCINE TYPE DIPHTHERIA, TETANUS, PERTUSSIS . (DTaP) or any combination . (if Td or DT(1) Indicate in corner box) POLIO-INACTIVATED POLIO . VACCINE (IPV) . (if oral vaccine, indicate OPV in corner box) MEASLES, MUMPS, RUBELLA (MMR) HAEMOPHILUS B (HIB) HEPATITIS B (3) VARICELLA (4) PNEUMOCOCCAL CONJUGATE (2) INFLUENZA (6) OTHER, SPECIFY:

by 12/31 during 9/1-3/31 flu season

(2)

TEST DATE

RESULT

required

(5)

Document below single antigen vaccine receipt, serology titers, or Varicella disease history

DATE: TITER:

Hepatitis B

DATE: TITER:

Varicella

1 dose required after 1st birthday required

Hepatitis A recommended

DATE:

TITER:

Measles

DATE: TITER:

Mumps

DATE: TITER:

Rubella

Provisional Admission Attached - Date Granted:________________

(1) (2) (3) (4)

Medical Exemption Attached

Religious Exemption Attached

IMM-8 OCT 08

(5) (6)

REQUIRES MEDICAL EXEMPTION REQUIRED FOR CHILD CARE/PRESCHOOL ENROLLEES (2 Months - 5th Birthday Only) REQUIRED FOR K-GRADE 1 (whichever is first). GRADE 6 BEGINNING 9-1-01, AND GRADES 9-12, EFFECTIVE 9-1-04 REQUIRED FOR DAY/CHILD CARE ENROLLED (19 Months and older) AND GRADE K-GRADE 1 (whichever is first) EFFECTIVE 9-1-04 MMR single antigen receipt requries MO/DAY/YR, serologies require titers, and varicella disease history requires MO/YR. REQUIRED FOR CHILD CARE/PRESCHOOL ENROLLEES (6 Months - 59 Months)

required at a younger age

required by this age

June 2010

New Jersey Department of Health and Senior Services STANDARD SCHOOL / CHILD CARE CENTER IMMUNIZATION RECORD

Required Immunizations - by age

NAME OF CHILD (Last, First, MI) NAME OF PARENT/GUARDIAN ADDRESS ADDRESS 1ST DOSE MO/DAY/YR 2ND DOSE MO/DAY/YR 3RD DOSE MO/DAY/YR 4TH DOSE MO/DAY/YR DATE OF BIRTH (Mo./Day/Yr.) SEX

18 MONTHS

required required required required required required 1 dose required after 1st birthday

recommended recommended recommended

M F

TELEPHONE NUMBER(S)

IMMUNIZATION REGISTRY NUMBER 5TH DOSE MO/DAY/YR LEAD SCREENING

(Not Required)

VACCINE TYPE DIPHTHERIA, TETANUS, PERTUSSIS . (DTaP) or any combination . (if Td or DT(1) Indicate in corner box) POLIO-INACTIVATED POLIO . VACCINE (IPV) . (if oral vaccine, indicate OPV in corner box) MEASLES, MUMPS, RUBELLA (MMR) HAEMOPHILUS B (HIB) HEPATITIS B (3) VARICELLA (4) PNEUMOCOCCAL CONJUGATE (2) INFLUENZA (6) OTHER, SPECIFY:

by 12/31 during 9/1-3/31 flu season

(2)

TEST DATE

RESULT

required

required

(5)

Document below single antigen vaccine receipt, serology titers, or Varicella disease history

DATE: TITER:

Hepatitis B

DATE: TITER:

Varicella

1 dose required after 1st birthday required

Hepatitis A recommended

DATE:

TITER:

Measles

DATE: TITER:

Mumps

DATE: TITER:

Rubella

Provisional Admission Attached - Date Granted:________________

(1) (2) (3) (4)

Medical Exemption Attached

Religious Exemption Attached

IMM-8 OCT 08

(5) (6)

REQUIRES MEDICAL EXEMPTION REQUIRED FOR CHILD CARE/PRESCHOOL ENROLLEES (2 Months - 5th Birthday Only) REQUIRED FOR K-GRADE 1 (whichever is first). GRADE 6 BEGINNING 9-1-01, AND GRADES 9-12, EFFECTIVE 9-1-04 REQUIRED FOR DAY/CHILD CARE ENROLLED (19 Months and older) AND GRADE K-GRADE 1 (whichever is first) EFFECTIVE 9-1-04 MMR single antigen receipt requries MO/DAY/YR, serologies require titers, and varicella disease history requires MO/YR. REQUIRED FOR CHILD CARE/PRESCHOOL ENROLLEES (6 Months - 59 Months)

required at a younger age

required by this age

June 2010

New Jersey Department of Health and Senior Services STANDARD SCHOOL / CHILD CARE CENTER IMMUNIZATION RECORD

Required Immunizations - by age

NAME OF CHILD (Last, First, MI) NAME OF PARENT/GUARDIAN ADDRESS ADDRESS 1ST DOSE MO/DAY/YR 2ND DOSE MO/DAY/YR 3RD DOSE MO/DAY/YR 4TH DOSE MO/DAY/YR DATE OF BIRTH (Mo./Day/Yr.) SEX

19 MONTHS

required required required required required required 1 dose required after 1st birthday

recommended recommended recommended

M F

TELEPHONE NUMBER(S)

IMMUNIZATION REGISTRY NUMBER 5TH DOSE MO/DAY/YR LEAD SCREENING

(Not Required)

VACCINE TYPE DIPHTHERIA, TETANUS, PERTUSSIS . (DTaP) or any combination . (if Td or DT(1) Indicate in corner box) POLIO-INACTIVATED POLIO . VACCINE (IPV) . (if oral vaccine, indicate OPV in corner box) MEASLES, MUMPS, RUBELLA (MMR) HAEMOPHILUS B (HIB) HEPATITIS B (3) VARICELLA (4) PNEUMOCOCCAL CONJUGATE (2) INFLUENZA (6) OTHER, SPECIFY:

by 12/31 during 9/1-3/31 flu season

(2)

TEST DATE

RESULT

required

required

(5)

Document below single antigen vaccine receipt, serology titers, or Varicella disease history

DATE: TITER:

Hepatitis B

DATE: TITER:

required 1 dose required after 1st birthday required

Hepatitis A recommended

Varicella

DATE: TITER:

Measles

DATE: TITER:

Mumps

DATE: TITER:

Rubella

Provisional Admission Attached - Date Granted:________________

(1) (2) (3) (4)

Medical Exemption Attached

Religious Exemption Attached

IMM-8 OCT 08

(5) (6)

REQUIRES MEDICAL EXEMPTION REQUIRED FOR CHILD CARE/PRESCHOOL ENROLLEES (2 Months - 5th Birthday Only) REQUIRED FOR K-GRADE 1 (whichever is first). GRADE 6 BEGINNING 9-1-01, AND GRADES 9-12, EFFECTIVE 9-1-04 REQUIRED FOR DAY/CHILD CARE ENROLLED (19 Months and older) AND GRADE K-GRADE 1 (whichever is first) EFFECTIVE 9-1-04 MMR single antigen receipt requries MO/DAY/YR, serologies require titers, and varicella disease history requires MO/YR. REQUIRED FOR CHILD CARE/PRESCHOOL ENROLLEES (6 Months - 59 Months)

required at a younger age

required by this age

June 2010

.

New Jersey Department of Health and Senior Services STANDARD SCHOOL / CHILD CARE CENTER IMMUNIZATION RECORD

Required Immunizations - by age

NAME OF CHILD (Last, First, MI) NAME OF PARENT/GUARDIAN ADDRESS ADDRESS 1ST DOSE MO/DAY/YR 2ND DOSE MO/DAY/YR 3RD DOSE MO/DAY/YR 4TH DOSE MO/DAY/YR DATE OF BIRTH (Mo./Day/Yr.) SEX

M F

KINDERGARTEN

required required required required

required unless

TELEPHONE NUMBER(S)

IMMUNIZATION REGISTRY NUMBER 5TH DOSE MO/DAY/YR required unless

4th dose is after 4th birthday

VACCINE TYPE DIPHTHERIA, TETANUS, PERTUSSIS . (DTaP) or any combination . (if Td or DT(1) Indicate in corner box) POLIO-INACTIVATED POLIO . VACCINE (IPV) . (if oral vaccine, indicate OPV in corner box) MEASLES, MUMPS, RUBELLA (MMR) HAEMOPHILUS B (HIB) HEPATITIS B (3) VARICELLA (4) PNEUMOCOCCAL CONJUGATE (2) INFLUENZA (6) OTHER, SPECIFY:

(2)

LEAD SCREENING

(Not Required)

TEST DATE

RESULT

required required

required

measles required

required

3rd dose is after 4th birthday

(5)

Document below single antigen vaccine receipt, serology titers, or Varicella disease history

DATE: TITER:

required required

required

recommended

required

Hepatitis B

DATE: TITER:

Varicella

DATE: TITER:

Measles

DATE: TITER:

Mumps

DATE: Hepatitis A Hepatitis A TITER:

Rubella

Provisional Admission Attached - Date Granted:________________

(1) (2) (3) (4)

Medical Exemption Attached

Religious Exemption Attached

IMM-8 OCT 08

(5) (6)

REQUIRES MEDICAL EXEMPTION REQUIRED FOR CHILD CARE/PRESCHOOL ENROLLEES (2 Months - 5th Birthday Only) REQUIRED FOR K-GRADE 1 (whichever is first). GRADE 6 BEGINNING 9-1-01, AND GRADES 9-12, EFFECTIVE 9-1-04 REQUIRED FOR DAY/CHILD CARE ENROLLED (19 Months and older) AND GRADE K-GRADE 1 (whichever is first) EFFECTIVE 9-1-04 MMR single antigen receipt requries MO/DAY/YR, serologies require titers, and varicella disease history requires MO/YR. REQUIRED FOR CHILD CARE/PRESCHOOL ENROLLEES (6 Months - 59 Months)

required at a younger age

required by this age

June 2010

.

New Jersey

Immunization Requirements

9/1/ 2008

.

2 mo.

min age min interval

4 mo.

min interval 4 wks

6 mo.

4 wks

12 15 mo. mo.

min min age interval for #4 4 mos 12 mos

18 mo.

19 mo.

min interval

K/1

DPT polio

6 wks

1 1

2 2

3

4 6 mos 5 no 5th needed if 4th after 4 y.o. or any 5

6 wks

4 wks

4 wks

3 4 wks 4 no 4th needed if 3rd after 4 y.o. / 4 doses max / >7y.o any 3

min interval min age

if 1&2 not pedvax or

Hib PCV flu MMR varicella

6 wks

1 1

4 wks

2 2

4 wks comvax

3

8 wks

12 mos

1 1

age 1 - 5 years, only need 1; none after age 5 age 1 - 5 years, only need 1; none after age 5 none after age 5

4 wks

6 wks

4 wks

8 wks

12 mos

min age (4 wk min interval between 2 doses) 6 mos.

1 annually per flu season by 12/31

( flu season ends March 31 ) 12 mos

1 1

2 (measles)

(disease documented by parent or MD is OK) min interval #1 - #2 4 wks min age 4 wks min min interval age #2 - #3 8 wks 24 wks

12 mos

( 4 wks min interval but 3 mos recc. before 2nd dose)

min interval

0-1-2 months X-4 months 0-

Hep B

birth

#1 - #3 16 wks

3 any 1

grade 6 and born after 1/1/97

Tdap

if 5 years since last

meningococcal

VACCINE TYPE Diptheria, Tetanus, Pertussis (DTaP) or any combination for children

Tetanus, Diptheria, Pertussis (Tdap) adol/adult formulation Polio (IPV)

Measles, Mumps, Rubella (MMR) Haemophilus B meningitis (HIB)

Hepatitis B (HepB) Hepatitis A (HepA) Chicken Pox (Varicella) Prevnar (Pneumococcal Conjugate) Human Papillomavirus (HPV) Rotavirus diarrhea Meningitis Influenza (Flu)

June 2010

VACCINE NAME Daptacel Infanrix Tripedia TriHIBit Pediarix Kinrix Pentacel Adacel Boostrix Decavac IPV Pediarix Kinrix Pentacel MMR Priorix Proquad ActHIB Hiberix Pedvax HIB TriHIBit Pentacel Comvax Engerix Comvax Twinrix Havrix Vaqta Twinrix Varivax Proquad Prevnar (PCV7, PCV13) Pneumovax23 Cervarix Guardasil Rotarix RotaTeq Menactra Menomune Menveo Afluria Fluarix, Fluvirin FluLaval, Fluzone FluMist

ANTIGENS INCLUDED DTaP DTaP DTaP DTaP, HIB DTaP, Hep B, IPV DTaP & IPV DTaP IPV, HIB Tdap Tdap Td

AGE GIVEN 6wks up to 7 yrs. 6wks up to 7 yrs. 6wks up to 7 yrs. 4th dose only 6wks up to 7 yrs. 4 to 6 yrs 6wks-4yrs 11 - 64 yo 10 - 64 yo 7 yrs & older 6 wks & older DTaP, Hep B, IPV 6wks up to 7 yrs. DTaP & IPV 4 to 6 yrs DTaP IPV, HIB 6wks-4yrs MMR 12 mos & older MMR 12mos. & older MMRV 12 mos. -12yrs. HIB 2 months ­ 5 yrs HIB 2 months ­ 5 yrs HIB 2 months ­ 5 yrs DTaP, HIB 4th dose only DTaP IPV, HIB 6wks-4yrs Hep B, HIB 6wks. to 15 mos. HepB Birth and up Hep B, HIB 6wks. to 15 mos. Hep A & Hep B 18 yrs & older Hep A 12mos & older Hep A 12 mos & older Hep A & Hep B 18 yrs & older Varicella 12 mos & older MMRV 12 mos. -12yrs. Pneumococcal Conjugate 2mos-59mos. Pneumococcal Polysaccharide 2yrs & older HPV 10-25 females only HPV 9 ­ 26 yrs male and Rotavirus 6-24 weeks Rotavirus 6-32 weeks Meningitis 2-55 yo Meningitis (polysaccharide) 2yrs & older Meningitis 11-55 yo Influenza 6 months & older Influenza (though not all Influenza types can be given as Influenza Live Nasal young as 6 months)

Vaccine Names - by brand

VACCINE NAME TYPE (ANTIGEN) Haemophilus B (HIB) ActHIB Diphtheria, Tetanus, Adacel Pertussis (Tdap) Influenza (Flu) Afluria Diphtheria, Tetanus, Boostrix Pertussis (Tdap) Human Papillomavirus (HPV) Cervarix Comvax AGE COHORT 2 months ­ 5 yrs 11 - 64 yo VACCINE NAME Menactra Menomune Menveo 10 - 64 yo 10-25 females only Pediarix Pedvax HIB MMR (Priorix) TYPE (ANTIGEN) Meningitis Meningitis AGE COHORT 2-55 yo 2yrs & older

Meningitis 11-55 yo Measles, Mumps, Rubella 12 mos & older Diphtheria, Tetanus, 6wks up to 7 yrs. Pertussis, Hepatitis B, Polio (DTaP, Hep B, IPV) Haemopholis B (HIB) 2 months ­ 5 yrs 6wks-4yrs

Daptacel Decavac Engerix Fluarix, FluLaval, FluMist, Fluvirin, Fluzone

Hepatitis B, Haemophilis B 6wks. to 15 mos. (Hep B, HIB) Diphtheria, Tetanus, 6wks up to 7 yrs. Pertussis (DTaP)

Tetanus, Pertussis (Td) Hepatitis B

7 yrs & older Birth and up 6 months & older (though not all formulations can be given as young as 6 months) 9 ­ 26 yrs male and female 12mos & older 2 months ­ 5 yrs 6wks up to 7 yrs. 4 to 6 yrs

Influenza (Flu)

Guardasil Havrix Hiberix Infanrix Kinrix

June 2010

Human Papillomavirus (HPV) Hepatitis A Haemophilis B (HIB) Diphtheria, Tetanus, Pertussis (DTaP) Diphtheria, Tetanus, Pertussis, Polio (DTaP & IPV)

Diphtheria, Tetanus, Pertussis, Polio, Pentacel Haemophilus B (DTaP IPV, HIB) Pneumococcal Pneumovax23 Prevnar (PCV7, PCV13) Pneumococcal Conjugate Measles, Mumps, Rubella Priorix (MMR) Measles, mumps, rubella Proquad (MMRV) and chicken pox (varicella) Rotavirus Rotarix Rotavirus RotaTeq Diphtheria, Tetanus, Pertussis, Haemophilus B TriHIBit (DTaP, HIB) Diphtheria, Tetanus, Tripedia Pertussis (DTaP) Hepatitis A & Hepatitis B Twinrix Hepatitis A Vaqta Chicken pox (varicella) Varivax Zostavax Shingles

2yrs & older 2mos-59mos. 12mos. & older 12 mos. -12yrs. 6-24 weeks 6-32 weeks 12 - 15 mo booster only 6wks up to 7 yrs. 18 yrs & older 12 mos & older 12 months & older 60yrs & older

I. Red Section: Letters/Forms to be completed and/or copied ­ 9 pages

New Jersey Department of Health and Senior Services STANDARD SCHOOL / CHILD CARE CENTER IMMUNIZATION RECORD

NAME OF CHILD (Last, First, MI) NAME OF PARENT/GUARDIAN ADDRESS ADDRESS 1ST DOSE MO/DAY/YR 2ND DOSE MO/DAY/YR 3RD DOSE MO/DAY/YR 4TH DOSE MO/DAY/YR

DATE OF BIRTH (Mo./Day/Yr.) TELEPHONE NUMBER(S)

SEX

M F

IMMUNIZATION REGISTRY NUMBER 5TH DOSE MO/DAY/YR LEAD SCREENING

(Not Required)

VACCINE TYPE DIPHTHERIA, TETANUS, PERTUSSIS . (DTaP) or any combination . (if Td or DT(1) Indicate in corner box) POLIO-INACTIVATED POLIO . VACCINE (IPV) . (if oral vaccine, indicate OPV in corner box) MEASLES, MUMPS, RUBELLA (MMR) HAEMOPHILUS B (HIB) (2) HEPATITIS B (3) VARICELLA (4) PNEUMOCOCCAL CONJUGATE (2) INFLUENZA (6) OTHER, SPECIFY:

TEST DATE

RESULT

(5)

Document below single antigen vaccine receipt, serology titers, or Varicella disease history

DATE: TITER:

Hepatitis B

DATE: TITER:

Varicella

DATE: TITER:

Measles

DATE: TITER:

Mumps

DATE: TITER:

Rubella

Provisional Admission Attached - Date Granted:________________

(1) (2) (3) (4)

Medical Exemption Attached

Religious Exemption Attached

IMM-8 OCT 08

(5) (6)

REQUIRES MEDICAL EXEMPTION REQUIRED FOR CHILD CARE/PRESCHOOL ENROLLEES (2 Months - 5th Birthday Only) REQUIRED FOR K-GRADE 1 (whichever is first). GRADE 6 BEGINNING 9-1-01, AND GRADES 9-12, EFFECTIVE 9-1-04 REQUIRED FOR DAY/CHILD CARE ENROLLED (19 Months and older) AND GRADE K-GRADE 1 (whichever is first) EFFECTIVE 9-1-04 MMR single antigen receipt requries MO/DAY/YR, serologies require titers, and varicella disease history requires MO/YR. REQUIRED FOR CHILD CARE/PRESCHOOL ENROLLEES (6 Months - 59 Months)

New Jersey Department of Health and Senior Services STANDARD SCHOOL / CHILD CARE CENTER IMMUNIZATION RECORD

NAME OF CHILD (Last, First, MI) NAME OF PARENT/GUARDIAN ADDRESS ADDRESS 1ST DOSE MO/DAY/YR 2ND DOSE MO/DAY/YR 3RD DOSE MO/DAY/YR 4TH DOSE MO/DAY/YR

DATE OF BIRTH (Mo./Day/Yr.) TELEPHONE NUMBER(S)

SEX

M F

IMMUNIZATION REGISTRY NUMBER 5TH DOSE MO/DAY/YR LEAD SCREENING

(Not Required)

VACCINE TYPE DIPHTHERIA, TETANUS, PERTUSSIS . (DTaP) or any combination . (if Td or DT(1) Indicate in corner box) POLIO-INACTIVATED POLIO . VACCINE (IPV) . (if oral vaccine, indicate OPV in corner box) MEASLES, MUMPS, RUBELLA (MMR) HAEMOPHILUS B (HIB) (2) HEPATITIS B (3) VARICELLA (4) PNEUMOCOCCAL CONJUGATE (2) INFLUENZA (6) OTHER, SPECIFY:

TEST DATE

RESULT

(5)

Document below single antigen vaccine receipt, serology titers, or Varicella disease history

DATE: TITER:

Hepatitis B

DATE: TITER:

Varicella

DATE: TITER:

Measles

DATE: TITER:

Mumps

DATE: TITER:

Rubella

Provisional Admission Attached - Date Granted:________________

(1) (2) (3) (4)

Medical Exemption Attached

Religious Exemption Attached

IMM-8 OCT 08

(5) (6)

REQUIRES MEDICAL EXEMPTION REQUIRED FOR CHILD CARE/PRESCHOOL ENROLLEES (2 Months - 5th Birthday Only) REQUIRED FOR K-GRADE 1 (whichever is first). GRADE 6 BEGINNING 9-1-01, AND GRADES 9-12, EFFECTIVE 9-1-04 REQUIRED FOR DAY/CHILD CARE ENROLLED (19 Months and older) AND GRADE K-GRADE 1 (whichever is first) EFFECTIVE 9-1-04 MMR single antigen receipt requries MO/DAY/YR, serologies require titers, and varicella disease history requires MO/YR. REQUIRED FOR CHILD CARE/PRESCHOOL ENROLLEES (6 Months - 59 Months)

August 2010 Dear Preschool/Child Care Director: Your local health department is preparing for the 2010 ­ 2011 flu season. It is their goal to prevent illness and the complications of illness from seasonal flu. This is primarily done through vaccination against the circulating strains of flu between October, 2010 and April, 2011. We want to stress the importance of flu vaccination for caregivers of young children as well as for young children. Keeping staff healthy reduces the spread of illness in a child care center. Reducing illness in children also slows the spread of illness. Children less than 6 months of age cannot get vaccinated therefore they rely on their caregivers to be vaccinated. We have drafted a parent letter that you may use to give parents information about the unpredictability of flu and the serious complications some children experience. Nationally about 200,000 children under the age of 5 are hospitalized each flu season. Children who have other medical conditions such as asthma, diabetes, heart conditions are at greater risk for developing complications from flu. The health department would like staff and parents to know that the vaccine is safe. Whether it is an inactivated (killed) or attenuated (weakened) vaccine, it cannot give the flu to the person receiving the vaccine. Recognizing the seriousness of flu, the NJ Department of Health and Senior Services (NJDHSS) has added the flu vaccine to the list of required vaccines for children aged 6 ­ 59 months in a day care or preschool setting. Although this requirement has been waived in previous years, there is no reason to expect that it will be waived this coming flu season. Furthermore, this year's flu vaccine will contain both vaccine against two strains of seasonal flu and the 2009 H1N1 flu. It is important for children to be vaccinated to reduce the risks of complications and to slow the spread of illness in the community. To promote vaccinations your local health department may be offering vaccines. They can be contacted directly for dates and times. We look forward to working with you by providing information and tools to support a safe and healthy environment for children in our community.

_________________ Date

Dear Parents:

The ____________________________________________________Health Department is offering seasonal flu vaccinations for children 6 months to 59 months of age. The following dates, times and places for getting the flu vaccine for your child are: Date(s)______________________________________ Time(s)______________________________________ Place(s)______________________________________ The best way to protect your child from getting seasonal flu and its potential complications is to get vaccinated. Flu is a serious and unpredictable illness. Each year about 200,000 children under the age of 5 are hospitalized because of complications of the flu. Children under the age of 2 are susceptible to the most serious complications of flu. Children with chronic health conditions such as asthma, diabetes and heart disease are also at risk of developing complications of flu. The vaccine cannot give a person the flu. It is safe and effective in preventing illness. It protects against the current strains of flu circulating during the flu season. The NJ Department of Health and Senior Services (NJDHSS) requires children 6 ­ 59 months of age attending a day care or preschool program receive a seasonal flu vaccine by December 31. Your health department is making this vaccine available to help parents find affordable, accessible seasonal flu vaccine in their community. If you have any questions please contact _______________________________.

Dear Parents, Please be advised that pursuant to Chapter 14 of the New Jersey State Immunization Code, all child care centers, preschools, camps or school programs must have an immunization record on every child prior to their admission into the facility. Failure to comply with this regulation puts every child at risk of a vaccine preventable disease outbreak. Your local Board of Health is committed to the enforcement of this law in order to assure the health and safety of every individual child in its jurisdiction. We appreciate your anticipated cooperation in providing your program the necessary records prior to admission. Should you have any specific questions, please feel free to contact your local health department. Sincerely, Public Health Nurse

Date: ___________________ Dear Parents, In cooperation with your local health department, we are actively committed to enforcing Chapter 14 of the State Immunization Requirements. The following vaccines are now due/overdue for your child. You will have thirty days from the date of this notice to provide proof of immunization to the Child Care Center/Pre-school. Failure to do so will result in the exclusion of your child until such time that the age appropriate immunizations have been given. ________ DTaP, Td, or DT Vaccine ________ Polio-Inactivated Polio Vaccine (IPV) ________ Measles, Mumps, Rubella (MMR) ________ Haemophilus B (HIB) ________ Hepatitis B (HBV) ________ Varicella (Chickenpox vaccine) ________ Pneumococcal Conjugate (PCV) ________ Influenza (Flu) ________ Other ______________________________________

We appreciate your cooperation as we strive to assure the health and safety of all our children.

Sincerely,

____________________________________ Director

August 2010

Dear Parents, In cooperation with your local health department, we are actively committed to enforcing Chapter 14 of the State Immunization Requirements. Over the next several months, your child will be required to have additional immunizations. The age and the dates at which these will be needed for your child have been listed below. You will have thirty days from the date of this letter to provide proof of immunization to the Child Care Center/Pre-school. Failure to do so will result in the exclusion of your child until such time that the age appropriate immunizations have been given. Two months _________________ Four months _________________ Six months _________________ _____________________

Twelve - Fifteen months

Fifteen - Eighteen months _____________________ Nineteen months Four-Six years _____________________ _____________________

We appreciate your cooperation as we strive to assure the health and safety of all our children.

Sincerely, _____________________________ Director ____________ Date

August 2010

Acknowledgement of Religious Exemption (to accompany religious exemption letter submitted by parent/guardian)

Religious exemptions to immunizations for your child/children are accepted pursuant to NJ State Sanitary Code regulations (8:57-4.4A).

Each school, preschool, or child care center shall exempt a child from mandatory immunization if the child's parent or guardian submits to the school, preschool, or child care center a written, signed statement requesting an exemption, pursuant to the requirements for religious exemption established at N.J.S.A. 26:1A-9.1, on "the ground that the . . . immunization interferes with the free exercise of the pupil's religious rights." 42 N.J.R. 1597(a)

************************************************************************************* I/we have received and read the attached Vaccine Information and acknowledge not giving immunizations to our child/children may put them at risk of serious illness and death. As parents/guardians, we are aware that children with exemptions from receiving immunizations may be excluded from school, pre-school or child care centers during a vaccine-preventable disease outbreak or threatened outbreak s determined by the Commissioner, Department of Health and Senior Services or his or her designee (8:57-4.4E). I/we would like our child/children to be exempted from mandatory immunizations. Administering vaccines to them interferes with the practice of our religious tenets. I/we accept the associated risks to our child/children. Child/children (name/names)_____________________________________________________________ Please print

Signature of Parent/Guardian_________________________________Date________________________

Signature of Parent/Guardian_________________________________Date________________________ ************************************************************************************* Name of school official_________________________________Title______________________________

Signature of school official____________________________________Date________________________

Why get vaccinated?

Why get vaccinated? Diptheria, tetanus and pertussis are all serious diseases caused by bacteria. Diptheria and pertussis are spread from person to person. Tetanus enters the body through cuts or wounds. DIPTHERIA causes a thick covering in the back of the throat. · It can lead to breathing problems, paralysis, heart failure and even death. TETANUS (Lockjaw) causes painful tightening of the muscles, usually all over the body. · It can lead to "locking" of the jaw so the victim cannot open his mouth or swallow. Tetanus leads to death in about 1 out of 10 cases. PERTUSSIS (Whooping Cough) causes coughing spells so bad that it is hard for infants to eat, drink or breathe. These spells can last for weeks. · It can lead to pneumonia, seizures (jerking and staring spells), brain damage and death. Diptheria, tetanus and pertussis vaccine (DTaP) can help prevent these diseases. Most children who are vaccinated with DTaP will be protected throughout childhood. Many more children would get these diseases if we stopped vaccinating. DTaP is a safer version of an older vaccine called DTP. DTP is no longer used in the United States. Why get vaccinated? Chickenpox (also called varicella) is a common childhood disease. It is usually mild, but it can be serious, especially in young infants and adults. · The chickenpox virus can be spread from person to person through the air, or by contact with fluid from chickenpox blisters. · It causes a rash, itching, fever and tiredness. · It can lead to severe skin infection, scars, pneumonia, brain damage or death. · A person who has had chickenpox can get a painful rash called shingles years later. · About 12,000 people are hospitalized for chickenpox each year in the United States. · About 100 people die each year in the United States as a result of chickenpox. Chickenpox vaccine can prevent chickenpox. Most people who get chickenpox vaccine will not get the chickenpox. But if someone who has been vaccinated does get chickenpox, it is usually very mild. They will have fewer spots, are less likely to have a fever and will recover faster.

________________________________________________________________________

Why get vaccinated? Measles, mumps and rubella are serious diseases. Measles · · Mumps · ·

Measles virus causes rash, cough, runny nose, eye irritation and fever. It can lead to ear infection, pneumonia, seizures (jerking and staring), brain damage and death.

Mumps virus causes fever, headache and swollen glands. It can lead to deafness, meningitis (infections of the brain and spinal cord covering), painful swelling of the testicles or ovaries, and, rarely, death. Rubella (German Measles) · Rubella virus causes rash, mild fever and arthritis (mostly in women). · If a woman gets rubella while she is pregnant, she could have a miscarriage or her baby could be born with serious birth defects. You or your child could catch these diseases by being around someone who has them. They spread from person to person through the air. Measles, mumps and rubella (MMR) vaccine can prevent these diseases. Most children who get their MMR shots will not get these diseases. Many more children would get them if we stopped vaccinating.

Why get vaccinated? Hepatitis B is a serious disease. The hepatitis B virus (HBV) can cause short term illness that leads to: · loss of appetite · diarrhea and vomiting · tiredness · jaundice (yellow skin or eyes) · pain in muscles, joints and stomach It can also cause long-term (chronic) illness that leads to: · liver damage · liver cancer · death About 1.25 million people in the U.S. have chronic HBV infection. Each year it is estimated that: · 80,000 people, mostly young adults, get infected with HBV · More than 11,000 people have to stay in the hospital because of hepatitis B · 4,000 to 5,000 people die from chronic hepatitis B Hepatitis B vaccine can prevent hepatitis B. It is the first anti-cancer vaccine because it can prevent a form of liver cancer. What is polio? Polio is a disease caused by a virus. It enters a child's (or adult's) body through the mouth. Sometimes it does not cause serious illness. But sometimes it causes paralysis (can't move arm or leg). It can kill people who get it, usually by paralyzing the muscles that help them breathe. Polio used to be very common in the United States. It paralyzed and killed thousands of people a year before we had a vaccine for it. Why get vaccinated? Inactivated Polio Vaccine (IPV) can prevent polio. History: A 1916 polio epidemic in the United States killed 6,000 people and paralyzed 27,000 more. In the early 1950's there were more than 20,000 cases of polio each year. Polio vaccination was begun in 1955. By 1960 the number of cases had dropped to about 3,000 and by 1979 there were only about 10. The success of polio vaccination in the U.S. and other countries sparked a world-wide effort to eliminate polio. Today: No wild polio has been reported in the United States for over 20 years. But the disease is still common in some parts of the world. It would only take one case of polio from another country to bring the disease back if we were not protected by vaccine. If the effort to eliminate the disease from the world is successful, some day we won't need polio vaccine. Until then, we need to keep getting our children vaccinated.

I. Blue Section: Resources ­ 19 pages

MINIMAL IMMUNIZATION REQUIREMENTS FOR SCHOOL ATTENDANCE IN NEW JERSEY Chapter 14: Immunization for Pupils in School

DISEASE(S) MEETS IMMUNIZATION REQUIREMENTS

(AGE 1-6 YEARS): 4 doses, with one dose given on or after the 4th birthday, OR any 5 doses. (AGE 7-9 YEARS): 3 doses of Td or any previously administered combination of DTP, DTaP, and DT to equal 3 doses. GRADE 6 (or comparable age level for special education programs): 1 dose (AGE 1-6 YEARS): 3 doses, with one dose given on or after the 4th birthday, OR any 4 doses. (AGE 7 or OLDER): Any 3 doses. If born before 1-1-90, 1 dose of a live Measlescontaining vaccine. If born on or after 1-1-90, 2 doses of a live Measles-containing vaccine. If entering a college or university after 9-1-95 and previously unvaccinated, 2 doses of a live Measles-containing vaccine.

COMMENTS

Any child entering pre-school, pre-Kindergarten, or Kindergarten needs a minimum of four doses. Pupils after the seventh birthday should receive adult type Td. DTP/Hib vaccine and DTaP also valid DTP doses. For pupils entering Grade 6 on or after 9-1-08 and born on or after 1-1-97. A child does not need a Tdap dose until FIVE years after the last DTP/DtaP or Td dose. Either Inactivated Polio Vaccine (IPV) or Oral Polio Vaccine (OPV) separately or in combination is acceptable. Polio vaccine is not required of pupils 18 years of age or older. Any child over 15 months of age entering child care, pre-school, or preKindergarten needs a minimum of 1 dose of measles vaccine. Any child entering Kindergarten needs 2 doses. Previously unvaccinated students entering college after 9-1-95 need 2 doses of measles-containing vaccine or any combination containing live measles virus administered after 1968. Documentation of 2 prior doses is acceptable. Laboratory evidence of immunity is also acceptable. Intervals between first and second measles/MMR/MR doses cannot be less than 1 month. Any child over 15 months of age entering child care, pre-school, or preKindergarten needs 1 dose of rubella and mumps vaccine. Each student entering college for the first time after 9-1-95 needs 1 dose of rubella and mumps vaccine or any combination containing live rubella and mumps virus administered after 1968. All children 19 months of age and older enrolled into a child care/pre-school center after 9-1-04 or children born on or after 1-1-98 entering a school for the first time in Kindergarten or Grade 1 need 1 dose of varicella vaccine. Laboratory evidence of immunity, physician's statement or a parental statement of previous varicella disease is also acceptable. Mandated only for children enrolled in child care, pre-school, or pre-Kindergarten. (1) Minimum of 2 doses of Hib vaccine is needed if between the ages of 2-11 months. (2) Minimum of 1 dose of Hib vaccine is needed after the first birthday. DTP/Hib and Hib/Hep B also valid Hib doses.

(1) If a child is between 11-15 years of age and has not received 3 prior doses of Hepatitis B then the child is eligible to receive 2-dose Hepatitis B Adolescent formulation. Laboratory evidence of immunity is also acceptable.

DTaP

Tdap

POLIO

MEASLES

RUBELLA and MUMPS

1 dose of live Mumps-containing vaccine. 1 dose of live Rubella-containing vaccine.

VARICELLA

1 dose on or after first birthday.

HAEMOPHILIS B (Hib)

(AGE 2-11 MONTHS)(1): 2 doses (AGE 12-59 MONTHS)(2): 1 dose

HEPATITIS B

(K-GRADE 12): 3 doses or 2 doses (1)

PNEUMOCOCCAL

(AGE 2-11 MONTHS)(1): 2 doses (AGE 12-59 MONTHS)(2): 1 dose (Entering GRADE 6 (or comparable age level for Special Ed programs): 1 dose (1) (Entering a four-year college or University, previously unvaccinated and residing in a campus dormitory): 1 dose (2) (AGES 6-59 MONTHS): 1 dose ANNUALLY

Mandated only for children enrolled in child care, pre-school, or pre-Kindergarten. (1) Minimum of 2 doses of Pneumococcal vaccine is needed if between the ages of 2-11 months. (2) Minimum of 1 dose of Pneumococcal vaccine is needed after the first birthday. (1) For pupils entering Grade 6 on or after 9-1-08 and born on or after 1-1-97. (2) Previously unvaccinated students entering a four-year college or university after 9-1-04 and who reside in a campus dormitory, need 1 dose of meningococcal vaccine. Documentation of one prior dose is acceptable. For children enrolled in child care, pre-school or pre-Kindergarten on or after 9-1-08. 1 dose to be given between September 1 and December 31 of each year.

MENINGOCOCCAL

INFLUENZA

AGE APPROPRIATE VACCINATIONS (FOR LICENSED CHILD CARE CENTERS/PRE-SCHOOLS)

CHILD'S AGE 2-3 Months 4-5 Months 6-7 Months 8-11 Months 12-14 Months 15-17 Months 18 Months-4 Years NUMBER OF DOSES CHILD SHOULD HAVE (BY AGE): 1 dose DTaP, 1 dose Polio, 1 dose Hib, 1 dose PCV7 2 doses DTaP, 2 doses Polio, 2 doses Hib, 2 doses PCV7 3 doses DTaP, 2 doses Polio, 2-3 doses Hib, 2-3 doses PCV7, 1 dose Influenza 3 doses DTaP, 2 doses Polio, 2-3 doses Hib, 2-3 doses PCV7, 1 dose Influenza 3 doses DTaP, 2 doses Polio, 1 dose Hib, 2-3 doses PCV7, 1 dose Influenza 3 doses DTaP, 2 doses Polio, 1 dose MMR, 1 dose Hib, 1 dose PCV7, 1 dose Influenza 4 doses DTaP, 3 doses Polio, 1 dose MMR, 1 dose Hib, 1 dose Varicella, 1 dose PCV7, 1 dose Influenza

PROVISIONAL ADMISSION:

Provisional admission allows a child to enter/attend school but must have a minimum of one dose of each of the required vaccines. Pupils must be actively in the process of completing the series. If a pupil is <5 years of age, they have 17 months to complete the immunization requirements. If a pupil is 5 years of age and older, they have 12 months to complete the immunization requirements.

GRACE PERIODS:

· 4-day grace period: All vaccines doses administered less than or equal to four days before either the specified minimum age or dose spacing interval shall be counted as valid and shall not require revaccination in order to enter or remain in a school, pre-school or child care facility. · 30-day grace period: Those children transferring into a New Jersey school, pre-school, or child care center from out of state/out of country may be allowed a 30day grace period in order to obtain past immunization documentation before provisional status shall begin.

MAR 08

Recommended Immunization Schedule for Persons Aged 0 Through 6 Years--United States · 2010 Forthosewhofallbehindorstartlate,seethecatch-upschedule

Vaccine

HepatitisB1 Rotavirus

2

Age

Birth HepB

1 month

2 4 6 12 15 18 19­23 months months months months months months months HepB RV DTaP Hib PCV IPV RV DTaP Hib PCV IPV RV 2 DTaP Hib4 PCV

see footnote 3

2­3 years

4­6 years

HepB

Diphtheria, Tetanus, Pertussis3 Haemophilus influenzae type b4 Pneumococcal5 Inactivated Poliovirus6 Influenza7 Measles, Mumps, Rubella8 Varicella

9

DTaP

DTaP

Hib PCV IPV Influenza (Yearly) MMR Varicella HepA (2 doses)

see footnote 8 see footnote 9

PPSV IPV

Range of recommended ages for all childrenexcept certainhigh-risk groups

MMR Varicella HepA Series MCV

Range of recommended ages for certain high-riskgroups

HepatitisA10 Meningococcal11 This schedule includes recommendations in effect as of December 15, 2009. 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. Considerations should include provider assessment, patient preference, and the potential for adverse events. Providers should consult the relevant Advisory 1. Hepatitis B vaccine (HepB). (Minimum age: birth) At birth: · AdministermonovalentHepBtoallnewbornsbeforehospitaldischarge. · IfmotherishepatitisBsurfaceantigen(HBsAg)-positive,administerHepB and0.5mLofhepatitisBimmuneglobulin(HBIG)within12hoursofbirth. · Ifmother'sHBsAgstatusisunknown,administerHepBwithin12hoursof birth.Determinemother'sHBsAgstatusassoonaspossibleand,ifHBsAgpositive,administerHBIG(nolaterthanage1week). After the birth dose: · TheHepBseriesshouldbecompletedwitheithermonovalentHepBoracombinationvaccinecontainingHepB.Theseconddoseshouldbeadministered atage1or2months.MonovalentHepBvaccineshouldbeusedfordoses administeredbeforeage6weeks.Thefinaldoseshouldbeadministeredno earlierthanage24weeks. · Infants born to HBsAg-positive mothers should be tested for HBsAg and antibodytoHBsAg1to2monthsaftercompletionofatleast3dosesofthe HepBseries,atage9through18months(generallyatthenextwell-child visit). · Administrationof4dosesofHepBtoinfantsispermissiblewhenacombinationvaccinecontainingHepBisadministeredafterthebirthdose.Thefourth doseshouldbeadministerednoearlierthanage24weeks. 2. Rotavirus vaccine (RV).(Minimumage:6weeks) · Administer the first dose at age 6 through 14 weeks (maximum age: 14 weeks6days).Vaccinationshouldnotbeinitiatedforinfantsaged15weeks 0 days or older. · Themaximumageforthefinaldoseintheseriesis8months0days · IfRotarixisadministeredatages2and4months,adoseat6monthsisnot indicated. 3. Diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP). (Minimumage:6weeks) · Thefourthdosemaybeadministeredasearlyasage12months,provided at least 6 months have elapsed since the third dose. · Administerthefinaldoseintheseriesatage4through6years. 4. Haemophilus influenzae type b conjugate vaccine (Hib). (Minimumage:6weeks) · IfPRP-OMP(PedvaxHIBorComvax[HepB-Hib])isadministeredatages2 and 4 months, a dose at age 6 months is not indicated. · TriHiBit(DTaP/Hib)andHiberix(PRP-T)shouldnotbeusedfordosesatages 2, 4, or 6 months for the primary series but can be used as the final dose in children aged 12 months through 4 years. 5. Pneumococcal vaccine. (Minimumage:6weeksforpneumococcalconjugate vaccine[PCV];2yearsforpneumococcalpolysaccharidevaccine[PPSV]) · PCVisrecommendedforallchildrenagedyoungerthan5years.Administer 1 dose of PCV to all healthy children aged 24 through 59 months who are not completely vaccinated for their age. · AdministerPPSV2ormoremonthsafterlastdoseofPCVtochildrenaged2 years or older with certain underlying medical conditions, including a cochlear implant. See MMWR1997;46(No.RR-8).

CS207330-A

Committee on Immunization Practices statement for detailed recommendations: http://www.cdc.gov/vaccines/pubs/acip-list.htm. Clinically significant adverse events that follow immunization should be reported to the Vaccine Adverse Event Reporting System (VAERS) at http://www.vaers.hhs.gov or by telephone, 800-822-7967. 6. Inactivated poliovirus vaccine (IPV) (Minimumage:6weeks) · The final dose in the series should be administered on or after the fourth birthday and at least 6 months following the previous dose. · If4dosesareadministeredpriortoage4yearsafifthdoseshouldbeadministered at age 4 through 6 years. See MMWR2009;58(30):829­30. 7. Influenza vaccine (seasonal). (Minimum age: 6 months for trivalent inactivatedinfluenzavaccine[TIV];2yearsforlive,attenuatedinfluenzavaccine [LAIV]) · Administerannuallytochildrenaged6monthsthrough18years. · Forhealthychildrenaged2through6years(i.e.,thosewhodonothaveunderlying medical conditions that predispose them to influenza complications), eitherLAIVorTIVmaybeused,exceptLAIVshouldnotbegiventochildren aged 2 through 4 years who have had wheezing in the past 12 months. · ChildrenreceivingTIVshouldreceive0.25mLifaged6through35months or0.5mLifaged3yearsorolder. · Administer2doses(separatedbyatleast4weeks)tochildrenagedyounger than 9 years who are receiving influenza vaccine for the first time or who were vaccinated for the first time during the previous influenza season but only received 1 dose. · ForrecommendationsforuseofinfluenzaA(H1N1)2009monovalentvaccine see MMWR2009;58(No.RR-10). 8. Measles, mumps, and rubella vaccine (MMR). (Minimum age: 12 months) · Administertheseconddoseroutinelyatage4through6years.However,the seconddosemaybeadministeredbeforeage4,providedatleast28days have elapsed since the first dose. 9. Varicella vaccine. (Minimum age: 12 months) · Administertheseconddoseroutinelyatage4through6years.However,the seconddosemaybeadministeredbeforeage4,providedatleast3months have elapsed since the first dose. · Forchildrenaged12monthsthrough12yearstheminimumintervalbetween dosesis3months.However,iftheseconddosewasadministeredatleast 28daysafterthefirstdose,itcanbeacceptedasvalid. 10. Hepatitis A vaccine (HepA). (Minimum age: 12 months) · Administer to all children aged 1 year (i.e., aged 12 through 23 months). Administer 2 doses at least 6 months apart. · Childrennotfullyvaccinatedbyage2yearscanbevaccinatedatsubsequent visits · HepAalsoisrecommendedforolderchildrenwholiveinareaswherevaccinationprogramstargetolderchildren,whoareatincreasedriskforinfection, or for whom immunity against hepatitis A is desired. 11. Meningococcal vaccine. (Minimum age: 2 years for meningococcal conjugate vaccine[MCV4]andformeningococcalpolysaccharidevaccine[MPSV4]) · AdministerMCV4tochildrenaged2through10yearswithpersistentcomplement component deficiency, anatomic or functional asplenia, and certain other conditionsplacingthamathighrisk. · Administer MCV4 to children previously vaccinated with MCV4 or MPSV4 after3yearsiffirstdoseadministeredatage2through6years.SeeMMWR 2009; 8:1042­3. 5

TheRecommendedImmunizationSchedulesforPersonsAged0through18YearsareapprovedbytheAdvisoryCommitteeonImmunizationPractices (http://www.cdc.gov/vaccines/recs/acip), the American Academy of Pediatrics (http://www.aap.org),andtheAmericanAcademyofFamilyPhysicians(http://www.aafp.org). DepartmentofHealthandHumanServices·CentersforDiseaseControlandPrevention

Need help responding to vaccine-hesitant parents?

Science-based materials are available from these respected organizations

Vaccine Education Center (VEC) Children's Hospital of Philadelphia

·Tearsheets--Offeredintear-offpadsof50,theseareintendedfor physicianstohandouttopatients.Usefultitlesforhesitantparents include"TooManyVaccines?""Thimerosal,""VaccinesandAutism,""AluminuminVaccines,"and"TheFactsAboutChildhood Vaccines." ·Videos--"Vaccines:SeparatingFactfromFear"and"Vaccinesand YourBaby"comeinDVDformat. Materialscanbeviewedorprintedathttp://vaccine.chop.edu/resources. Tear-offpadsandDVDs,aswellasotherVECmaterials,canbeordered atnominalcostfromtheVECwebsite.

California Immunization Coalition

TheCaliforniaImmunizationCoalition(CIC)hasdevelopedseveral excellentproviderpiecesthatdiscusscommonquestionsmanyparents mayhaveregardingvaccinesfortheirchildren.Theseinclude ·"RespondingtoParents'Top10Concerns" http://immunizeca.org/documents/IMM-917_web.pdf ·"TalkingwithParentsAboutVaccineSafety" http://immunizeca.org/documents/IMM-915_web.pdf ·"AlternateVaccineSchedules:HelpingParentsSeparateFactFrom Fear"http://immunizeca.org/documents/IMM-988.pdf

Centers for Disease Control and Prevention (CDC)

Among CDC's many online immunization resources is the "Parent's GuidetoChildhoodImmunization,"a68-pagebookletthatcanbeordered orprintedatwww.cdc.gov/vaccines/pubs/parents-guide. OtherCDCwebpagescanbemadeprint-readybyclicking"PrinterFriendly Format" in the top right-hand corner of the page. Here are examplesthatmayhelpyouworkwithhesitantparents: ·"SomeCommonMisconceptions" www.cdc.gov/vaccines/vac-gen/6mishome.htm ·"HowVaccinesPreventDisease" www.cdc.gov/vaccines/vac-gen/howvpd.htm ·"WhatWouldHappenIfWeStoppedVaccinations?" www.cdc.gov/vaccines/vac-gen/whatifstop.htm ·"WhyIt'sImportanttoMonitorVaccineSafety" www.cdc.gov/vaccinesafety/Vaccine_Monitoring/Index.html

Immunization Action Coalition (IAC)

IACoffersready-to-printeducationalpiecesthatareappropriatefor hesitantparents: ·"ClearAnswers&SmartAdviceAboutYourBaby'sShots,"anexcerpt fromthepopularbook"Baby411"byDr.AriBrown www.immunize.org/catg.d/p2068.pdf ·"MMRVaccineDoesNotCauseAutism:ExaminetheEvidence!" www.immunize.org/catg.d/p4026.pdf ·"VaccinesWork!"www.immunize.org/catg.d/p4037.pdf ·Many other online resources for addressing vaccine concerns are availableatwww.immunize.org/concerns. ·Consider establishing a vaccine policy for your practice. You can downloadandcustomizethesamplepolicylocatedat www.immunize.org/catg.d/p2067.pdf.

American Academy of Pediatrics (AAP)

·Thischartshowshesitantparentshowgreatanimpactvaccination hashadonchildhealth: www.aap.org/immunization/families/faq/whyimmunize.pdf. ·An aid to help parents evaluate information on the Internet: www.aap.org/immunization/families/faq/FAQ_Internet.pdf. ·"Facts for Parents About Vaccine Safety" In English: www.aap.org/ immunization/families/VaccineSafety1pagerEnglish.pdforSpanish: www.aap.org/immunization/families/VaccineSafety1pagerSpanish.pdf. ·Generalguidelinesfortalkingtohesitantparentsareoutlinedhere: www.aap.org/immunization/pediatricians/pdf/Vaccine-Hesitant%20 Parent_Final.pdf. ·Whenparentscannotbeconvinced,considerusingAAP'sRefusal to Vaccinateformatwww.aap.org/immunization/pediatricians/pdf/ RefusaltoVaccinate.pdf.

Institute for Vaccine Safety, Johns Hopkins University

TheInstituteforVaccineSafetycollectsvaccine-specificsafetyinformation.OfparticularinterestisitsComponentssection,whichcontains tablesspecifyingthecontentsofvariousvaccines: www.vaccinesafety.edu/components.htm.

For parents with concerns about vaccines and autism

AAP has issued a statement that can be printed at www.aap.org/ advocacy/releases/autismparentfacts.htm. Parents may wish to investigatefurtheratwww.aap.org/healthtopics/Autism.cfm.IACalso recommendsthesebooks: · Autism's False Prophets: Bad Science, Risky Medicine, and the Search for a Cure,byPaulA.Offit,MD · Unstrange Minds: Remapping the World of Autism, byRoyRichard Grinker,PhD

For parents who want to do further searching on their own

IAChasdevelopedaone-pageguide"ReliableSourcesofImmunizationInformation:Wheretogotofindanswers!"thatcanbedownloaded atwww.immunize.org/catg.d/p4012.pdf.

Every Child by Two (ECBT)

CreatedbyEveryChildbyTwo,www.vaccinateyourbaby.orgfocuses onansweringparents'commonlyaskedquestionsaboutvaccines.It featuresvideoclipsandlinkstocurrentvaccinenewsstories.

Technical content reviewed by the Centers for Disease Control and Prevention, July 2010.

www.immunize.org/catg.d/p2070.pdf · Item #P2070 (7/10)

Immunization Action Coalition · 1573 Selby Ave. · St. Paul, MN 55104 · (651) 647-9009 · www.vaccineinformation.org · www.immunize.org

Common Questions Parents ask

about infant immunizations

Is it okay for my baby to have so many shots at once? Don't infants have natural immunity? Haven't we gotten rid of most of these diseases in this country? I heard that some vaccines can cause autism. Is this true?

Yes. Studies show that kids' bodies--even infants--can handle many shots at once. Having several vaccines at once is safe, even for a newborn. Combination vaccines protect your child against more than one disease with a single shot. This reduces the number of shots and office visits your child would need. It's not your imagination; there are a greater number of shots now than even a few years ago. That's because as science advances, we are able to protect your child against more diseases than ever before. Babies get some temporary immunity (protection) from mom during the last few weeks of pregnancy--but only for the diseases mom is immune to. These antibodies do not last long, leaving the infant vulnerable to disease. Thanks to vaccines, most diseases prevented by vaccines are no longer common in this country. Even the few cases we have in the U.S. could very quickly become tens or hundreds of thousands of cases if we stopped vaccinating. It's not uncommon to have measles outbreaks, whooping cough outbreaks, chickenpox outbreaks, and other diseases when vaccination rates drop. Kids that are not fully vaccinated can become seriously sick and spread it through a community. No. Scientific studies and reviews have found no relationship between vaccines and autism. Groups of experts, including the American Academy of Pediatrics and the Institute of Medicine (IOM), also agree that vaccines are not responsible for the number of children now recognized to have autism. Many of the diseases vaccines protect against can be very dangerous to infants. Newborns, babies, and toddlers can all be exposed to diseases from parents and other adults, brothers and sisters, on a plane, at child care, or even at the grocery store. International travel is easier than ever--your baby can be exposed to diseases from other countries without you knowing. Don't wait to protect your baby and risk these diseases when he or she needs protection now. It is easier to stay up to date than to catch up!

Can't I just wait until my child goes to school to catch up on immunizations? Why does my child need a chickenpox shot? Isn't it a mild disease? My child is sick right now. Is it okay for her to still get shots? Where can I get more information?

CS124445 01/21/09

Chickenpox can actually be a serious disease for kids if the blisters become infected. Before vaccine was available, about 50 kids died every year from chickenpox, and about 1 in 500 kids who got chickenpox were hospitalized. Yes, usually. Talk with the doctor, but children can usually get vaccinated even if they have a mild illness like a cold, earache, mild fever, or diarrhea. If the doctor says it is okay, your child can still get vaccinated.

Centers for Disease Control and Prevention (CDC) · www.cdc.gov/vaccines or 800-CDC-INFO (232-4636) american academy of Pediatrics · www.aap.org the Children's Hospital of Philadelphia · www.vaccine.chop.edu immunization action Coalition (iaC) · www.immunize.org every Child By two · www.ecbt.org

then ...

. . .

Without immunizations your child may have to be excluded at times from school or child care.

your child will be left at risk of catching the disease

During disease outbreaks, unimmunized children may be excluded from school or child care until the outbreak is over, both for their own protection and for the protection of others. This causes hardship for the child and parent.

what to do . . .

We strongly encourage you to immunize your child, but ultimately the decision is yours. Please discuss any concerns you have with a trusted healthcare provider or call the immunization coordinator at your local or state health department. Your final decision affects not only the health of your child, but also the rest of your family, the health of your child's friends and their families, classmates, neighbors, and community.

For more information about vaccines, go to: · Immunization Action Coalition: www.vaccineinformation.org and www.immunize.org · Centers for Disease Control and Prevention: www.cdc.gov/nip CDC-INFO Contact Center: (800) 232-4636 · American Academy of Pediatrics: www.cispimmunize.org · National Network for Immunization Information: www.immunizationinfo.org · Vaccine Education Center: www.vaccine.chop.edu

your child will be a threat to others

your child at times must be kept out of school or child care

Immunization Action Coalition 1573 Selby Avenue, Suite 234 Saint Paul, MN 55104 phone: (651) 647-9009 fax: (651) 647-9131 www.immunize.org www.vaccineinformation.org

This brochure was created by the California Department of Health Services, Immunization Branch, and was modified with permission by the Immunization Action Coalition (IAC). The content was reviewed by the Centers for Disease Control and Prevention. It may be reproduced without permission. If you alter it, please acknowledge it was adapted from the California Department of Health Services and IAC. www.immunize.org/catg.d/p4017.pdf · Item #P4017 (3/06)

Wh at.i.f.

you don't immunize your child

.

?

What if . . .

What if you don't immunize your child? While most state laws provide for religious or personal exemptions to required immunizations, concerned parents should still consider the consequences of

.

Soviet Union, where many children and adults had not been immunized. Their reported cases of diphtheria rose from 839 in 1989 to 47,802 in 1994, when 1,746 persons died. At least 20 infected individuals exported the disease along the way.

Without immunizations your child is at greater risk of catching one of the vaccine-preventable diseases.

· Before the availability of a chickenpox

vaccine, almost every child suffered from this disease. During 1988­1995, up to 10,000 people were hospitalized each year from complications of chickenpox--most of them previously healthy children. An average of 43 children died from chickenpox each year during 1990­1994. reported 152 influenza-related deaths among children younger than 18.

Vaccines were developed to protect individuals from dangerous and sometimes deadly diseases. Vaccines are safe and effective, and such diseases are still a threat.

· Pertussis or "whooping cough" is an extremely dangerous disease for infants. It is not easily treated and can result in permanent brain damage or death. During 1997­2000, nearly 30,000 cases of pertussis were reported in the United States, including 62 pertussis-related deaths. Of infected infants younger than age 6 months, two-thirds needed to be hospitalized. In 2004, 25,827 cases were reported--the most cases reported since 1959. · Measles is dangerous and very contagious.

During the 1989­1991 U.S. measles epidemic, approximately 55,000 cases and 132 deaths (mostly children) were reported. Worldwide, measles kills approximately 500,000 children each year. nose and throat that can lead to serious breathing problems, heart failure, paralysis, and even death. In recent years, there have been few cases of diphtheria in the United States. However, a diphtheria epidemic recently occurred in countries of the former

.

· During the 2003­04 influenza season, 40 states

Without immunizations your child can infect others.

Children who are not immunized can transmit vaccine-preventable diseases throughout the community.

· Unvaccinated people can pass diseases on

to babies who are too young to be fully immunized.

· Unvaccinated people pose a threat to

children and adults who can't be immunized for medical reasons. This includes people with leukemia and other cancers, HIV/AIDS and other immune system problems, and persons receiving chemotherapy, radiation therapy, or large doses of corticosteroids.

not immunizing their children.

?

· Diphtheria is an infectious disease of the

· Unvaccinated people can infect the small

percentage of children whose immunizations did not "take."

YOUR BABY'S FIRST VACCINES

W H A T Y O U N E E D T O K N O W

Babies get six vaccines between birth and 6 months of age. These vaccines protect your baby from 8 serious diseases (see the next page).

Your baby will get vaccines today that prevent these diseases: Hepatitis B Polio Pneumococcal Disease Diphtheria, Tetanus & Pertussis Rotavirus Hib

(Provider: Check appropriate boxes)

These vaccines may be given separately, or some might be given

together in the same shot (for example, Hepatitis B and Hib can be

given together, and so can DTaP, Polio and Hepatitis B).

These "combination vaccines" are as safe and effective as

the individual vaccines, and mean fewer shots for your baby.

These vaccines may all be given at the same visit.

Getting several vaccines at the same time will not harm your baby.

This Vaccine Information Statement (VIS) tells you about the benefits and risks of these vaccines. It also contains information about reporting an adverse reaction, the National Vaccine Injury Compensation Program, and how to get more information about childhood diseases and vaccines. Please read this VIS before your child gets his or her immunizations, and take it home with you afterward. Ask your doctor, nurse, or other healthcare provider if you have questions.

Individual Vaccine Information Statements are also available for these vaccines.

Many Vaccine Information Statements are available in Spanish and other languages. See www.immunize.org/vis

department of health and human services

Centers for Disease Control and Prevention

Vaccine Information Statement (Interim) 42 U.S.C. § 300aa-26

9/18/2008

Vaccine Benefits: Why get vaccinated?

Your children's first vaccines protect them from 8 serious diseases, caused by viruses and bacteria. These diseases have injured and killed many children (and adults) over the years. Polio paralyzed about 37,000 people and killed about 1,700 each year in the 1950s before there was a vaccine. In the 1980s, Hib disease was the leading cause of bacterial meningitis in children under 5 years of age. About 15,000 people a year died from diphtheria before there was a vaccine. Most children have had at least one rotavirus infection by their 5th birthday. None of these diseases has completely disappeared. Without vaccination, they will come back. This has happened in other parts of the world.

Prevented by Childhood Vaccines

8 Diseases

HEPATITIS B

Virus

DIPHTHERIA

Bacteria

You can get it from contact with an infected person.

Signs and symptoms include a thick covering in the back of

the throat that can make it hard to breathe.

It can lead to breathing problems, heart failure, and death.

You can get it from contact with blood or body fluids of an infected person. Babies can get it at birth if the mother is infected, or through a cut or wound. Adults can get it from unprotected sex, sharing needles, or other exposures to blood. Signs and symptoms include tiredness, diarrhea and vomiting, jaundice (yellow skin or eyes), and pain in muscles, joints and stomach. It can lead to liver damage, liver cancer, and death.

TETANUS (Lockjaw)

Signs and symptoms include painful tightening of the muscles, usually all over the body.

Bacteria

You can get it from a cut or wound. It does not spread from person to person.

P0LIO

Virus

You can get it from close contact with an infected person. It enters the body through the mouth. Signs and symptoms can include a cold-like illness, or there may be no signs or symptoms at all. It can lead to paralysis (can't move arm or leg), or death (by paralyzing breathing muscles).

It can lead to stiffness of the jaw, so the victim can't open his mouth or swallow. It leads to death in about 1 case out of 5.

PERTUSSIS (Whooping Cough)

You can get it from contact with an infected person.

Bacteria

PNEUMOCOCCAL

You can get it from contact with an infected person.

Bacteria

Signs and symptoms include violent coughing spells that can make it hard for an infant to eat, drink, or breathe. These spells can last for weeks. It can lead to pneumonia, seizures (jerking and staring spells), brain damage, and death.

Signs and symptoms include fever, chills, cough, and chest pain. It can lead to meningitis (infection of the brain and spinal cord coverings), blood infections, ear infections, pneumonia, deafness, brain damage, and death.

HIB

(Haemophilus influenzae type b)

Bacteria

You can get it from contact with an infected person. Signs and symptoms. There may be no signs or symptoms in mild cases. It can lead to meningitis (infection of the brain and spinal cord coverings); pneumonia; infections of the blood, joints, bones, and covering of the heart; brain damage; deafness; and death.

ROTAVIRUS

Virus

You can get it from contact with other children who are infected. Signs and symptoms include severe diarrhea, vomiting and fever. It can lead to dehydration, hospitalization (up to about 70,000 a year), and death.

How Vaccines Work

Immunity from Disease: When a child gets sick with one of these diseases, her immune system produces immunity, which keeps her from getting the same disease again. But getting sick is unpleasant, and can be dangerous. Immunity from Vaccines: Vaccines are made with the same bacteria or viruses that cause a disease, but they have been weakened or killed to make them safe. A child's immune system responds to a vaccine the same way it would if the child had the disease. This means he will develop immunity without having to get sick first.

Routine Childhood Vaccines

Six vaccines are recommended for children between birth and 6 months of age. They can prevent the 8 diseases described on the previous page. Children will also get at least one "booster" dose of most of these vaccines when they are older. · DTaP (Diphtheria, Tetanus & Pertussis) Vaccine: 5 doses ­ 2 months, 4 months, 6 months, 15-18 months, 4-6 years. Some children should not get pertussis vaccine. These children can get a vaccine called DT, which does not contain pertussis. · Hepatitis B Vaccine: 3 doses ­ Birth, 1-2 months, 6-18 months. · Polio Vaccine: 4 doses ­ 2 months, 4 months, 6-18 months, 4-6 years. · Hib (Haemophilus influenzae type b) Vaccine: 3 or 4 doses ­ 2 months, 4 months, 6 months, 12-15 months. Several Hib vaccines are available. With one type, the 6-month dose is not needed. · Pneumococcal Vaccine: 4 doses ­ 2 months, 4 months, 6 months, 12-15 months. Older children with certain diseases may also need this vaccine. · Rotavirus Vaccine: 2 or 3 doses ­ 2 months, 4 months, 6 months. Rotavirus is an oral (swallowed) vaccine, not a shot. Two rotavirus vaccines are available. With one type, the 6 month dose is not needed.

Vaccine Risks

Vaccines can cause side effects, like any other medicine. Mostly these are mild "local" reactions such as tenderness, redness or swelling where the shot is given, or a mild fever. They happen in up to 1 child out of 4 with most child hood vaccines. They appear soon after the shot is given and go away within a day or two. More severe reactions can also occur, but this happens much less often. Some of these reactions are so uncommon that experts can't tell whether they are caused by vaccines or not. Among the most serious reactions to vaccines are severe allergic reactions to a substance in a vaccine. These reactions happen very rarely ­ less than once in a million shots. They usually happen very soon after the shot is given. Doctor's office or clinic staff are trained to deal with them. The risk of any vaccine causing serious harm, or death, is extremely small. Getting a disease is much more likely to harm a child than getting a vaccine. Other Reactions The following conditions have been associated with routine childhood vaccines. By "associated" we mean that they appear more often in children who have been recently vaccinated than in those who have not. An association doesn't prove that a vaccine caused a reaction, but does mean it is probable. DTaP Vaccine Mild Problems: Fussiness (up to 1 child in 3); tiredness or poor appetite (up to 1 child in 10); vomiting (up to 1 child in 50); swelling of the entire arm or leg for 1-7 days (up to 1 child in 30) ­ usually after the 4th or 5th dose. Moderate Problems: Seizure (jerking or staring)(1 child in 14,000); non-stop crying for 3 hours or more (up to 1 child in 1,000); fever over 105°F (1 child in 16,000). Serious Problems: Long-term seizures, coma, lowered consciousness, and permanent brain damage have been reported very rarely after DTaP vaccine. They are so rare we can't be sure they are caused by the vaccine. Polio Vaccine / Hepatitis B Vaccine / Hib Vaccine These vaccines have not been associated with mild problems other than local reactions, or with moderate or serious problems. Pneumococcal Vaccine Mild Problems: During studies of the vaccine, some children became fussy or drowsy or lost their appetite. Rotavirus Vaccine Mild Problems: Children who get rotavirus vaccine are slightly more likely than other children to be irritable or to have mild, temporary diarrhea or vomiting. This happens within the first week after getting a dose of vaccine. Rotavirus vaccine does not appear to cause any serious side effects.

Precautions

If your child is sick on the date vaccinations are scheduled, your provider may want to put them off until she recovers. A child with a mild cold or a low fever can usually be vaccinated that day. But for a more serious illness, it may be better to wait. Some children should not get certain vaccines. Talk with your provider if your child had a serious reaction after a previous dose of a vaccine, or has any life-threatening allergies. (These reactions and allergies are rare.) If your child had any of these reactions to a previous dose of DTaP: - A brain or nervous system disease within 7 days - Non-stop crying for 3 or more hours - A seizure or collapse - A fever over 105°F

Talk to your provider before getting DTaP Vaccine.

If your child has: - A life-threatening allergy to the antibiotics neomycin, streptomycin, or polymyxin B

Talk to your provider before getting Polio Vaccine.

If your child has: - A life-threatening allergy to yeast

Talk to your provider before getting Hepatitis B Vaccine.

If your child has: - A weakened immune system - Ongoing digestive problems - Recently gotten a blood transfusion or other blood product -Ever had intussusception (an uncommon type of intestinal obstruction)

Talk to your provider before getting Rotavirus Vaccine.

What if my child has a moderate or severe reaction?

What should I look for?

Look for any unusual condition, such as a serious allergic reaction, high fever, weakness, or unusual behavior. Serious allergic reactions are extremely rare with any vaccine. If one were to happen, it would most likely come within a few minutes to a few hours after the shot. Signs of a serious allergic reaction can include: - difficulty breathing - hoarseness or wheezing - swelling of the throat - weakness - hives - dizziness - paleness - fast heart beat

What should I do?

Call a doctor, or get the child to a doctor right away. Tell your doctor what happened, the date and time it happened, and when the shot was given. Ask your healthcare provider to report the reaction by filing a Vaccine Adverse Event Reporting System (VAERS) form. Or you can file this report yourself through the VAERS website at www.vaers.hhs.gov, or by calling 1-800-822-7967. VAERS does not provide medical advice.

The National Vaccine

Injury Compensation Program

A federal program exists to help pay for the care of any one who has a serious reaction to a vaccine. For information about the National Vaccine Injury Compensation Program, call 1-800-338-2382 or visit their website at www.hrsa.gov/vaccinecompensation.

For More Information

Ask your healthcare provider. They can show you the vaccine package insert or suggest other sources of information. Call your local or state health department. Contact the Centers for Disease Control and Prevention (CDC) at 1-800-232-4636 (1-800-CDC-INFO). Visit CDC websites at www.cdc.gov/vaccines and www.cdc.gov/ncidod/diseases/hepatitis.

DIPHTHERIA

TETANUS &

PERTUSSIS

W H A T Y O U

VACCINES

N E E D T O K N O W

Many Vaccine Information Statements are available in Spanish and other languages. See www.immunize.org/vis.

1

Why get vaccinated?

Diphtheria, tetanus, and pertussis are serious diseases caused by bacteria. Diphtheria and pertussis are spread from person to person. Tetanus enters the body through cuts or wounds. DIPHTHERIA causes a thick covering in the back of the throat. · It can lead to breathing problems, paralysis, heart failure, and even death. TETANUS (Lockjaw) causes painful tightening of the muscles, usually all over the body. · It can lead to "locking" of the jaw so the victim cannot open his mouth or swallow. Tetanus leads to death in up to 2 out of 10 cases. PERTUSSIS (Whooping Cough) causes coughing spells so bad that it is hard for infants to eat, drink, or breathe. These spells can last for weeks. · It can lead to pneumonia, seizures (jerking and staring spells), brain damage, and death. Diphtheria, tetanus, and pertussis vaccine (DTaP) can help prevent these diseases. Most children who are vaccinated with DTaP will be protected throughout childhood. Many more children would get these diseases if we stopped vaccinating. DTaP is a safer version of an older vaccine called DTP. DTP is no longer used in the United States.

3

Some children should not get DTaP vaccine or should wait

· Children with minor illnesses, such as a cold, may be vaccinated. But children who are moderately or severely ill should usually wait until they recover before getting DTaP vaccine. · Any child who had a life-threatening allergic reaction after a dose of DTaP should not get another dose. · Any child who suffered a brain or nervous system disease within 7 days after a dose of DTaP should not get another dose. · Talk with your doctor if your child: - had a seizure or collapsed after a dose of DTaP, - cried non-stop for 3 hours or more after a dose of DTaP,

- had a fever over 105oF after a dose of DTaP.

Ask your health care provider for more information. Some of these children should not get another dose of pertussis vaccine, but may get a vaccine without pertussis, called DT.

4

Older children and adults

DTaP is not licensed for adolescents, adults, or children 7 years of age and older. But older people still need protection. A vaccine called Tdap is similar to DTaP. A single dose of Tdap is recommended for people 11 through 64 years of age. Another vaccine, called Td, protects against tetanus and diphtheria, but not pertussis. It is recommended every 10 years. There are separate Vaccine Information Statements for these vaccines.

2

Who should get DTaP vaccine and when?

Children should get 5 doses of DTaP vaccine, one dose at each of the following ages: 3 2 months 3 4 months 3 6 months 3 4-6 years 315-18 months DTaP may be given at the same time as other vaccines.

Diphtheria/Tetanus/Pertussis

5/17/2007

5

What are the risks from DTaP vaccine?

6

What if there is a moderate or severe reaction?

Getting diphtheria, tetanus, or pertussis disease is much riskier than getting DTaP vaccine. However, a vaccine, like any medicine, is capable of causing serious problems, such as severe allergic reactions. The risk of DTaP vaccine causing serious harm, or death, is extremely small. Mild Problems (Common) · Fever (up to about 1 child in 4) · Redness or swelling where the shot was given (up to about 1 child in 4) · Soreness or tenderness where the shot was given (up to about 1 child in 4) These problems occur more often after the 4th and 5th doses of the DTaP series than after earlier doses. Sometimes the 4th or 5th dose of DTaP vaccine is followed by swelling of the entire arm or leg in which the shot was given, lasting 1-7 days (up to about 1 child in 30). Other mild problems include: · Fussiness (up to about 1 child in 3) · Tiredness or poor appetite (up to about 1 child in 10) · Vomiting (up to about 1 child in 50) These problems generally occur 1-3 days after the shot. Moderate Problems (Uncommon) · Seizure (jerking or staring) (about 1 child out of 14,000) · Non-stop crying, for 3 hours or more (up to about 1 child out of 1,000) · High fever, over 105oF (about 1 child out of 16,000) Severe Problems (Very Rare) · Serious allergic reaction (less than 1 out of a million doses) · Several other severe problems have been reported after DTaP vaccine. These include: - Long-term seizures, coma, or lowered consciousness - Permanent brain damage. These are so rare it is hard to tell if they are caused by the vaccine. Controlling fever is especially important for children who have had seizures, for any reason. It is also important if another family member has had seizures. You can reduce fever and pain by giving your child an aspirin-free pain reliever when the shot is given, and for the next 24 hours, following the package instructions.

What should I look for?

Any unusual conditions, such as a serious allergic reaction, high fever or unusual behavior. Serious allergic reactions are extremely rare with any vaccine. If one were to occur, it would most likely be within a few minutes to a few hours after the shot. Signs can include difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, a fast heart beat or dizziness. If a high fever or seizure were to occur, it would usually be within a week after the shot.

What should I do?

· Call a doctor, or get the person to a doctor right away. · Tell your doctor what happened, the date and time it happened, and when the vaccination was given. · Ask your doctor, nurse, or health department to report the reaction by filing a Vaccine Adverse Event Reporting System (VAERS) form. Or you can file this report through the VAERS web site at www.vaers.hhs.gov, or by calling 1-800-822-7967. VAERS does not provide medical advice

7

The National Vaccine Injury Compensation Program

In the rare event that you or your child has a serious reaction to a vaccine, a federal program has been created to help pay for the care of those who have been harmed. For details about the National Vaccine Injury Compensation Program, call 1-800-338-2382 or visit the program's website at www.hrsa.gov/vaccinecompensation.

8

How can I learn more?

· Ask your health care provider. They can give you the vaccine package insert or suggest other sources of information. · Call your local or state health department's immunization program. · Contact the Centers for Disease Control and Prevention (CDC): - Call 1-800-232-4636 (1-800-CDC-INFO) - Visit the National Immunization Program's website at www.cdc.gov/vaccines

U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Disease Control and Prevention

DTaP (5/17/07)

Vaccine Information Statement

42 U.S.C. § 300aa-26

POLIO VACCINE

W H A T Y O U N E E D T O K N O W

Many Vaccine Information Statements are available in Spanish and other languages. See www.immunize.org/vis.

1

What is polio?

3

Who should get polio vaccine and when?

Polio is a disease caused by a virus. It enters a child's (or adult's) body through the mouth. Sometimes it does not cause serious illness. But sometimes it causes paralysis (can't move arm or leg). It can kill people who get it, usually by paralyzing the muscles that help them breathe. Polio used to be very common in the United States. It paralyzed and killed thousands of people a year before we had a vaccine for it.

IPV is a shot, given in the leg or arm, depending on age. Polio vaccine may be given at the same time as other vaccines.

Children

Most people should get polio vaccine when they are children. Children get 4 doses of IPV, at these ages: 3 A dose at 2 months 3 A dose at 6-18 months 3 A dose at 4 months 3 A booster dose at 4-6 years Adults Most adults do not need polio vaccine because they were already vaccinated as children. But three groups of adults are at higher risk and should consider polio vaccination:

(1) people traveling to areas of the world where polio is common, (2) laboratory workers who might handle polio virus, and (3) health care workers treating patients who could have polio.

2

Why get vaccinated?

Inactivated Polio Vaccine (IPV) can prevent polio. History: A 1916 polio epidemic in the United States killed 6,000 people and paralyzed 27,000 more. In the early 1950's there were more than 20,000 cases of polio each year. Polio vaccination was begun in 1955. By 1960 the number of cases had dropped to about 3,000, and by 1979 there were only about 10. The success of polio vaccination in the U.S. and other countries sparked a world-wide effort to eliminate polio. Today: No wild polio has been reported in the United States for over 20 years. But the disease is still common in some parts of the world. It would only take one case of polio from another country to bring the disease back if we were not protected by vaccine. If the effort to eliminate the disease from the world is successful, some day we won't need polio vaccine. Until then, we need to keep getting our children vaccinated.

Adults in these three groups who have never been

vaccinated against polio should get 3 doses of IPV:

3 The first dose at any time,

3 The second dose 1 to 2 months later,

3 The third dose 6 to 12 months after the second.

Adults in these three groups who have had 1 or 2 doses

of polio vaccine in the past should get the remaining 1 or 2

doses. It doesn't matter how long it has been since the

earlier dose(s).

Oral Polio Vaccine: No longer recommended

There are two kinds of polio vaccine: IPV, which is the shot recommended in the United States today, and a live, oral polio vaccine (OPV), which is drops that are swallowed. Until recently OPV was recommended for most children in the United States. OPV helped us rid the country of polio, and it is still used in many parts of the world. Both vaccines give immunity to polio, but OPV is better at keeping the disease from spreading to other people. However, for a few people (about one in 2.4 million), OPV actually causes polio. Sinc the risk of getting polio in the United States is now extremely low, experts believe that using oral polio vaccine is no longer worth the slight risk, except in limited circumstances which your doctor can describe. The polio shot (IPV) does not cause polio. If you or your child will be getting OPV, ask for a copy of the OPV supplemental Vaccine Information Statement.

Adults in these three groups who have had 3 or more doses of polio vaccine (either IPV or OPV) in the past may get a booster dose of IPV. Ask your health care provider for more information.

Polio - 1/1/2000

4

Some people should not get IPV or should wait.

· Tell your doctor what happened, the date and time it happened, and when the vaccination was given.

· Ask

These people should not get IPV: · Anyone who has ever had a life-threatening allergic reaction to the antibiotics neomycin, streptomycin or polymyxin B should not get the polio shot.

your doctor, nurse, or health department to report the reaction by filing a Vaccine Adverse Event Reporting System (VAERS) form.

Or you can file this report through the VAERS

website at www.vaers.hhs.gov or by calling

1-800-822-7967.

VAERS does not provide medical advice. Reporting reactions helps experts learn about possible problems with vaccines.

· Anyone who has a severe allergic reaction to a polio

shot should not get another one. These people should wait:

· Anyone who is moderately or severely ill at the time the

shot is scheduled should usually wait until they recover before getting polio vaccine. People with minor illnesses, such as a cold, may be vaccinated. Ask your health care provider for more information.

7

Vaccine The National Vaccine Injury Compensation Program

In the rare event that you or your child has a serious reaction to a vaccine, there is a federal program that can help pay for the care of those who have been harmed. For details about the National Vaccine Injury Compensation Program, call 1-800-338-2382 or visit the program's website at www.hrsa.gov/vaccinecompensation

5

What are the risks from IPV?

Some people who get IPV get a sore spot where the shot was given. The vaccine used today has never been known to cause any serious problems, and most people don't have any problems at all with it. However, a vaccine, like any medicine, could cause serious problems, such as a severe allergic reaction. The risk of a polio shot causing serious harm, or death, is extremely small.

8

How can I learn more?

· Ask your doctor or nurse. They can give you the vaccine package insert or suggest other sources of information. · Call your local or state health department's immunization program. · Contact the Centers for Disease Control and Prevention (CDC): -Call 1-800-232-4636 (1-800-CDC-INFO) -Visit the National Immunization Program's website at http://www.cdc.gov/vaccines

6

What if there is a serious reaction?

What should I look for? Look for any unusual condition, such as a serious allergic reaction, high fever, or unusual behavior. If a serious allergic reaction occurred, it would happen within a few minutes to a few hours after the shot. Signs of a serious allergic reaction can include difficulty breathing, weakness, hoarseness or wheezing, a fast heart beat, hives, dizziness, paleness, or swelling of the throat What should I do? · Call a doctor, or get the person to a doctor right away.

U U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Disease Control and Prevention

Vaccine Information Statement 42 U.S.C. § 300aa-26

Polio (1/1/2000)

MEASLES, MUMPS & RUBELLA (MMR)

1

Why get vaccinated?

WHAT YOU NEED TO

Measles, mumps, and rubella are serious diseases. Measles · Measles virus causes rash, cough, runny nose, eye irritation, and fever. · It can lead to ear infection, pneumonia, seizures (jerking and staring), brain damage, and death. Mumps · Mumps virus causes fever, headache, and swollen glands. · It can lead to deafness, meningitis (infection of the brain and spinal cord covering), painful swelling of the testicles or ovaries, and, rarely, death. Rubella (German Measles) · Rubella virus causes rash, mild fever, and arthritis (mostly in women). · If a woman gets rubella while she is pregnant, she could have a miscarriage or her baby could be born with serious birth defects. You or your child could catch these diseases by being around someone who has them. They spread from per son to person through the air. Measles, mumps, and rubella (MMR) vaccine can prevent these diseases. Most children who get their MMR shots will not get these diseases. Many more children would get them if we stopped vaccinating.

VACCINES

KNOW

unless they can show that they have had either the vaccines or the diseases. Ask your provider for more information. MMR vaccine may be given at the same time as other vaccines.

Note: A "combination" vaccine called MMRV, which contains both MMR and varicella (chickenpox) vaccines, may be given instead of the two individual vaccines to people 12 years of age and younger.

Many Vaccine Information Statements are available in Spanish and other languages. See www.immunize.org/vis.

3

Some people should not get

MMR vaccine or should wait

· People should not get MMR vaccine who have ever had a life-threatening allergic reaction to gelatin, the antibiotic neomycin, or to a previous dose of MMR vaccine. · People who are moderately or severely ill at the time the shot is scheduled should usually wait until they recover before getting MMR vaccine. · Pregnant women should wait to get MMR vaccine until after they have given birth. Women should avoid getting pregnant for 4 weeks after getting MMR vaccine. · Some people should check with their doctor about whether they should get MMR vaccine, including anyone who: - Has HIV/AIDS, or another disease that affects the immune system - Is being treated with drugs that affect the immune system, such as steroids, for 2 weeks or longer. - Has any kind of cancer - Is taking cancer treatment with x-rays or drugs - Has ever had a low platelet count (a blood disorder) · People who recently had a transfusion or were given other blood products should ask their doctor when they may get MMR vaccine Ask your provider for more information.

2

Who should get MMR vaccine and when?

Children should get 2 doses of MMR vaccine: ­ The first at 12-15 months of age ­ and the second at 4-6 years of age. These are the recommended ages. But children can get the second dose at any age, as long as it is at least 28 days after the first dose. Some adults should also get MMR vaccine: Generally, anyone 18 years of age or older who was born after 1956 should get at least one dose of MMR vaccine,

4

What are the risks from MMR vaccine?

allergic reaction can include difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, a fast heart beat or dizziness. What should I do? · Call a doctor, or get the person to a doctor right away. · Tell your doctor what happened, the date and time it happened, and when the vaccination was given. · Ask your provider to report the reaction by filing a Vaccine Adverse Event Reporting System (VAERS) form. Or you can file this report through the VAERS website at www.vaers.hhs.gov, or by calling 1-800-822-7967.

A vaccine, like any medicine, is capable of causing seri ous problems, such as severe allergic reactions. The risk of MMR vaccine causing serious harm, or death, is extremely small. Getting MMR vaccine is much safer than getting any of these three diseases. Most people who get MMR vaccine do not have any problems with it. Mild Problems · Fever (up to 1 person out of 6) · Mild rash (about 1 person out of 20) · Swelling of glands in the cheeks or neck (rare) If these problems occur, it is usually within 7-12 days after the shot. They occur less often after the second dose. Moderate Problems · Seizure (jerking or staring) caused by fever (about 1 out of 3,000 doses) · Temporary pain and stiffness in the joints, mostly in teenage or adult women (up to 1 out of 4) · Temporary low platelet count, which can cause a bleeding disorder (about 1 out of 30,000 doses) Severe Problems (Very Rare) · Serious allergic reaction (less than 1 out of a million doses) · Several other severe problems have been known to occur after a child gets MMR vaccine. But this happens so rarely, experts cannot be sure whether they are caused by the vaccine or not. These include: - Deafness - Long-term seizures, coma, or lowered consciousness

- Permanent brain damage

Note: The first dose of MMRV vaccine has been associated with rash and higher rates of fever than MMR and varicella vaccines given separately. Rash has been reported in about 1 person in 20 and fever in about 1 person in 5. Seizures caused by a fever are also reported more often after MMRV. These usually occur 5-12 days after the first dose.

VAERS does not provide medical advice.

6

The National Vaccine Injury Compensation Program

A federal program has been created to help people who may have been harmed by a vaccine. For details about the National Vaccine Injury Compensation Program, call 1-800-338-2382 or visit their website at www.hrsa.gov/vaccinecompensation.

7

How can I learn more?

· Ask your provider. They can give you the vaccine package insert or suggest other sources of information. · Call your local or state health department. · Contact the Centers for Disease Control and Prevention (CDC): - Call 1-800-232-4636 (1-800-CDC-INFO) - Visit CDC website at: www.cdc.gov/vaccines

5

What if there is a moderate or

severe reaction?

department of health and human services

Centers for Disease Control and Prevention Vaccine Information Statement (Interim)

MMR Vaccine (3/13/08) 42 U.S.C. §300aa-26

What should I look for?

· Any unusual condition, such as a high fever, weakness, or behavior changes. Signs of a serious

MMRV

1

(MEASLES, MUMPS, RUBELLA & VARICELLA)

WHAT YOU NEED TO KNOW

Many Vaccine Information Statements are available in Spanish and other languages. See www.immunize.org/vis.

VACCINE

Children may also get these vaccines as 2 separate shots: MMR (measles, mumps and rubella) and varicella vaccines. 1 Shot (MMRV) or 2 Shots (MMR & Varicella)? · Both options give the same protection. · One less shot with MMRV. · Children who got the first dose as MMRV have had more fevers and fever-related seizures (about 1 in 1,250) than children who got the first dose as separate shots of MMR and varicella vaccines on the same day (about 1 in 2,500). Your health-care provider can give you more information, including the Vaccine Information Statements for MMR and Varicella vaccines.

Measles, Mumps, Rubella & Varicella

These are recommended ages. But children can get the second dose up through 12 years as long as it is at least 3 months after the first dose.

Measles, Mumps, Rubella, and Varicella (chickenpox) can be serious diseases: Measles · Causes rash, cough, runny nose, eye irritation, fever. · Can lead to ear infection, pneumonia, seizures, brain damage, and death. Mumps · Causes fever, headache, swollen glands. · Can lead to deafness, meningitis (infection of the brain and spinal cord covering), infection of the pancreas, painful swelling of the testicles or ovaries, and, rarely, death. Rubella (German Measles) · Causes rash and mild fever; and can cause arthritis, (mostly in women). · If a woman gets rubella while she is pregnant, she could have a miscarriage or her baby could be born with serious birth defects. Varicella (Chickenpox) · Causes rash, itching, fever, tiredness. · Can lead to severe skin infection, scars, pneumonia, brain damage, or death. · Can re-emerge years later as a painful rash called shingles. These diseases can spread from person to person through the air. Varicella can also be spread through contact with fluid from chickenpox blisters. Before vaccines, these diseases were very common in the United States.

Anyone 13 or older who needs protection from these diseases should get MMR and varicella vaccines as separate shots. MMRV may be given at the same time as other vaccines.

3

Some children should not get MMRV vaccine or should wait

Children should not get MMRV vaccine if they: · Have ever had a life-threatening allergic reaction to a previous dose of MMRV vaccine, or to either MMR or varicella vaccine. · Have ever had a life-threatening allergic reaction to any component of the vaccine, including gelatin or the antibiotic neomycin. Tell the doctor if your child has any severe allergies. · Have HIV/AIDS, or another disease that affects the immune system. · Are being treated with drugs that affect the immune system, including high doses of oral steroids for 2 weeks or longer.

2

MMRV Vaccine

MMRV vaccine may be given to children from 1 through 12 years of age to protect them from these four diseases. Two doses of MMRV vaccine are recommended: ­ The first dose at 12 through 15 months of age ­ The second dose at 4 through 6 years of age

· Have any kind of cancer. · Are being treated for cancer with radiation or drugs.

Check with your doctor if the child: · Has a history of seizures, or has a parent, brother or sister with a history of seizures. · Has a parent, brother or sister with a history of immune system problems. · Has ever had a low platelet count, or another blood disorder. · Recently had a transfusion or received other blood products. · Might be pregnant. Children who are moderately or severely ill at the time the shot is scheduled should usually wait until they recover before getting MMRV vaccine. Children who are only mildly ill may usually get the vaccine. Ask your provider for more information.

and problems such as: - Deafness. - Long-term seizures, coma, lowered consciousness. - Permanent brain damage. Because these problems occur so rarely, we can't be sure whether they are caused by the vaccine or not.

5

What if there is a severe reaction?

What should I look for? Any unusual condition, such as a high fever or behavior changes. Signs of a severe allergic reaction can include difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, a fast heart beat or dizziness. What should I do? · Call a doctor, or get the person to a doctor right away. · Tell the doctor what happened, the date and time it happened, and when the vaccination was given. · Ask your provider to report the reaction by filing a Vaccine Adverse Event Reporting System (VAERS) form. Or you can file this report through the VAERS website at www.vaers.hhs.gov, or by calling 1-800-822-7967. VAERS does not provide medical advice.

4

What are the risks from MMRV vaccine?

A vaccine, like any medicine, is capable of causing serious problems, such as severe allergic reactions. The risk of MMRV vaccine causing serious harm, or death, is extremely small. Getting MMRV vaccine is much safer than getting measles, mumps, rubella, or chickenpox. Most children who get MMRV vaccine do not have any problems with it. Mild Problems · Fever (about 1 child out of 5). · Mild rash (about 1 child out of 20). · Swelling of glands in the cheeks or neck (rare). If these problems happen, it is usually within 5-12 days after the first dose. They happen less often after the second dose. Moderate Problems · Seizure caused by fever (about 1 child in 1,250 who get MMRV), usually 5-12 days after the first dose. They happen less often when MMR and varicella vaccines are given at the same visit as separate shots (about 1 child in 2,500 who get these two vaccines), and rarely after a 2nd dose of MMRV. · Temporary low platelet count, which can cause a bleeding disorder (about 1 child out of 40,000). Severe Problems (Very Rare) Several severe problems have been reported following MMR vaccine, and might also happen after MMRV. These include severe allergic reactions (fewer than 4 per million),

6

The National Vaccine Injury Compensation Program

The National Vaccine Injury Compensation Program (VICP) was created in 1986. Persons who believe they may have been injured by a vaccine may file a claim with VICP by calling 1-800-338-2382 or visiting their website at www.hrsa.gov/vaccinecompensation.

7

How can I learn more?

· Ask your provider. They can give you the vaccine package insert or suggest other sources of information. · Call your local or state health department. · Contact the Centers for Disease Control and Prevention (CDC): - Call 1-800-232-4636 (1-800-CDC-INFO) - Visit CDC's website at www.cdc.gov/vaccines

DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention

Vaccine Information Statement (Interim) MMRV Vaccine (5/21/10) 42 U.S.C. §300aa-26

Haemophilus Influenzae

Type b (Hib) Vaccine

W H A T Y O U N E E D T O K N O W

Many Vaccine Information Statements are available in Spanish and other languages. See www.immunize.org/vis.

1

What is Hib disease?

2

Who should get Hib vaccine and when?

Haemophilus influenzae type b (Hib) disease is a serious disease caused by a bacteria. It usually strikes children under 5 years old. Your child can get Hib disease by being around other children or adults who may have the bacteria and not know it. The germs spread from person to person. If the germs stay in the child's nose and throat, the child probably will not get sick. But sometimes the germs spread into the lungs or the bloodstream, and then Hib can cause serious problems. Before Hib vaccine, Hib disease was the leading cause of bacterial meningitis among children under 5 years old in the United States. Meningitis is an infection of the brain and spinal cord coverings, which can lead to lasting brain damage and deafness. Hib disease can also cause: · pneumonia · severe swelling in the throat, making it hard to breathe · infections of the blood, joints, bones, and covering of the heart · death Before Hib vaccine, about 20,000 children in the United States under 5 years old got severe Hib disease each year and nearly 1,000 people died. Hib vaccine can prevent Hib disease. Many more children would get Hib disease if we stopped vaccinating.

Children should get Hib vaccine at: 3 2 months of age 3 6 months of age* 3 4 months of age 3 12-15 months of age

* Depending on what brand of Hib vaccine is used, your child might not need the dose at 6 months of age. Your doctor or nurse will tell you if this dose is needed.

If you miss a dose or get behind schedule, get the next dose as soon as you can. There is no need to start over. Hib vaccine may be given at the same time as other vaccines. Older Children and Adults Children over 5 years old usually do not need Hib vaccine. But some older children or adults with special health conditions should get it. These conditions include sickle cell disease, HIV/AIDS, removal of the spleen, bone marrow transplant, or cancer treatment with drugs. Ask your doctor or nurse for details.

3

Some people should not get Hib vaccine or should wait

· People who have ever had a life-threatening allergic reaction to a previous dose of Hib vaccine should not get another dose. · Children less than 6 weeks of age should not get Hib vaccine. · People who are moderately or severely ill at the time the shot is scheduled should usually wait until they recover before getting Hib vaccine. Ask your doctor or nurse for more information.

4

What are the risks from Hib vaccine?

Or you can file this report through the VAERS web site at www.vaers.hhs.gov, or by calling 1-800-822-7967. VAERS does not provide medical advice

A vaccine, like any medicine, is capable of causing serious problems, such as severe allergic reactions. The risk of Hib vaccine causing serious harm or death is extremely small. Most people who get Hib vaccine do not have any problems with it. Mild Problems · Redness, warmth, or swelling where the shot was given (up to 1/4 of children) · Fever over 101oF (up to 1 out of 20 children) If these problems happen, they usually start within a day of vaccination. They may last 2-3 days.

6

Vaccine The National Vaccine Injury Compensation Program

In the rare event that you or your child has a serious reaction to a vaccine, a federal program has been created to help you pay for the care of those who have been harmed. For details about the National Vaccine Injury Compensation Program, call 1-800-338-2382 or visit the program's website at www.hrsa.gov/vaccinecompensation

7

How can I learn more?

5

What if there is a moderate or severe reaction?

· Ask your doctor or nurse. They can give you the vaccine package insert or suggest other sources of information. · Call your local or state health department's immunization program. · Contact the Centers for Disease Control and Prevention (CDC): - Call 1-800-232-4636 (1-800-CDC-INFO) - Visit the National Immunization Program's website at www.cdc.gov/vaccines

What should I look for?

Any unusual condition, such as a serious allergic reaction, high fever or behavior changes. Signs of a serious allergic reaction can include difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, a fast heart beat, or dizziness within a few minutes to a few hours after the shot. What should I do? · Call a doctor, or get the person to a doctor right away. · Tell your doctor what happened, the date and time it happened, and when the vaccination was given.

U.S. Department of Health & Human Services

· Ask your doctor, nurse, or health department to report the reaction by filing a Vaccine Adverse Event Reporting System (VAERS) form.

Centers for Disease Control and Prevention

Hib (12/16/98)

Vaccine Information Statement 42 U.S.C. § 300aa-26

HEPATITIS B VACCINE

WHAT YOU NEED TO

1

What is hepatitis B?

K N O W

Many Vaccine Information Statements are available in Spanish and other languages. See www.immunize.org/vis.

2

Hepatitis B vaccine: Why get vaccinated?

Hepatitis B is a serious disease that affects the liver. It is caused by the hepatitis B virus (HBV). HBV can cause: Acute (short-term) illness. This can lead to: · loss of appetite · diarrhea and vomiting · tiredness · jaundice (yellow skin or eyes) · pain in muscles, joints, and stomach Acute illness is more common among adults. Children who become infected usually do not have acute illness. Chronic (long-term) infection. Some people go on to develop chronic HBV infection. This can be very serious, and often leads to: ·liver damage (cirrhosis) ·liver cancer ·death Chronic infection is more common among infants and children than among adults. People who are infected can spread HBV to others, even if they don't appear sick. · In 2005, about 51,000 people became infected with hepatitis B. · About 1.25 million people in the United States have chronic HBV infection. · Each year about 3,000 to 5,000 people die from cirrhosis or liver cancer caused by HBV. Hepatitis B virus is spread through contact with the blood or other body fluids of an infected person. A person can become infected by: - contact with a mother's blood and body fluids at the time of birth; - contact with blood and body fluids through breaks in the skin such as bites, cuts, or sores; - contact with objects that could have blood or body fluids on them such as toothbrushes or razors; - having unprotected sex with an infected person; - sharing needles when injecting drugs; - being stuck with a used needle on the job.

Hepatitis B vaccine can prevent hepatitis B, and the serious consequences of HBV infection, including liver cancer and cirrhosis. Routine hepatitis B vaccination of U.S. children began in 1991. Since then, the reported incidence of acute hepatitis B among children and adolescents has dropped by more than 95% ­ and by 75% in all age groups. Hepatitis B vaccine is made from a part of the hepatitis B virus. It cannot cause HBV infection. Hepatitis B vaccine is usually given as a series of 3 or 4 shots. This vaccine series gives long-term protection from HBV infection, possibly lifelong.

3

Who should get hepatitis B vaccine and when?

Children and Adolescents · All children should get their first dose of hepatitis B vaccine at birth and should have completed the vaccine series by 6-18 months of age. · Children and adolescents through 18 years of age who did not get the vaccine when they were younger should also be vaccinated. Adults · All unvaccinated adults at risk for HBV infection should be vaccinated. This includes: - sex partners of people infected with HBV, - men who have sex with men, - people who inject street drugs, - people with more than one sex partner, - people with chronic liver or kidney disease, - people with jobs that expose them to human blood, - household contacts of people infected with HBV, - residents and staff in institutions for the developmentally disabled,

- kidney dialysis patients,

- people who travel to countries where hepatitis B is common, - people with HIV infection. · Anyone else who wants to be protected from HBV infection may be vaccinated.

reaction can include difficulty breathing, hoarse ness or wheezing, hives, paleness, weakness, a fast heart beat or dizziness. What should I do? · Call a doctor, or get the person to a doctor right away. · Tell your doctor what happened, the date and time it happened, and when the vaccination was given. · Ask your doctor, nurse, or health department to report the reaction by filing a Vaccine Adverse Event Reporting System (VAERS) form. Or you can file this report through the VAERS

web site at www.vaers.hhs.gov, or by calling

1-800-822-7967.

VAERS does not provide medical advice.

4

Who should NOT get hepatitis B vaccine?

· Anyone with a life-threatening allergy to baker's yeast, or to any other component of the vaccine, should not get hepatitis B vaccine. Tell your provider if you have any severe allergies. · Anyone who has had a life-threatening allergic reaction to a previous dose of hepatitis B vaccine should not get another dose. · Anyone who is moderately or severely ill when a dose of vaccine is scheduled should probably wait until they recover before getting the vaccine. Your provider can give you more information about these precautions. Pregnant women who need protection from HBV infection may be vaccinated.

7

The National Vaccine Injury Compensation Program

In the event that you or your child has a serious reaction to a vaccine, a federal program has been created to help pay for the care of those who have been harmed. For details about the National Vaccine Injury Compensation Program, call 1-800-338-2382 or visit their website at www.hrsa.gov/vaccinecompensation.

5

Hepatitis B vaccine risks

Hepatitis B is a very safe vaccine. Most people do not have any problems with it. The following mild problems have been reported: · Soreness where the shot was given (up to about 1 person in 4). · Temperature of 99.9°F or higher (up to about 1 person in 15). Severe problems are extremely rare. Severe allergic reactions are believed to occur about once in 1.1 million doses. A vaccine, like any medicine, could cause a serious reaction. But the risk of a vaccine causing serious harm, or death, is extremely small. More than 100 million people have gotten hepatitis B vaccine in the United States.

8

How can I learn more?

· Ask your doctor or nurse. They can give you the vaccine package insert or suggest other sources of information. · Call your local or state health department. · Contact the Centers for Disease Control and Prevention (CDC): - Call 1-800-232-4636 (1-800-CDC-INFO)

- Visit CDC websites at:

www.cdc.gov/ncidod/diseases/hepatitis

www.cdc.gov/vaccines

www.cdc.gov/travel

6

What if there is a moderate or severe reaction?

department of health and human services

Centers for Disease Control and Prevention Vaccine Information Statement (Interim)

Hepatitis B (7/18/07) 42 U.S.C. § 300aa-26

What should I look for? · Any unusual condition, such as a high fever or behavior changes. Signs of a serious allergic

CHICKENPOX VACCINE

WHAT YOU NEED TO

1

Why get vaccinated?

Catch-Up Anyone who is not fully vaccinated, and never had chickenpox, should receive one or two doses of chickenpox vaccine. The timing of these doses depends on the person's age. Ask your provider. Chickenpox vaccine may be given at the same time as other vaccines.

Note: A "combination" vaccine called MMRV, which contains both chickenpox and MMR vac cines, may be given instead of the two individual vaccines to people 12 years of age and younger.

K N O W

Many Vaccine Information Statements are available in Spanish and other languages. See www.immunize.org/vis.

Chickenpox (also called varicella) is a common childhood disease. It is usually mild, but it can be serious, especially in young infants and adults. · It causes a rash, itching, fever, and tiredness. · It can lead to severe skin infection, scars, pneumonia, brain damage, or death. · The chickenpox virus can be spread from person to person through the air, or by contact with fluid from chickenpox blisters. · A person who has had chickenpox can get a painful rash called shingles years later. · Before the vaccine, about 11,000 people were hospitalized for chickenpox each year in the United States. · Before the vaccine, about 100 people died each year as a result of chickenpox in the United States. Chickenpox vaccine can prevent chickenpox. Most people who get chickenpox vaccine will not get chickenpox. But if someone who has been vaccinated does get chickenpox, it is usually very mild. They will have fewer blisters, are less likely to have a fever, and will recover faster.

3

Some people should not get chickenpox vaccine or should wait

· People should not get chickenpox vaccine if they have ever had a life-threatening allergic reaction to a previous dose of chickenpox vaccine or to gelatin or the antibiotic neomycin. · People who are moderately or severely ill at the time the shot is scheduled should usually wait until they recover before getting chickenpox vaccine. · Pregnant women should wait to get chickenpox vaccine until after they have given birth. Women should not get pregnant for 1 month after getting chickenpox vaccine. · Some people should check with their doctor about whether they should get chickenpox vaccine, including anyone who: - Has HIV/AIDS or another disease that affects the immune system - Is being treated with drugs that affect the immune system, such as steroids, for 2 weeks or longer - Has any kind of cancer - Is getting cancer treatment with radiation or drugs · People who recently had a transfusion or were given other blood products should ask their doctor when they may get chickenpox vaccine.

2

Who should get chickenpox vaccine and when?

Routine Children who have never had chickenpox should get 2 doses of chickenpox vaccine at these ages: 1st Dose: 12-15 months of age 2nd Dose: 4-6 years of age (may be given earlier, if at least 3 months after the 1st dose) People 13 years of age and older (who have never had chickenpox or received chickenpox vaccine) should get two doses at least 28 days apart.

Chickenpox

3/13/08

Ask your provider for more information.

4

What are the risks from chickenpox vaccine?

allergic reaction can include difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, a fast heart beat or dizziness. What should I do? · Call a doctor, or get the person to a doctor right away. · Tell your doctor what happened, the date and time it happened, and when the vaccination was given. · Ask your provider to report the reaction by filing a Vaccine Adverse Event Reporting System (VAERS) form. Or you can file this report through the VAERS website at www.vaers.hhs.gov, or by calling 1-800-822-7967.

A vaccine, like any medicine, is capable of causing serious problems, such as severe allergic reactions. The risk of chickenpox vaccine causing serious harm, or death, is extremely small. Getting chickenpox vaccine is much safer than getting chickenpox disease. Most people who get chickenpox vaccine do not have any problems with it. Reactions are usually more likely after the first dose than after the second. Mild Problems · Soreness or swelling where the shot was given (about 1 out of 5 children and up to 1 out of 3 adolescents and adults) · Fever (1 person out of 10, or less) · Mild rash, up to a month after vaccination (1 person out of 25). It is possible for these people to infect other members of their household, but this is extremely rare. Moderate Problems · Seizure (jerking or staring) caused by fever (very rare). Severe Problems · Pneumonia (very rare) Other serious problems, including severe brain reac tions and low blood count, have been reported after chickenpox vaccination. These happen so rarely experts cannot tell whether they are caused by the vaccine or not. If they are, it is extremely rare.

Note: The first dose of MMRV vaccine has been associated with rash and higher rates of fever than MMR and varicella vaccines given separately. Rash has been reported in about 1 person in 20 and fever in about 1 person in 5. Seizures caused by a fever are also reported more often after MMRV. These usually occur 5-12 days after the first dose.

VAERS does not provide medical advice.

6

The National Vaccine Injury Compensation Program

A federal program has been created to help people who may have been harmed by a vaccine. For details about the National Vaccine Injury Compensation Program, call 1-800-338-2382 or visit their website at www.hrsa.gov/vaccinecompensation.

7

How can I learn more?

· Ask your provider. They can give you the vaccine package insert or suggest other sources of information. · Call your local or state health department. · Contact the Centers for Disease Control and Prevention (CDC): - Call 1-800-232-4636 (1-800-CDC-INFO) - Visit CDC website at: www.cdc.gov/vaccines

5

What if there is a moderate or

severe reaction?

department of health and human services

Centers for Disease Control and Prevention Vaccine Information Statement (Interim)

Varicella Vaccine (3/13/08) 42 U.S.C. §300aa-26

What should I look for?

· Any unusual condition, such as a high fever, weakness, or behavior changes. Signs of a serious

PNEUMOCOCCAL CONJUGATE

1

Pneumococcal disease

Infection with Streptococcus pneumoniae bacteria can make children very sick. It causes blood infections, pneumonia, and meningitis, mostly in young children. (Meningitis is an infection of the covering of the brain.) Although pneumococal meningitis is relatively rare (less than 1 case per 100,000 people each year), it is fatal in about 1 of 10 cases in children. Pneumococcal meningitis can also lead to other health problems, including deafness and brain damage. Before routine use of pneumococcal conjugate vaccine, pneumococcal infections caused: · over 700 cases of meningitis, · 13,000 blood infections, · about 5 million ear infections, and · about 200 deaths annually in the United States in children under five. Children younger than 2 years of age are at higher risk for serious disease than older children. Pneumococcal bacteria are spread from person to person through close contact. Pneumococcal infections may be hard to treat because some strains of the bacteria have become resistant to the drugs that are used to treat them. This makes prevention of pneumococcal infections through vaccination even more important.

VACCINE

PCV13 may also prevent some cases of pneumonia and some ear infections. But pneumonia and ear infections have many causes, and PCV13 only works against the types of pneumococcal bacteria targeted by the vaccine. PCV13 is given to infants and toddlers, to protect them when they are at greatest risk for serious diseases caused by pneumococcal bacteria. In addition to receiving PCV13, older children with certain chronic illnesses may get a different vaccine called PPSV23. There is a separate Vaccine Information Statement for that vaccine.

W H A T Y O U N E E D T O K N O W

Many Vaccine Information Statements are available in Spanish and other languages. See http://www.immunize.org/vis.

3

Who should get PCV13, and when?

Infants and Children Under 2 Years of Age PCV13 is recommended as a series of 4 doses, one dose at each of these ages: 2 months, 4 months, 6 months, and 12 through 15 months Children who miss their shots at these ages should still get the vaccine. The number of doses and the intervals between doses will depend on the child's age. Ask your health care provider for details. Children who have begun their immunization series with PCV7 should complete the series with PCV13. Older Children and Adolescents · Healthy children between their 2nd and 5th birthdays who have not completed the PCV7 or PCV13 series before age 2 years should get 1 dose. · Children between the 2nd and 6th birthdays with medical conditions such as: - sickle cell disease, - a damaged spleen or no spleen, - cochlear implants, - diabetes, - HIV/AIDS or other diseases that affect the immune system (such as cancer, or liver disease), or - chronic heart or lung disease,

or who take medications that affect the immune

system, such as immunosuppressive drugs or steroids,

should get 1 dose of PCV 13 (if they received 3

2

Pneumococcal conjugate vaccine (PCV13)

There are more than 90 types of pneumococcal bacteria. The new pneumococcal conjugate vaccine (PCV13) protects against 13 of them. These bacteria types are responsible for most severe pneumococcal infections among children. PCV13 replaces a previous conjugate vaccine (PCV7), which protected against 7 pneumococ cal types and has been in use since 2000. During that time severe pneumococcal disease dropped by nearly 80% among children under 5.

doses of PCV7 or PCV13 before age 2 years), or 2 doses of PCV13 (if they have received 2 or fewer doses of PCV7 or PCV13). A dose of PCV13 may be administered to children and adolescents 6 through 18 years of age who have certain medical conditions, even if they have previously received PCV7 or PPSV23. Children who have completed the 4-dose series with PCV7: Healthy children who have not yet turned 5, and children with medical conditions who have not yet turned 6, should get one additional dose of PCV13. Ask your health care provider if you have questions about any of these recommendations. PCV13 may be given at the same time as other vaccines.

· Up to about 8 out of 10 became fussy or irritable. Life-threatening allergic reactions from vaccines are very rare. If they do occur, it would be within a few minutes to a few hours after the vaccination.

6

What if there is a severe reaction?

What should I look for? Any unusual condition, such as a high fever or behavior changes. Signs of a severe allergic reaction can include difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, a fast heart beat or dizziness. What should I do? · Call a doctor, or get the person to a doctor right away. · Tell the doctor what happened, the date and time it happened, and when the vaccination was given. · Ask your provider to report the reaction by filing a Vaccine Adverse Event Reporting System (VAERS) form. Or you can file this report through the VAERS website at: http://www.vaers.hhs.gov, or by calling 1-800-822-7967. VAERS does not provide medical advice.

4

Some children should not get PCV13 or should wait

Children should not get PCV13 if they had a serious (life-threatening) allergic reaction to a previous dose of this vaccine, to PCV7, or to any vaccine containing diphtheria toxoid (for example, DTaP). Children who are known to have a severe allergy to any component of PCV7 or PCV13 should not get PCV13. Tell your health care provider if your child has any severe allergies. Children with minor illnesses, such as a cold, may be vaccinated. But children who are moderately or severely ill should usually wait until they recover before getting the vaccine.

7

The National Vaccine Injury Compensation Program

The National Vaccine Injury Compensation Program (VICP) was created in 1986. Persons who believe they may have been injured by a vaccine may file a claim with VICP by calling 1-800-338-2382 or visiting their website at http://www.hrsa.gov/vaccinecompensation.

5

What are the risks from PCV13?

Any medicine, including a vaccine, could possibly cause a serious problem, such as a severe allergic reaction. However, the risk of any vaccine causing serious harm, or death, is extremely small. In studies, most reactions after PCV13 were mild. They were similar to reactions reported after PCV7, which has been in use since 2000. Reported reactions varied by dose and age, but on average: · About half of children were drowsy after the shot, had a temporary loss of appetite, or had redness or tenderness where the shot was given. · About 1 out of 3 had swelling where the shot was given. · About 1 out of 3 had a mild fever, and about 1 in 20 had a higher fever (over 102.2°F).

8

How can I learn more?

· Ask your provider. They can give you the vaccine package insert or suggest other sources of information. · Call your local or state health department. · Contact the Centers for Disease Control and Prevention (CDC): - Call 1-800-232-4636 (1-800-CDC-INFO) or - Visit CDC's website at http://www.cdc.gov/vaccines.

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

Vaccine Information Statement (Interim) PCV13 4/16/2010 42 U.S.C. §300aa-26

INFLUENZA

1

Why get vaccinated?

Influenza ("flu") is a contagious disease. It is caused by the influenza virus, which can be spread by coughing, sneezing, or nasal secretions. Anyone can get influenza, but rates of infection are highest among children. For most people, symptoms last only a few days. They include: · fever · sore throat · chills · fatigue · cough · headache · muscle aches Other illnesses can have the same symptoms and are often mistaken for influenza. Infants, the elderly, pregnant women, and people with certain health conditions ­ such as heart, lung or kidney disease or a weakened immune system ­ can get much sicker. Flu can cause high fever and pneumonia, and make existing medical conditions worse. It can cause diarrhea and seizures in children. Each year thousands of people die from seasonal influenza and even more require hospitalization. By getting vaccinated you can protect yourself from influenza and may also avoid spreading influenza to others.

INACTIVATED

VACCINE

2010-11

It takes up to 2 weeks for protection to develop after the shot. Protection lasts about a year. Some inactivated influenza vaccine contains a preservative called thimerosal. Thimerosal-free influenza vaccine is available. Ask your healthcare provider for more information.

WHAT YOU NEED TO KNOW

Many Vaccine Information Statements are available in Spanish and other languages. See http://www.immunize.org/vis

Hojas de Informacián Sobre Vacunas están disponibles en Español y en muchos otros idiomas. Visite http://www.immunize.org/vis

3

Who should get inactivated influenza vaccine and when?

WHO All people 6 months of age and older should get flu vaccine. Vaccination is especially important for people at higher risk of severe influenza and their close contacts, including healthcare personnel and close contacts of children younger than 6 months. People who got the 2009 H1N1 (pandemic) influenza vaccine, or had pandemic flu in 2009, should still get the 2010-2011 seasonal influenza vaccine. WHEN Getting the vaccine as soon as it is available will provide protection if the flu season comes early. You can get the vaccine as long as illness is occurring in your community. Influenza can occur at any time, but most influenza occurs from November through May. In recent seasons, most infections have occurred in January and February. Getting vaccinated in December, or even later, will still be beneficial in most years. Adults and older children need one dose of influenza vaccine each year. But some children younger than 9 years of age need two doses to be protected. Ask your healthcare provider. Influenza vaccine may be given at the same time as other vaccines, including pneumococcal vaccine.

2

Inactivated influenza vaccine

There are two types of influenza vaccine: 1. Inactivated (killed) vaccine, or the "flu shot" is given by injection into the muscle. 2. Live, attenuated (weakened) influenza vaccine is sprayed into the nostrils. This vaccine is described in a separate Vaccine Information Statement. A "high-dose" inactivated influenza vaccine is available for people 65 years of age and older. Ask your healthcare provider for more information. Influenza viruses are always changing, so annual vaccination is recommended. Each year scientists try to match the viruses in the vaccine to those most likely to cause flu that year. The 2010-2011 vaccine provides protection against A/H1N1 (pandemic) influenza and two other influenza viruses ­ influenza A/H3N2 and influenza B. It will not prevent illness caused by other viruses.

4

Some people should not get inactivated influenza vaccine or should wait

· Tell your healthcare provider if you have any severe (life-threatening) allergies. Allergic reactions to influenza vaccine are rare.

- Influenza vaccine virus is grown in eggs. People with a severe egg allergy should not get influenza vaccine. - A severe allergy to any vaccine component is also a

reason not to get the vaccine.

- If you ever had a severe reaction after a dose of

influenza vaccine, tell your healthcare provider.

· Tell your healthcare provider if you ever had GuillainBarré Syndrome (a severe paralytic illness, also called GBS). Your provider will help you decide whether the vaccine is recommended for you. · People who are moderately or severely ill should usually wait until they recover before getting flu vaccine. If you are ill, talk to your healthcare provider about whether to reschedule the vaccination. People with a mild illness can usually get the vaccine.

The safety of vaccines is always being monitored. For more information, visit:

http://www.cdc.gov/vaccinesafety/Vaccine_Monitoring/Index.html and http://www.cdc.gov/vaccinesafety/Activities/Activities_Index.html

6

What if there is a severe reaction?

What should I look for? Any unusual condition, such as a high fever or behavior changes. Signs of a severe allergic reaction can include difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, a fast heart beat or dizziness. What should I do? · Call a doctor, or get the person to a doctor right away. · Tell the doctor what happened, the date and time it

happened, and when the vaccination was given.

· Ask your healthcare provider to report the reaction by filing a Vaccine Adverse Event Reporting System (VAERS) form. Or you can file this report through the VAERS website at http://www.vaers.hhs.gov, or by calling 1-800-822-7967. VAERS does not provide medical advice.

5

What are the risks from inactivated influenza vaccine?

A vaccine, like any medicine, could possibly cause serious problems, such as severe allergic reactions. The risk of a vaccine causing serious harm, or death, is extremely small. Serious problems from inactivated influenza vaccine are very rare. The viruses in inactivated influenza vaccine have been killed, so you cannot get influenza from the vaccine. Mild problems: · soreness, redness, or swelling where the shot was given · hoarseness; sore, red or itchy eyes; cough · fever · aches If these problems occur, they usually begin soon after the shot and last 1-2 days. Severe problems: · Life-threatening allergic reactions from vaccines are very rare. If they do occur, it is usually within a few minutes to a few hours after the shot. · In 1976, a type of inactivated influenza (swine flu) vaccine was associated with Guillain-Barré Syndrome (GBS). Since then, flu vaccines have not been clearly linked to GBS. However, if there is a risk of GBS from current flu vaccines, it would be no more than 1 or 2 cases per million people vaccinated. This is much lower than the risk of severe influenza, which can be prevented by vaccination.

One brand of inactivated flu vaccine, called Afluria, should not be given to children 8 years of age or younger, except in special circumstances. A related vaccine was associated with fevers and fever-related seizures in young children in Australia. Ask your healthcare provider for more information.

7

The National Vaccine Injury Compensation Program

The National Vaccine Injury Compensation Program (VICP) was created in 1986. People who believe they may have been injured by a vaccine can learn about the program and about filing a claim by calling 1-800-338-2382, or visiting the VICP website at http://www.hrsa.gov/vaccinecompensation.

8

How can I learn more?

· Ask your healthcare provider. They can give you the vaccine package insert or suggest other sources of information. · Call your local or state health department. · Contact the Centers for Disease Control and Prevention (CDC): - Call 1-800-232-4636 (1-800-CDC-INFO) or - Visit CDC's website at http://www.cdc.gov/flu

DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention

Vaccine Information Statement (Interim)

Inactivated Influenza Vaccine (8/10/10) 42 U.S.C. §300aa-26

LIVE, INTRANASAL

INFLUENZA

1

Why get vaccinated?

Influenza ("flu") is a contagious disease. It is caused by the influenza virus, which can be spread by coughing, sneezing, or nasal secretions. Anyone can get influenza, but rates of infection are highest among children. For most people, symptoms lasts only a few days. They include: · fever · cough · sore throat · headache · chills · muscle aches · fatigue

WHAT YOU NEED TO KNOW 3

Vaccine Information Statements are available in Spanish and many other languages. See www.immunize.org/vis Hojas de Informacián Sobre Vacunas están disponibles en Español y en muchos otros idiomas. Visite www.immunize.org/vis

VACCINE 2010-11

Who can receive LAIV?

LAIV is recommended for healthy people 2 through 49 years of age, who are not pregnant and do not have certain health conditions (see #4, below). People who got the 2009 H1N1 (pandemic) influenza vaccine, or had pandemic flu in 2009, should still get the 2010-2011 seasonal influenza vaccine.

4

Other illnesses can have the same symptoms and are often mistaken for influenza. Infants, the elderly, pregnant women, and people with certain health conditions ­ such as heart, lung or kidney disease or a weakened immune system ­ can get much sicker. Influenza can cause high fever and pneumonia, and make existing medical conditions worse. It can cause diarrhea and seizures in children. Each year thousands of people die from seasonal influenza and even more require hospitalization. By getting vaccinated you can protect yourself from influenza and may also avoid spreading influenza to others.

LAIV is not recommended for everyone. The following people should get the inactivated vaccine (flu shot) instead: · Adults 50 years of age and older or children from 6 through 23 months of age. (Children younger than 6 months should not get either influenza vaccine.) · Children younger than 5 years with asthma or one or more episodes of wheezing within the past year. · Pregnant women. · People who have long-term health problems with: - heart disease - kidney or liver disease - lung disease - metabolic disease, such as diabetes - asthma - anemia, and other blood disorders · Anyone with certain muscle or nerve disorders (such as seizure disorders or cerebral palsy) that can lead to breathing or swallowing problems. · Anyone with a weakened immune system. · Anyone in close contact with someone whose immune system is so weak they require care in a protected environment (such as a bone marrow transplant unit). Close contacts of other people with a weakened immune system (such as those with HIV) may receive LAIV. Healthcare personnel in neonatal intensive care units or oncology clinics may receive LAIV. · Children or adolescents on long-term aspirin treatment. Tell your healthcare provider if you have any severe (lifethreatening) allergies. Allergic reactions to influenza vaccine are rare. - Influenza vaccine virus is grown in eggs. People with a severe egg allergy should not get influenza vaccine. - A severe allergy to any vaccine component is also a reason not to get the vaccine. - If you ever had a severe reaction after a dose of influenza vaccine, tell your healthcare provider.

Some people should not receive LAIV

2

Live, attenuated influenza vaccine - LAIV (nasal spray)

There are two types of influenza vaccine: 1. Live, attenuated influenza vaccine (LAIV) contains live but attenuated (weakened) influenza virus. It is sprayed into the nostrils. 2. Inactivated (killed) influenza vaccine, or the "flu shot," is given by injection into the muscle. This vaccine is described in a separate Vaccine Information Statement. Influenza viruses are always changing, so annual vaccination is recommended. Each year scientists try to match the viruses in the vaccine to those most likely to cause flu that year. The 2010 ­ 2011 vaccine provides protection against A/H1N1 (pandemic) influenza and two other influenza viruses­ influenza A/H3N2 and influenza B. It will not prevent illness caused by other viruses. It takes up to 2 weeks for protection to develop after the vaccination. Protection lasts about a year. LAIV does not contain thimerosal or other preservatives.

Tell your healthcare provider if you ever had Guillain-Barré Syndrome (a severe paralytic illness, also called GBS). Your provider will help you decide whether the vaccine is recommended for you. Tell your healthcare provider if you have gotten any other vaccines in the past 4 weeks. Anyone with a nasal condition serious enough to make breathing difficult, such as a very stuffy nose, should get the flu shot instead. People who are moderately or severely ill should usually wait until they recover before getting flu vaccine. If you are ill, talk to your healthcare provider about whether to reschedule the vaccination. People with a mild illness can usually get the vaccine.

· If rare reactions occur with any product, they may not be identified until thousands, or millions, of people have used it. Millions of doses of LAIV have been distributed since it was licensed, and the vaccine has not been associated with any serious problems. The safety of vaccines is always being monitored. For more information, visit: www.cdc.gov/vaccinesafety/Vaccine_Monitoring/Index.html and www.cdc.gov/vaccinesafety/Activities/Activities_Index.html

7

What if there is a severe reaction?

5

Getting the vaccine as soon as it is available will provide protection if the flu season comes early. You can get the vaccine as long as illness is occurring in your community. Influenza can occur any time, but most influenza occurs from November through May. In recent seasons, most infections have occured in January and February. Getting vaccinated in December, or even later, will still be beneficial in most years. Adults and older children need one dose of influenza vaccine each year. But some children younger than 9 years of age need two doses to be protected. Ask your healthcare provider. Influenza vaccine may be given at the same time as other vaccines.

When should I receive influenza vaccine?

What should I look for? Any unusual condition, such as a high fever or behavior changes. Signs of a severe allergic reaction can include difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, a fast heart beat or dizziness. What should I do? · Call a doctor, or get the person to a doctor right away. · Tell the doctor what happened, the date and time it happened, and when the vaccination was given. · Ask your healthcare provider to report the reaction by filing a Vaccine Adverse Event Reporting System (VAERS) form. Or you can file this report through the VAERS website at www.vaers.hhs.gov, or by calling 1-800-822-7967. VAERS does not provide medical advice.

6

What are the risks from LAIV?

8

The National Vaccine Injury Compensation Program

A vaccine, like any medicine, could possibly cause serious problems, such as severe allergic reactions. The risk of a vaccine causing serious harm, or death, is extremely small. Live influenza vaccine viruses very rarely spread from person to person. Even if they do, they are not likely to cause illness. LAIV is made from weakened virus and does not cause influenza. The vaccine can cause mild symptoms in people who get it (see below). Mild problems: Some children and adolescents 2-17 years of age have reported: · runny nose, nasal congestion or cough · fever · headache and muscle aches · wheezing · abdominal pain or occasional vomiting or diarrhea Some adults 18-49 years of age have reported: · runny nose or nasal congestion · cough, chills, tiredness/weakness Severe problems: · Life-threatening allergic reactions from vaccines are very rare. If they do occur, it is usually within a few minutes to a few hours after the vaccination. · sore throat · headache

The National Vaccine Injury Compensation Program (VICP) was created in 1986. Persons who believe they may have been injured by a vaccine can learn about the program and about filing a claim by calling 1-800-338-2382, or visiting the VICP website at www.hrsa.gov/vaccinecompensation.

9

How can I learn more?

· Ask your healthcare provider. They can give you the vaccine package insert or suggest other sources of information. · Call your local or state health department. · Contact the Centers for Disease Control and Prevention (CDC): - Call 1-800-232-4636 (1-800-CDC-INFO) or - Visit CDC's website at www.cdc.gov/flu

DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention

Vaccine Information Statement (Interim) Live, Attenuated Influenza Vaccine (8/10/10) U.S.C. §300aa-26

Web addresses to Immunization Tool Kit resources NJ immunization requirements for school age children ­ effective June 2010

NJ Administrative code 8:57-4 http://www.state.nj.us/health/forms/imm.doc

CDC recommended vaccine schedule for children 0 ­ 6 years old

http://www.cdc.gov/vaccines/recs/schedules/downloads/child/2010/10_0-6yrs-schedule-pr.pdf

Your Baby's First Vaccines-What You Need To Know

http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-multi.pdf

Help for Vaccine Hesitant Parents

http://www.immunize.org/catg.d/p2070.pdf

Common Questions Parents Ask about Infant Immunization

http://www.cdc.gov/vaccines/events/niiw/2009/downloads/f_provider-qa-color-508.pdf

What if you don't immunize your child?

http://www.immunize.org/catg.d/p4017.pdfnize.org

Vaccine Information Statements

http://www.cdc.gov/vaccines/pubs/vis/default.htm Current versions of the above CDC documents as well as updated vaccine schedules, schedules for older children, schedules for adults, catch up schedules and many other resources can also be viewed by going to the web address below and selecting the desired document. http://www.cdc.gov/vaccines/recs/schedules/child-schedule.htm

Reportable Illnesses

http://www.nj.gov/health/cd/documents/reportable_diseases.pdf

Quick Reference

Reporting Requirements for Communicable Diseases and Work-Related Conditions

To protect public health, certain diseases and conditions are required to be reported in a timely manner by specific health care providers, administrators, and laboratory directors (see New Jersey Administrative Code 8:57 and 8:58).

CONFIRMED or SUSPECT CASES TELEPHONE IMMEDIATELY to the LOCAL HEALTH DEPARTMENT

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Health care providers required to report: physicians, advanced practice nurses, physician assistants, and certified nurse midwives. Administrators required to report: persons having control or supervision over a health care facility, correctional facility, school, youth camp, child care center, preschool, or institution of higher education. Laboratory directors: For specific reporting guidelines, see NJAC 8:57-1.7.

REPORTABLE WITHIN 24 HOURS OF DIAGNOSIS to the LOCAL HEALTH DEPARTMENT REPORTABLE DIRECTLY to the NJ DEPARTMENT OF HEALTH AND SENIOR SERVICES Hepatitis C, acute and chronic, newly diagnosed cases only Written report within 24 hours HIV/AIDS 609-984-5940 or 973-648-7500 Written report within 24 hours

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Anthrax Botulism Brucellosis Diphtheria Foodborne intoxications (including, but not limited to, ciguatera, paralytic shellfish poisoning, scombroid, or mushroom poisoning) Haemophilus influenzae, invasive disease Hantavirus pulmonary syndrome Hepatitis A, acute Influenza, novel strains only Measles Meningococcal invasive disease Outbreak or suspected outbreak of illness, including, but not limited to, foodborne, waterborne or nosocomial disease or a suspected act of bioterrorism Pertussis Plague Poliomyelitis Rabies (human illness) Rubella SARS-CoV disease (SARS) Smallpox Tularemia Viral hemorrhagic fevers (including, but not limited to, Ebola, Lassa, and Marburg viruses)

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To find the local health department, go to: http://nj.gov/health/lh/ directory/lhdselectcounty.shtml

1. If the individual lives in NJ, report to the local health department where the person lives. 2. If unable to reach the local health department, contact the NJ Department of Health and Senior Services at: 609-588-7500 (regular business hours) or 609-392-2020 (holidays/off hours). 3. If the individual does not live in NJ, report to the NJ Department of Health and Senior Services.

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Revised November 2008 www.nj.gov/health/cd

Amoebiasis Animal bites treated for rabies Arboviral diseases Babesiosis Campylobacteriosis Cholera Creutzfeldt-Jakob disease Cryptosporidiosis Cyclosporiasis Diarrheal disease (child in a day care center or a foodhandler) Ehrlichiosis Escherichia coli, shiga toxin producing strains (STEC) only Giardiasis Hansen's disease Hemolytic uremic syndrome, post-diarrheal Hepatitis B, including newly diagnosed acute, perinatal and chronic infections, and pregnant women who have tested positive for Hep B surface antigen Influenza-associated pediatric mortality Legionellosis Listeriosis Lyme disease Malaria Mumps Psittacosis Q fever Rocky Mountain spotted fever Rubella, congenital syndrome Salmonellosis Shigellosis Staphylococcus aureus, with intermediatelevel resistance (VISA) or high-levelresistance (VRSA) to vancomycin only Streptococcal disease, invasive group A Streptococcal disease, invasive group B, neonatal Streptococcal toxic shock syndrome Streptococcus pneumoniae, invasive disease Tetanus Toxic shock syndrome (other than Streptococcal) Trichinellosis Typhoid fever Varicella (chickenpox) Vibriosis Viral encephalitis Yellow fever Yersiniosis

AIDS HIV infection Child exposed to HIV perinatally

Sexually Transmitted Diseases 609-588-7526 Report within 24 hours

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Chancroid Chlamydia, including neonatal conjunctivitis Gonorrhea Granuloma inguinale Lymphogranuloma venereum Syphilis, all stages and congenital

Tuberculosis (confirmed or suspect cases) 609-588-7522 Written report within 24 hours Occupational and Environmental Diseases, Injuries, and Poisonings 609-984-1863 Report within 30 days after diagnosis or treatment

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Work-related asthma (possible, probable, and confirmed) Silicosis Asbestosis Pneumoconiosis, other and unspecified Extrinsic allergic alveolitis Lead, mercury, cadmium, arsenic toxicity in adults Work-related injury in children (< age 18) Work-related fatal injury Occupational dermatitis Poisoning caused by known or suspected occupational exposure Pesticide toxicity Work-related carpal tunnel syndrome Other occupational disease

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