State immunization rule changes for children set for Aug. 1

At least for Spokane Public Schools, a deadline to receive vaccine records before or by a child’s first day of school attendance is being extended to Oct. 8 due to COVID-19, said Becky Doughty, SPS director of health services.

School officials and pediatricians, however, are urging parents to get kids in to see health care providers for their vaccines before the school year. SPS is scheduled to start Sept. 3, with details still being determined.

“Yes, we’re going to go ahead and still make sure all our students have up-to-date immunizations under the assumption that we’ll be coming together and starting school at a normal time this fall,” Doughty said.

“Even if we didn’t, our expectation would be that at any time that could change, and we’d want to make sure all their immunizations are up to date.”

With Spokane Regional Health District, SPS is looking at plans for a drive-thru immunization clinic to help families who need to get kids vaccinated for the start of the school year. In the past, the agencies partnered for a vaccine clinic at Shaw Middle School that attracted hundreds of families.

“Our goal again is to support the families and partner with them during this time knowing how hard it is, especially if you’re already having a hard time accessing care,” Doughty said.

“It’s really not on everybody’s minds right now, but what we don’t want to see is an outbreak of other communicable diseases that we can prevent with vaccines because we’re not getting those vaccinations done. So we really want to support families that way.”

Among Washington’s vaccination rule changes effective Aug. 1, immunization records are now required to be verified by a medical provider or pulled from a state database for school or child care entry, Doughty said.

“What that means is that for all immunizations turned in on or after Aug. 1, or if the student is new to the district, we need to have medically verified immunization records,” Doughty said.

Previously, parents were allowed to fill out the certificate of immunization status for the district reporting all shots a student has had and turn it into schools.

“Now if they fill out that form and turn it into us, it must be signed off by a provider, or another way for us to get those records is to get a copy of vaccinations the student received from the provider. They’ll give a little report to a patient as they’re leaving. We also can print out, or the provider can print out, a report from the state database that would be the electronic copy of the certificate of immunization status form, and that also is considered a valid record.”

Another immunization change affects timing of when a shot is given for tetanus, diphtheria and whooping cough – called Tdap – moved up from being done before sixth grade to as of Aug. 1 now before seventh grade. Doughty said most current SPS students already have met the Tdap requirement.

“So for our kids who are going into seventh grade this year, they already have satisfied that requirement for us if they’ve been in the district because they had to have that Tdap going into sixth grade,” she said.

The Tdap change will simplify timing for families and doctors, said pediatrician Dr. Matt Thompson of the Kids Clinic in Spokane who is a member of the Washington chapter of the American Academy of Pediatrics.

He said administering Tdap before seventh grade also better coincides with offering two recommended vaccines in that age group: meningococcal disease and human papillomavirus, or HPV.

“The goal of having Tdap after age 10 but before sixth grade presented problems at times with timing based on age and when their yearly physicals were scheduled,” Thompson said.

“We had a very tight window in which to get that required vaccine to where they were old enough but not yet registered for sixth grade.”

Based on department of health records, statewide immunization rates for children 18 and younger were down 30% in March compared to average numbers from 2015-2019. In April during stay-home orders, they were down 40%. The rates improved in May but were still down about 27%.

Numbers for June indicate that more younger kids are getting immunizations, but rates still fell significantly for teens, with vaccine doses administered last month for ages 13-17 down nearly 37%.

Thompson said the lower rates recently are concerning. The first two months of 2020 held record numbers compared with 2015-2019, and recent gains are small.

“We’re still well below where we hoped to be this year,” he said.

Another concern is the Washington state measles outbreak in 2019 that sickened more than 70 people in Clark County, where only 85% of kindergartners had received the vaccine for measles, mumps and rubella.

“At a time when we need it – this year after seeing outbreaks of measles and more pertussi cases – it’s important for parents to know we are expecting and encouraging them to bring their children in for their routine well visits for all the many things we do, including nutrition, development, social-behavioral issues and also those vital vaccines,” Thompson said.

He added that multiple safety features are in place for children’s well visits, from staying in the car and going directly into an exam room to heightened sanitation. These visits can’t go virtual.

“You can’t replace the exam, and obviously for vaccines, someone needs to be within the reach of a needle,” he said.

The immunization policy changes also clarify conditional status entry into school or child care for 30 calendar days if progress is being made. Children may begin school or child care after turning in all medically verifiable records and remain even if there’s a missing dose, such as the second round of the MMR vaccine, but if the 30 days expire without updated records, “the child must be excluded from further attendance,” the DOH website says.

The rules mainly affect children entering kindergarten, seventh grade or students new to the school district, Doughty said. She said school nurses can answer questions near school start dates, or people can email questions to her at rebeccado@spokaneschools.org.