New York State updates vaccine schedule for children

If we don't vaccinate, wards of iron lungs.
If we don’t vaccinate, wards of iron lungs.

As you may be aware, there was a relatively large measles outbreak in New York City (pdf), hitting 26 individuals according to the New York City Department of Health. Some have stated that the outbreak was small, but compared to the historical average of around 60 measles cases per year for the whole United States, and when it was thought that we had “defeated” measles in the USA, 26 is a surprisingly large number.

New York City also had a 2011-12 outbreak of whooping cough (Bordetella pertussis), which was infecting individuals at nearly 4X the historical rate.

In light of these outbreaks, the New York State Department of Health (DOH) announced that it has updated its immunization requirements for school attendance to meet the revised standards recently published by Advisory Committee on Immunization Practices (ACIP), which is a group of medical and public health experts that have developed vaccine and immunization recommendations to reduce the incidence and prevent disease amongst America’s children. The goal of these recommendations is to reduce the incidence of vaccine preventable diseases.

The new 2014 standards did not add any new vaccines for school entry; however, they did update the number of doses required and the minimum intervals between doses. Generally, ACIP makes several recommendations a year, and state health departments “catch up” with the newest recommendations when they set the standard for the upcoming school year.

According to said Acting State Health Commissioner Howard Zucker, MD, JD, “immunizations protect children from serious childhood diseases, like whooping cough and measles, and have an excellent track record of safety and effectiveness. I encourage parents to talk to their children’s healthcare provider and work with their school’s health services to ensure that all immunizations are up-to-date.”

New School Immunization Requirements

The new requirements, which apply to daycare, head start, nursery, pre-kindergarten and grades kindergarten through 12, represent the best evidence and data available to public health researchers, and is the first update to the New York State requirements in over a decade.

  • Students entering kindergarten or 6th grade in the 2014-2015 school year will now be required to have two doses of the varicella (chicken pox) vaccine and 3-5 doses of poliomyelitis vaccine. The updated varicella and polio vaccination requirements will be phased in over the next seven years and will be required for all grades by the 2020-2021 school year.
  • For all other required vaccines, students in day care, head start, nursery, pre-kindergarten and grades kindergarten through 12 will be required to have age-appropriate doses in accordance with the ACIP schedule (pdf).
  • A student who is in process is defined as one who has had the first dose of vaccine in all of the required immunization series and has appointments to complete the series in accordance with the ACIP catch up schedule.
  • Students may present proof of immunity by serology (blood test) for the following immunizations: measles, mumps, rubella, hepatitis B, varicella, and poliomyelitis.
  • Medical exemptions to immunizations must be reissued annually. The written exemption must identify the immunization exempted, the medical contraindication for the exemption, and the length of time the immunization is contraindicated. A sample medical exemption form is available one the website.
  • Any child who has been vaccinated according to the ACIP recommendations, which are followed by most health care providers, should not need further vaccinations in order to attend day care or school.
Line of New York City children receiving vaccines during World War II.
Line of New York City children receiving vaccines during World War II.

New York State and City allow for legitimate medical exemptions to some or all of these vaccines, but they require certification and renewal each year. The state and city also allow religious exemptions, but recent court decisions (also here) have empowered school administrators to restrict or disallow those exemptions.

I cannot be sure that the New York State Department of Health was responding to outbreaks of measles and whooping cough to re-examine its  vaccine requirements, but it would make sense. And hopefully it, along with the reduction or elimination of nonsense religious exemptions (there are simply no legitimate anti-vaccine religious groups), will reduce or eliminate outbreaks of vaccine preventable disease.

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The Original Skeptical Raptor
Chief Executive Officer at SkepticalRaptor
Lifetime lover of science, especially biomedical research. Spent years in academics, business development, research, and traveling the world shilling for Big Pharma. I love sports, mostly college basketball and football, hockey, and baseball. I enjoy great food and intelligent conversation. And a delicious morning coffee!