Immunization Compliance

  1. Hi everyone! This is my first year in school nursing. I am feeling very defeated with immunization compliance. I still have 35 non-compliant students. The due date for our immunization report is October 20th. I have done a call out in September. Sent a letter to the student's home. After that, I called each parent (if they didn't answer, I sent an e-mail). This week, I called the students in my office and gave them a copy of their record and told them which ones they need and when they need it by to stay enrolled in school. Is there anything else I can do? I feel like nothing is working. Thanks!!!
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  2. 22 Comments

  3. by   Rubor
    Is your school conducting exclusions? Have your admin get involved. I ask my principals to call if I have done all I can do. Sometimes they have better luck.
  4. by   GdBSN
    The only thing that works is excluding the students from school. It sounds like you have done everything you can, now you have to get admin behind you and exclude for non-compliance. (Side note - if you are from Texas, Gov. Abbott waived the deadline for compliance due to the hurricane and floods.)
  5. by   WineRN
    Quote from Rubor
    Is your school conducting exclusions? Have your admin get involved. I ask my principals to call if I have done all I can do. Sometimes they have better luck.
    Hopefully your school does exclusions. We require everything by the first day of school. I send letters all summer and do phone calls the week before school starts. The day before school, the principal calls.

    If not, I would see if admin would back you up for excluding them from all extra curricular activities and field trips until a record is received.
  6. by   OldDude
    Quote from GdBSN
    (Side note - if you are from Texas, Gov. Abbott waived the deadline for compliance due to the hurricane and floods.)
    I haven't heard of this, can you direct me to the document? That'd be awesome!
  7. by   GdBSN
    Quote from OldDude
    I haven't heard of this, can you direct me to the document? That'd be awesome!
    Ok, wrong dept. but still came from the state. I just copied and pasted the email. Our head nurse said our district does not have a deadline, until further notice.


    Dear School Administrator:
    The purpose of this letter is to remind school districts of the current immunization rules that affect students displaced by Hurricane Harvey and to provide information on how schools can obtain immunization histories for transfer students.
    The Texas Department of State Health Services (DSHS) rules relating to immunization requirements for school entry allow a student transferring from one Texas school to another to be provisionally enrolled without proof of required immunizations for up to 30 days. (Texas Administrative Code, Title 25, Part I, Chapter 97, Subchapter B, Section 97.69.) As the 30-day period draws closer to an end, if there appears to be a significant number of displaced students who are still having trouble obtaining their immunization records, DSHS will consider whether a short additional provisional enrollment period is possible. The 30-day time period begins the day the student begins attending classes at the new school.
    Additionally, students displaced by Hurricane Harvey and who are considered homeless under the federal McKinney-Vento Act may be admitted to attend school without documentation of required immunizations for up to 30 days. (Texas Administrative Code, Title 25, Part I, Chapter 97, Subchapter B, Section 97.66(b).) For more information regarding specific guidelines for homeless students, contact the Texas Homeless Education Office (1-800-446-3142 or www.theotx.org).
    Many schools have electronic access to ImmTrac2, the Texas immunization registry. Many student immunization records can be found there. Most school districts are registered to use or access ImmTrac2. If you do not know if you are registered or to register for ImmTrac2, please email ImmTrac2@dshs.texas.gov and include the school district name followed by "Harvey."
    Please contact the DSHS Immunization Unit at (800) 252-9152 with any further questions about immunization requirements or accessing ImmTrac2. Information is also available at Immunization Unit - Texas Department of State Health Services.
  8. by   OldDude
    30 day provisional enrollment from another Texas public school was already in place..."DSHS will consider..." isn't helpful to me. But thank you.
  9. by   tippeny
    Thank you for the information regarding students affected by Harvey. I am in Maryland but we have a student that transferred here from Houston b/c the family lost everything and now she/he lives with a sister. We have no immunization record at all for this child. Our admissions secretary and PPW are under the assumption that homeless students, unaccompanied minors, and situations like the one in Houston preclude the student from needing to produce a shot record. I have tried to tell them it is still a requirement but they won't do the leg work. So it all falls on me. (Sigh) Immunization compliance is the bane of my existence!!!! (Don't get me started.......)
  10. by   SullyRN
    Agree with others, check on exclusion, this usually lights a fire under the parents butt.

    Also, I call doctors offices. If the child has provided a certificate that is non-compliant I just look at where ever it came from (or where their physical came from) and call. In A LOT of cases especially with DTaP and IPV, the doctors office simply left off a dose. I've had a handful of MMR and VVAX that were non-compliant and the dates were just written down wrong.

    I have a whole spreadsheet dedicated to non-compliant vaccines and I got one school down from 126 to 14. My current school is at 11. Yeah, it's more work, but honestly parents assume their child is compliant if the doctors office tells them so. The one's parents get really mad on is the Hep B.'s that were given a week too soon.

    IMO, they need to cut out the middle man (us) and go straight to the source (doctors office) when auditing. I can't make a doctor give a child a shot, and I've had two instances where they refuse to give another Hep. B. and my student's will forever be non-compliant (I have it written on a script that they are not giving them another dose).
  11. by   Farawyn
    Quote from RNTexas13
    Hi everyone! This is my first year in school nursing. I am feeling very defeated with immunization compliance. I still have 35 non-compliant students. The due date for our immunization report is October 20th. I have done a call out in September. Sent a letter to the student's home. After that, I called each parent (if they didn't answer, I sent an e-mail). This week, I called the students in my office and gave them a copy of their record and told them which ones they need and when they need it by to stay enrolled in school. Is there anything else I can do? I feel like nothing is working. Thanks!!!
    It's so overwhelming. I have a nurse help me. over the summer.
  12. by   OldDude
    Dear School Administrator:
    On August 29, 2017, the Department of State Health Services (DSHS) sent school districts in Texas a letter regarding provisional enrollment for homeless students or students transferring from one Texas school to another due to displacement from Hurricane Harvey. In that letter, DSHS made a commitment to evaluate the need to further extend provisional enrollment.
    The current immunization requirements give homeless or transferring students a 30-day provisional enrollment period during which immunization records must be provided to their school (See the Texas Administrative Code, Title 25, Part I, Chapter 97, Subchapter B, Section 97.66 and 97.69). Under the authority of the Governor’s extension of the Hurricane Harvey disaster declaration, the DSHS has elected to suspend the 30-day requirement in the rule referenced above for displaced students having trouble producing immunization records to their school. This suspension will expire on November 1, 2017, unless extended by the Office of the Governor.

    This had yesterday's date on it...
  13. by   Jen-Elizabeth
    Quote from SullyRN
    Agree with others, check on exclusion, this usually lights a fire under the parents butt.

    Also, I call doctors offices. If the child has provided a certificate that is non-compliant I just look at where ever it came from (or where their physical came from) and call. In A LOT of cases especially with DTaP and IPV, the doctors office simply left off a dose. I've had a handful of MMR and VVAX that were non-compliant and the dates were just written down wrong.

    I have a whole spreadsheet dedicated to non-compliant vaccines and I got one school down from 126 to 14. My current school is at 11. Yeah, it's more work, but honestly parents assume their child is compliant if the doctors office tells them so. The one's parents get really mad on is the Hep B.'s that were given a week too soon.

    IMO, they need to cut out the middle man (us) and go straight to the source (doctors office) when auditing. I can't make a doctor give a child a shot, and I've had two instances where they refuse to give another Hep. B. and my student's will forever be non-compliant (I have it written on a script that they are not giving them another dose).
    I've called doctor's offices as well, even for missing records. Immunizations are something I can access without needing a parent to sign off on, so I've been lucky that most doctors office will fax me the record if needed.

    For me, it is also frustrating when the 4th polio vaccine was given too early and doctor won't give it again. That one I just made a note on and move on.

    And working with 7-12 grades, the tdap is the bane of my existence.
  14. by   ruby_jane
    The McKinney-Vento act allows provisional enrollment in any state when a student is considered homeless. Provisional only means you have 30 days to find the record. In Texas, OP, the law is on your side. Students who are not compliant may be removed from campus until they are in compliance.

    The guidance for hurricane-displaced kids is also here:

    Texas School & Child-Care Facility Immunization Requirements

    Good luck!

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