Immunization Audit—-fail?

[cmh1118, BSN]

Hi I’m relaying this for a friend who called me hysterical today. She works in Texas at a private school where immunizations are required and only medical exemptions signed by MD are accepted. No conscience exemptions. She just took over a few months ago right before covid hit. The previous nurse was apparently awful.

She’s been going through her shot records and so many are insufficient. That part she’s taking care of and getting everyone caught up. However, her principal informed her they underwent an audit in January. Certain shot records were sent in and no results have come back.

So my friend is freaking out if they “fail” the audit due to that. Does the school get reprimanded or some kind of demerit? Has anyone been through that or have any knowledge of that? It would be the Texas department of health. I told her to just call them directly and explain and ask what she could do.

Any advice? Thanks!

[Flare, ASN, BSN]

so probably about a decade ago, I took over a middle school. In my state, it's required to get a Tdap and menactra when beginning middle school. So I get into the school, expecting that things would be as expected. I soon realized that the previous year's 6th graders (my 7th graders) did not have their vaccines all worked out as they should have been the previous year. I worked feverishly to establish compliance in the current sixth grade year AND with the 7th graders also. I have no idea if the previous nurse had issues during her audit - I'm guessing no?? I mean it was never mentioned to me. I ended up purposely missing the state vaccine reporting deadline. I advised my principal what was going on and why and I also spoke to the local health dept nurse (who would be auditing me). The health dept nurse worked with me to get the kids up to compliance, even running an extra shot clinic.

In the end it worked out, but it's never a good scene when the person before you leaves you a hot mess.

[cmh1118, BSN]

1 minute ago, Flare said:

so probably about a decade ago, I took over a middle school. In my state, it's required to get a Tdap and menactra when beginning middle school. So I get into the school, expecting that things would be as expected. I soon realized that the previous year's 6th graders (my 7th graders) did not have their vaccines all worked out as they should have been the previous year. I worked feverishly to establish compliance in the current sixth grade year AND with the 7th graders also. I have no idea if the previous nurse had issues during her audit - I'm guessing no?? I mean it was never mentioned to me. I ended up purposely missing the state vaccine reporting deadline. I advised my principal what was going on and why and I also spoke to the local health dept nurse (who would be auditing me). The health dept nurse worked with me to get the kids up to compliance, even running an extra shot clinic.

In the end it worked out, but it's never a good scene when the person before you leaves you a hot mess.

Thanks for the response. What a mess but sounds like it was an easy fix. I think she’s so worried the school will be in trouble. I figured they’d work with you and help you get them caught up. They don’t seem like they’re out to close schools for that or anything.

[Flare, ASN, BSN]

We could have potentially gotten in trouble. The state here reserves the right to fine the district and principal 250 per student per day for knowingly having non-compliant students in attendance. I believe that is largely enforced by the local health dept nurse, as that's who told me that was the consequence, and is generally considered when there is a failure to act on the districts part. It's there to help give us some teeth when you present the admin with the non-compliant list and request that they be excluded until compliant. Some principals are wishy-washy.

[ruby_jane, BSN, RN]

1. There is a history of poor compliance - not her fault.

2. All parents must obtain an exemption for conscience from TDH. No exceptions except -

3. Medical exemptions are a thing with a note from the doctor. Usually these are given because the student has a condition like RA and they are on Humira or similar and cannot have the MMR or Varicella booster. There is usually no reason someone cannot have a non-live vaccine. If the parent feels strongly that in addition to the varicella booster, sweet baby can't have that TDaP and MCV vaccine - see #2.

4. This is an administrative issue. She needs to tell the principal that effective beginning of school, in compliance with TDH rules and state law, all students must be current with an updated immunization record or a current exemption.

ALSO - the principal may NOT want to enforce this because s/he wants the kids in school and kicking a kid out is not acceptable to him/her for a variety of reasons. She needs to stand tough!!