Vaccine FAQ

Hepatitis A

Students in grades kindergarten through 12th grade are required to have two doses of Hepatitis A with the first dose received on or after the first birthday. To enroll in K-12, the child should already have 2 doses.

However, if the student has 1 dose at time of enrollment in K-12, the child may be provisionally enrolled IF the first dose of hepatitis A was received in the last 6 months. At this time, we would follow CDC’s catch-up recommendation for hepatitis A vaccine. When catching up, the minimal interval between the two hepatitis A doses is 6 months.

Once provisionally enrolled, the child must receive the 2nd dose as rapidly as medically feasible, which in this case is 6 months after the first dose. If more than 6 months have lapsed since the child received the first dose of hepatitis A, the child should not be enrolled (provisionally or otherwise) until the 2nd dose is received.

As for childcare, an 18-month window between dose 1 and dose 2 is built in with the first dose being required by 25 months and the 2nd dose by 43 months.

Meningococcal

In the 86th Legislature, HB 3884 required DSHS to create procedures for school districts to provide information relating to bacterial meningitis to students and parents. DSHS shall prescribe the form and content of the information.

Meningitis is an inflammation of the covering of the brain and spinal cord. It can be caused by viruses, parasites, fungi, and bacteria. Viral meningitis is the most common and the least serious form. Bacterial meningitis is the most likely form to cause serious, long-term complications. It is an uncommon disease but requires urgent treatment with antibiotics to prevent permanent damage or death.

Multiple organisms can cause bacterial meningitis. Two common types are Streptococcus pneumoniae, with more than 80 serogroups that can cause illness, and Neisseria meningitidis, with five serogroups that most commonly cause meningitis.

Measles, Mumps, and Rubella (MMR)

Q: Some of my older students received two doses of measles and one dose each of mumps and rubella, which satisfied the old school entry requirements. Will these students need to receive additional doses of MMR?
A: Students that were vaccinated prior to 2009 with two doses of measles and one dose each of mumps and rubella should be considered compliant. All other students must show proof of two doses of MMR vaccine.

Polio

Q: What are the polio vaccine requirements for students in Texas schools?
A: As outlined in §97.63 of the Texas Administrative Code, students in kindergarten through 12th grade are required to have four doses of polio vaccine - one of which must have been received on or after the fourth birthday. Or, if the third dose was administered on or after the fourth birthday, only three doses are required. Any combination of oral polio vaccine (OPV) & inactivated poliovirus vaccine (IPV) doses is acceptable, provided age requirements and total number of doses are met.

Q: Is polio vaccine required for persons enrolled in school once they turn 18?
A: No, polio vaccine is not required for persons 18 years of age or older.

Q: A student received a combination of oral polio vaccine (OPV) and inactivated poliovirus vaccine (IPV). Can this student be enrolled?
A: Yes, the student can enroll as long as they received the required number of doses outlined in §97.63 of the Texas Administrative Code.

Q: A student received oral polio vaccine (OPV) in another country. What are the school entry requirements for students who received only OPV?
A: The requirements are the same for students who received an all IPV series and for those who received an all OPV series: four doses are required, provided one dose was received on or after the fourth birthday. However, three doses meet the requirement if the third dose was received on or after the fourth birthday.

Tdap Requirements

Tetanus and diphtheria toxoids and acellular pertussis (Tdap) vaccine. (Minimum age: 10 years for both Boostrix and Adacel)

Routine Vaccination:

Administer one dose of Tdap vaccine to all adolescents aged 11 through 12 years
Tdap may be administered regardless of the interval since the last tetanus and diphtheria toxoid-containing vaccine.
Administer one dose of Tdap vaccine to pregnant adolescents during each pregnancy (preferably during the early part of gestational weeks 27 through 36), regardless of time since prior Td or Tdap vaccination.

Catch-up Vaccination:

Persons aged 7 years and older who are not fully immunized with DTaP vaccine should receive Tdap vaccine as one dose (preferably the first) in the catch-up series; if additional doses are needed, use Td vaccine. For children 7 through 10 years who receive a dose of Tdap as part of the catch-up series, an adolescent Tdap vaccine dose at age 11 through 12 years may be administered.
Persons aged 11 through 18 years who have not received Tdap vaccine should receive a dose, followed by tetanus and diphtheria toxoids (Td) booster doses every 10 years thereafter.
Inadvertent doses of DTaP vaccine:

If administered inadvertently to a child aged 7 through 10 years, the dose may count as part of the catch-up series. This dose may count as the adolescent Tdap dose, or the child may receive a Tdap booster dose at age 11 through 12 years.
If administered inadvertently to an adolescent aged 11 through 18 years, the dose should be counted as the adolescent Tdap booster.

Texas Administrative Code, Rule 97.63 (III) Tdap:

(-a-) Seventh grade. Students are required to have one booster dose of a tetanus/diphtheria/pertussis-containing vaccine for entry into the seventh grade, if at least five years have passed since the last dose of a tetanus-containing vaccine. If five years have not elapsed since the last dose of a tetanus-containing vaccine at entry into the seventh grade, then this dose will become due as soon as the five-year interval has passed. Td vaccine is an acceptable substitute if Tdap vaccine is medically contraindicated.
(-b-) Grades 8 - 12. Students who have not already received Tdap vaccine are required to receive one booster dose of Tdap when ten years have passed since the last dose of a tetanus-diphtheria-containing vaccine.

Applying the Rules

To enroll in the seventh grade:

Children with at least three doses of the primary diphtheria/tetanus/pertussis series (DTaP and/or DT):

Must have one dose of Tdap prior to enrollment.

If they have received Tdap, Td, DT, or DTaP in the past five years, no vaccine is needed.
If five years pass during seventh grade, the child should receive a Tdap at that time to stay enrolled in school.

Children who do not have at least three doses of diphtheria/tetanus/pertussis vaccine (DTaP and/or DT)

Must receive one dose of Tdap and/or Td.

Three doses of diphtheria/tetanus/pertussis vaccines must be received, at least one of which should be Tdap (unless medically contra-indicated).

Students can be enrolled in school while receiving the additional doses, as long as at least one vaccine has been administered and they receive the doses as soon as it is medically feasible.

To enroll in 8-12th grade:

Children with at least 3 doses of the primary diphtheria/tetanus/pertussis series (DTaP and/or DT):

Must have one dose of Tdap before enrollment.

No vaccine is needed if they have received Tdap, Td, DT, or DTaP in the past ten years.
If ten years pass between 8th and 12th grade, the child should receive one dose of Tdap at that time to stay enrolled in school.

Children that do NOT have at least three doses of diphtheria/tetanus/pertussis vaccine (DTaP and/or DT)

Must receive one dose of Tdap and/or Td.

A total of three doses of diphtheria/tetanus/pertussis vaccines must be received, and at least one of which should be Tdap (unless medically contra-indicated).
Students can be enrolled in school while receiving the additional doses, as long as at least one vaccine has been administered and they are receiving the doses as soon as is medically feasible.