Changes In Immunization Requirements Go Into Effect

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NASHVILLE – Parents of children enrolling in child care, pre-school, Kindergarten and 7th grade should make plans now to be sure their children are up to date with their immunizations, if they haven’t already. Pediatric practices and county health department clinics expect to be busy all summer providing the vaccines and certificates necessary to meet the new immunization requirements that went into effect on July 1.

New requirements have been adopted to better protect children from serious diseases, especially those that can spread easily in a school or pre-school setting. In addition to the new 2010 requirements for those attending child care, pre-school and school, changes for new Tennessee college students go into effect in 2011. The state has also introduced a new official Tennessee Certificate of Immunization required for children starting pre-school, Kindergarten and seventh grade this fall. Children already enrolled in other grades do not need a new certificate.

“These new requirements serve to better protect children and teens from diseases like pneumococcal meningitis and pertussis that can cause serious illness or even death. The epidemic of pertussis in California has caused five infant deaths so far this year and serves as a prime example of the importance of vaccine and prevention,” said Health Commissioner Susan R. Cooper, MSN, RN. “Parents should schedule children now for appointments with the health department or pediatricians to ensure they are up to date on immunizations before the beginning of the 2010 – 2011 school year.”

Summer checkups are a great time to vaccinate adolescents who rarely see a health care provider. The Department of Health’s new school immunization rules require all incoming seventh grade students to have a tetanus-diphtheria-pertussis booster (Tdap), and a second dose of the varicella (chickenpox) vaccine or a history of varicella illness.

“Although we excel at infant immunization in Tennessee, we fall well behind the rest of the nation for immunization of preteens and teens,” said Kelly Moore, MD, medical director for the state immunization program. “According to the 2008 National Immunization Survey, two in three teens in Tennessee are missing at least one vaccine recommended for their age. Parents and care-givers can protect their teens from meningitis, cervical cancer and other serious conditions by ensuring each preteen and teen gets the required vaccines and the other important vaccines recommended for them.”

Parents and guardians should submit the new Certificate of Immunization to schools no later than the start of classes in the fall. Because all new Kindergarten students and seventh graders will need the new certificate, public schools are allowing a one-time grace period until October 1 to submit the form, according to the state Department of Education. Check with your school for more information.

All required vaccines are already recommended for all children by the Centers for Disease Control and Prevention and the American Academy of Pediatrics. A complete list of the new immunization requirements and information for parents and health care providers are available on the Tennessee Department of Health website at  HYPERLINK "" \o ""

Examples of changes that will go into effect are as follows:

Children enrolling in child care, pre-school or pre-Kindergarten must now show documentation of hepatitis A, hepatitis B, and pneumococcal vaccine.

All children entering the seventh grade this fall must submit proof of a booster dose of the tetanus, diphtheria, and pertussis (Tdap) vaccine; and confirm either chickenpox immunity through the disease or receipt of two doses of the varicella vaccine.

In July 2011, new full-time enrollees to Tennessee colleges who were born after 1979 will need to provide proof of chickenpox immunity through either the disease or two doses of the varicella vaccine.

Children and teens younger than age 19 who have TennCare as well as those who do not have health insurance can receive free vaccines through the federal Vaccines for Children Program in participating private medical offices and health departments. Ask your child’s health care provider if they participate in VFC. If a child has insurance that does not pay for vaccines or if parents are unable to afford them, local health departments can provide the vaccine. Health departments and VFC providers give the vaccine for a small fee that can be adjusted based on your income.

Local health departments and private health care providers in Tennessee can issue the new certificates. Health care providers can go to for more information.

For general information about vaccines, visit For questions about school policies or health examinations, contact your local school system. For more information on the new requirements, call your county health department or go to the Web at

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