Before children go to school this fall, parents should make sure they have the appropriate immunizations and documentation. For the first time in a decade, the Tennessee Department of Health has issued new immunization requirements.

Two things parents should know:

1. The state requires that children who start pre-school, pre-kindergarten, kindergarten, seventh grade, or a new student starting school in Tennessee for the first time, turn in an immunization certificate to the school or child care provider. This new form was distributed to physicians and health departments in April.  

2. The new requirements call for vaccines that previously were not required to enter school. However, these vaccines were routinely recommended for children by Centers for Disease Control and Prevention (CDC), American Academy of Pediatrics (AAP) and American Academy of Family Physicians (AAFP). The school requirements reflect recommendations many physicians were already following, according to Keith English, MD, chief of Infectious Disease at Le Bonheur Children's Hospital.

Cost should not prevent parents from vaccinating their children. Children and teens younger than 19 years-old who have TennCare or don’t have health insurance can receive free vaccines through the federal Vaccines for Children (VFC) program in participating medical offices and health departments. Parents should ask their providers if they participate in VFC. If a child has insurance that doesn’t pay for vaccines and parents can’t afford them, local health departments can provide the vaccine. Health departments and VFC providers charge a small administration fee to give the free vaccine, which can be adjusted based on your income.

 For more information visit the Tennessee Department of Health’s web site at http://health.state.tn.us/CEDS/required.htm. If you have questions, please contact your child’s physician or the health department.

Le Bonheur Children’s Hospital wants to help parents learn more about back-to-school vaccines. Noel "Kip" Frizzell, MD, medical director of Care Coordination and local pediatrician, answered some frequently asked questions regarding immunizations.

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 Q: At what age do children begin getting school immunizations?

A: The typical "school shots" are usually given anytime from age 4 to age 6.

 Q: Many children begin pre-school at the age of 3. Do their yearly vaccinations from wellness checkups cover the school vaccines, or do they need a separate round of school-specific vaccines

A: Most children who are entering pre-school will be up to date on their shots. They will have received all of the necessary vaccines by age 2 if they are getting the recommended checkups.

Q: What vaccines are included in school immunizations?

A: Most children entering kindergarten need four things: DTaP, IPV, MMR and Varicella vaccine. Beginning in January 2011, all children will need to have two documented doses of Hepatitis A vaccine. Children entering the seventh grade are now required to have a TdaP booster and a second dose of the Varicella vaccine.

Q: When should children receive the meningitis vaccine?

A: The meningitis vaccine is now recommended for children ages 11 and older. Younger children are not required to receive the vaccine because the risk of acquiring meningitis increases among teens and young adults.

 Q: What do colleges or universities require? 

A: College students will need to make sure they had a Tdap booster, a second MMR and a meningitis vaccine. Hepatitis A and B are recommended but usually not required.

Q: To avoid the back-to-school rush, is it appropriate for children  to receive their school vaccinations any time during the summer months?

A: Parents should be making these appointments for check-ups as soon as possible. The visit will include an exam, possible hearing and vision screen, vaccines and completion of all the school forms. For more information contact your pediatrician’s office or visit http://health.state.tn.us/CEDS/required.htm.