"We need to listen to what the community has been saying for decades-that when the roof over their heads is caving in, when there's not enough food on the table and domestic violence is an everyday occurrence, they have been saying to us, 'I need your help in these visible life-threatening situations first. And please don't label me as non-complaint-I am trying to prevent child abuse and neglect by caring for these more immediate needs. you won't have to convince me to immunize my child if you have gained my trust and confidence in you."'
--Maria gomez, Director, Mary's Center for maternal and Child Health,
Children's Action Network, Washington, DC
Head Start Immunization Requirements
By Robin Brocato, MHS, Health
Services Specialist, Head Start Bureau
In July 1994, ACYF-PI-94-13 on the topic of immunizations, was sent to all Head Start grantee and delegate agencies. This Program Instruction presented the Head Start immunization requirements for all children enrolled in Head Start, and was based on the 1994 Advisory Committee on Immunization Practices (ACIP) recommended schedule for childhood immunizations.Since then there have been many changes in the field of immunization. An important change was the issuance in January 1995 of a joint schedule for recommended childhood immunizations by the ACIP, the American Academy of Pediatrics (AAP), and the American Academy of Family Physicians (AAFP). This schedule allows for the second dose of vaccine against measles, mumps, and rubella (MMR) to be given to children at either 4 to 6 years of age or at ages 11 to 12. The schedule also changes the range of time that other doses of vaccines can be given.
Other changes in the ACIP/AAP/ AAFP recommendations (made since Head Start issued the 1994 Program Instruction) include the recommendation that all young children receive the varicella-zoster (chicken pox) vaccine, and children living in communities where outbreaks of hepatitis A have occurred receive the hepatitis A vaccine. Currently the ACIP, the AAP, and the AAFP are considering changes to the type of polio vaccine administered, from an oral polio vaccine (OPV) to an inactivated polio vaccine (IPV).
The Head Start Bureau has been contacted by numerous grantees, Regional Offices, training and technical assistance (TiTA) providers, and State Health Departments about complying with Head Start immunization requirements that differ from State requirements, such as requiring the 5th DPT, the 4th OPV, and the hepatitis B and Hib vaccines for children not immunized as infants.
Over the next few months the Bureau will conduct conference calls with Regional Offices, T/TA providers, and the Centers for Disease Control and Prevention for input on how best to meet the challenges of immunizing all children in Head Start. Also to be discussed will be how to ensure and maintain high program quality and best practices for all Head Start grantee and delegate agencies while allowing for flexibility among States to ensure that grantees can get children immunized and be in compliance with Head Start requirements.
Since the new Head Start Performance Standards will not be effective until the 1997-98 school year, the Bureau expects to send out an interim Program Instruction on immunizations later this year. Until that time, all programs are to follow the requirements presented in ACYF-PI-94-13. Although not mandatory, administration of the most recently recommended vaccines (chicken pox and hepatitis A) is strongly encouraged by the Head Start Bureau.