As the school year comes to a close and parents formulate an endless summer to-do list for their children, one item should be at the top: back-to-school vaccinations.
State law requires students entering kindergarten, seventh grade and 12th grade to receive specific vaccinations.
While parents should provide the school with their child's certificate of immunization on the first day, they officially have 30 calendar days after classes start to provide proof of immunization. Failure to do so will restrict the child from attending school until parents provide the certificate or prove their child has begun the immunization process.
Dr. Erica Pettigrew, medical director of the Orange County Health Department, said Orange County is seeing an uptick in vaccine-preventable infections such as pertussis and chickenpox. She said other parts of the state are seeing more measles cases, which Orange County is on high alert for, though the county has only had measles exposures.
"We want to make sure that kids are protected, and the best way to protect them is through vaccination," Pettigrew said.
What vaccines does your child need before they start school?
Rising Kindergarteners
According to the North Carolina Division of Public Health, kindergarteners are required or recommended to have the following vaccinations:
Rising Seventh Graders
In addition to all required vaccinations for rising kindergarteners, it is recommended or required for rising seventh graders to have the following:
Rising 12th Graders
In addition to all previously required vaccinations, it is recommended or required for rising twelfth graders to have the following:
Where can you vaccinate your child in the Triangle over the summer?
Wake County
Wake County Public Health offers intermittent summer vaccine clinics on Tuesdays from 5:30 p.m. to 7:30 p.m. for students entering kindergarten, 7th, and 12th grades.
"At each clinic, public health nurses will be available to administer vaccines, answer parent questions and make sure each child meets school requirements for immunizations," according to a May 12 Wake County press release.
When visiting the clinic, parents or legal guardians should bring their photo ID, child's immunization records, and insurance card. The last patient will be seen at 7:15 p.m.
"Making sure students are up to date on their vaccines is one of the simplest ways we can support a healthy start to the school year," Wake County Commissioner Susan Evans said in the press release.
Orange County
While Orange County Public Health has not scheduled back-to-school vaccine clinics, state officials are continuing to monitor if they are needed.
"Orange County Health Department (OCHD) has been proactively working with our local school districts in the last few weeks to assess children's vaccine needs ahead of this coming fall," Marcy Williams, OCHD's Public Health Education Manager, said in a statement.
Meanwhile, OCHD is open for vaccine appointments during regular business hours and till 6:30 p.m. on Tuesdays at both the Hillsborough and Chapel Hill locations.
"Currently, we do not have any walk-in clinics scheduled, but there are lots of appointments available for vaccines," Williams said. "We are monitoring the situation, and we will consider walk-in clinics if that need is identified."
Call 919-245-2400 to make a vaccination appointment at either clinic.
Durham County
According to a Durham County Public Health spokesperson, the county will not schedule back-to-school clinics until later in the year as the traditional school year begins.
Chief Communications Officer of Durham County Deborah Craig-Ray said the county will publicize upcoming offerings in the future as they have done in past years.
Are there more affordable options for back-to-school vaccinations?
Vaccines for Children (VFC) is funded by the Centers for Disease Control and Prevention, and run by the North Carolina Immunization Program. It provides free vaccines, including back-to-school vaccines, to eligible children whose families cannot afford them.
A child is eligible for VFC if they have N.C. Medicaid or are eligible to get N.C. Medicaid, they do not have private health insurance, their insurance does not cover all recommended vaccines or if they are Native American or Alaskan Native.
Qualified children can get vaccinated by a doctor or clinic enrolled in the program. You can search for the nearest VFC-enrolled program here.
While VFC covers the cost of vaccines, there may be other fees. You can request a "vaccine-only" appointment — available at all VFC-enrolled providers — to prevent an additional office-visit fee.
The provider can also charge a fee to administer the vaccine, but they cannot deny a child their vaccinations because a parent is unable to pay it.
When should your child get vaccinated?
Your child may have to get a vaccine before or after the kindergarten, seventh or twelfth grade deadline because of factors including the required wait in between doses, a child's age, their year of birth, when the vaccine was administered and missed doses.
"Ensuring your child is going to their well child checks, every year after age three and more frequently under age three," Williams said, "is the best way to ensure they don't get behind on vaccinations.
Pettigrew said major public health guidelines and societies such as the American Academy of Pediatrics and the American Academy of Family Physicians both recommend children get all their vaccines for the year at once rather than space them out.
"Big picture, when they get what they're due for at one time, they're much more likely to have that protection than if they're going to come back multiple times for an appointment," she said.
What does North Carolina's back-to-school immunization law mandate?
N.C. Immunization law falls under Chapter 130, Article 6, part 2, sections 152 to 158 of the N.C. General Statutes.
Section 152 states "Every child present in this State shall be immunized against diphtheria, tetanus, whooping cough, poliomyelitis, red measles (rubeola) and rubella," in addition to immunization against any other disease the Commission for Public Health may deem in the "interest of public health."
It is the responsibility of a child's parent or legal guardian to "ensure that the child has received the required immunizations at the age required by the Commission."
Under Section 155, children attending any K-12 school, "whether public, private, religious, or a child care facility," must receive required immunizations, including home schools. Home schools must maintain records of immunizations as required by the Department of Education Division of Non-Public Schools.
The only exception to N.C. K-12 immunization requirements are for children with a medical or religious exemption, under Sections 156 and 157, respectively.
A doctor or physician licensed to practice medicine in NC can request a medical exemption for children who cannot get a vaccine(s) for medical reasons, such as a severe allergy or weakened immune system. The doctor or physician should fill out the NC Medical Exemption Statement Form and parents will send the form, in place of or with the certificate of immunization, to their child's school.
If a family has religious beliefs that conflict with immunization, a parent can send a statement of objection in place of the certificate of immunization.
The state does not have a template for the statement, nor does it need to be notarized, signed by a religious leader or prepared by an attorney. The statement must include the child's name, date of birth and the reason for the objection.
Pettigrew said parents debating whether to vaccinate their kids should speak to a trusted medical professional who will "bring the facts, the evidence, the science, and work with the parents to make the best decision for their kids."
What if you are moving?
If families are moving within N.C., parents do not have to take any additional steps to transfer their child's immunization records.
Williams said N.C. has a statewide database that lists vaccines N.C. residents have received and school nurses typically have access to it.
She said parents new to the state should make an appointment at the primary location they plan to take their children for medical care to and receive any vaccinations their children might be missing.
Local health departments can also provide immunizations for children who are new residents.
Next Steps
Schedule your child's back-to-school vaccination appointment as soon as possible, whether it's with your primary care provider, a VFC-enrolled provider, the county health department, at a local back-to-school vaccine clinic or with a trusted medical professional.
Save the record of immunization your child receives at the appointment for when the first day of school rolls around.
"Health care providers share the same goal as families — a healthy future for all children," Williams said.
You can learn more about K-12 immunizations in NC here.