Page 23 - Delaware Medical Journal - January/February 2019
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PUBLIC HEALTH
was documented in the U.S. in 2000.6 Measles is still common in countries in
and travelers with the disease continue
to bring measles into the U.S., where it can spread in communities where groups of people are unvaccinated. DPH credits Delaware’s high immunization rates for its low measles threshold, as it reported no measles cases in 2014, one in 2015, and no cases since 2016.7
Chickenpox (varicella) incidence has declined in Delaware since 2006, when 66 cases were reported. Sixteen cases of varicella were reported in 2015 and 12 cases were reported in 2016, though the count increased to 22 in 2017. As of late were probable.8
Immunizations are important
due to these and other circulating vaccine-preventable diseases. DPH’s Immunization Program assesses the vaccination coverage for school-age children by conducting an annual school immunization survey. The survey the annual Cooperative Agreement with the CDC.
BACKGROUND
A Cooperative Agreement with the CDC has funded the School Immunization Survey since 2008, when the objective was incorporated into the Immunization Program Operations Manual (IPOM). The Delaware Immunization Program conducts its survey every year between January 1 and April 30. Results enable the program to assess the vaccination coverage of each vaccine required for children to attend school in Delaware. The survey also helps to identify gaps and trends in immunization exemptions. Once complete, the Immunization Program provides each school’s kindergarten vaccination coverage
and exemption rates to the Delaware Department of Education (DOE).
METHODS
The Immunization Program contacts DOE each year to collect the complete list of schools that have kindergarten students. The program then submits the list of schools to the CDC for a random sample selection. The CDC returns a random sample of schools to the Immunization Program, which in turn forwards the random sample information to DOE.
superintendents of the upcoming survey,
numbers to the Immunization Program. The program then mails letters with instructions to selected schools. Selected schools return immunization coverage- rate data to the Immunization Program, which analyzes and presents data to DOE via the CDC’s online Program Annual Report and Progress Assessment (PAPA) website in conjunction with prior-year and posts Delaware’s school survey
data on the CDC’s “SchoolVaxView” website (www.cdc.gov/vaccines/imz- managers/coverage/schoolvaxview/ index.html). SchoolVaxView is a source for data, information, and news about school vaccination coverage from state reports of the estimated number of children in childcare, kindergarten, and middle school who received vaccinations recommended or required by their state.9
Delaware has two types of vaccine exemptions: medical and religious. Medical exemptions must comply with stipulations of the medical exemption forms issued by DPH. The clinician signing the School Vaccination Medical child’s health or medical condition, one or more of the required vaccines may
adversely affect the child temporarily or permanently. Delaware schools, childcare programs, and other agencies that require proof of immunization accept the signed medical exemption statement verifying true contraindications/precautions. For religious exemptions, parents or guardians Religious Belief10 that immunization is against their religious beliefs. The Chief of the DPH Communicable Diseases Bureau reviews all medical exemptions for accuracy and clarity.
When DPH declares an outbreak of a vaccine-preventable disease, or believes an exempted child has had or is at risk
of having an exposure to a vaccine- preventable disease, by state law, the child must be temporarily excluded from attending childcare and/or school until the risk period ends.
For Delaware’s 2017 survey, there were
13 exemptions (1.2%); 12 were religious and one was medical. That total was unchanged from the 2016 survey. By county, the vaccine exemption counts were: New Castle County (11: one medical, 10 religious); Kent County (none); and Sussex County (two religious).
RESULTS
Delaware’s school-entry immunization
1,053 students. Completion rates that surpassed the Healthy People 2020 (HP2020) target of 90% for each vaccine series were:
• Four or more doses of DTaP vaccine: 97.1%.
• Four doses of polio vaccine: 97.2%. • Three doses of hepatitis B vaccine:
97.8%.
• Two doses of MMR vaccine: 96.4%.
• One dose of varicella vaccine: 96.2%.
The sustained high vaccination rates brought visibility to Delaware. In 2016
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