graders are now required

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1 7 12 to get a whooping cough shot before starting the school year TH - TH graders are now required Call your doctor today ShotsForSchool.org IMM-1035 (11-10)

2 7TH 12TH GRADE IMMUNIZATION CHART What Shots Does My Child Need? As parents, we can t be near our children every minute. Immunizing our children is one thing we can do to protect their health for years to come. REQUIRED vaccine for 7th 12th graders school year Tdap (tetanus, diphtheria, pertussis) What this means for YOUR child Tdap safely protects against 3 dangerous diseases: tetanus, diphtheria, and whooping cough (also called pertussis). Whooping cough has been increasing in the U.S. It continues to be widespread in California. For the school year only, children entering 7th 12th grade will need proof of a Tdap shot before starting school. For and beyond, only students entering 7th grade will need proof of a Tdap shot. RECOMMENDED vaccines for 7th 12th graders Meningococcal Chickenpox (Varicella) Human Papillomavirus (HPV) Seasonal Flu What this means for YOUR child Meningococcal meningitis is easily spread by kissing, sharing drinks, coughing, or sneezing. This disease could cause your otherwise healthy child to lose an arm or leg, become paralyzed, or die. The shot can protect them from several types of this deadly infection. Chickenpox is usually worse for adolescents and adults than for kids. A total of two doses of chickenpox vaccine are needed if your child has never had chickenpox disease. This 3-shot vaccine series is recommended for girls to help protect them from cancer of the cervix (a part of their reproductive system) later in life. Boys ages 9 to 26 years may also receive the vaccine. The flu is a serious illness. Even young and healthy children need protection against the flu! This year s flu vaccine protects against 3 flu viruses, including the H1N1 flu virus. Children should visit their doctor or health care provider to get their shots. Children 18 years old and younger who are uninsured or underinsured may qualify for the Vaccines for Children Program to get free or low cost immunization services. To find a provider near you, call or visit: Some local pharmacies and Health Departments may also offer vaccines.

3 Updated: 1/27/11 AB 354: The New 7 th 12 th Grade California Immunization Law California Department of Public Health, Immunization Branch What PARENTS Need To Know Frequently Asked Questions What is the new Tdap requirement for 7 th 12 th graders? Starting July 2011, a new law (AB 354) changing California immunization requirements for all students entering 7 th -12 th grades goes into effect. The law requires: This coming school year ( ), all students entering into 7 th, 8 th, 9 th, 10 th, 11 th or 12 th grades will need proof of an adolescent whooping cough booster shot (called Tdap ) before starting school. For the next school year ( ) and future school years, all students entering into 7 th grade only will need proof of a Tdap shot to start school. Do ALL 7 th 12 th grade students need to get the Tdap shot? Yes. For this coming school year ( school year), all students going into 7 th 12 th grades must have proof of having had the Tdap booster shot before starting school. This includes current students, new students and transfer students in both public and private schools. Beginning the year after ( school year), the law will only affect 7 th graders. Limited exemptions are allowed. What is Tdap? Tdap is a booster vaccine for older children, adolescents, and adults. It safely protects against 3 dangerous diseases: tetanus, diphtheria, and whooping cough (also called pertussis). Why was the Tdap requirement added? This new requirement will help protect your child and others in your school and community from whooping cough. Whooping cough is a serious disease that causes coughing fits that can last for months. It can be deadly for infants. In recent years, whooping cough has been increasing in the United States. In 2010, whooping cough was widespread in California. What are the diseases tetanus, diphtheria and whooping cough (pertussis)? Tetanus (also called lockjaw) causes painful tightening of the muscles. It can lead to locking of the jaw so the person cannot open his/her mouth or swallow. Diphtheria is a throat infection that can lead to breathing problems, paralysis, heart failure and death. Whooping cough (also called pertussis) is a contagious disease that causes violent coughing fits that make it hard to breathe. It spreads easily when someone with the disease coughs or sneezes. Symptoms can last for months. Whooping cough is very dangerous for young babies. When should my child get vaccinated? Now. A large number of students need a Tdap shot before the start of school next year. Avoid the rush and make sure your child can start school on time. Make an appointment for your incoming 7 th 12 th grader to get a Tdap booster shot now. Children as young as 10 years old are recommended to get vaccinated with Tdap. This will protect them against the ongoing threat of whooping cough and will meet the Tdap school requirement for when they are in 7 th grade. Keep documentation of your child s Tdap booster shot in a safe place. Your child will need proof of immunization in order to start school.

4 What if my child has had whooping cough recently or in the past? Your child will still need a Tdap booster shot. Immunity developed after having whooping cough disease wears off, leaving your child at risk for getting whooping cough again. A Tdap booster shot is needed to both protect your child in the future and to meet the school requirement. Why should my child get vaccinated? In addition to it being a new requirement for starting school, children who get a Tdap booster shot will be better protected during their school years. Immunization also helps to protect others within the home, in the community, and at school. Immunizations help to prevent school closures. Many schools in California have suffered from outbreaks of whooping cough. Students got very sick and parents missed work and lost wages to care for their sick children. In some cases, schools had to close because there were not enough healthy teachers to keep schools open. Where can my child get vaccinated? Children should visit their regular doctor or health care provider to get their Tdap shot. Children 18 years old and younger who are uninsured or underinsured may qualify for the Vaccines for Children Program. To find a provider near you, call or visit: Some local pharmacies and Health Departments may also offer the Tdap vaccine. What if my child does not have proof of a Tdap shot before school starts? He/She may not start school. Any student who does not have proof of getting a Tdap booster shot will not be allowed to start school until proof of immunization is given to the school. Are immunization exemptions allowed under California law? The same exemptions for children entering kindergarten apply. For more information, visit the Immunization Law page at What if my child has received a Tdap booster shot before 10 years of age? Your child will be considered to have met the new school requirement with proof of getting a dose of Tdap on or after their 7th birthday. However, we recommend that children receive Tdap on or after their 10th birthday to provide better protection throughout their adolescent years. What other immunizations should I consider for my child? Preteens and teens are also recommended to receive vaccines against meningococcal disease (brain or blood infection), flu (influenza), HPV (human papillomavirus, a cause of cervical cancer), and any vaccine they may have missed during childhood. The recommended vaccine schedule may be found at Talk with your healthcare provider for more information. Should parents and others at home get the Tdap vaccine? All persons 10 years and older are recommended to be vaccinated with Tdap now if they haven t done so to protect them against the ongoing threat of pertussis. Immunization also helps to protect close contacts, including young infants for whom pertussis is most severe and sometimes fatal. Where can I go for more information? For more information, visit the California Department of Public Health, Immunization Branch website at

5 1 of 1 4/14/2011 7:29 PM Print Whooping Cough Vaccination Clinics View this page in: Español Tiếng Việt You should ask your regular healthcare provider for the whooping cough shot. Pregnant women or women who have recently given birth should get the shot from their OB/GYN provider. To obtain a whooping cough vaccination for your child, please see your regular health care provider. If your child does not have health insurance or a regular medical provider, please click here for a list of community providers that offer pediatric primary care services, including vaccinations. To check if your child is eligible for free or low-cost children s health insurance, please call: Children s Health Initiative: Child Health & Disability Prevention Program: Medi-Cal Eligibility: SCVHHS Valley Connection: New! Tdap clinic for 7th 12th graders who do not have medical insurance The Public Health Department will offer low-cost Tdap shots for children entering 7th through 12th grades that are being impacted by the new Tdap vaccination law (AB 354) and do not have a medical provider, health insurance or are underinsured. Santa Clara County Public Health Immunization Clinic Tdap Clinic for 7th 12th graders Public Health Immunization Clinic 976 Lenzen Avenue, Suite 1500 San Jose, CA View Map Thursday Afternoons: 1:00pm-4:30pm (Tdap clinic for students entering 7th-12th grade only) Cost: $15 each shot for uninsured/underinsured (based on Vaccine for Children financial screening) Bring child's yellow immunization card in order to receive shot. If you have questions, please call the Public Health Information Line at (408)

6 Where Can My Child Get Vaccinated in Santa Clara County? The following providers offer pediatric primary care services including vaccinations. Please call for hours and cost if any. PEDIATRIC IMMUNIZATIONS School Health Centers Franklin McKinley School Center 645 Wool Creek Dr., San Jose, CA Gilroy Neighborhood Health Clinic 7861 Murray Avenue, Gilroy CA Overfelt Neighborhood Health Clinic 1835 Cunningham Avenue, San Jose, CA San Jose High Neighborhood Health Clinic 1149 E. Julian St., Bldg. H San Jose, CA Washington Neighborhood Health Clinic 100 Oak St., San Jose, CA Planned Parenthood Mar Monte Planned Parenthood, Blossom Hill 5440 Thornwood Dr., #G, San Jose, CA Planned Parenthood, Mountain View 225 San Antonio Rd., Mtn. View, CA Planned Parenthood, San Jose 1691 The Alameda, San Jose, CA Planned Parenthood, Sunnyvale 604 E. Evelyn Ave., Sunnyvale, CA Mar Monte Community Clinic 2470 Alvin Ave., Ste. 80, San Jose, CA Community Clinics/Health Centers Asian Americans for Community Involvement 2400 Moorpark Ave., Ste. 319, San Jose, CA Indian Health Center 1333 Meridian Ave., San Jose, CA San Jose Foothill Family Community Clinic 2880 Story Rd., San Jose, CA To see if your child is eligible for free or low cost children s health insurance, please call: Children s Health Initiative Child Health & Disability Prevention Program Gardner Family Health Network Alviso Health Center 1621 Gold St., Alviso, CA CompreCare Health Center 3030 Alum Rock Ave., San Jose, CA Gardner Health Center 195 E. Virginia St., San Jose, CA Gardner South County Health Center 7526 Monterey St., Gilroy, CA St. James Health Center 55 E. Julian St., San Jose, CA Mayview Community Health Centers 270 Grant Ave., Palo Alto, CA Moffett Blvd., #101, Mtn. View, CA Morse Ave., Sunnyvale, CA Medi-Cal Eligibility Santa Clara Valley Health & Hospital System Valley Connection Santa Clara County Public Health Department Immunization Program Revised 9/21/10

7 Dónde puede mi niño recibir sus vacunas en el Condado de Santa Clara? Los proveedores siguientes ofrecen servicios de cuidado pediátrico primario incluyendo vacunaciones. Por favor llame para averiguar horarios y costos, si los hay. VACUNACIONES PEDIÁTRICAS Centros de salud en escuelas Franklin McKinley School Center 645 Wool Creek Dr., San Jose, CA Gilroy Neighborhood Health Clinic 7861 Murray Avenue, Gilroy CA Overfelt Neighborhood Health Clinic 1835 Cunningham Avenue, San Jose, CA San Jose High Neighborhood Health Clinic 1149 E. Julian St., Bldg. H San Jose, CA Washington Neighborhood Health Clinic 100 Oak St., San Jose, CA Planned Parenthood Mar Monte Planned Parenthood, Blossom Hill 5440 Thornwood Dr., #G, San Jose, CA Planned Parenthood, Mountain View 225 San Antonio Rd., Mtn. View, CA Planned Parenthood, San Jose 1691 The Alameda, San Jose, CA Planned Parenthood, Sunnyvale 604 E. Evelyn Ave., Sunnyvale, CA Mar Monte Community Clinic 2470 Alvin Ave., Ste. 80, San Jose, CA Clínicas comunitarias / Centros de salud Asian Americans for Community Involvement 2400 Moorpark Ave., Ste. 319, San Jose, CA Indian Health Center 1333 Meridian Ave., San Jose, CA San Jose Foothill Family Community Clinic 2880 Story Rd., San Jose, CA Para averiguar si su niño es elegible para seguro de salud infantil gratis o de bajo costo llame a: Children s Health Initiative Child Health & Disability Prevention Program Gardner Family Health Network Alviso Health Center 1621 Gold St., Alviso, CA CompreCare Health Center 3030 Alum Rock Ave., San Jose, CA Gardner Health Center 195 E. Virginia St., San Jose, CA Gardner South County Health Center 7526 Monterey St., Gilroy, CA St. James Health Center 55 E. Julian St., San Jose, CA Mayview Community Health Centers 270 Grant Ave., Palo Alto, CA Moffett Blvd., #101, Mtn. View, CA Morse Ave., Sunnyvale, CA Medi-Cal Eligibility Santa Clara Valley Health & Hospital System Valley Connection Programa de Vacunaciones del Departamento de Salud Pública del Condado de Santa Clara MS-0749 Translated by DCM SCVMC Language Services 9/23/10

8 Con Cuûa Toâi Coù Theå Chích Ngöøa Taïi Ñaâu Trong Haït Santa Clara Những trung tâm y tế sau đây cung cấp dịch vụ nhi khoa tổng quát và chích ngừa. Xin gọi để biết giờ làm việc và giá tiền, nếu có. CHỦ NG NGỪ A TRẺ EM Trung Tâm Y Tế Học Đường Franklin McKinley School Center 645 Wool Creek Dr., San Jose, CA Gilroy Neighborhood Health Clinic 7861 Murray Avenue, Gilroy CA Overfelt Neighborhood Health Clinic 1835 Cunningham Avenue, San Jose, CA San Jose High Neighborhood Health Clinic 1149 E. Julian St., Bldg. H San Jose, CA Washington Neighborhood Health Clinic 100 Oak St., San Jose, CA Planned Parenthood Mar Monte Planned Parenthood, Blossom Hill 5440 Thornwood Dr., #G, San Jose, CA Planned Parenthood, Mountain View 225 San Antonio Rd., Mtn. View, CA Planned Parenthood, San Jose 1691 The Alameda, San Jose, CA Planned Parenthood, Sunnyvale 604 E. Evelyn Ave., Sunnyvale, CA Mar Monte Community Clinic 2470 Alvin Ave., Ste. 80, San Jose, CA Trung Tâm Y Tế/Y Viện Cộng Đồng Asian Americans for Community Involvement 2400 Moorpark Ave., Ste. 319, San Jose, CA Indian Health Center 1333 Meridian Ave., San Jose, CA San Jose Foothill Family Community Clinic 2880 Story Rd., San Jose, CA Gardner Family Health Network Alviso Health Center 1621 Gold St., Alviso, CA CompreCare Health Center 3030 Alum Rock Ave., San Jose, CA Gardner Health Center 195 E. Virginia St., San Jose, CA Gardner South County Health Center 7526 Monterey St., Gilroy, CA St. James Health Center 55 E. Julian St., San Jose, CA Mayview Community Health Centers 270 Grant Ave., Palo Alto, CA Moffett Blvd., #101, Mtn. View, CA Morse Ave., Sunnyvale, CA Muốn biết con của quý vị có đủ điều kiện xin bảo hiểm sức khỏe trẻ em miễn phí hoặc giá thấp, xin gọi: Children s Health Initiative Child Health & Disability Prevention Program Medi-Cal Eligibility Santa Clara Valley Health & Hospital System Valley Connection Chương Trình Chủng Ngừa Sở Y Tế Công Cộng Hạt Santa Clara MV-0749

9 INSTRUCTIONS FOR SCHOOL STAFF Personal Beliefs Exemption Form Pertussis (Whooping Cough) Booster Immunization [Tdap] Requirement CDPH 8261 The pertussis booster immunization (Tdap) requirement applies to: In the school year, all students entering or advancing into 7th, 8th, 9th, 10th, 11th or 12th grades. In and future school years, all students entering or advancing into 7th grade. If a child is to be exempted for reasons of personal beliefs, the parent or guardian must sign and date an affidavit. Names of all children who are exempt should be maintained on an exempt roster for immediate identification in case of disease outbreak in the community. This form is not to be sent home. The parent or guardian who wishes to exercise the exemption: 1. Provides the information at the top of the form: the student s name, birthdate, parent/guardian name, telephone number, street address, city, and zip code. 2. Signs and dates the affidavit section of the form in the shaded box while in the presence of the school staff member. A Spanish version is also provided. The school staff member: 1. Fills out the Blue Card sticker (PM 286 S), checking the box that indicates use of the personal beliefs exemption status. 2. Affixes the sticker to the student s Blue Card (PM 286), if not already affixed. 3. Files the completed Personal Beliefs Exemption Form (CDPH 8261) and the Blue Card with affixed sticker in the student s permanent record. CDPH 8261 Instructions (2/11)