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A child headed back to school takes an immunization shot to the arm by a Hillsborough County Health Department volunteer as part of the federally-funded Vaccine For Children Program.

As Florida students head back to school with new clothes, fresh notebooks and sharpened pencils, many will also clutch sore muscles where they took recent immunization shots if they’re attending a Florida school for the first time.

Volunteer doctors across the state are helping to immunize kids throughout August before the first day of school. In Hillsborough County, the health department may need a few more volunteers at any of its seven sites where vaccines are offered for free, said Margaret Ewin, immunization program manager for the Hillsborough County Health Department.

“We have very good support from community partners,” Ewin said. “We encourage any pediatric providers to volunteer their time.”

The Orange County Health Department in Orlando relies almost exclusively on its own staff to give vaccines to children, said spokeswoman Mirna Chamorro. The county’s three clinics that offer vaccines will stay open for longer hours through August to handle the increased demand as kids head back to school.

Phyllis Yambor, RN, deals with contraindications of vaccines at the state level as Florida’s executive community health nursing director. As for the notion that a vaccine can cause a particular illness that it’s immunizing against: a complete myth, she said.

“They might cause a little soreness,” Yambor said. “But that’s about it. Chickenpox might create a rash on a certain number of kids as they are developing immunity.” Sometimes people might get the flu, but it’s likely coincidental that it occurred around the time of the shot, she said. About 80 percent of vaccines, however, are not live strains of the virus.

County health clinics offer free vaccines to children under age two under the federal Vaccine for Children program, which is 98 percent federally funded. In Florida, the program costs around $160 million, said Charles Alexander, Florida Department of Health bureau of immunizations chief.

“We’ve been fortunate enough to receive pretty good funding, but the problem is in the private office where parents have insurance,” Alexander said. “Those costs are very big in the private sector. Cost is always a concern, almost a barrier in some cases.”

In Hillsborough County there are 3,000 infants who are uninsured or underinsured who are eligible for free vaccines. Of those in their database, 100 percent are fully up-to-date, no exceptions, Ewin said.

Throughout the state, 83.2 percent of all children — including those with private insurance not included in the county’s records — under age two were fully immunized in 2007, the latest that figures are available. In 2006, the state had a 79.2 percent implementation rate. Though the rate is below the national goal of 90 percent, Florida ranks 12th in the country for its success rate, Alexander said.

The state has a handle on this figure through a statewide database into which every child born in Florida is entered. Doctors are then directed to update a child’s immunization records through the Internet at www.Flshots.org. The Web site also allows parents to check on their child’s records by consolidating information from multiple providers.

Getting more children vaccinated comes down to notifying parents and doctors that their kids must return to the doctor’s office for immunizations at regular times up to a child’s second birthday. The health department does much of its outreach through county medical societies, Alexander said.

One of the current obstacles that health officials face is reminding doctors to get a fourth immunization dose in the first series of shots.

“We have a new slogan,” Alexander said. “Four for Sure. We’re trying to remind all the private clinics.”

Children should receive the following shots by two years of age:
• one vaccination against measles/mumps/rubella (MMR)
• three vaccinations against polio (IPV)
• four vaccinations against diphtheria, tetanus, and pertussis (DTaP)
• one vaccination against varicella (chickenpox or VZV)
• three or four vaccinations against haemophilus influenzae type B (HIB)
• three vaccinations against hepatitis B (HBV)
• four vaccinations against pneumococcal disease (Prevnar)
• one or two doses of influenza vaccine



August 2008

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