Back to School: Kindergarten, sixth grade are prime time for vaccinations

By Josette Keelor

As families prepare children for the new school year, school districts remind of vaccines required through the Lord Fairfax Health District.

Virginia state regulations require children be immunized before beginning school in the fall or returning to school after previous vaccines lose their effectiveness, said Michael Hirsch, director of special services for Warren County Public Schools.

“All the school divisions are required to have the same immunizations,” he said.

Required vaccines are diphtheria, tetanus and pertussis (Tdap or DTP); haemophilus influenzae type B (Hib); measles, mumps and rubella (MMR); and polio. This year children born after Jan. 1, 1997 need to get an update on the varicalla or chickenpox vaccine and children born after Jan. 1 1994 should have a third dose of hepatitis B vaccine before starting school this fall.

Since 2006, state law has also required the human papillomavirus (HPV) vaccine for females, but according to Pam Unhoch, coordinator of health services for Frederick County Public Schools, parents can elect against the vaccine without documentation.

Also approved for boys, it’s the only vaccine in Virginia she said is required by law that contains an “opt-out.”

The American Academy of Pediatric Medicine also recommends vaccinations against meningitis, hepatitis A and influenza, Unhoch said.

Exemptions exist for religious and health reasons, but she said exemptions occur infrequently.

“Virginia’s a very conservative state,” she said. “We don’t have many religious exemptions.”

According to Unhoch, a “healthy majority” of vaccinated children can help buffer the community from those not vaccinated. But that’s no reason not to vaccine.

Vaccines help prevent the spread of diseases communities haven’t seen in several decades, and Unhoch pointed out recent cases of whooping cough and measles occurring throughout the U.S. can lead to epidemics.

“It hasn’t been proven that vaccines cause illness,” she said. “It’s important that all our kids are immunized and up to date.”

Lord Fairfax Health District Director Dr. Charles Devine III has noticed a decline in those seeking exemptions locally, citing “more education and just better knowledge that’s out there.”

After a research paper published in 1998 claimed a correlation between autism and the MMR vaccine, “There was a great deal of fear and concern,” Devine said. The paper by medical doctor Andrew Wakefield, published in the United Kingdom medical journal Lancet, has been disproved and in 2010 fully retracted.

Last year, compliance of recommended vaccinations for students entering public kindergartens in the Lord Fairfax Health District was 96.5 percent, above the state rate of 93.3 percent, Devine explained. The number of local medical exemptions last year was 7 and religious exemptions 18.

Required vaccines are available to children free or with insurance through the Lord Fairfax Health District, which covers Clarke, Frederick, Page, Shenandoah and Warren counties and the city of Winchester. Vaccinations are also available at many pharmacy locations.

Vaccinations should be done when children begin kindergarten and sixth grade. Children should have a basic series of immunizations during infancy and throughout early childhood, with a booster Tdap shot before starting middle school.

Since 2006, all rising sixth graders have needed a Tdap booster, a tetanus-containing vaccine that protects in part against a disease also called lockjaw and causes the painful tightening of muscles through the body, including the mouth, making it difficult to swallow. Tdap also prevents against pertussis, or whooping cough, and diphtheria, which can lead to breathing problems, paralysis, heart failure and death.

“When [children are] getting ready to enter school, 99 percent already have them done,” Hirsch said. A spring clinic of Tdap booster shots through the health department also helps prevent a “mad rush” of vaccines during the summer.

For information about vaccines, call district offices of the Lord Fairfax Health District at 540-722-3470 (Winchester/Frederick), 955-1033 (Berryville), 635-3159 (Front Royal), 743-6528 (Luray) or 459-3733 (Woodstock.)

Contact staff writer Josette Keelor at 540-465-5137, ext. 176, or

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