Some Maryland children might need to roll up their sleeves for a few more vaccinations before school begins next fall.
By Sept. 1, pupils entering prekindergarten to ninth grade will have to show records to prove their immunity to hepatitis B and varicella, more commonly known as chickenpox.
Preschoolers will also need a pneumococcal vaccine that protects against bacterial meningitis, blood infections and common ear infections.
In Maryland, vaccinations are covered by most insurance plans, or children could go to immunization clinics held by local health departments; Baltimore County has scheduled clinics for this month.
"We don't want any kids to wait until the last minute to get their appointment with their doctor," said Greg Reed, program manager for the Center for Immunization at the state Department of Health and Mental Hygiene.
The department began phasing in requirements for chickenpox and hepatitis B vaccinations a decade ago, with the goal of having all children vaccinated by 2013. Last year, the state legislature requested that deadline be moved up to 2009, Reed said.
"Both of these things have been on the books for a while," Reed said. "They're just accelerated."
Although the average child has no major complications from chickenpox, more than 100 children nationwide die annually from secondary infections, Reed said.
There also are financial costs.
"You can imagine the economic impact of parents having to miss two weeks of work to care for that sick child," Reed said.
Hepatitis B vaccination consists of three shots usually given over six months. Children under age 13 would receive one shot for chickenpox, but older students should have two.
If children have had chickenpox, they can provide documentation from their doctors that states the month and year they had the disease instead of being vaccinated, Reed said.
Children without such records could take a blood test to prove their immunity. But guidelines on the state Health Department's Web site note that getting vaccinated might be more "expedient."
All vaccines potentially could cause side effects, and Reed recommended discussing all possible adverse events with the child's physician.
Waivers for these and other vaccinations will be granted only for medical exemptions or "bona fide religious beliefs and practices," under state regulations governing school immunizations.
