Be sure to screen patients for a history of varicella and vaccinate those who are still susceptible. Sporadic outbreaks of chickenpox are being reported throughout the state, including in schools and day care centers, according to the Indiana State Department of Health (ISDH).
The Centers for Disease Control and Prevention (CDC), defines an outbreak as five cases of chickenpox in an elementary school or three cases in an intermediate or high school.
“Varicella vaccine should be routinely administered to all children at 12 months of age, with a second dose at four to six years old, or at entry to kindergarten,” advised Joan Duwve, M.D., medical director for the ISDH. “Doses administered prior to 12 months old do not count toward school immunization requirements.”
The CDC recommends in outbreak situations, all students and staff have either a history of the disease or two valid doses of varicella vaccine, regardless of grade. Those who do not have adequate proof of immunity should be excluded from classes and extracurricular activities for 21 days after the date of last known exposure, regardless of objector status.
“Physicians should be reminded that live viral vaccines like varicella, MMR or flumist, if not administered at the same time, should be separated by at least 28 days,” noted Dr. Duwve. “The dose of live viral vaccine given prior to 28 days after a previous live viral vaccine will not be valid and will need to be repeated.”
Don’t forget CHIRP
The ISDH also urges you to enter all vaccine doses for children and adults in the Children’s and Hoosiers Immunization Registry (CHIRP) program. The free Internet-based, statewide program is designed to help you and other health care providers track immunization records of all Hoosiers. Some of the registry’s features include:
- Immediate access to immunization records of a patient previously seen elsewhere
- Ability to track vaccine inventory by lot number
- Accurate forecasting to prevent invalid or unneeded doses of vaccine
- Display features stating why a vaccine marked invalid does not meet ACIP guidelines
- Reminder cards and letters to patients
“CHIRP provides a quick and effective assessment of vaccine history, especially during school outbreaks,” explained Dr. Duwve.
Learn more about CHIRP on in.gov.