Through the promotion of physical, mental, and social growth, school nurses work to maximize the achievement and well-being of students. As the primary health care provider within the educational environment, the school nurse shares in the responsibility of directing growth towards the achievement of each student's maximum potential, both as a student and as a member of the community.

If you have questions please contact Sandra Jaimez Gutierrez, Health Services Administrative Assistant (650) 833-4240 or health@pausd.org 

Rosemarie Dowell, RN - Lead District Nurse

Lorebelle Orlowski, RN - District Nurse

Tanya Simpson, RN - District Nurse

 

 

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Immunization Requirements for K-12 Enrollment starting 2019-20 School Year

K-12 Admission

Polio - 4 doses (3 doses OK if at least one is given on or after the 4th birthday)

DTaP - 5 doses (4 doses OK if at least one is given on or after the 4th birthday, 3 doses OK if at least one dose of Tdap, DTaP, or DTP is given on or after the 7th birthday)

Hepatitis B - 3 doses

Measles, Mumps, Rubella (MMR) - 2 doses given on or after the 1st birthday (two doses of measles, two doses of mumps, and one dose of rubella meet the requirement, either separately or combined)

Varicella - 2 doses

Tdap (Grades 7th-12th) - 1 dose given on or after the 7th birthday

7th Grade Advancement

Tdap - 1 dose given on or after the 7th birthday

Varicella - 2 doses

Personal Belief Waivers (SB 277 Effective since 2016)

Senate Bill (SB) 277: 

  • Will no longer permit immunization exemptions based on personal beliefs for children in child care, public and private schools;
  • Will permit personal belief exemptions filed at a school or child care facility in California before January 1, 2016 to remain valid until a pupil reaches TK/kindergarten or 7th grade;
  • Will not require immunization documentation for:
    • Students in home-based private schools
    • Students enrolled in an independent study program who do not receive classroom-based instruction
    • Access to special education and related services specified in an individualized education program

Medical Exemptions

A medical exemption has to be signed exclusively by a California licensed physician (M.D. or D.O.) and must include the student's name, student's date of birth, and physician signature or clinic stamp.

Temporary Medical Exemption

A parent or guardian must submit a written statement from a licensed physician (M.D. or D.O.) which states:

  • The specific nature of the physical condition or medical circumstance for which the licensed physician does not recommend immunization;
  • They probable duration of the physical condition or medical circumstance;
  • Each specific required immunization from which the pupil is exempt; and
  • The date that the medical exemption expires for each respective immunization.

A temporary medical exemption shall not exceed twelve calendar months from the date of the licensed physician's written statement. Once this expiration date has occurred, the child may continue in attendance only after the school or child-care center receives documentation of the immunizations now due.

Permanent Medical Exemption

A parent or guardian must submit a written statement from a licensed physician (M.D. or D.O.) which states:

  • The specific nature of the physical condition or medical circumstance for which the licensed physician does not recommend immunization;
  • That the physical condition or medical circumstance is permanent; and
  • Each specific required immunization from which the pupil is exempt.

http://www.shotsforschool.org/

For information on where to get immunizations for your child in Santa Clara County, click here.

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Immunization Requirements for School FAQs

1. What’s DIFFERENT about the new immunization dose requirements for school (TK/K-12)?

Starting in the 2019-2020 school year, school immunization requirements will include:

2 (rather than 1) doses of chickenpox vaccine at

  • TK/Kindergarten entry
  • 7th grade advancement
  • TK/K-12 admission or transfer
  • 2 MMR doses and 3 Hepatitis B vaccine doses at admission or transfer for most K-12 students.

As these requirements reflect longstanding national recommendations, many children have already met these requirements.

TK/K Admission —
new-reg-chart2
New requirements also met by 2 doses measles, 2 doses mumps, and 1 dose rubella vaccine.
** Prior requirements also met by 2 doses measles, 1 dose mumps, and 1 dose rubella vaccine.

1st -12th Grade Admission – 
new-reg-chart3
New requirements also met by 2 doses measles, 2 doses mumps, and 1 dose rubella vaccine.
** Prior requirements also met by:
Age 7-17 years: 1 dose measles, 0 doses mumps, and 1 dose rubella vaccine.
7th grade: 2 doses measles, 0 doses mumps, and 0 doses rubella vaccine.

7th Grade Advancement 
7th grade advancement
Complete details in 17 CCR section 6025, Table B.

 

2. What’s DIFFERENT about the new immunization requirements for pre-kindergarten (child care or preschool)?

Starting July 1, 2019, immunization requirements include:

  • Chickenpox vaccine is required at age 15 months and older (rather than age 18 months and older).
  • Other required vaccine dose requirements remain the same.
  • As children age into requirements, parents have 30 days to submit updated records showing the child has met the requirements. For example, when an already admitted child who is up-to-date on shots turns 18 months old, the parents have 30 days from the day the child turns 18 months old to submit records that the child has received the 4th dose of DTaP and 3rd dose of Hep B.

 

3. Do students admitted in previous school years have to meet the new requirements in the 2019-2020 school year?

If a child is considered an admission at any school at any date on or after July 1, 2019 (including transfer students), the child will need to meet the newer immunization requirements in effect at the time of admission.

If a child is advancing to 7th grade in the fall of 2019 or later, the child must meet the 7th grade requirements in effect at the time of entry into 7th grade (i.e., 1 dose of Tdap, 2 doses of chickenpox vaccine).

If a child has an expiring personal beliefs exemption prior to attending school on or after July 1, 2019, the child will need to meet all current immunization requirements.

 

4. For admissions on or after July 1, 2019, what is required for a medical exemption to a required immunization?

Starting July 1, 2019, a parent or guardian must submit a signed, written statement from a physician (MD or DO) licensed in California which states:

  • The specific nature of the physical condition or medical circumstance of the child for which a licensed physician does not recommend immunization.
  • Each specific required vaccine that is being exempted.
  • Whether the medical exemption is permanent or temporary.
  • If the exemption is temporary, an expiration date no more than 12 calendar months from the date of signing.

 

5. Does a medical exemption filed for a child attending before July 1, 2019, need to meet the new requirements?

In some cases. A medical exemption filed previously remains valid until the earliest of:

  • When the child is next considered to be an admission at a school or pre-kindergarten facility (applies to both temporary and permanent medical exemptions), at which time staff will need to confirm if the previously filed medical exemption meets the newer requirements, or
  • The expiration date specified in the medical exemption (applies to temporary medical exemptions)or
  • Advancement to 7th grade, for a medical exemption from varicella vaccine or Tdap.

 

6. May other practitioners, besides licensed physicians (MDs and DOs), provide a medical exemption to a required immunization?

No. Only a licensed Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO) may provide a medical exemption.

 

7. To meet the chickenpox requirement for TK/K-12 admission or for advancement into 7th grade, may a school accept an immunization record that indicates a "history of chickenpox disease"?

No, this is not sufficient documentation to meet school requirements.  Medical exemption documentation may be used for a child who had chickenpox disease that was documented by a physician. 

 

8. What are the requirements for students entering a home-based private school or independent study program and do not receive classroom-based instruction?

Students entering:

  • A home-based private school or
  • An independent study program and do not receive classroom-based instruction

are not subject to immunization requirements. Parents or guardians must provide records to the respective schools of any required immunizations received by these students.

 

9. Are students who are homeless or in foster care subject to the immunization requirements?

Yes. However, a student who is homeless or in foster care, when transferring into a new school, may be admitted immediately if the student arrives without immunization records. Schools should utilize their resources to make sure these students have received all required immunizations as soon as possible.

 

10Are California schools and child care facilities required to report the immunization status of all pupils at selected ages and grades?

Yes. All California schools and child care facilities, whether public or private, are required to report to the California Department of Public Health and the local health department each year the immunization status of all pupils, without exceptions, admitted at specified ages or grade levels. (Citation: California Health and Safety Code Section 120375 and 17 CCR § 6075)

 

11May schools and child care facilities share student immunization information with public health agencies? 

Reporting of student immunization information to public health agencies is allowed by state and federal laws, including but not limited to

California laws:

  • Chapters 1 (commencing with section 120325) and 2.5 (commencing with section 120440) of Part 2, of Division 105 of the Health and Safety Code

Federal laws:

  • The Health Insurance Portability and Accountability Act of 1996 (HIPAA) (45 CFR Part 160 and Subparts A and E of Part 164), and
  • The Family Educational Rights and Privacy Act (FERPA) (20 U.S.C. § 1232g; 34 CFR Part 99), which applies to educational agencies or institutions that receive funds from programs administered by the U.S. Department of Education.

 

12. Where may I find immunization coverage data for children in schools and child care facilities?

Data are posted at the following sites:

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7th Grade Immunization Requirements

As a 7th grader, to make sure your student is healthy at school, PAUSD will need to have the following documents in your student’s record:

  • One dose of Tdap (Diphtheria, Tetanus, and Pertussis) given on or after the 7th birthday.
  • Two doses of Varicella.

 

Students who had a valid personal beliefs exemption filed before 2016 between Kindergarten and 6th grade need to meet the requirements listed for TK/K-12 as well as requirements for 7th grade. These students will need documentation for the following immunizations:

  • Diphtheria, Tetanus, and Pertussis containing vaccine (DTaP, DTP, DT, Tdap, or Td) - 3 doses
    • One dose of Tdap vaccine given on or after the 7th birthday will meet the 7th grade requirement and count as one of the 3 doses required for students TK/K-12. 
  • Polio (OPV or IPV) - 4 doses (3 doses ok if one given on or after the 2nd birthday)
  • MMR - 2 doses (or 2 doses of measles-containg vaccine and 1 dose of of rubella vaccine)
  • Varicella - 2 doses

For information on where to get immunizations for your child in Santa Clara County, click here.

Vaccination records or a letter from your child's physician can be delivered to Health Services

  • Mail: Attn: Health Services, 25 Churchill Ave., Palo Alto, 94306
  • E-mail: health@pausd.org
  • Fax: (650)833-4226
  • Drop-Off: District Office Portable A - 25 Churchill Ave., Palo Alto, 94306
    • Hours: 8 am - 4:45 pm. Note: During summer, the District Office is closed on Fridays.
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Medication Administration - at School or on Field Trips

Any student who is required to take prescribed medication during the school day may be assisted by a school nurse or designated school personnel if the school receives a completed “Medication Authorization Form” signed by a California licensed health care provider and the student’s parent or guardian (EC 49423).

Upon written parent’s consent and school nurse approval, a student may be allowed to carry and self-administer prescription auto-injectable epinephrine, prescription inhaled asthma medication, or medications and supplies prescribed for the management of diabetes. No other medications, except for emergency use, may be carried.* Students may be allowed to carry and self-administer these prescribed medications if the school receives a completed “Medication Authorization Form” and the “Student/Parent Consent to Carry and Self-Administer Medication” form and after approval by the school nurse.

*For approval to carry and self-administer other medications that are of a confidential nature, need urgent administration, or other reasons, please contact a district nurse. Exceptions to the above rule will be made on a case by case basis in consultation with the district nurse and student's physician.  A district nurse can be contacted at health@pausd.org or (650)833-4240.

Medication forms can be obtained from the school health office or printed from the links below.

No medication, including herbal remedies or other over-the-counter drugs, will be stored or dispensed at school without written authorization from the physician and parent. All medication permits must be renewed at the beginning of the school year before school employees may assist with medication administration. Medication must be supplied by the parent in the original prescription clearly labeled with student’s name, medication, dosage and directions, or original over-the-counter container. Updated forms for the next school year must be signed after the current school year ends.

Your child's school will keep an accurate written record documenting that the medication was administered in the prescribed amount at the prescribed time.

Medication Authorization Forms

 

If your student has Type 1 Diabetes, Type 2 Diabetes, or a specialized health care procedure (i.e. Catheterization, Gastrostomy Tubes, etc.), please contact Health Services directly at health@pausd.org or 650-833-4240 for information on necessary forms and protocols. 

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Health Protocols & Forms

If your child has a chronic health condition, asthma, seizures, or severe allergies (anaphylactic reaction), the health office at each school can help keep your child safe and healthy by completing the appropriate forms and returning the forms to your school office before school starts. This will help us prepare to care for your child. Please make sure that you ALWAYS keep your emergency card up to date.

If your child has diabetes please contact the Health Services Office at (650) 833-4240 to setup your child's Diabetes protocol.

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Health Screenings

The District Nurses and other qualified professionals conduct screenings at school sites.

All students are screened at the grade levels listed below:

Vision and Hearing: Grades TK, K, 2nd, 5th, and 8th.

Color Vision: Grade 1

Students may also be screened if the parent, teacher or school nurse suspect a vision or hearing problem and for special education assessments and as needed for district health initiatives. Those who fail the initial screening will be re-tested by the school nurse. Parents will be notified and referred for further follow-up only when a problem is identified (EC 49456, 49452.5).

Parents may submit a written request to the school principal for exemption from any of the above health screenings.

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Student Illness

For the safety and protection of all, students should not attend school with any symptoms below and will be sent home for any of the following symptoms:

  • Cold symptoms. Keep student home during period of productive cough and yellow or green nasal discharge.
  • Fever of 100 degrees or higher. Students who have been ill with a fever need to be fever-free, without the use of medication, for 24 hours before returning to school.
  • Eyes that are red, swollen, crusting or draining
  • Untreated, draining ears or earache
  • Diarrhea or Vomiting. Keep student home for 24 hours before returning to school.
  • Severe nausea
  • Severe sore throat
  • Head lice
  • Childhood communicable disease – contact the district nurse

If a student is at school with any of these symptoms, the parent/guardian will be called to pick up the student. Under certain circumstances, parents may be asked to consult a physician and to provide a written note from a doctor indicating that the student may return to school.

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Pertussis (Whooping Cough)

In the event that a case of pertussis, also known as whooping cough, is reported at any PAUSD school, the PAUSD nursing team works very closely with the Santa Clara County Department of Public Health to respond to and prevent cases of pertussis from spreading. The PAUSD nursing team uses the public health department’s protocol to ensure the health and well- being of all PAUSD students. Please use the following resources to learn more about Pertussis and how to prevent it:

California Department of Public Health – Pertussis (whooping cough)

California Department of Public Health – Pertussis Quick Sheet / Spanish

Centers for Disease Control and Prevention – About Pertussis

Centers for Disease Control and Prevention - Diphtheria, Tetanus, and Pertussis Vaccine Recommendations

Centers for Disease Control and Prevention - Tdap Vaccine Information Statement / Spanish / Chinese Traditional / Other Languages