016.15.3-13. Mandatory Immunizations
AR ADC 016.15.3-13Arkansas Administrative Code
Ark. Admin. Code 016.15.3-13
016.15.3-13. Mandatory Immunizations
State law requires that certain immunizations are obtained before a child enters school. Foster parents should assist in maintaining current immunizations. See Recommended Immunizations Timetable.
Physicians' Guide to Preventive Health Screening
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Recommended Immunization Schedule for Persons Aged 0 Through 6 Years--United States • 2009
For those who fall behind or start late, see the catch-up schedule
Age | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
Vaccine | Birth | 1 month | 2 months | 4 months | 6 months | 12 months | 15 months | 18 months | 19-23 months | 2-3 years | 4-6 years | |
Hepatitis B1 | HepB | HepB | see footnote 1 | HepB | ||||||||
Rotavirus2 | RV | RV | RV2 | Range of recommended ages | ||||||||
Diphtheria, Tetanus, Pertussis3 | DTaP | DTaP | DTaP | see footnote 3 | DTaP | DTaP | ||||||
Haemophilus influenzae type b4 | Hib | Hib | Hib4 | Hib | ||||||||
Pneumococcal5 | PCV | PCV | PCV | PCV | PPSV | Certain high-risk groups | ||||||
Inactivated Poliovirus | IPV | IPV | IPV | IPV | ||||||||
Influenza6 | Influenza (Yearly) | |||||||||||
Measles, Mumps, Rubella7 | MMR | see footnote 7 | MMR | |||||||||
Varicella8 | Varicella | see footnote 8 | Varicella | |||||||||
Hepatitis A9 | HepA (2 doses) | HepA Series | ||||||||||
Meningococcal10 | MCV | |||||||||||
This schedule indicates the recommended ages for routine administration of currently licensed vaccines, as of December 1, 2008. for children aged 0 through 6 years. Any dose not administered at the recommended age should be administered at a subsequent visit, when indicated and feasible. Licensed combination vaccines may be used whenever any component of the combination is indicated and other components are not contraindicated and if approved by the Food and Drug Administration for that dose of the series. Providers should consult the relevant Advisory Committee on Immunization Practices statement for detailed recommendations, including high-risk conditions: http://www.cdc.gov/vaccines/pubs/acip-list.htm. Clinically significant adverse events that follow immunization should be reported to the Vaccine Adverse Event Reporting System (VAERS). Guidance about how to obtain and complete a VAERS form is available at http://www.vaers.hhs.gov or by telephone, 800-822-7967.
At birth:
• Administer monovalent HepB to all newborns before hospital discharge.
• If mother is hepatitis B surface antigen (HBsAg)-positive, administer HepB and 0.5 mL of hepatitis B immune globulin (HBIG) within 12 hours of birth.
• If mother's HBsAg status is unknown, administer HepB within 12 hours of birth. Determine mother's HBsAg status as soon as possible and, if HBsAg-positive, administer HBIG (no later than age 1 week).
After the birth dose:
• The HepB series should be completed with either monovalent HepB or a combination vaccine containing HepB. The second dose should be administered at age 1 or 2 months. The final dose should be administered no earlier than age 24 weeks.
• Infants born to HBsAg-positive mothers should be tested for HBsAg and antibody to HBsAg (anti-HBs) after completion of at least 3 doses of the HepB series, at age 9 through 18 months (generally at the next well-child visit).
4-month dose:
• Administration of 4 doses of HepB to infants is permissible when combination vaccines containing HepB are administered after the birth dose.
• Administer the first dose at age 6 through 14 weeks (maximum age: 14 weeks 6 days). Vaccination should not be initiated for infants aged 15 weeks or older (i.e., 15 weeks 0 days or older).
• Administer the final dose in the series by age 8 months 0 days.
• If Rotarix® is administered at ages 2 and 4 months, a dose at 6 months is not indicated.
• The fourth dose may be administered as early as age 12 months, provided at least 6 months have elapsed since the third dose.
• Administer the final dose in the series at age 4 through 6 years.
• If PRP-OMP (PedvaxHIB® or Comvax® [HepB-Hib]) is administered at ages 2 and 4 months, a dose at age 6 months is not indicated.
• TriHiBit® (DTaP/Hib) should not be used for doses at ages 2, 4, or 6 months but can be used as the final dose in children aged 12 months or older.
• PCV is recommended for all children aged younger than 5 years. Administer 1 dose of PCV to all healthy children aged 24 through 59 months who are not completely vaccinated for their age.
• Administer PPSV to children aged 2 years or older with certain underlying medical conditions (see MMWR 2000; 49[No. RR-9]). including a cochlear implant.
• Administer annually to children aged 6 months through 18 years.
• For healthy nonpregnant persons (i.e., those who do not have underlying medical conditions that predispose them to influenza complications) aged 2 through 49 years, either LAIV or TIV may be used.
• Children receiving TIV should receive 0.25 mL if aged 6 through 35 months or 0.5 mL if aged 3 years or older.
• Administer 2 doses (separated by at least 4 weeks) to children aged younger than 9 years who are receiving influenza vaccine for the first time or who were vaccinated for the first time during the previous influenza season but only received 1 dose.
• Administer the second dose at age 4 through 6 years However, the second dose may be administered before age 4, provided at least 28 days have elapsed since the first dose.
• Administer the second dose at age 4 through 6 years. However, the second dose may be administered before age 4, provided at least 3 months have elapsed since the first dose.
• For children aged 12 months through 12 years the minimum interval between doses is 3 months. However, if the second dose was administered at least 28 days after the first dose, it can be accepted as valid.
• Administer to all children aged 1 year (i.e., aged 12 through 23 months). Administer 2 doses at least 6 months apart.
• Children not fully vaccinated by age 2 years can be vaccinated at subsequent visits.
• HepA also is recommended for children older than 1 year who live in areas where vaccination programs target older children or who are at increased risk of infection. See MMWR 2006; 55(No. RR-7).
• Administer MCV to children aged 2 through 10 years with terminal complement component deficiency, anatomic or functional asplenia, and certain other high-risk groups. See MMWR 2005; 54(No. RR-7).
• Persons who received MPSV 3 or more years previously and who remain at increased risk for meningococcal disease should be revaccinated with MCV.
The Recommended Immunization Schedules for Persons Aged 0 Through 18 Years are approved by the Advisory Committee on Immunization Practices (www.cdc.gov/vaccines/recs/acip). the American Academy of Pediatrics (http://www.aap.org), and the American Academy of Family Physicians (http://www.aafp.org).
DEPARTMENT OF HEALTH AND HUMAN SERVICES • CENTERS FOR DISEASE CONTROL AND PREVENTION
Recommended Immunization Schedule for Persons Aged 7 Through 18 Years--United States • 2009
For those who fall behind or start late, see the schedule below and the catch-up schedule
Age | ||||
|---|---|---|---|---|
Vaccine | 7-10 years | 11-12 years | 13-18 years | |
Tetanus, Diphtheria, Pertussis1 | see footnote 1 | Tdap | Tdap | |
Human Papillomavirus2 | see footnote 2 | HPV (3 doses) | HPV Series | Range of recommended ages |
Meningococcal3 | MCV | MCV | MCV | |
Influenza4 | Influenza (Yearly) | |||
Pneumococcal5 | PPSV | Catch-up immunization | ||
Hepatitis A6 | HepA Series | |||
Hepatitis B7 | HepB Series | Certain high-risk groups | ||
Inactivated Poliovirus8 | IPV Series | |||
Measles, Mumps, Rubella9 | MMR Series | |||
Varicella10 | Varicella Series | |||
This schedule indicates the recommended ages for routine administration of currently licensed vaccines, as of December 1, 2008. for children aged 7 through 18 years. Any dose not administered at the recommended age should be administered at a subsequent visit, when indicated and feasible. Licensed combination vaccines may be used whenever any component of the combination is indicated and other components are not contraindicated and if approved by the Food and Drug Administration for that dose of the series. Providers should consult the relevant Advisory Committee on Immunization Practices statement for detailed recommendations, including high-risk conditions: http://www.cdc.gov/vaccines/pubs/acip-list.htm. Clinically significant adverse events that follow immunization should be reported to the Vaccine Adverse Event Reporting System (VAERS). Guidance about how to obtain and complete a VAERS form is available at http://www.vaers.hhs.gov or by telephone. 800-822-7967.
• Administer at age 11 or 12 years for those who have completed the recommended childhood DTP/DTaP vaccination series and have not received a tetanus and diphtheria toxoid (Td) booster dose.
• Persons aged 13 through 18 years who have not received Tdap should receive a dose.
• A 5-year interval from the last Td dose is encouraged when Tdap is used as a booster dose; however, a shorter interval may be used if pertussis immunity is needed.
• Administer the first dose to females at age 11 or 12 years.
• Administer the second dose 2 months after the first dose and the third dose 6 months after the first dose (at least 24 weeks after the first dose).
• Administer the series to females at age 13 through 18 years if not previously vaccinated.
• Administer at age 11 or 12 years, or at age 13 through 18 years if not previously vaccinated.
• Administer to previously unvaccinated college freshmen living in a dormitory.
• MCV is recommended for children aged 2 through 10 years with terminal complement component deficiency, anatomic or functional asplenia, and certain other groups at high risk. See MMWR 2005; 54(No. RR-7).
• Persons who received MPSV 5 or more years previously and remain at increased risk for meningococcal disease should be revaccinated with MCV.
• Administer annually to children aged 6 months through 18 years.
• For healthy nonpregnant persons (i.e., those who do not have underlying medical conditions that predispose them to influenza complications) aged 2 through 49 years, either LAIV or TIV may be used.
• Administer 2 doses (separated by at least 4 weeks) to children aged younger than 9 years who are receiving influenza vaccine for the first time or who were vaccinated for the first time during the previous influenza season but only received 1 dose.
• Administer to children with certain underlying medical conditions (see MMWR 1997; 46[No. RR-8]). including a cochlear implant. A single revaccination should be administered to children with functional or anatomic asplenia or other immunocompromising condition after 5 years.
• Administer 2 doses at least 6 months apart.
• HepA is recommended for children older than 1 year who live in areas where vaccination programs target older children or who are at increased risk of infection See MMWR 2006; 55(No. RR-7).
• Administer the 3-dose series to those not previously vaccinated.
• A 2-dose series (separated by at least 4 months) of adult formulation Recombivax HB® is licensed for children aged 11 through 15 years.
• For children who received an all-IPV or all-oral poliovirus (OPV) series. a fourth dose is not necessary if the third dose was administered at age 4 years or older.
• If both OPV and IPV were administered as part of a series, a total of 4 doses should be administered, regardless of the child's current age.
• If not previously vaccinated, administer 2 doses or the second dose for those who have received only 1 dose, with at least 28 days between doses.
• For persons aged 7 through 18 years without evidence of immunity (see MMWR 2007; 56[No. RR-4]). administer 2 doses if not previously vaccinated or the second dose if they have received only 1 dose.
• For persons aged 7 through 12 years, the minimum interval between doses is 3 months. However, if the second dose was administered at least 28 days after the first dose, it can be accepted as valid.
• For persons aged 13 years and older, the minimum interval between doses is 28 days.
The Recommended Immunization Schedules for Persons Aged 0 Through 18 Years are approved by the Advisory Committee on Immunization Practices (www.cdc.gov/vaccines/recs/acip), the American Academy of Pediatrics (http://www.aap.org), and the American Academy of Family Physicians (http://www.aafp.org).
DEPARTMENT OF HEALTH AND HUMAN SERVICES • CENTERS FOR DISEASE CONTROL AND PREVENTION
Catch-up Immunization Schedule for Persons Aged 4 Months Through 18 Years Who Start Late or Who Are More Than 1 Month Behind--United States • 2009
The table below provides catch-up schedules and minimum intervals between doses for children whose vaccinations have been delayed. A vaccine series does not need to be restarted, regardless of the time that has elapsed between doses. Use the section appropriate for the child's age.
CATCH-UP SCHEDULE FOR PERSONS AGED 4 MONTHS THROUGH 6 YEARS | |||||
|---|---|---|---|---|---|
Vaccine | Minimum Age for Dose 1 | Minimum Interval Between Doses | |||
Dose 1 to Dose 2 | Dose 2 to Dose 3 | Dose 3 to Dose 4 | Dose 4 to Dose 5 | ||
Hepatitis B1 | Birth | 4 weeks | 8 weeks | ||
(and at least 16 weeks after first dose) | |||||
Rotavirus2 | 6 wks | 4 weeks | 4 weeks2 | ||
Diphtheria, Tetanus, Pertussis3 | 6 wks | 4 weeks | 4 weeks | 6 months | 6 months3 |
Haemophilus influenzae type b4 | 6 wks | 4 weeks | 4 weeks4 | 8 weeks (as final dose) | |
If first dose administered at younger than age 12 months | If current age is younger than 12 months | This dose only necessary for children aged 12 months through 59 months who received 3 doses before age 12 months | |||
8 weeks (as final dose) | 8 weeks (as final dose)4 | ||||
If first dose administered at age 12-14 months | If current age is 12 months or older and second dose administered at younger than age 15 months | ||||
No further doses needed | No further doses needed | ||||
If first dose administered at age 15 months or older | If previous dose administered at age 15 months or older | ||||
Pneumococcal5 | 6 wks | 4 weeks | 4 weeks | 8 weeks (as final dose) | |
If first dose administered at younger than age 12 months | If current age is younger than 12 months | This dose only necessary for children aged 12 months through 59 months who received 3 doses before age 12 months or for high-risk children who received 3 doses at any age | |||
8 weeks | 8 weeks | ||||
(as final dose for healthy children) | (as final dose for healthy children) | ||||
If first dose administered at age 12 months or older or current age 24 through 59 months | If current age is 12 months or older | ||||
No further doses needed | No further doses needed | ||||
for healthy children if first dose administered at age 24 months or older | for healthy children if previous dose administered at age 24 months or older | ||||
Inactivated Poliovirus6 | 6 wks | 4 weeks | 4 weeks | 4 weeks6 | |
Measles, Mumps, Rubella7 | 12 mos | 4 weeks | |||
Varicella8 | 12 mos | 3 months | |||
Hepatitis A9 | 12 mos | 6 months | |||
CATCH-UP SCHEDULE FOR PERSONS AGED 7 THROUGH 18 YEARS | |||||
Tetanus, Diphtheria/ Tetanus, Diphtheria, Pertussis10 | 7 yrs10 | 4 weeks | 4 weeks | 6 months | |
If first dose administered at younger than age 12 months | If first dose administered at younger than age 12 months | ||||
6 months | |||||
If first dose administered at age 12 months or older | |||||
Human Papillomavirus11 | 9 yrs | Routine dosing intervals are recommended11 | |||
Hepatitis A9 | 12 mos | 6 months | |||
Hepatitis B1 | Birth | 4 weeks | 8 weeks | ||
(and at least 16 weeks after first dose) | |||||
Inactivated Poliovirus6 | 6 wks | 4 weeks | 4 weeks | 4 weeks6 | |
Measles, Mumps, Rubella7 | 12 mos | 4 weeks | |||
Varicella8 | 12 mos | 3 months | |||
If the person is younger than age 13 years | |||||
4 weeks | |||||
If the person is aged 13 years or older | |||||
• Administer the 3-dose series to those not previously vaccinated.
• A 2-dose series (separated by at least 4 months) of adult formulation Recombivax HB® is licensed for children aged 11 through 15 years.
• The maximum age for the first dose is 14 weeks 6 days. Vaccination should not be initiated for infants aged 15 weeks or older (i.e., 15 weeks 0 days or older).
• Administer the final dose in the series by age 8 months 0 days.
• If Rotarix® was administered for the first and second doses, a third dose is not indicated.
• The fifth dose is not necessary if the fourth dose was administered at age 4 years or older.
• Hib vaccine is not generally recommended for persons aged 5 years or older. No efficacy data are available on which to base a recommendation concerning use of Hib vaccine for older children and adults. However, studies suggest good immunogenicity in persons who have sickle cell disease, leukemia, or HIV infection, or who have had a splenectomy; administering 1 dose of Hib vaccine to these persons is not contraindicated.
• If the first 2 doses were PRP-OMP (PedvaxHIB® or Comvax®), and administered at age 11 months or younger, the third (and final) dose should be administered at age 12 through 15 months and at least 8 weeks after the second dose.
• If the first dose was administered at age 7 through 11 months, administer 2 doses separated by 4 weeks and a final dose at age 12 through 15 months.
• Administer 1 dose of pneumococcal conjugate vaccine (PCV) to all healthy children aged 24 through 59 months who have not received at least 1 dose of PCV on or after age 12 months.
• For children aged 24 through 59 months with underlying medical conditions, administer 1 dose of PCV if 3 doses were received previously or administer 2 doses of PCV at least 8 weeks apart if fewer than 3 doses were received previously.
• Administer pneumococcal polysaccharide vaccine (PPSV) to children aged 2 years or older with certain underlying medical conditions (see MMWR 2000; 49[No. RR-9]), including a cochlear implant, at least 8 weeks after the last dose of PCV.
• For children who received an all-IPV or all-oral poliovirus (OPV) series, a fourth dose is not necessary if the third dose was administered at age 4 years or older.
• If both OPV and IPV were administered as part of a series, a total of 4 doses should be administered, regardless of the child's current age.
• Administer the second dose at age 4 through 6 years. However, the second dose may be administered before age 4, provided at least 28 days have elapsed since the first dose.
• If not previously vaccinated, administer 2 doses with at least 28 days between doses.
• Administer the second dose at age 4 through 6 years. However, the second dose may be administered before age 4, provided at least 3 months have elapsed since the first dose.
• For persons aged 12 months through 12 years, the minimum interval between doses is 3 months. However, if the second dose was administered at least 28 days after the first dose, it can be accepted as valid.
• For persons aged 13 years and older, the minimum interval between doses is 28 days.
• HepA is recommended for children older than 1 year who live in areas where vaccination programs target older children or who are at increased risk of infection. See MMWR 2006; 55(No. RR-7).
• Doses of DTaP are counted as part of the Td/Tdap series.
• Tdap should be substituted for a single dose of Td in the catch-up series or as a booster for children aged 10 through 18 years; use Td for other doses.
• Administer the series to females at age 13 through 18 years if not previously vaccinated.
• Use recommended routine dosing intervalis for series catch-up (i.e., the second and third doses should be administered at 2 and 6 months after the first dose). However, the minimum interval between the first and second doses is 4 weeks. The minimum interval between the second and third doses is 12 weeks, and the third dose should be given at least 24 weeks after the first dose.
Information about reporting reactions after immunization is available online at http://www.vaers.hhs.gov or by telephone, 800-822-7967. Suspected cases of vaccine-preventable diseases should be reported to the state or local health department. Additional information, including precautions and contraindications for immunization, is available from the National Center for Immunization and Respiratory Diseases at http://www.cdc.gov/vaccines or telephone, 800-CDC-INFO (800-232-4636).
DEPARTMENT OF HEALTH AND HUMAN SERVICES • CENTERS FOR DISEASE CONTROL AND PREVENTION
The immunization schedules shown above should serve as a guideline only; acceptable alternate schedules do exist, and consultation may be required in some cases.
Hospitalization
• When a child in foster care is hospitalized, the Family Service Worker working with the child must provide the hospital with the child's Medicaid number, if applicable, vital statistics, previous medical history, and other identifying information as indicated.
• The Family Service Worker signs both the admission forms and the required consent for surgery if indicated. A second opinion by a medical specialist will be obtained before major surgery whenever possible.
• The Family Service Worker completing admission forms must leave with the hospital the name and telephone number of the Worker to be contacted regarding the child.
• Foster parents shall not sign a child in foster care into the hospital or sign other medical or surgical consent. Physicians and hospitals may determine that an emergency exists and waive the usual required consent, or they may take consents on the telephone with a second party at the hospital listening and verifying the consent. The Foster Parents should notify the FSW immediately when a child in foster care is hospitalized. As soon as possible, the FSW shall visit the hospital and sign the required consents.
Prescription Drugs
Children in foster care are eligible for prescription drugs through the State Prescription Drug Program.
When there are no Medicaid providers available in cases of emergency, the FSW (with the approval of the County Supervisor) will authorize and bill for medication and medical services using a DHS-1914.
Credits
Amended Nov. 25, 2010.
Current with amendments received through February 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 016.15.3-13, AR ADC 016.15.3-13
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