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Mel Gravely
June-11-2019

Vaccination Requirements for Head Start/Early Head Start

Head Start at the national level does not have any explicit rules regarding the vaccination status of children who attend local programs (a bill proposed in 2015 would’ve required all Head Start children to be vaccinated, but never made it to a vote). As it stands now, it is only mentioned once in the Head Start Act (Sec.640(m)(2)) when discussing homeless families and how programs are required to give them extra consideration when it comes to providing required documents, including proof of immunizations.

Rather, Head Start at the national level defers to individual states when it comes to immunization requirements for children who attend school. Like any other publicly-funded school, Head Start must follow state law when it comes to vaccinations.

According to the National Conference of State Legislators, all 50 states have some sort of legislation on the books that require children to be vaccinated before they can attend public school. However, exemptions are allowed under certain circumstances. 46 states allow families to claim a religious exemption. Of those, 16 allow a “personal belief” exemption, which includes any moral or philosophical objection to vaccination. Four states, including California, Mississippi, West Virginia, and Maine, only allow exemptions for medical reasons.

Documentation requirements for schools can also differ state to state. For example, West Virginia requires all exemption paperwork to be submitted for review to the public health department, while in other states schools need to maintain their own internal records and have them available for review if requested.

In the past 10 years, there has been a lot of news coverage about the trend toward parents not vaccinating their children (often referred to as the “anti-vax” movement). Fueled in part by social media, some parents have come to think that vaccines aren’t safe. In response, some states are viewing this as a public health emergency and have tightened restrictions on vaccination requirements for school-aged children.

For example, in winter 2015, California experienced a very high-profile outbreak of measles that was traced back to unvaccinated children at Disneyland. Soon after, the legislature passed Senate Bill 277, joining states Mississippi and West Virginia in removing both the religious and personal exemptions for vaccination of school children.

The following year, California went even further with Senate Bill 792. Intended to protect the youngest children, some of whom are too young to get vaccinnated, SB 792 requires employees and volunteers of preschool and daycare facilities to be vaccinated against influenza, pertussis, and measles. While many states require paid workers at preschools to be vaccinated, I couldn’t find any legislation on the books in other states that also requires volunteers to be vaccinated.

As you can probably guess, this has added an additional barrier to parent participation in California Head Start programs. In our last webinar, we had this question come up about how to overcome this. To be perfectly honest, we weren’t aware of the requirement until now.

With that said, I feel that if you have been doing the things you need to do to be successful in parent engagement, then this extra requirement shouldn’t be as large of a barrier as you may think. Engage with your community-based counterparts in the healthcare field (as you should be doing already), and gather as much information as you can about immunization costs, coverage, and programs. Communicate that information to parents in a way that they can understand using the channel that they prefer. After that, do everything you can to facilitate them getting the required immunizations through community partnerships, reminders, and encouragement.

Do you find children often come to school without their required immunizations? How are you guiding families through that process? And for California residents, what strategies have you found are working to make sure parent volunteers are vaccinated? We’d love to have your feedback! Leave your comments below!

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