By Lenzy Krehbiel-Burton
For many children across Oklahoma, back to school season generally means a new backpack, a new pair of shoes and a visit to the doctor’s office for a new round of vaccines.
In an effort to minimize the risk of an outbreak, the State of Oklahoma has required students to be immunized against certain diseases before attending any public or private school since 1970.
Entering the 2019-2020 school year, Oklahoma’s mandatory immunization list for incoming kindergarteners includes measles, mumps, rubella, tetanus, diphtheria, pertussis, varicella, polio, hepatitis A and hepatitis B.
Oklahoma law does allow parents to apply for an exemption to the mandate on religious, philosophical or medical reasons. However, the exemption request is subject to approval by the Oklahoma State Department of Health, and exempt students may be required to stay home if a disease outbreak strikes a community.
According to 2017-2018 data published by the OSDH, 91 percent of public school kindergartners and 84 percent of their private school counterparts were fully vaccinated. About 6 percent of private school kindergartners and 2 percent of public school kindergartners had at least one exemption.
In Pottawatomie County, the rate was even higher, with 94.6 percent of all kindergartners completely up to date on immunizations.
A registered nurse with Citizen Potawatomi Nation’s Health Services, Lisa Vernon has administered multiple vaccines over the years to area children and teenagers. To help alleviate the anxiety that many of her patients experience, she keeps of a pocket full of treats on standby and is upfront about what the experience entails.
“I am honest with them that it’ll sting,” she said. “If you calm the muscle, the better it’s going to feel. I let them know it’ll help keep them healthy and that it is OK to scream or cry. Breathing helps with relaxing as well. I sometimes try to have them think about something else.”
She also encourages parents of younger children to bring a book, security blanket, stuffed animal or some other small distraction with them to help minimize any stress.
Although the required vaccine list covers 10 different diseases, incoming kindergartners are getting 10 shots at a time.
A two-dose vaccine cocktail for measles, mumps and rubella is among the required immunizations to start school in Oklahoma. When both doses are administered, the vaccine is 97 percent effective at preventing the diseases, according to the Centers for Disease Control. It is recommended that children get the first dose between 12 and 15 months of age, with the second dose given between the ages of 4 and 6 years old.
Another three diseases — tetanus, diphtheria, and pertussis, or whooping cough — are also addressed via cocktail. An additional TDaP booster is required at age 11 or no later than entering the seventh grade.
Two additional optional vaccines are available at age 11 as well, one for meningococcal disease and another for the human papillomavirus. Meningococcal disease first shows flu-like symptoms then quickly worsens as it infects the blood stream, brain and spine. It can be contracted through kissing, sharing drinks or other activities with exposure to a saliva-borne bacterium. If inoculated at 11, the CDC recommends an additional booster shot around age 16.
A separate meningococcal vaccine is also available for teenagers and college students in their early 20s who will be living in dormitories and considered at high risk for contracting the disease. It is a two-dose series with each dose taken one month apart.
HPV is the most common sexually transmitted infection in the United States and a leading cause of cervical cancer. As per the CDC, an estimated 79 million Americans have at least one strain of HPV, with 14 million cases contracted each year. More than 200 different strains exist, with two specific types, 16 and 18, accounting for more than 70 percent of all cervical cancer and pre-cancer diagnoses.
If administered before age 15, the HPV vaccine comes in two doses. Three doses are needed for efficacy in recipients older than age 15.
“The main thing is to get the kids vaccinated before they’re exposed to the virus,” Vernon said. “I’m so proud of parents that say yes to this one. It’s been out at least 12 years, and it’s growing in popularity.”
Neither the CPN Health Services nor the Indian Health Care Resource Center in Tulsa have formal outreach events planned to facilitate access. The latter is offering additional appointment slots in the weeks leading up to the start of school. The CPN’s two clinics have a finite number of vaccine doses available on-site and encourage parents to schedule an appointment by calling 405-878-4693.
The Oklahoma City Indian Clinic hosted back-to-school vaccine outreach events in July. Immunizations are still available at the facility via appointment.