New rules that would change the age for the immunizations required to attend school were approved for public comment Thursday by the state Board of Health.
The new rules would lower the required age for a Tdap - Tetanus, diphtheria and pertussis - vaccination from before seventh grade to when a child reaches the age of 11.
While children younger than 2 are most afflicted by whooping cough - also known as pertussis - the prevalence of the disease is rising in children who are 9, 10 and 11, according to Arkansas Department of Health data from 2009 to 2013. Before the Tdap is administered, children get a vaccine known as DTaP, which targets the same diseases in a different dose and is generally given by age 5or 6.
Children who are 10 have been slightly more afflicted than 11-year-olds, but 10 is younger than what the Advisory Committee on Immunization Practices at the federal Centers for Disease Control and Prevention recommends for Tdap immunization, said Kerry Krell, a Health Department spokesman.
The board originally approved reducing the age for the vaccine to 10 years old but changed that after receiving feedback from doc-tors who said that administering the shots would be easier at 11 because of other vaccines that must be administered for school attendance.
“We’ll have to watch and see if that does make a difference,” said Dr. Jennifer Dillaha, state medical director for immunizations. “We hope that it does. … It would make sense for children to receive it [the vaccine] at an earlier age - at age 10 - but that’s a decision primary-care providers and parents can make together.”
Whooping cough is “a highly contagious disease that can cause uncontrolled coughing fits with potentially serious complications,” according the Health Department. Infants are at the highest risk of death for the disease.
Children’s immunity to the disease is wearing off before they get to seventh grade, when students are usually 12 or 13 years old, Dillaha said.
“What’s happening is we have a combination of people who are not getting vaccinated, and those who do - immunity [is] waning,” she said.
In 2013, Arkansas had 466 whooping-cough cases, up from 80 cases in 2011 - a 482.5 percent increase.
Earlier this year, a Health Department official said the rise in whooping cough had a lot to do with the latest vaccine not lasting as many years as expected.
“It’s hard to predict how long it will last for people,” Dillaha said Thursday.
The new rules, which also include changes for hepatitis-A and meningitis immunizations, will go online for a 30-day public comment period to be specified later. After that, the rules will have to go before two legislative committees - the public health and rules panels - before they can be placed back in front of the board with any recommended changes.
The board, which meets quarterly, is hoping to see the rules again in July to finally approve them for a Sept. 1 effective date.
The hepatitis-A rule would be modified to require children in kindergarten and first grade to have had at least one dose of the hepatitis-A vaccine. Previously, the requirement was two doses, which Dillaha said was more stringent than the Advisory Committee on Immunization Practices recommends.
Hepatitis-A is a liver disease that can be severe and last several months, according to the CDC. It is usually spread through contact with and ingestion of fecal matter. The CDC says the vaccine is the best way to prevent hepatitis-A.
A meningococcal vaccine would be required for school children who are 16. Students entering seventh grade already must have the vaccine, and the rules would simply add another dose at age 16.
Meningitis involves inflammation of the protective membranes covering the brain and spinal cord, according to the CDC.
The midteens-throughearly-20s age group is at increased risk for the disease, experiencing the highest incidence, Dillaha said.
Arkansas, Pages 9 on 04/25/2014