Back-to-school scramble is on for child vaccines. Florida drops to 10-year low in completing shot regimen

The scramble is on in South Florida to get children vaccinated for the new school year.

Health departments, pediatricians and mobile clinics are slammed with children who still need the required vaccines to start school for the first time, or to enter the seventh grade. During the pandemic, many Florida children fell behind on yearly well-checks and vaccine schedules. Now, parents are trying to catch up to prevent their children from missing school.

On Friday, Latoya Brown said she is one of those parents. She brought her 9-year-old daughter Kaylie to get a wellness exam and vaccines at the Joe DiMaggio Children's Mobile Health Center parked outside the Boys and Girls Club in Davie.

"She was up to date before the pandemic but she never got back on schedule," Brown said.

The Hollywood mother said she lost private insurance coverage for Kaylie during the pandemic, but wants her daughter to be protected from diseases. She learned about the mobile clinic from her daughter's summer camp, just in time for the start of the new school year. "It's less daunting for parents and it's free of charge," she said.

Florida's required immunizations protect against diseases including tetanus, diphtheria, measles, mumps, rubella, varicella, hepatitis B and polio. Some of the shots are a series of boosters spaced apart. Immunization forms are required to start kindergarten and again in seventh grade when additional shots are needed.

"A lot of children are behind on vaccines but they will get what they need to get into school with the understanding that they will need to catch up on boosters after school starts," said Dr. Lisa Gwynn, medical director for the UHealth Pediatric Mobile Clinic for uninsured children. She also is Program Director for the School Health Initiative, nine pediatric clinics in Miami-Dade County schools.

The 2020-21 school year marked a more than 10-year low for Florida's kindergarten and seventh-grade students completing all doses of required immunizations, according to a Florida Department of Health report.

About 91.7% of kindergarten students statewide completed the required vaccines and 94.3% of seventh-grade students. The state goal is for 95% of students to have received all doses of required vaccines. The statewide immunization rate is not available yet for the 2022-23 school year.

Florida pediatricians are pushing harder this school year, concerned that childhood diseases nearly wiped out through vaccinations could come back if immunization rates further decline.

"This is a busy time for pediatricians trying to get kids into our clinics who are behind on mandated vaccine requirements," said Dr. Thresia Gambon, a Miami pediatrician and president of the Florida Chapter of the American Academy of Pediatrics. "Pediatricians in all areas of the state are attending health fairs, doing promotion on social media … we are all promoting back-to-school immunizations and hoping kids come in and get them."

Across South Florida, health departments are holding free immunization clinics, and mobile clinics are going into neighborhoods to reach families who are uninsured or underinsured. At Joe DiMaggio Children's Hospital in Hollywood, a Back-to-School Health Fair on Aug. 5 drew 150 children who received physical exams and vaccinations.

Dr. Michelle Smith, a pediatrician with Joe DiMaggio Children's Hospital, says parents have more questions this year about vaccines. "They want to know which vaccines are absolutely needed, what they cover and what are the possible side effects."

Smith, who works on the Joe DiMaggio mobile clinic and oversees pediatric residents at the hospital, says for most part childhood vaccines are well-tolerated. "These are not new vaccines. They have been around a long time. The most common side effect is redness or swelling at injection site."

Palm Beach, Broward and Miami-Dade counties all have immunization vans that travel into neighborhoods with a higher rate of uninsured families. In Broward County, the Joe DiMaggio mobile health unit travels throughout South Broward.

"Our mobile van is a full-fledged clinic," said Soraya Hernandez, director of community services for Joe DiMaggio Children's Hospital.

Hernandez said children don't need an appointment to get their shots at the mobile clinic, but can schedule one if desired.

"The last few weeks have been very busy," she said. "This week we have been going to YMCAs or places that have camps going on. We get there in the morning and stay all day. Yesterday we saw 30 children."

Because Florida keeps an electronic record of shots, Hernandez said a pediatrician in the mobile clinic can see exactly what vaccines a child needs and afterward can provide the required form for school. This year, she said, they are seeing children arrive from out of the state or out of the country who need multiple vaccines.

Kizzy Moreira arrived in Miramar from Venezuela last month, eager to get her two children enrolled in public schools.. Her sons Silvano Castillo, 10, and Santiago Castillo, 4, both needed required shots and physical exams. Friends had told her about the mobile van and on Friday, Moreira arrived with her boys for a walk-in appointment.

"It was so easy," she said after she received the paperwork she needed. "They are ready to start school."

Broward County Public Schools takes a tough stance on vaccine requirements and a doctor's exam. Their rule is students without a completed Certificate of Immunization will not be allowed to attend classes until the document is provided. The absence is considered unexcused. School starts Aug. 21. However a spokesperson for the district said students new to Broward County Public Schools have 30 days to get into compliance with the vaccination requirements.

Palm Beach County requires shots and a physical. School started in Palm Beach County on Thursday. The school district says students must show a Florida Certification of Immunization before they can attend school.

Pediatricians say they are concerned about the rise in students who get exemptions from immunizations. Students can get a medical exemption signed by a doctor, or a religious exemption. These exemptions now account for 8.2% of Florida's kindergarten students, according to state health records. The number of students who opted out of vaccinations for religious reasons in particular has risen and last year accounted for about 7,913 children.

"It's important for kids to get vaccinated to protect them from diseases that can be a threat to their health," Gwynn said. "We still see outbreaks of these diseases when immunization rates get below a certain threshold. Even cases of polio still exist."

Florida pediatricians worry that the controversy over the COVID-19 vaccine created a spillover effect for childhood immunizations.

"At the Florida Chapter of the American Academy of Pediatrics we really try to promote wellness vaccines and point to their long standing safety profiles," Gambon said. "We try on a individual basis to talk to the parents and the kids about importance of vaccines to keep them healthy as well as to keep others healthy."

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