Several changes were recently made to North Carolina’s immunization rules based on recommendations from the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices. These rule changes were designed to help reduce the incidence of pertussis (whooping cough) and mumps disease among North Carolinians. Health care providers should make note of these changes. Please educate your staff and clients and vaccinate the children, adolescents and teenagers in your practice who will be impacted by the new rules.

Tdap Vaccine Requirement:

Effective January 1, 2008, the administrative rule, 10A NCAC 41A.0401, has been changed, adding requirements for one booster dose of Tdap (tetanus/diphtheria/pertussis) vaccine to be given to the following age groups:

• All individuals attending public school who are entering the 6th grade on or after August 1, 2008, if five years or more have passed since the last dose of tetanus/diphtheria toxoid
• All individuals not attending public schools (i.e., private, home-school, non-traditional schools) who are 12 years of age on or after August 1, 2008, if five years or more have passed since the last dose of tetanus/diphtheria toxoid.
• Individuals enrolling in college or university for the first time on or after July 1, 2008, if a tetanus/diphtheria toxoid or tetanus/diphtheria/pertussis vaccine has not been administered within the past 10 years.

Mumps Vaccine Requirement:

This administrative rule change also impacts mumps vaccination. Individuals are now required to receive a second dose of mumps vaccine before enrolling in school, college or university for the first time. Children were previously required to have only one dose of mumps vaccine. Most children already receive two doses of the MMR vaccine (measles-mumps-rubella) by age four. Therefore, this rule will primarily affect children who received single antigen doses of the vaccines. Beginning with the 2008-09 school year, all children entering school for the first time will need to have received two doses of measles, two doses of mumps, and one dose of rubella vaccine prior to entry.

These rule changes will affect North Carolina's children, adolescents and teens for the 2008-09 school year. Though the responsibility of having the child immunized ultimately falls to the parent or guardian, health care providers are encouraged to do everything possible to reach the students (and their parents) who will need to be vaccinated prior to elementary, 6th grade, or college entry.

Educational Materials:

Below are some additional materials that have been developed to help educate parents and providers about the rule change. Please feel free to order these materials by faxing in the order form (found below) or by downloading the materials directly.

Additional Materials for Providers about the Immunization Rule Change:

• Immunization Rule Change Materials Order Form

Provider Education Resources

• Rule Change Flyer - educational resource for providers with details about the rule change
• Pocket Guide - for providers with a listing of all required vaccines by point of school entry
• Tdap: What You Should Know
• Vaccine Information Statement for Tdap Vaccine
• Vaccine Information Statement for MMR vaccine

Patient Education Materials - for 6th Grade Requirement

• Reminder/Recall Postcard - for rising 6th grade students
• Fact Sheet for Parents of rising 6th grade students, in color
• Fact Sheet for Parents of rising 6th grade students, in black and white
• Spanish Fact Sheet for Parents of rising 6th grade students, in color
• Spanish Fact Sheet for Parents of rising 6th grade students, in black and white

Patient Education Materials - for College Requirement

• Reminder/Recall Postcard - for students about to enter college