A Clinician’s Handbook for Childhood & Adult Immunizations in Georgia
Vaccine Requirements for Attending Facilities and Schools in Georgia
Relative to the Certificate of Immunization (Form 3231)
Required Doses for Attendance in Facilities and Schools For Children Who Started Immunizations Before Age 7 Years*
| Required Vaccines | 2 Months of Age | 4 Months of Age | 6 Months of Age | 12 months | 15 months | 18 months | 24 months | 4-6 Yrs.* | Total Doses Required** For Checking |
|---|---|---|---|---|---|---|---|---|---|
| [1] DTP, DTaP, DT | 1 | 2 | 3 | 4 | 5 | 4 or 5 (See Footnote [1]) | |||
| [2]Hepatitis B | 1 | 2 | 3 | 3 (See Footnote [2]) | |||||
| [3]Hib PRP-T or | 1 | 2 | 3 | 4 | N/A for school (See Footnote [3]) | ||||
| [3]Hib PRP-OMP | 1 | 2 | 3 | N/A for school (See Footnote [3]) | |||||
| [4]Polio | 1 | 2 | 3 | 4 | 3 or 4 (See Footnote [4]) | ||||
| [5]MMR | 1 | 2 | 2 (See Footnote [5]) | ||||||
| [6] Varicella | 1 | 2 | 2 (See Footnote [6]) | ||||||
| [7] PCV | 1 | 2 | 3 | 4 | N/A for school (See Footnote [7]) | ||||
| [8] Hepatitis A | 1 | 2 | (See Footnote [8]) | ||||||
*These requirements were established in accordance with the current Recommended Childhood and Catch-Up Immunization Schedules, United States. (See references on reverse side.) Georgia requirements for kindergarten (5 years) include doses indicated for 4-6 years.
**Children who are behind schedule may attend while in the process of completing the requirements with minimum intervals as indicated below.
Minimum Ages For Initial Immunization And Minimum Intervals Between Doses
| Vaccine | Minimum Age for First Dose | Minimum interval from dose 1 to 2 | Minimum interval from dose 2 to 3 | Minimum interval from dose 3 to 4 | Minimum interval from dose 4 to 5 | With respect to these intervals, 1 month is a minimum of 4 weeks or 28 days. |
|---|---|---|---|---|---|---|
| [1] DTP/DTaP (DT) | 6 weeks | 1 month | 1 month | 6 months | See Footnote [1] | Don't restart any series, no matter how long since the previous dose. Doses given ≤ 4 days before the minimum age or the minimum interval may be counted as valid. Two different live vaccines must be given on the same day or spaced at least 28 days apart. |
| [2] Hepatitis B | birth | 1 month | See Footnote [2] | N/A | N/A | |
| [3]Hib(Primary Series) | ||||||
| PRP-T (ActHIB) | 6 weeks | 1 month | 1 month | See Footnote [3] | N/A | |
| PRP-OMP (Pedvax) | 6 weeks | 1 month | See Footnote [3] | N/A | N/A | |
| [4] Polio | 6 weeks | 1 month | 1 month | See Footnote [4] | N/A | |
| [5] MMR | 12 months | 1 month | N/A | N/A | N/A | |
| [6] Varicella | 12 months | 3 months | N/A | N/A | N/A | |
| [7] PCV | 6 weeks | 1 month | 1 month | See Footnote [7] | N/A | |
| [8] Hepatitis A | 12 months | 6 months | ||||
[1] One dose of DTP/DTaP/DT must be on or after the 4th birthday. If the 4th dose was on or after the 4th birthday, the 5th dose is not needed. The 4th dose should be administered a minimum of 6 months after the 3rd dose. However, the 4th dose does not need to be repeated if administered ≥ 4 months after dose 3. Total doses of diphtheria and tetanus toxoids should not exceed 6 before the 7th birthday.
[2] The 3rd dose of Hepatitis B vaccine should be given a minimum of 4 months after the 1st dose and 2 months after the 2nd dose and not before 24 weeks of age.
[3] The number of doses of Hib depends on age at 1st dose and brand of vaccine given. The last dose in the series, whether 3rd or 4th, should be given at least 2 months after the previous dose and not before 12 months of age. Hib is required for children younger than 5 years attending facilities. Hib is not required for admission to kindergarten (5 years) through grade 12 and is not indicated for children who have reached the 5th birthday. One dose is sufficient if it is given at age 15 months or later. Brand names for PRP-T is ActHIB. The brand name for PRP-OMP is Pedvax Hib and the Hib component of Comvax(Hepatitis B-Hib) is Pedvax Hib.
[4] Booster dose must be given on or after the 4th birthday and a 6 month interval is required between the last dose of the primary series and the booster dose. If the 3rd dose of all IPV or all OPV series is given on or after the 4th birthday, a 4th dose is not required provided there is a 6 month interval since the previous dose.
[5] The MMR requirement is 2 doses of measles vaccine, 2 doses of mumps vaccine and 1 dose of rubella vaccine . The vaccines may be given as MMR or MMRV (combined antigens) or as single antigens.
[6] The varicella requirement is for 2 doses of varicella-containing vaccine for entry into any level, K-12. (See Side 2 of REQ, Footnote [4]).These may be administered as single dose varicella or in combination as MMRV.
[7] The number of doses in the PCV series depends on age at 1st dose. The last dose in the series should be given at least 2 months after the previous dose and not before 12 months of age.
[8] Hepatitis A vaccine should be administered to all children born on or after 1-1-06.
Required Doses for Attendance in Schools For Children Who Started Immunizations At Age 7 Years or Older*
| Required Vaccines** with footnote numbers in [ ] | First Visit | 1 Month After First | 1 Month After Second | 1 Month After Third | 4 Months After First | 6 Months After Previous | Total Doses Required*** For Checking Complete For School Attendance Box on Immunization Certificate |
|---|---|---|---|---|---|---|---|
| [1] Hepatitis B Engerix 10 mcg or Recombivax 5 mcg | 1 | 2 | 3 | 3 (See Footnote [1]) | |||
| [1] Hepatitis B Recombivax 10 mcg (11-15 years only) | 1 | 2 | 2 (See Footnote [1]) | ||||
| [2]Polio | 1 | 2 | 3 | 4 or 3 | 4 or 3 (See Footnote [2]) | ||
| [3]MMR | 1 | 2 | 2 (See Footnote [3]) | ||||
| [4]Varicella | 1 | 2 | 2 (See Footnote [4]) | ||||
| [5]Td/Tdap | 1(Tdap) | 2(Td) | 3(Td) | 3 (See Footnote [5]) | |||
| [6] Meningococcal | 1 or 2 doses | 1 (See Footnote [6]) | |||||
*These requirements were established in accordance with the current Recommended Childhood Immunization Schedule, United States. See References.
**There are other vaccines included in the Childhood Immunization Schedule that are recommended routinely but are not required in GA for child care or school attendance.
***Children who are behind schedule may attend while in the process of completing requirements with minimum intervals indicated above. With respect to the 1 month is a minimum of 4 weeks or 28 days.
Footnotes
[1] The 3rd dose of Hepatitis B Engerix-B 10 mcg or Recombivax-HB 5 mcg should be given a minimum of 4 months after the 1st dose and 2 months after the 2nd dose. A 3rd dose is not needed when 2 doses of Adult Recombivax-HB 10 mcg are given when a child is 11-15 years old and the 2 doses are at least 4 months apart.
Documentation of the vaccine brand of this alternate schedule is very important, especially when issuing the 3231 certificate.
[2] If the 3rd dose of all IPV or OPV series is given on or after the 4th birthday, a 4th dose is not required provided there is a 6 month interval since the previous dose.
[3] The MMR requirement is 2 doses of measles vaccine, 2 doses of mumps vaccine and 1 dose of rubella vaccine . The vaccines may be given as
MMR or MMRV (combined antigens) or as single antigens.
[4] Two doses of varicella vaccine are required for children entering school at any level, K-12, for the first time. For children already enrolled, the second dose is required at 6th grade. If given before age 12, the doses should be separated by 3 months, however, the 2nd dose does not need to be repeated if administered ≥ 1 month after 1st dose. If given on or after the 13th birthday, the doses should be separated by 4 or more weeks.
[5] One dose of Tdap is required for 7th grade. Tdap can be administered regardless of the interval since the last Td. If a primary series is indicated, one dose preferably the first dose, should be Tdap. A dose of Tdap given on or after the 7th birthday meets school requirement.
[6] One dose of MCV4 is required for 7th grade; routinely at age 11-12 years. A dose of MCV4 given on or after 10 years meets school requirement. A booster dose of MCV4 is required for 11th grade; routinely at age 16 years or older. If the first dose of MCV4 is given at 16 years or older, a booster dose is not required.
References
Official Code of Georgia Annotated, Section 20-2-771
Rules of the Department of Public Health, Chapter 511-2-2
Georgia Immunization Program Manual
Georgia VFC Program Manual
Recommendations of the Advisory Committee on Immunization Practices (ACIP)
The Red Book – Report of the Committee on Infectious Diseases
Recommended Childhood & Catch-Up Immunization Schedules, U.S.: Centers for Disease Control and Prevention
American Academy of Pediatrics (AAP)
Approved by ACIP, AAP and American Academy of Family Physicians (AAFP)