October 25, 2002
Dear School Administrator:
Since 1994, the Advisory Committee on Immunization Practices (ACIP) has recommended that doses of vaccine separated by less than the recommended minimum interval should not be considered part of a primary series. ACIP continues to recommend that vaccine doses not be given at intervals less than the minimum intervals or earlier than the minimum age. In an effort to increase the flexibility of the complicated childhood immunization schedule, however, ACIP now recommends that vaccine doses administered up to four days before the minimum interval or age can be counted as valid. ACIP believes that administering a dose a few days earlier than the minimum interval or age is unlikely to have a significant negative effect on the immune response to that dose.
Hence, on September 6, 2002, the Texas Board of Health adopted an amendment to the Immunization Requirements for Children and Students in Texas Public and Private Schools, Child-Care Facilities and Institutions of Higher Education [Title 25 Health Services, Chapter 97, Texas Administrative Code (TAC) §§97.63] regarding the validity of vaccine doses administered less than or equal to four days before the minimum interval or age. This does not change the recommendation for routine vaccination, but rather makes an allowance that should be considered when evaluating records after a child has been vaccinated.
Effective immediately, all vaccine doses administered less than or equal to four days before the required minimum interval or age shall be considered valid doses when evaluating a student immunization record for compliance with the immunization requirements for school and child-care entry. Please contact Monica Gamez, Immunization Compliance Coordinator, at (800) 252-9152 if you have any questions or need further information about immunization requirements.
Jan W. Pelosi, M.P.H., Director
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