Even though it's not quite summer, it's not too early to prepare for the next school year. In addition to the usual new notebooks and pencils, some elementary school students in Alaska will need immunizations before school starts this fall or by July 1 if they are attending child care. Children in kindergarten through sixth grade will need to show proof that they have received two varicella (chickenpox) vaccinations or that they already have had the disease. Children in pre-school and Head Start or those attending child care who are not yet in elementary school will continue to need only one varicella vaccination.

Varicella is a contagious disease that usually occurs in childhood. Although many people think that it is not a serious illness, varicella can lead to severe skin infections, scars, pneumonia, brain damage and death. Serious disease complications are much more likely to occur in infants less than one year of age (too young to be vaccinated) and in unvaccinated children and adults who are older than 12. It is not possible to predict who will develop serious or even deadly complications from varicella infection. Persons who previously were completely healthy have been known to die as a result of this disease.

A single varicella vaccination is estimated to be effective for only 80 to 85percent of children. This means that some persons who have received only one vaccination may remain unprotected. Approximately one-third of these vaccinated-but-unprotected children will experience moderate disease if they get chickenpox. A second varicella vaccination greatly reduces the risk of disease among these unprotected children and has been shown to be 100 percent effective against development of severe disease.

To ensure children are protected against this disease, beginning July 1, verification that a child has already had varicella (or any other vaccine-preventable disease) will require confirmation by an Alaska-licensed physician (medical doctor or doctor of osteopathy), advanced nurse practitioner or physician's assistant. These medical professionals must document this verification on an official state form that may be obtained from schools, health care providers or the Alaska Immunization Program Web site www.epi.alaska.gov/immunize. Documentation of history of varicella disease, signed by an Alaska-licensed medical doctor, advanced nurse practitioner or physiciain's assistant, and dated prior to July 1, 2009, will continue to be considered valid.

Children who have had varicella disease may still receive the vaccine. Unvaccinated children without an exemption will be excluded from attending school and school activities.

Reactions to varicella vaccination are uncommon and are usually limited to soreness and/or redness at the site of vaccination. The stronger, naturally circulating virus is more likely to re-emerge in adulthood as shingles than is the weakened virus used in the vaccine.

Also beginning July 1, school immunization regulations require that students who need a 10 year Td (tetanus/diphtheria) booster, typically at age 14-16, receive Tdap vaccine (tetanus/diphtheria/acellular pertussis). Outbreaks of pertussis, or whooping cough, are occurring in Alaska communities. This disease can be devastating to infants.

More information regarding the updated immunization requirements may be obtained through your school nurse, your local health care provider, the Homer Public Health Center (235-8857) or by calling the Alaska Immunization Helpline at 888-430-4321. Call your local health care provider or the Homer Public Health Center at 235-8857 today to make an immunization appointment.

Judy Dean has been a public health nurse for the state of Alaska for more than 10 years. She has served in Juneau and Homer.

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