Why Day Care Centers Require Vaccination Proof

by Janel C. Atlas

When your child comes home from the care center, you expect him to bring home a colorful drawing or a story about a new friend. Sometimes he comes home with the sniffles, an unavoidable consequence of kids in close contact.
What parents, day care centers, the government and pediatricians all strive to avoid, though, is children bringing home a serious illnesses. Without preventive measures, diseases can easily spread in child care centers. Parents can provide protection by keeping children up-to-date with their immunization schedules.

Benefits of Vaccination
Vaccines introduce a small dose of weakened illness to the body, which builds immunity to the disease. According to the Vaccine Education Center at the Children’s Hospital of Philadelphia (CHOP), before vaccines, every year in the U.S., polio would paralyze 10,000 children and measles would infect about 4 million, killing 3,000. Chicken pox (varicella), infected 4 million children, causing 11,000 hospitalizations and more than 100 deaths.
Barbara Watson, MD, director of the Philadelphia Varicella Active Surveillance Project, says that while most children who develop chicken pox recover completely, many people don’t realize there can be complications, including encephalitis, pneumonia, and various effects on the blood system and the liver.
Since the introduction of the varicella vaccine in 1995, hospitalizations in the Philadelphia area due to chicken pox have dropped from 20 down to two per year. Vaccines have totally or nearly eradicated diseases such as smallpox, polio, diphtheria, and HiB infections (hemophilus influenzae type B), according to the U.S. Centers for Disease Control and Prevention (CDC).
Thanks to research and public health policy, a comprehensive vaccination program has been put in place. However, warns Amy Wishner, program director of the American Academy of Pediatrics (AAP) Pennsylvania chapter, “We can become complacent because we might not see the disease today as much as we used to or even at all.” But vaccinations are still vitally important, because diseases are still active elsewhere in the world. “Any disease is just a plane ride away,” says Wishner.

Who Decides?
The CDC and AAP recommend which vaccines should be required. Each state bases its required vaccination list on those recommendations. All states now require licensed child care providers to obtain and submit records showing that each enrolled child is up-to-date with immunizations.
Unlicensed child care providers, especially in-home care facilities, might not require all enrolled children to show they’ve received the recommended immunizations. Check with your provider if you have concerns about health standards at the facility.
As a parent, it is your right to refuse to comply with your state’s immunization schedule, but you should understand that your child might be refused enrollment in licensed child care centers until she has met the state’s vaccination standards. If there are important medical reasons why your child should refrain from getting a vaccine, states require documentation from your child’s pediatrician.

Concerns about Vaccinations
Some parents express concern about possible side effects or dangers associated with receiving the vaccination shots. Paul Offit, MD, Chief of Infectious Diseases at CHOP, offers this reassurance: “Anytime the CDC and AAP recommend a vaccine, it’s because they’ve concluded that its benefits definitely outweigh the potential dangers.” Says the AAP’s Amy Wishner, “I see the situation as an equation of risk and benefit. And the equation turns out to be so much in favor of the vaccine.”
Research consistently shows that although there is always a small risk of side-effects or severe reaction, vaccinations provide some of the best protection from dangerous illnesses that we can give our children. “You don’t want your children to suffer if you can prevent it,” says Dr. Watson.
Assuring that your child is protected from preventable diseases isn’t just for your family’s safety. Dr. Watson reminds us to “consider the community aspect of contagious diseases.” Immunizations not only protect your child, but others.

Other Measures
Immunization is not the only health-related issue a parent should consider when preparing to enroll a child in day care. Libby Ungvary, director of the Pennsylvania Early Childhood Education Linkage System (ECELS) suggests that all children receive hearing, vision, and lead screenings. These tests can be performed at the pediatrician’s office.
Ungvary recommends that when parents choose a day care provider, they make a health and safetychecklist. Child Care Aware provides a checklist at www.childcareaware.org/en/tools/parentsguide. She also recommends that if your child has special health-care needs, you provide the staff with a health plan and make sure they know how to
handle specific health issues.
Caregivers sometimes recognize a potential health problem before the parents do. Says Ungvary, “It is important to keep open communication between the child care provider, parents, and the child’s physician.”
Immunizations can insure your child’s safety, and the safety of other children attending child care centers, so that they come home with silly songs and new stories, not with a vaccine-preventable illness.

Janel C. Atlas is a local freelance writer.

For More Info

•For details of the CDC and AAP recommended immunization schedule, see www.cdc.gov/nip/recs/child-schedule.pdf
•For other vaccine information see www.cispimmunize.org and www.cdc.gov/nip
• You can also call the National Immunization Hotline, 800-232-2522 (English) or 800-232-0233 (Spanish).
• The Vaccine Education Center at the Children’s Hospital of Philadelphia provides info about each vaccine and possible side effects. www.chop.edu/consumer/jsp/division/generic.jsp?id=75697