August 14, 1997

SPRINGFIELD, IL -- The Illinois Department of Public Health today announced it has delayed enforcement for one year a new requirement that all students entering 5th grade or children 2 years of age or older enrolling in school-operated pre-kindergarten programs have three doses of hepatitis B vaccine.

"Due to the complexity of the new mandate, which involves three separate visits to a health care provider over several months, it was decided a one-year delay will allow parents greater opportunity to have their children immunized according to the recommended vaccination schedule and not force their exclusion from school," said Dr. John R. Lumpkin, state public health director.

Dr. Lumpkin said there was concern that, faced with the possibility of their child not being able to attend school or school-operated pre-kindergarten programs because all the required hepatitis B immunizations had not been received, parents may opt to have the three- dose regimen in less than the optimum time schedule.

While three months is the current minimum requirement -- the first two shots four weeks apart and the third shot at least two months after the second -- health officials recommend the spacing between the first and third shot be at least four months and, at the physician's discretion, could be up to six months apart.

"The long-lasting effectiveness of the hepatitis B vaccine has been found to be better if the time between the second and third shots is at least three months," Dr. Lumpkin said.

Although enforcement of the requirement is delayed for a year, Dr. Lumpkin said it is still incumbent on parents and school districts to make sure children receive the immunizations so there will be no problem with districts meeting the required 90 percent compliance for the 1998-99 school year. A year from now, school districts will have to ensure 6th graders meet the hepatitis B requirement, as well as, entering 5th graders and pre-kindergarten students.

An emergency rule to amend the Illinois School Code regarding the hepatitis B requirement was filed today with the Secretary of State's Office and is effective immediately. This rulemaking will delay the enforcement of the hepatitis B immunization requirement for one year and require that the first and last dose of the three-dose series must be at least four months apart.

Hepatitis B is caused by a virus that attacks the liver and can cause cirrhosis and liver cancer. It is spread by direct contact with the blood or body fluids of an infected person. A person can be infected in several ways, including: during birth when the infected mother passes the virus to her baby; by sharing personal items, such as a razor or toothbrush; by being stuck with a used needle and by having sex with an infected person.

For those who exhibit signs of hepatitis B, the symptoms include yellowing of the skin and eyes, loss of appetite, nausea, vomiting, fever, stomach or joint pain, and extreme tiredness. Illinois has averaged 350 cases of hepatitis B per year over the past five years. In addition, the

Department received reports of an average of nearly 1,300 hepatitis B carriers a year for the past five years. A person can be a carrier of the virus and exhibit no symptoms, but spread the disease.

While the hepatitis B compliance is put off for a year, parents still must comply with Illinois law mandates that children in elementary and secondary public and private schools be

immunized against seven childhood diseases. State law also requires that children have a physical exam at school entry and at kindergarten and grades 5 and 9. Children entering licensed day care, preschool or kindergarten for the first time must show proof they have been assessed or screened for lead poisoning. The Illinois State Board of Education does not require schools to exclude children if they have not been tested for lead poisoning.

Children without the state-mandated physical and vaccinations may not be allowed to attend school until these requirements are met. The only exceptions are for those children whose parents or physicians have filed a religious or medical exemption with the school district.

Children entering Illinois elementary and secondary schools for the first time must meet the following immunization requirements:

• Measles -- Two doses of live measles vaccine, with the first dose at 12 months of age or later and the second dose at least one month after the first; a physician- diagnosed case of measles; or laboratory evidence of immunity.

• Polio (TOPV) -- Three or more doses administered at appropriate intervals with the last dose being a booster and received on or after the child's fourth birthday.

• Diphtheria, Tetanus (lockjaw), Pertussis (whooping cough) (DTP) -- Four or more doses administered at the appropriate intervals with the last dose being a booster received on or after the child's fourth birthday.

• Mumps -- Vaccine at 12 months of age or later, or physician-diagnosed case of mumps.

• Rubella -- Vaccine at 12 months of age or later or laboratory evidence of immunity.

School districts must demonstrate at least 90 percent compliance with state-mandated immunizations and school physical requirements each year or face a 10 percent loss of state aid. For the 1996-97 school year, there was 98.1 percent compliance with immunization requirements.

For information on obtaining immunizations or a school physical, individuals should contact their physicians, their local health departments or telephone the state's immunization hotline at 800-323-GROW (voice and TTY).

Illinois Department of Public Health 535 West Jefferson Street Springfield, Illinois 62761 Phone 217-782-4977 Fax 217-782-3987 TTY 800-547-0466 Questions or Comments