August 11, 1998

SPRINGFIELD, ILL. – Dr. John R. Lumpkin, state public health director, wants to remind parents that all students entering the fifth or sixth grades and children 2 years of age or older entering school-operated pre-kindergarten programs or day care centers this fall must be immunized against hepatitis B. Failure to comply with the requirement can mean exclusion from school.

"Our long-term goal is to provide universal protection against hepatitis B, a very serious disease that has no cure," said Dr. Lumpkin. "Hepatitis B is being targeted because there are more cases of it reported annually than all other combined vaccine-preventable diseases for which childhood immunizations are currently required. This vaccine provides important long-term protection and is our only hope to eliminate hepatitis B, just as we've previously eradicated smallpox and will soon eliminate polio."

Enforcement of the requirement, which was slated to become effective July 1, 1997, was delayed for one year to give parents more time to schedule children for this immunization. Hepatitis B immunization involves three shots over a minimum of four months. The first two shots should be given at least four weeks apart and the third at the end of the four months. However, health officials recommend the spacing between the second and third shots should be longer, so that the interval between the first and third shots is six months. For example, if a child receives the first shot on January 1, the second shot should be given one month later, on February 1. The third and final shot in the series should be given between May 1 and July 1.

The state's immunization requirements were amended in 1996 to include the hepatitis B immunization requirement. It applies to children in all schools entering fifth grade on or after July 1997 and to children 2 years of age or older in all day care centers and school- or school-district operated programs such as nursery school, early childhood, pre-school and pre-kindergarten. Since enforcement of the requirement was delayed for a year, school districts also will have to ensure that this year's sixth graders have been immunized.

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 an 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; or by having sex with an infected person.

Illinois averaged 314 cases of hepatitis B per year from 1993 to 1997. In addition, the Department received reports of approximately 1,400 hepatitis B carriers per year for the past five years. A person can be a carrier of the virus and exhibit no symptoms, but spread the disease.

In addition to the hepatitis B vaccine, 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 – Three or more doses administered at appropriate intervals with the last dose being a booster received on or after the child's fourth birthday.
• Diphtheria, tetanus (lockjaw), pertussis (whooping cough) (DTaP or 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 – One dose of mumps vaccine at 12 months of age or later; a physician-diagnosed case of mumps; or laboratory confirmed evidence of immunity.
• Rubella – One dose of 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 (school entry, kindergarten, fifth grade and ninth grade) each year or face a 10 percent loss of state aid.

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