It’s Time for Kindergarten Round Up in Michigan

Sarah de Ruiter, BSN, RN, MA, Immunization Nurse Educator, Michigan Department of Health and Human Services, Division of Immunization

It’s kindergarten round-up time again and many Michigan schools are actively enrolling the kindergarten class of 2023/2024. This is a crucial time when healthcare providers have the opportunity to communicate with families about the importance of adding routine childhood and COVID-19 vaccinations to their back-to-school checklist.

On October 20, 2022, the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) recommended updates to the 2023 childhood and adult immunization schedules, which includes incorporating recommendations for COVID-19 vaccines. These updates ensure the 2023 schedules are consistent with all ACIP recommendations made during 2022. The 2023 schedules will become effective when published on the CDC website in February 2023.

During the COVID-19 pandemic, we saw a concerning drop in routine immunizations for children. On January 13, 2023, CDC reported that during the 2020–21 school year, national coverage with state-required vaccines among kindergarten students declined from 95% to approximately 94%. During the 2021–22 school year, coverage decreased again to approximately 93% for all state-required vaccines. The exemption rate remained low (2.6%). An additional 3.9% without an exemption were not up to date with measles, mumps and rubella vaccine. Despite widespread return to in-person learning, COVID-19–related disruptions have continued to affect vaccination coverage and assessment for the 2021–22 school year, preventing a return to coverage rates prior to the COVID-19 pandemic.

To get kids back on track, it is important for providers to assess immunization records at every visit to see which vaccines are needed to protect them and others from communicable disease. For the best protection, health care providers should vaccinate their pediatric patients from vaccine-preventable diseases according to the CDC recommended child and adolescent immunization schedule.

Michigan requires all incoming kindergarteners and 4-6-year-old transfer students to have appropriate documentation of vaccines protecting against diphtheria, tetanus, pertussis, polio, measles, mumps, rubella, hepatitis B, and varicella. By vaccinating children according to the CDC schedule, your patients will receive all the vaccines required for school and daycare entry.

To help understand school and daycare vaccine requirements, the Michigan Department of Health and Human Services (MDHHS) has created easy-to-read handouts that target healthcare providers, schools and daycares, and parents. These documents are available on the MDHHS Immunization Information for Families and Providers website. As a reminder, patients requesting a non-medical waiver for school should be referred to their Local Health Department (LHD). Health care providers should only provide parents with a medical immunization waiver (i.e., true medical contraindication to vaccine(s)) when needed.

Remember to check the Michigan Care Improvement Registry (MCIR) for every patient at every well and sick child visit to determine which vaccines are needed to best protect them. All vaccines administered to persons less than 20 years of age, including flu and COVID-19 vaccines, are required to be entered into MCIR within 72 hours of vaccine administration. By protecting your patients with all ACIP-recommended vaccines, you are helping young Michiganders stay healthy and ready to learn.

Healthcare providers are trusted sources of information for parents and guardians. They can also help families make the informed decision to vaccinate. Here are some ways to help catch school-aged children up on vaccination.

  • Prioritize ensuring everyone catches up on routine vaccination
  • Identify individuals behind on their vaccinations
  • Encourage vaccination catch-up through reminders, recall, and outreach
  • Make strong vaccine recommendations
  • Make vaccines easy for everyone to find and afford

Routine and catch-up vaccination will require efforts from healthcare systems, healthcare providers, schools, state and local governments, and families. Routine Immunizations on Schedule for Everyone (RISE) is part of a recently launched CDC initiative called “Let’s RISE.” This initiative provides actionable strategies, resources and data to support getting all Americans back on schedule with their routine immunizations. Applying CDC’s strategies along with sharing facts and answering families’ questions about routine and COVID-19 vaccines is an important step in ensuring everyone is protected from vaccine preventable disease and disability.