Vaccination Requirements

1. All medical staff must show proof of Hep B immunization.
2. The following chart is required of all camp staff/volunteers: up to date Tdap, MMR (immunization or proof of immunity), and Varicella (immunization or proof of immunity). We will exempt anyone born prior to 1957 from the MMR and Varicella requirement, and before 1980 from the Varicella requirement.
3. If Proof of immunization is not available, titers can be drawn (MMR, Varicella) to check for antibodies. This can be expensive and require laboratory orders (obtained by primary care provider) that may ultimately determine that a booster vaccine is required. The least disruptive alternative is to have Varicella or MMR booster doses completed.
4. Due to the resurgence of Pertussis (whooping cough) in the United States, the following Tdap guidelines are recommended.
   a. Tdap use in adults. ACIP recommends that all adults aged 19 years and older who have not yet received a dose of Tdap should receive a single dose. Tdap should be administered regardless of interval since last tetanus or diphtheria toxoid-containing vaccine.
   b. Tdap in Adolescents: For routine use, adolescents aged 11 through 18 years who have completed the recommended childhood diphtheria and tetanus toxoids and pertussis/diphtheria and tetanus toxoids and acellular pertussis (DTP/DTaP) vaccination series should receive a single dose.
   c. After receipt of Tdap, persons should continue to receive Td/Tdap for routine booster immunization against tetanus and diphtheria, according to previously published guidelines (every 10 years, or 5 years for wound management).
5. If a volunteer cannot find proof Tdap, MMR, or Varicella immunization or immunity, they will need a booster before camp (available at any doctor’s office, urgent care, many pharmacies, or Health Departments). Many states maintain Electronic Immunization Registries where all immunizations and proof of disease information is kept. This can be accessed through the local Health Department or Medical Offices.
6. All campers must upload proof of the above vaccinations in Camp Doc (according to the expectations of their age). The exception is when written documentation is provided by the campers’ physician that there is a medical reason for the vaccines not to be given on schedule. The camper or caregiver’s belief in non-vaccination is NOT a valid reason for admission to camp, and the camper will not be eligible to attend.

Reference: Advisory Committee on Immunization Practices (ACIP) 2012 Recommendations

MMR: The CDC recommendation, which we are following, is: Administer 1 dose of measles, mumps, and rubella vaccine (MMR) to adults with no evidence of immunity to measles, mumps, or rubella.

Evidence of Immunity to MMR includes any of the following:

• Documentation of age-appropriate MMR vaccination
• Laboratory evidence of immunity or laboratory confirmation of disease
• Diagnosis or verification by a healthcare provider, with documentation in the patients’ medical record
• Evidence of laboratory confirmation, if testing was performed at the time of acute disease

Varicella: Documentation of age-appropriate varicella vaccine.

• Preschool age children (12 months to 3 years): 1 dose
• School age children, adolescents, and adults: 2 doses 4-8 weeks apart (If more than 8 weeks since the 1st dose, the 2nd dose may be given without restarting the schedule).

Evidence of Immunity to Varicella includes any of the following:

• Documentation of age-appropriate varicella vaccination
• Laboratory evidence of immunity or laboratory confirmation of disease
• Birth in the United States before 1980 (except healthcare providers)
• Diagnosis or verification of a history of varicella (chickenpox) or herpes zoster (shingles) by a healthcare provider
• An epidemiologic link to another varicella case or to a laboratory confirmed case, with documentation in the patients’ medical record
• Evidence of laboratory confirmation, if testing was performed at the time of acute disease.

Tdap: Tdap is the immunization given after age 11 (as opposed to DTaP, which is an immunization for infants/toddlers). Volunteers must have had the Tdap and Td or DTaP booster within 10 years. The important item being that they have received an additional “post-kindergarten” dose of pertussis vaccine and are keeping up with boosters every 10 years.

Camp Quality uses the CDC immunization guidelines.