NYC mom/dads, help me with immunization requirements for daycare.

[dancingflower]

I am cross-posting in the vax forum too!

My son is 28 months and possibly starting daycare this fall (it is depending on waiting lists). He is being delayed and selectively vaxed but now, If he is really to start school and follow the NYS requirements for immunization, there will be too many shots in a short period in order to catch up. Is there any way to "dance around" those requirements to give us time?

DS has had a lot of his vax, so I expected that when the time to start school arrived, it would just take us a few shots to catch up. I was wrong. All of those imminent and/or deadly threats (polio,  sexually transmitted hep B, chickenpox, influenza) are the shots piling up on his missing list.

His daycare is city funded so it's very supervised and it will be strict.

From today to September, DS is missing:

2 polios: he has had already one dose out of "superstition" 

1 Hib and 1 varicella: oh well!

3 HepB: oh why! 

Hep B (3 doses) is listed in the requirements for daycare but I read below in the fine print : "students starting at 6th grade must have 3 doses of Hep B..." . It seems conflicting.

I'm here really hoping that there can be any resource, like, starting daycare  while in an immunization plan, having had a first dose of each. I hope DS doesn't have to  receive all of those shots in the next 3 months but rather space them through 4/5 months and be admitted in the program with some sort of grace period to catch up. 

Is there anyone out there who knows how it goes in NYC?

[LitMom]

So, at a minimum, they want him to have the first dose of everything, and then they want you to continue to "catch up" during the year. The "Catch up Schedule" on page 5 of this document is useful: http://www.nyc.gov/html/doh/downloads/pdf/imm/vacsc4-1.pdf

Look at how many you need to catch up on to have the minimum doses, and then stage them accordingly. You don't have to have 3 HepBs before school starts, just 1 for example. But, if you do 1 HepB now, they'll say he's ready to have another before school starts... Also look at the HiB and Prevnar requirements, because they need less of them if they're over 15 months old. I believe just 1 of each, but I'll have to check.

[LitMom]

Okay, so, I presume he's had: 

4 DTaP

1 Polio

at least 1 Prevnar, depending on age

1 MMR

With the ones you mentioned remaining:

"2 polios: he has had already one dose out of "superstition" 

1 Hib and 1 varicella: oh well!

3 HepB: oh why!" 

If it were me, I would maybe do the HiB and Polio together now; then the varicella by itself in July; then the 3rd Polio in August; and squeak in the first HepB in September right before school starts. Then you're supposed to follow the catch up schedule on their recommendations for the remaining 2 HepBs, which is 4-8 weeks later for dose 2 and 16 weeks later for dose 3. But some places don't check again until the next year's health form, so you could spread them out much more than that. 

I'm not a doctor nor have I thought this through deeply though, so don't take it as medical advice! You only have 2 that you're doing more than one dose of, the Polio and the HepB. And if you do HepB now, they'll want you to do another in 4 weeks, so to put that off, you'll have to do it right before school starts/right before the health form is due. That means you'll likely have to finish the Polio entirely, unless you want to give Polio and HepB together. I can't comment on that either; I have no idea how they do together. 

[dancingflower]

Thanks for helping plan my rush schedule. I knew somebody knew how to dance this tune. Ill pass by DS ped, don't worry.

I understood the why in the timing for the multiple doses and its genius.

DS won't be turned away with only the first of his 3 doses of HepB. . yay!

Me and DH really need child care by now but when I saw the number of shots required to attend school, I was even considering keeping DS at home, using a nanny for those few irreconcilable hours and hold tight in the others. But oh, we truly need child care for a few days.

It is so sad to having to do vaccines that may, highly likely, be unnecessary. Why oh why?
Edited by dancingflower - 6/5/12 at 10:14pm