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GOVERNMENT OF THE VIRGIN ISLANDS OF THE UNITED STATES VIRGIN ISLANDS DEPARTMENT OF HEALTH IMMUNIZATION PROGRAM ST. CROIX OFFICE ST. THOMAS OFFICE CHARLES HARWOOD COMPLEX 1303 HOSPITAL GROUND, SUITE 10 3500 ESTATE RICHMOND CHARLOTTE AMALIE CHRISTINASTED, ST. CROIX, VI. 00820-4370 ST. THOMAS, VI 00802-6722 TEL: (340)-718-1311 TEL: (340) 776-1113 Revised 2022 | Immunization | Head Start 1 July 14, 2022 Honorable Kimberly Causey Gomez Commissioner Department of Human Services Knud Hansen Complex, Building A 1303 Hospital Ground St. Thomas, VI 00802 Re: VACCINE RECOMMENDATIONS FOR CHILDCARE FACILITIES, PRESCHOOL REGISTRATION, AFTER SCHOOL PROGRAMS & SUMMER CAMPS (2022-2023 School Year) As part of the Department of Health’s mandate to ensure healthy communities in the Territory, it is recommended that the Department of Human Services (DHS) require the following immunizations for infants and children attending daycare centers and pre-school in the US Virgin Islands. The following vaccines are recommended by the Department of Health as well as the Advisory Committee on Immunization Practice (ACIP), the American Academy of Pediatrics (AAP), and the American Academy of Family Physicians (AAFP):  Hepatitis B, Rotavirus, Diphtheria, Tetanus, Pertussis, Haemophilus Influenzae type b, Pneumococcal (Prevnar) Inactivated Poliovirus, Measles, Mumps, Rubella, Varicella, Hepatitis A, and Influenza. Please note: The Influenza vaccine is being recommended for the population you regulate. Children in childcare facilities 6 months old and above are encouraged to receive the influenza vaccine (unless the child is exempt–see guidelines below.) Through ongoing assessment of our coverage rates, it has been determined that less than 10% of the Virgin Islands' children are vaccinated against influenza. Conditions in childcare facilities also promote GOVERNMENT OF THE VIRGIN ISLANDS OF THE UNITED STATES VIRGIN ISLANDS DEPARTMENT OF HEALTH IMMUNIZATION PROGRAM ST. CROIX OFFICE ST. THOMAS OFFICE CHARLES HARWOOD COMPLEX 1303 HOSPITAL GROUND, SUITE 10 3500 ESTATE RICHMOND CHARLOTTE AMALIE CHRISTINASTED, ST. CROIX, VI. 00820-4370 ST. THOMAS, VI 00802-6722 TEL: (340)-718-1311 TEL: (340) 776-1113 Revised 2022 | Immunization | Head Start 2 the spread of influenza: there are a large number of people together who are in close contact, and there is poor respiratory hygiene (e.g., covering a cough). Even more, the highest rates of infection are in children less than 5 years old. CDC recommends that everyone 6 months of age and older get a seasonal flu vaccine. Vaccination is especially important for certain people who are at high-risk or who are in close contact with a high-risk person, including the following groups:  Children younger than 5 years of age, and children of any age with a long-term health condition like asthma, diabetes, or disorders of the brain or nervous system. These children are at a higher risk of serious flu complications (like pneumonia) if they get the flu. For the complete list of those at high risk, visit People at High Risk of Developing Flu-Related Complications.  Adults who meet any of the following criteria listed below should get a seasonal flu vaccine: o Are in close contact with children younger than 5 years of age (people who live with them). o Are out-of-home caregivers (nannies, daycare providers, etc.) of children younger than 5 years of age. o Live with or have another close contact with a child or children of any age with a chronic health problem (asthma, diabetes, etc.). o Are healthcare workers The Department of Health requests that the Department of Human Services sends an official notice to all childcare centers and pre-schools of your departments’ updated vaccine requirements and revises your Universal Health Record form to include all of the above vaccines.  All children shall receive the recommended vaccine(s) (and the total number of doses), at the minimum age recommended in the attached immunization schedule before admission to the childcare facility; however, for each child, eligibility to receive recommended vaccines will be determined by the clinic Nurse or health care provider. GOVERNMENT OF THE VIRGIN ISLANDS OF THE UNITED STATES VIRGIN ISLANDS DEPARTMENT OF HEALTH IMMUNIZATION PROGRAM ST. CROIX OFFICE ST. THOMAS OFFICE CHARLES HARWOOD COMPLEX 1303 HOSPITAL GROUND, SUITE 10 3500 ESTATE RICHMOND CHARLOTTE AMALIE CHRISTINASTED, ST. CROIX, VI. 00820-4370 ST. THOMAS, VI 00802-6722 TEL: (340)-718-1311 TEL: (340) 776-1113 Revised 2022 | Immunization | Head Start 3  Special vaccination instructions for children aged 6 months through 8 years of age for the influenza vaccines are also attached for your information and implementation. For more information concerning the number of doses recommended based on the child’s age and immunization history, please refer to the attached “Recommended Immunization Schedule for Children and Adolescents Aged 18 Years and Younger.” Please call the Department of Health, Maternal Child, and Health clinic at (340) 777-8804 for St. Thomas/St. John or (340) 514-6839 on St. Croix if you have any questions concerning the vaccines recommended for infants and children specified above. Please note: Exemptions may be granted for school-aged children based on the principles and teachings of a recognized religious organization/church, notarized personal statement, and if the vaccines/medical agents are medically contraindicated. Sincerely, _______________________________/ ______________ Justa Encarnacion, RN BSN, MBA/HCM Date Commissioner of Health 7/28/2022 GOVERNMENT OF THE VIRGIN ISLANDS OF THE UNITED STATES VIRGIN ISLANDS DEPARTMENT OF HEALTH IMMUNIZATION PROGRAM ST. CROIX OFFICE ST. THOMAS OFFICE CHARLES HARWOOD COMPLEX 1303 HOSPITAL GROUND, SUITE 10 3500 ESTATE RICHMOND CHARLOTTE AMALIE CHRISTINASTED, ST. CROIX, VI. 00820-4370 ST. THOMAS, VI 00802-6722 TEL: (340)-718-1311 TEL: (340) 776-1113 Revised 2022 | Immunization | Head Start 4