It is inevitable, said Susan Hill. A few days before Loudoun County schools start, a mother will call frantically trying to get her child into the county Health Department clinic for a required physical.
Hill, a registered public health nurse and the county's immunization coordinator, will have to explain the clinic is booked only to hear the mother continue to plead her case because school starts in two days and without the physical, the child will not be able to attend the first day of class.
"It's clichŽ, but true, poor planning on your part does not constitute poor execution on our part," Hill said.
Even so, Wayde Byard, public information officer for the school system, said there are not many students turned away on the first day.
"A couple years ago, we had children on the first day that were sent over to the health department to get their immunizations and that day were back in class," Byard said.
LOUDOUN COUNTY Public Schools requires all new students to the school system to have up-to-date immunization records and physicals before they will be permitted to attend class.
Hill said the health clinic is already booked as far as physicals go, but it is still accepting walk-in immunizations.
"All required childhood immunizations are free regardless, if they are required by law for entrance to school," Hill said.
Hill said the clinic gets busy as the first day of school approaches. Typically, students coming to Loudoun County from another country make up the bulk of clients because immunization records may not be complete or their home country may have different requirements. However, the clients are not limited to foreign-born residents.
Nor is it just young children. While a majority of immunizations are recommended by the Centers for Disease Control and Prevention (CDC) to be administered within the first two years of childhood, there are some shots that require boosters, usually every 10 years, such as tetanus and hepatitis B. In addition, a hepatitis A shot should be considered if a person travels often. And the flu vaccine is recommend every year, as early as age 6 months.
"Some colleges require some shots," said Dr. David Goodfriend, director of the county Health Department. "People throughout their whole life should be getting vaccinations."
New this year, said Hill, is the recommendation that adolescents, anyone under the age 19, receive a vaccination for meningitis.
Even though health-care professionals recommend the booster shots, the school system does not, said Byard. However, participation in athletics require students to undergo physicals. At the same time, the school system will see if immunizations are out of date and "steer them in the right direction," said Byard.
NORMALLY, THE CLINIC sees about 25 families per day for a range of services, however, as the first day of school approaches, the clinic is "bombarded with families," Hill said. The clinic has four registered nurses who can provide the immunizations on a walk-in basis. The clinic requires the complete immunization record for the child, if there is one. For children younger than 18, a parent or responsible adult must also be present. The staff will review the records and determine what immunizations have yet to be administered. If no records exists, the child begins the entire immunization process and the adult is given an immunization schedule to follow to ensure the child receives all the appropriate vaccines at the proper times.
"What we don't want is a child with meningitis or hepatitis when we can prevent it," Goodfriend said.
According to the Virginia Department of Health, across the United States there is a yearly average of 114,000 influenza-related hospitalizations and 36,000 deaths. In addition, there are approximately 2,500 to 3,000 cases of meningococcal disease Ñ a potentially fatal disease caused by meningitis Ñ in the U.S., while in Virginia in 2004 there were 24 cases with two resulting in fatalities.
Goodfriend said there has been some reports that claim a link between autism and some vaccines, however, he said, "I firmly believe there is no link. I hope and encourage all children get vaccinated whether it is required or not because a child can contract something and bring it home."
The school system, however, does allow a waiver from the immunizations for religious reasons, said Goodfriend.