Immigrant Influx Tests Shot Policy

Claudette Riley, Tennessean.com, August 2, 2006

New immigrants are coming to Tennessee public schools in record numbers, and federal law requires Tennessee to admit many of them whether or not they have had required immunizations.

The influx has come with no increase in nurse or bookkeeping staff, and schools are not required to track or report the number of children who show up each year without all their vaccinations or shot records. Children who aren’t vaccinated against dangerous and sometimes deadly diseases are at greater risk of getting sick.

State law requires that students receive all required vaccinations “prior” to enrolling in public schools, but districts can’t keep certain groups of students, including homeless kids—some of them new immigrants who have temporary housing—from registering and going to class even if they have missing or incomplete health records. And, while about 97 percent of all children statewide are immunized, the population of children who are less likely to have all their shots keeps going up.

“It’s a concern among all parents. If they are going to have a policy, then a policy needs to be carried forward so all children are treated the same,” said Richard Buck, a parent of two and Overton cluster representative to the Parents Advisory Council. “It’s very important that you do preventive medicine.”

It isn’t clear how many children show up on Tennessee school doorsteps each year without all the required vaccinations because schools aren’t required to track or report that information. While the schools fill out annual compliance reports, they don’t have to tell anyone how many showed up without their records and how long they were in school before the records were found or shots were given.

“It’s not something that is brought to our attention,” said Rachel Woods, spokeswoman for the state Department of Education.

Buck said he understands that there are exemptions, but he wants to know more about the process and about why the number of students who show up without all their shots isn’t tracked closely.

“They send letters out (about immunizations), and I assumed it was being followed up,” he said. “I have questions.”

Homeless students must be allowed to immediately enroll, and because the federal definition of homelessness ranges from families in shelters and motels to those doubled-up with another family, many migrant and new immigrant families fall into that category. The estimated number of such “homeless” students enrolled in schools statewide jumped from about 3,400 in 2000 to more than 5,800 four years later.

“That is the one big exception. This is one area where we are flexible,” said Tina Bozeman, coordinator of school health services for Metro schools.

The overwhelming majority of students who enter public schools this month will be vaccinated against a wide range of diseases, ranging from polio to hepatitis and measles.

Dr. Kelly Moore, medical director of the state Department of Health’s immunization program, said at least 97 percent of children in this state have their required vaccinations. Among children who don’t have all their shots, she said, only a sliver requested an allowable exemption on the basis of medical or religious reasons.

Students from other countries aren’t given free passes. While schools aren’t allowed to require a Social Security number or other documents to prove citizenship, they do ask for a home address (or proof of residency) as well as immunization records.

“It’s the same as Americans, they have to have exactly the same shots,” said Jan Lanier, who worked this summer as the interim English Language Learner coordinator for Metro schools. “They have to provide that the child is getting the shots and keeping their appointments. There are no exceptions.”

Catherine Knowles, director of Metro schools’ homeless education program, said schools don’t bar homeless kids from enrolling, but they work closely with the family to track down the paperwork or get the necessary shots.

“A homeless child cannot be denied enrollment if they’re not immunized, but that doesn’t mean they never have to get it,” Knowles said, noting that it’s less stressful for older students. “The assumption is that if you’ve been enrolled in school, you’ve been immunized.”

Systems have some leeway in giving students extra time to produce an up-to-date immunization record depending on where they used to live.

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