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Early Childhood Immunization Report

This school-level report includes immunization compliance data for early childhood students, including the number of doses they received and the most recent dose for DTaP/DTP/DT, Polio, MMR, Hib, Hepatitis A, Hepatitis B, Varicella, and any exemptions on file.

The report generates two separate outputs for the Immunization Data Report Total Sheet Form 108 and the Immunization Data Report Form 108B for each early childhood age group.

The Form 108 groups students by their birth date: born on or after April 1, 2012 and born from October 1, 2008 through March 31, 2012.

Selection Criteria

Selection criteria determine which database records are used in the report. Refer to selection criteria for analysis when the report does not return the correct records.

Student Selection

The report selects records from the [Students] table based on the following criteria:

  • The student must be enrolled in the school on or between the School Start Date and Date of Report entered at report runtime.
  • The student must be enrolled in a pre-kindergarten grade level, e.g. Grade_Level = -1.

Note: The report uses the Date of Report to determine the student’s age for immunization compliance.

Report Input

For help with navigation and running the report, see How to Find and Generate a Report.

Field

Description

Current Selection Students

Indicate which students to include in the report by selecting one of the following options:

  • The selected [number] students only – Run the report for students in the current selection.
  • All students – Run the report for all students in the current school or district that meet the selection criteria.

Note: If running the report for a single student, or group of students, select the students prior to running report.

School Start Date

Enter the first day of the school year.

Date of Report

Enter the date of the report. This value is usually either the current date, or November 15th, the date the report is due.

Contact Name

Enter the contact name to report in the header of the report output.

Contact Email

Enter the contact email address to report in the header of the report output.

Facility ID

Enter the facility ID to report in the header of the report output (usually starts with CDC or SGH).

Report Output

Each of the fields displayed in the output of the reports are described below. See Understanding the Report Output Table for a definition of each column in the table.

Immunization Data Report Total Sheet Form 108

Data Element

Description

[Table]FieldName

Name Of Child Care

The name of the school.

[Schools]Name

License #

This value is not reported and should be entered manually.

N/A

Phone

The school’s phone number

[Schools]SchoolPhone

Fax

The school’s fax number.

[Schools]SchoolFax

Mailing Address, City, Zip

The school’s address.

[Schools]SchoolAddress

[Schools]SchoolCity

[Schools]SchoolZip

County

The county in which the school is located.

[Schools]CountyName

Director or Contact Person

The name of the person completing the report.

N/A

E-mail

The email address of the contact person.

N/A

1. Attendance

The number of students enrolled in the school on the Date of Report, entered at report runtime.

[Students]EntryDate

[Students]ExitDate

2. Immunization Records on File

The number of students with an immunization record on file.

[HealthStudImmRec]StudentID

[HealthStudImmRec]HealthVaccineID

3. DTaP/DTP/DT

The number of students who received zero, one, two, three, or four or more doses of the DTaP/DTP/DT vaccine.

The total should equal the value for the number of students enrolled in the school.

[HealthStudDoseRec]Dose>=0,1,2,3,4

[HealthStudDoseRec]DateAdministered

[HealthVaccine]StateReportCode=DTaP_DTP or DT

4. OPV/IPV

The number of students who received zero, one, two, or three or more doses of the OPV/IPV vaccine.

The total should equal the value for the number of students enrolled in the school.

[HealthStudDoseRec]Dose>=0,1,2,3

[HealthStudDoseRec]DateAdministered

[HealthVaccine]StateReportCode=IPV_OPV

5. MMR

The number of students who received zero, one, two, or more doses of the MMR vaccine.

The total should equal the value for the number of students enrolled in the school.

[HealthStudDoseRec]Dose>=0,1,2

[HealthStudDoseRec]DateAdministered

[HealthVaccine]StateReportCode=MMR

6. Hib

The number of students who received zero, one, two, three, four or more doses of the Hib vaccine.

The total should equal the value for the number of students enrolled in the school.

[HealthStudDoseRec]Dose>=0,1,2,3,4

[HealthStudDoseRec]DateAdministered

[HealthVaccine]StateReportCode=Hib

7. Hep A

The number of students who received zero, one, two, or more doses of the Hepatitis A vaccine.

The total should equal the value for the number of students enrolled in the school.

[HealthStudDoseRec]Dose>=0,1,2

[HealthStudDoseRec]DateAdministered

[HealthVaccine]StateReportCode=HepA

8. Hep B

The number of students who received zero, one, two, three, or more doses of the Heb B vaccine.

The total should equal the value for the number of students enrolled in the school.

[HealthStudDoseRec]Dose>=0,1,2,3

[HealthStudDoseRec]DateAdministered

[HealthVaccine]StateReportCode=HepB

9. Varicella

The number of students who received one or more doses of the Varicella vaccine, including students who have a history of the chicken pox.

A history of chicken pox is determined by assigning the Exemption “History of Disease / Parental Recall of Disease” to the student for their Varicella vaccine.

[HealthStudDoseRec]Dose>=1

[HealthStudDoseRec]DateAdministered

[HealthVaccine]StateReportCode=VAR

[HealthStudImmRec]HealthImmExemptID

[HealthStudImmRec]ExemptionDate

[HealthImmExempt]StateReportCode = Hist_Recall

How many children enrolled in a childcare setting before 9/1/11 with parental recall of chicken pox disease?

The number of students who enrolled in the school before September 1, 2011 and whose parents claim that the student had the chicken pox.

A history of chicken pox is determined by assigning the Exemption “History of Disease / Parental Recall of Disease” to the student for their Varicella vaccine.

After September 1, 2011, parents can no longer claim a history of chicken pox for the student; the student must receive the vaccination or provide laboratory evidence of immunity.

[Students]EntryDate

[HealthStudImmRec]HealthImmExemptID

[HealthStudImmRec]ExemptionDate

[HealthImmExempt]StateReportCode = Hist_Recall

How many children have no doses of Varicella vaccine and did not establish parental recall of chicken pox disease before 9/1/11?

The number of students who have not received the Varicella vaccine and who also cannot establish a parental claim that they had the chicken pox.

A history of chicken pox is determined by assigning the Exemption “History of Disease / Parental Recall of Disease” to the student for their Varicella vaccine.

[HealthStudDoseRec]Dose=0

[HealthVaccine]StateReportCode=VAR

[HealthStudImmRec]HealthImmExemptID

[HealthStudImmRec]ExemptionDate

[HealthImmExempt]StateReportCode = Hist_Recall

10. Religious Exemption

The number of students who have a Religious Exemption.

[HealthStudImmRec]HealthImmExemptID

[HealthStudImmRec]ExemptionExpiryDate

[HealthImmExempt]StateReportCode = Perm_Pers

11. Temporary Medical Exemption

The number of students who have a Temporary Medical Exemption.

[HealthStudImmRec]HealthImmExemptID

[HealthStudImmRec]ExemptionExpiryDate

[HealthImmExempt]StateReportCode = Temp_Med

12. Permanent Medical Exemption

The number of students who have a Permanent Medical Exemption.

[HealthStudImmRec]HealthImmExemptID

[HealthStudImmRec]ExemptionExpiryDate

[HealthImmExempt]StateReportCode = Perm_Med

13. Laboratory Evidence of Immunity

The number of students who can provide laboratory evidence of immunity.

[HealthStudImmRec]HealthImmExemptID

[HealthStudImmRec]ExemptionExpiryDate

[HealthImmExempt]StateReportCode = Lab_Immun

Immunization Data Report Form 108B

Data Element

Description

[Table]FieldName

Full Name of Child Care or Preschool Facility

The name of the school.

[Schools]Name

Facility ID #

ID number of facility (usually starts with CDC or SGH). Value entered at report run-time.

N/A

Director/Contact Person

The name of the person completing the report. Entered at report run-time.

N/A

E-mail Address

The email address of the contact person. Entered at report run-time.

N/A

Phone

The school’s phone number

[Schools]SchoolPhone

Fax

The school’s fax number.

[Schools]SchoolFax

Mailing Address, City, Zip

The school’s address.

[Schools]SchoolAddress

[Schools]SchoolCity

[Schools]SchoolZip

County

The school’s county.

[Schools]CountyName

Date of Report

The date entered at report runtime.

N/A

Children with birth dates on or after April 1, 2012

Or

Children with birth dates from October 1, 2008 through March 31, 2012

Indicates the age level of the students included in the report.

N/A

Child’s Name

The name of the student.

[Students]LastFirst

Date of Birth

The student’s date of birth.

[Students]DOB

DTaP/DTP/DT

How many doses on record?

The number of doses of the DTaP/DTP/DT vaccine on record for the student.

[HealthStudDoseRec]Dose

[HealthVaccine]StateReportCode=DTaP_DTP or DT

Polio

How many doses on record?

The number of doses of the Polio vaccine on record for the student.

[HealthStudDoseRec]Dose

[HealthVaccine]StateReportCode=IPV_OPV

MMR

How many doses on record?

The number of doses of the MMR vaccine on record for the student.

[HealthStudDoseRec]Dose

[HealthVaccine]StateReportCode=MMR

Hib

How many doses on record?

The number of doses of the Hib vaccine on record for the student.

[HealthStudDoseRec]Dose

[HealthVaccine]StateReportCode=Hib

Hep A

How many doses on record?

The number of doses of the Hepatitis A vaccine on record for the student.

[HealthStudDoseRec]Dose

[HealthVaccine]StateReportCode=HepA

Hep B

How many doses on record?

The number of doses of the Hepatitis B vaccine on record for the student.

[HealthStudDoseRec]Dose

[HealthVaccine]StateReportCode=HepB

Varicella

How many doses on record?

The number of doses of the Varicella vaccine on record for the student.

[HealthStudDoseRec]Dose

[HealthVaccine]StateReportCode=VAR

Exemptions

Religious

Indicates if the student has a Religious Exemption.

[HealthStudImmRec]HealthImmExemptID

[HealthStudImmRec]ExemptionExpiryDate

[HealthImmExempt]StateReportCode = Perm_Pers

Exemptions

Temporary Medical

Indicates if the student has a Temporary Medical Exemption.

[HealthStudImmRec]HealthImmExemptID

[HealthStudImmRec]ExemptionExpiryDate

[HealthImmExempt]StateReportCode = Temp_Med

Exemptions

Permanent Medical

Indicates if the student has a Permanent Medical Exemption.

[HealthStudImmRec]HealthImmExemptID

[HealthStudImmRec]ExemptionExpiryDate

[HealthImmExempt]StateReportCode = Perm_Med

Exemptions

Lab Evidence of Immunity

Indicates if the student has laboratory evidence of immunity.

[HealthStudImmRec]HealthImmExemptID

[HealthStudImmRec]ExemptionExpiryDate

[HealthImmExempt]StateReportCode = Lab_Immun

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