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New Jersey Department of Children and Families Policy Manual




Child Protection and Permanency

Effective Date:



Health Services



Health Services




Health Services



Child and Adolescent Immunizations


Immunizations        12-22-2003


Preventive care, including immunization, is an essential part of maintaining child health. Immunizations protect children from many serious childhood diseases. New Jersey requires immunizations for children entering school and day care programs. It is recommended that all children in the United States receive immunizations against the following 11 diseases:


·         Diphtheria;


·         Tetanus (Lock Jaw);


·         Pertussis (Whooping Cough);


·         Polio;


·         Measles;


·         Mumps;


·         Rubella (German Measles);


·         Hepatitis B;


·         Haemophilus Influenzae Type B;


·         Varicella (Chicken Pox); and


·         Pneumococcal Disease.


Many of these immunizations are given in combination to reduce the number of shots needed to provide protection. Common vaccine combinations and abbreviations include:


·         Hep B- Hepatitis B Vaccine;


·         DTaP- Diphtheria and Tetanus Toxoids and acellular Pertussis Vaccine;


·         Hib- Haemophilus Influenzae Type B Conjugate Vaccine;


·         IPV- Inactivated Poliovirus Vaccine;


·         MMR- Measles, Mumps and Rubella Vaccine;


·         VAR- Varicella Vaccine;


·         PCV- Pneumococcal Conjugate Vaccine; and


·         Td- Tetanus and Diphtheria Toxoids.


Immunizations and Medical Examinations


Children must have periodic medical examinations to receive immunizations according to established national guidelines. Caregivers must be reminded by the Worker to schedule medical examinations for children. The Worker must file medical reports/documentation or evidence of appointments in the case file. To remain up-to-date with immunizations and other preventive care, it is recommended that children have medical examinations at the following ages:


·         Under six weeks of age;


·         Two months;


·         Four months;


·         Six months;


·         Nine months;


·         Twelve months;


·         Fifteen months;


·         Eighteen months;


·         Twenty-four months; and


·         Once a year to age 21.


It is preferable for children to have an identified physician who is familiar with their health history and coordinates all of their health care and immunizations. The Worker needs to assist the Caregiver in finding a physician who can coordinate the child's health care and immunizations on an ongoing basis.


Modified Immunization Schedule


Children that have special medical issues such as HIV/AIDS, cancer or prematurity may require altered immunization schedules. These children may need different or additional immunizations while other children may not be able to receive some of the recommended immunizations. In all instances of special medical issues and delayed or interrupted immunization schedules, the physician determines the appropriate immunization schedule on a case by case basis.

Refer to the National Immunization Program website at to view the current Recommended Immunization Schedules. Refer to the Child Health web page, located on the CP&P intranet, for additional immunization and child health information.


Other Important Immunization Information


·         Older children and adolescents who have not been immunized with the Hepatitis B series should receive this immunization;


·         Influenza vaccine (Flu shot) is recommended once a year (preferably in October but also in November and December) for children of any age with a chronic health condition. Workers should encourage caregivers to speak with the child's health care provider to determine if the child should receive the influenza vaccine. Caregivers of these children should also be immunized;


·         Immunization guidelines are updated often to make adjustments for new vaccines and other changes. Physicians assess what immunizations are needed for preschool and school-aged children during scheduled visits; and


·         If a child is suspected or known to have fallen behind on immunizations, the family must arrange for a health care appointment as soon as possible.