Recommended Immunizations for Campers
Dear Children's Camp Operator:
This letter is to remind summer camps in New York State of the importance of:
- immunization in the camp setting and
- immediate reporting of any suspect vaccine preventable disease to the local health department
There has been an increase in the number of cases of vaccine-preventable diseases in the United States over the last several years, many of which have been linked to foreign travel or spread through children's summer camps. There are also a significant number of international campers and staff in New York State. These individuals provide a diverse experience at camp. However, they may also introduce vaccine-preventable diseases that are endemic in their countries of origin.
Within the last ten years there have been two outbreaks of mumps that began in summer camps in New York State; one of which resulted in more than 3,500 cases of mumps. Last summer and early fall, several cases of pertussis were reported among recent camp participants. During the case investigations, it was subsequently discovered that these individuals had previously-unreported cough illnesses while at camp, spreading disease in the camp and leading to secondary cases in home and community settings.
The best protection against vaccine-preventable diseases is broad vaccination coverage. Therefore, vaccination of all individuals who will be working in or attending summer camps is recommended.
Subpart 7-2 of the New York State Sanitary Code requires camps to maintain immunization records for all campers which includes dates for all immunizations against diphtheria, Haemophilus influenza type b, hepatitis b, measles, mumps, poliomyelitis, rubella, tetanus and varicella (chicken pox). The record must be kept on file for every camper and updated annually.
In addition, the New York State Department of Health (NYSDOH) strongly recommends that all staff at children's summer camps be fully immunized with all routinely recommended vaccines. Camps will need this information to quickly identify at-risk individuals if a suspect case of vaccine preventable disease occurs. Camps should also assess their risk for vaccine preventable disease outbreaks and take appropriate steps to reduce this risk. Camps should maintain current and accurate immunization records for all staff. Additionally, camps should maintain a detailed list of individuals, campers and staff, who are not fully protected against vaccine preventable diseases. The list should clearly identify which disease(s) an individual is vulnerable to contracting. Having immunization and health information readily available allows for a timely and appropriate public health response to control illness when required.
In summary, please take the following steps to reduce the risk for an outbreak of a vaccine preventable disease at your camp:
- Review the immunization records of all campers and staff; consider requiring additional vaccines for individuals who are not immune.
- Maintain up-to-date immunization records for all campers and staff, including known exemptions or individuals who lack immunity.
- Develop a policy that includes contact information for the immediate notification of the LHD by your medical staff of any suspected cases of vaccine preventable diseases.
RECOMMENDED IMMUNIZATIONS FOR CAMPERS
- The part of the State Sanitary Code that applies to campers is Subpart 7-2, which requires that the camp maintain immunization records for all campers. It does not, however, specify which vaccines are required for camp attendance.
- Individual camp policy may choose to recommend or require specific immunizations of their campers. For the optimal health and safety of all campers and camp staff, the New York State Department of Health (NYSDOH) strongly recommends that all campers meet the age appropriate immunization schedule as set forth by the Advisory Committee on Immunization Practices (ACIP): http://www.cdc.gov/vaccines/schedules/
- At a minimum, campers should meet the same immunization requirements as school-aged children as indicated in Public Health Law (PHL) Article 21, Title 6, Section 2164. Refer to New York State Immunization Requirements for School Entrance/Attendance, available at: http://www.health.ny.gov/publications/2370.pdf.
- In New York State, PHL Article 21, Title 6, Section 2167 also requires the notification of campers and parents about recommendations for and the availability of meningococcal vaccine for all campers attending overnight camps for a period of 7 or more consecutive nights.
RECOMMENDED IMMUNIZATIONS FOR STAFF AND EMPLOYEES
- Recommended immunizations, for all summer camp employees, including international staff, are based on the current recommendations of the ACIP. For further details consult ACIP publications accessible at: http://www.cdc.gov/vaccines/acip/ and the Centers for Disease Control (CDC), found at: http://www.cdc.gov/vaccines/adults/rec-vac/.
- Immunizations that are routinely recommended, at a minimum, (if not already administered, a history of disease does not exist, or serology has not proven immunity) include:
- 2 measles, mumps, and rubella (MMR) vaccine doses
- 1 tetanus, diphtheria, and acellular pertussis (Tdap) vaccine booster dose within the last 10 years,
- 2 varicella vaccine doses.
- Immunizations that are recommended for employees that have special requirements include:
- Hepatitis B vaccine for employees with reasonably anticipated risk for exposure to blood or body fluids (e.g. health care workers, lifeguards)
- Meningococcal vaccine for teens 11 – 18 years of age and for first year college students who live in dormitories.
VACCINE PREVENTABLE DISEASE REPORTING DETAILS
- Most vaccine-preventable diseases are reportable by law, and often even one case is considered an outbreak.
- The camp health director or other healthcare provider should discuss with staff the symptoms of vaccine-preventable diseases. Patients with VPD are infectious before they feel sick, so disease can be spread rapidly in camp settings. The need to report the first sign of illness to the director should be stressed.
- If one of these diseases is suspected in even one camper or camp employee, your local health department (LHD) should be notified immediately. Delays in reporting have led to large outbreaks at camps.
- If you or your health director are considering the diagnosis of a vaccine-preventable disease and are ordering testing, then you should report the case to the LHD at that time and isolate the ill individual.
- By notifying the LHD, as required, the LHD can facilitate obtaining rapid test results and institution of control measures, if indicated.
- Camp operators must also report to the permit-issuing official.
- Medical providers should refer to New York State Department of Health Communicable Disease Reporting Requirements for reporting instructions, available at: http://www.health.ny.gov/professionals/diseases/reporting/communicable/.
- For additional information on immunizations given in other countries or on immunizations in general, please call your local health department or the NYSDOH Bureau of Immunization at 518-473-4437.
- For NYS vaccine schedules and school entrance requirements: https://www.health.ny.gov/prevention/immunization/childhood_and_adolescent.htm.
- More information can also be obtained at the CDC website at http://www.cdc.gov/vaccines/.
- Communicable Disease Fact Sheets are available from the NYSDOH at: http://www.health.ny.gov/diseases/communicable/
Thank you for your efforts to keep camps free of vaccine-preventable disease.
Elizabeth Rausch-Phung, M.D., M.P.H.
Director, Bureau of Immunization
New York State Department of Health