It is recommended that Colorado children have immunizations to protect them from these childhood diseases by the time they enter kindergarten or first grade: diphtheria, tetanus and pertussis or whooping cough (DTaP); haemophilus influenzae type b (HIB); hepatitis A; hepatitis B; influenza; measles; mumps; pneumococcal disease; polio; rotavirus; rubella; and varicella or chickenpox.

Immunizations specified for the child's age are required for enrollment at a child-care center, beginning at two months of age, in addition to being required for school entry.

The 11 required vaccinations are described below:

• Chickenpox (varicella): The requirement for this vaccine, which first became mandatory in Colorado on July 1, 2000, is being gradually phased in, although health officials recommend that the vaccine be administered to all children and youth up to the age of 18 who have not had the disease. For the 2008-09 school year, one dose of the varicella or chickenpox vaccination is currently required for second through seventh grade. With the new school entry requirement, children entering kindergarten and first grade are required to have a second dose of varicella or chickenpox vaccination. Previously, if a parent or guardian confirmed the child already had chickenpox, the immunization would not be required. But the new requirement for the 2008-09 school year requires the vaccine unless there is documentation by a health care provider that the child has had chickenpox.
• Diphtheria/tetanus/pertussis (DTaP): In general, a total of five doses of diphtheria, tetanus and pertussis (whooping cough) vaccine are required for students entering a Colorado school for the first time. Only four doses of the vaccine are required if the fourth dose was administered on or after the fourth birthday. Children who are 7 years of age or older no longer receive the DtaP vaccine. Children between 7 though 9 years of age instead receive Td vaccine if they need to complete the requirement for tetanus and diptheria. Children 10 years of age or older receive the Tdap vaccine to complete the requirement for tetanus and diphtheria and to provide protection from pertussis.
• Hepatitis B: A total of three doses of this vaccine are required for preschool and all grades.
• Haemophilus influenzae Type B (Hib): This vaccine is a preschool requirement for children 4 years of age or younger but is not required for children 5 years of age or older. One, two or three doses of this vaccine are required, depending on both the child's current age and the age when the vaccine was administered.
• Measles, mumps and rubella (MMR): Two doses of this vaccine are required for kindergarten through 12th grades. One dose is required for preschool children.
• Polio: In general, three doses of this vaccine are required for children in preschool. Grade school, middle school and high school students entering a Colorado school for the first time are required to have four doses of this vaccine. The exception to this rule is if a child received his or her third polio vaccine at or after the age of 4.
• Pneumococcal disease (Prevnar/PCV7): Pneumonia is a contagious disease that can have serious effects in infants and young children. The vaccine, Prevnar (PCV7), is an effective immunization administered in a series to children to prevent pneumonia. The Centers for Disease Control and Prevention recommends the routine vaccination of preschool children with the PCV7 vaccine. It now will be required for children in licensed child-care through 23 months of age, and the number of doses depends on when the vaccine was initially administered.
• Tetanus/diphtheria/pertussis (Tdap): CDC recommends all 11- to 12-year olds receive a dose of Tdap. In Colorado, Tdap vaccine will be required for all incoming sixth, seventh, tenth and eleventh graders this upcoming school year (SY 2008-09), and in subsequent years that schedule will incorporate other grades as well.

The Health Department advised parents and guardians to take immunization records with them when enrolling a child in a Colorado school for the first time.

Reynolds said that if the school determines that a child's immunizations are incomplete, parents have only 14 days after receiving notification from the school for their child to receive the first recommended immunization and to present to the school a written plan for completion of the remaining immunizations.

Reynolds added that Colorado law permits schools to suspend students until receiving proof that the immunization requirements have been completed, are in process, or that a parent has chosen to file a request for exemption. The state's schools are to deny admittance of students who do not present an immunization record at the beginning of school.

Under Colorado law, parents may choose to have their children exempted from immunization requirements for medical, religious or personal reasons. Exemption forms, which are required in lieu of the certificate of immunization for those parents who choose exemption, are on the reverse side of the state's Certificate of Immunization and can be obtained from doctors' offices and at schools.