January 4, 2017
Dear Colleagues,
Happy New Year! Welcome to 2017!! This email is packed full of news of events, seminars, workshops and other information essential to ALL school nurses. Please be sure to forward to all School Nurses in your community!
Please note the attached memo concerning vision screening protocols. Apparently, an older version was circulated recently that incorrectly stated that vision screenings were required in all grades; the correct version of the MDPH approved vision screening protocols is attached. Please contact your regional consultant for any additional questions or concerns. Our apologies for any inconvenience this may have caused. In addition, I have attached an updated report from the Children’s Eye Foundation of the American Association for Pediatric Ophthalmology and Strabismus that includes an AAP-endorsed guide based on a policy statement from the AAP and other health care groups on instrument-based pediatric vision screening. The guide discusses the importance of vision screenings for children including instrument-based screening. The recommendation remains the same as previously; instrument-based screening is ONLY appropriate for children 6 years and younger.
Please continue to check the BU SHIELD website (www.SHIELD-BU.org) for upcoming SBIRT programs for all school staff. SBIRT 1 (Introduction to SBIRT) will continue to be held at various venues across the state….watch for one in your region soon. All school staff involved with SBIRT and other interested individuals such as students, parents, substance abuse coalition members and community members are welcome to attend this introductory session. SBIRT 2&3 are now combined to provide training in SBIRT Essentials of Implementation. These trainings are available upon request to local school districts (we ask for a 15 staff member minimum to attend). Just complete the training request form found on the MASBIRT website at http://www.masbirt.org/training-request. Staff involved with SBIRT Screenings are strongly encouraged to attend this supplemental trainings.
The best to you as you begin a new year!
Mary Ann, Janet and Carol
“I have never felt that anything really mattered but the satisfaction of knowing that you stood for the things in which you believed, and had done the very best you could.” — Eleanor Roosevelt, first lady, diplomat and activist
School Nurses in the News!
Congratulations to Shanyn Toulouse, Regional Consultant for the Northeast on passing the examination for national certification as a school nurse! This is certainly a hard-earned recognition and I have attached the list of school nurses from Massachusetts who have earned this certification! Our congratulations to all who have earned this certification and appreciation for the continuing education required to maintain it!
From the Department of Elementary and Secondary Education (DESE) and the Department of Public Health (DPH):
DPH and DESE are offering a free training in the Comprehensive School Physical Activity Program in February. Details are below and a flyer is attached for your information.
February 3, 2017
9:30am – 2pm (lunch will be provided)
YMCA of Central Mass (Worcester)
No cost to attend, but we ask that schools commit to piloting a new assessment tool in their schools after the training (2 page checklist based on nationally established standards for PE/PA in schools) and sharing their results with us. Interested parties should contact Amy Rojas amy.rojas@state.ma.us to sign up.
From the Department of Elementary and Secondary Education (DESE)
As part of Restraint and Seclusion Prevention Training Calendar, please see the attached flyer for information on “Using PBIS in Alternative School Settings” training. This training is presented by DESE and will be held on Friday, January 20th, 2017 at the Department of Mental Health Office, Hadley Building, 167 Lyman Street Westborough, MA 01581.
From The Children’s Behavioral Health Knowledge Center Webinar Series:
Register Today!
Facts and Fantasies About Bullying and Cyberbullying
Wednesday, January 18th, 2017
11:00am- 12:00pm
Professionals working with children tend to hear about “bullying” and “cyberbullying” problems continuously, but how often do children and parents use these terms accurately? What behaviors are used to bully, and how often do online behaviors intersect with what happens in school? Are bullying and cyberbullying always the result of emotional disorders, or can they be attributed to lack of knowledge and cognitive misperceptions? Recent research investigating the more effective ways of discussing and addressing these issues with children and adolescents will be reviewed, and resources discussed.
Presenter: Elizabeth K. Englander, Ph.D., Director, Massachusetts Aggression Reduction Center, Professor of Psychology, Bridgewater State University Click here to read Dr. Englander’s bio
From Boston Childrens Hospital:
Please see the attached registration form for the annual Pediatric Asthma and Allergy Conference sponsored by Boston Children’s Hospital
From the Executive Office of Public Safety and Security:
See the attached letter which outlines the nuances of the legalization of marijuana in our state. For our purposes, marijuana is still illegal for under 18, but this does state the parameters of possession, etc. The revised scope of the legal possession provision does NOT permit any person to possess any quantity of marijuana on the grounds of a public or private preschool or K-12 school. For individuals over 21 who possess less than one ounce of marijuana on school grounds, a civil penalty still exists. For persons under 21, previous penalties still apply. State and local governments retain the authority to prohibit possession of marijuana within their buildings.
From the Massachusetts Interscholastic Athletic Association (MIAA):
Please see the attached flyers announcing two upcoming workshops: Opioids and Teen Mental Health
From the Massachusetts General Hospital THRIVE Program:
Attached is the flyer for the Massachusetts General Hospital (MGH) THRIVE Program Conference on Epilepsy. Please contact Robyn Bluestein, Program Manager of the Carol and James Herscot Center for TSC at MGH, for any questions or additional information at RBLUESTEIN@PARTNERS.ORG
Gallop Poll Results:
Nurses again top survey for ethics, trustworthiness among professions! Nursing remains the most-trusted profession in Gallup’s annual honesty and ethical standards poll for the 15th year running, with 84% of respondents rating nurses’ honesty and ethical standards as high or very high. In the survey, pharmacists and physicians followed nurses with 67% and 65% ratings, respectively. Gallup.com (12/19).
From the Food and Drug Administration (FDA):
The U.S. Food and Drug Administration today expanded the approved use of Dexcom’s G5 Mobile Continuous Glucose Monitoring System to allow for replacement of fingerstick blood glucose (sugar) testing for diabetes treatment decisions in people 2 years of age and older with diabetes. This is the first FDA-approved continuous glucose monitoring system that can be used to make diabetes treatment decisions without confirmation with a traditional fingerstick test. The system was previously approved to complement, not replace, fingerstick testing for diabetes treatment decisions. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm534056.htm
From the Opioid Task Force of Franklin County and the North Quabbin Region:
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From the Massachusetts Advisory Committee on Immunization Practices (ACIP):
The Advisory Committee on Immunization Practices (ACIP) and the Centers for Disease Control and Prevention (CDC) have updated their recommendations for HPV vaccine stating that only 2 doses of HPV vaccine are needed for adolescents who begin the vaccination series before their 15th birthday. They were published in the MMWR on December 16, 2016 (attachment 1). This new 2-dose recommendation provides an opportunity to achieve protection against vaccine-preventable HPV-related cancers with just 2 office visits. MDPH and CDC recommend that providers implement the new recommendations immediately.
ACIP and CDC revised their recommendations for HPV vaccination after a thorough review of studies during several ACIP meetings. Data from clinical trials showed that boys and girls aged 9 through 14 years who received 2 doses of 9vHPV vaccine (0, 6-12 month schedule) produced immune responses that were significantly higher for all 9vHPV types compared to females aged 16-26 years who received 3 doses (0, 1-2, 6 month schedule). Additional studies found similar results for 4vHPV and 2vHPV vaccines.
A person’s HPV vaccine schedule is now determined by their age when they begin the series; and whether or not they have certain immunocompromising conditions. Please see table below.
| Age/Immunocompromising Conditions | Recommended Number of Doses | Recommended Dosing Schedule |
| Persons initiating vaccination at age 9 through 14 years, except persons with certain immunocompromsing conditions (see below) | 2 | 0, 6-12 months1 |
| Person initiating HPV vaccination at ages 15 through 26 years | 3 | 0, 1-2, 6 months2 |
| Persons with certain immunocompromising conditions that might reduce cell-mediated or humoral immunity initiating the vaccine series at 9 through 26 years (see below) | 3 | 0, 1-2, 6 months2 |
1 In a 2-dose schedule, the minimum interval between doses 1 and 2 is 5 calendar months. If the 2nd dose is administered at a shorter interval, a 3rd dose should be administered a minimum of 12 weeks after the 2nd dose and a minimum of 5 months after the 1st dose.
2 In a 3-dose schedule, the minimum intervals are: 4 weeks between the 1st and 2nd dose; 12 weeks between the 2nd and 3rd dose; and 5 months between the 1st and 3rd dose. If a vaccine dose is administered after a shorter interval, it should be re-administered after another minimum interval has elapsed since the most recent dose.
HPV Vaccine Recommendations for Those with Certain Immunocompromising Conditions
The ACIP recommends 3 doses of HPV vaccine (0, 1-2, 6 months) for persons with certain immunocompromising conditions that might reduce cell-mediated immunity or humoral immunity, regardless of age. Such conditions include B lymphocyte antibody deficiencies, T lymphocyte complete or partial defects, HIV infection, malignant neoplasm, transplantation, autoimmune disease or immunosuppressive therapy, since immune response to vaccination may be attenuated.
However, children <15 years with the following conditions can receive the 2-dose HPV vaccine schedule: asplenia, sickle cell disease, asthma, chronic granulomatous disease, chronic liver disease, chronic lung disease, chronic renal disease, CNS anatomic barrier defects (e.g., cochlear implant), complement deficiency, diabetes, heart disease.
Immediate Implementation
MDPH and CDC urge clinicians to begin implementing these new recommendations immediately. Specifically, providers should:
- Schedule patients starting the vaccination series before their 15th birthday to receive their 2nd dose of HPV vaccine 6-12 months after receiving the 1st dose.
- Continue to provide teens and young adults who start the series on or after their 15th birthday with 3 doses of HPV vaccine.
To facilitate implementation, CDC has created a very helpful resource. Their Clinician FAQ: CDC Recommendations for HPV Vaccine 2-Dose Schedules explains the reasons for changing the HPV vaccine recommendation and provides tips for talking with parents about the change (attachment 2).
Questions
For questions about HPV vaccine recommendations, please call the Immunization Program at 617-983-6800. For questions about state supplied vaccine availability and ordering, please contact the Vaccine Management Unit at 617-983-6828.
Additional Resources:
- CDC’s Main HPV website: cdc.gov/hpv
- CDC’s MMWR policy note contains more information on the recent ACIP recommendations: https://www.cdc.gov/mmwr/volumes/65/wr/mm6549a5.htm?s_cid=mm6549a5_e
- CDC’s Clinician FAQ: CDC Recommendations for HPV Vaccine 2-Dose Schedules explains the reasons for changing the HPV vaccine recommendation and provides tips for talking with parents about the change: https://www.cdc.gov/hpv/downloads/hcvg15-ptt-hpv-2dose.pdf
- HPV Vaccine Information Statement (VIS) has been updated:: https://www.cdc.gov/vaccines/hcp/vis/vis-statements/hpv.pdf
- Current Issues in Immunization NetConference. Lauri E Markowitz, MD – CDC’s Associate Director of Science for HPV, reviews the updated HPV vaccination recommendations: http://www.cdc.gov/vaccines/ed/ciinc/2016-10-26.html
- Package insert for 9-valent HPV vaccine, updated after FDA approval for use in a 2-dose series for adolescents aged 9 through 14 years: http://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm426445.htm
- CDC’s “tip sheet” for guidance on answering questions parents may have about the HPV vaccine: https://www.cdc.gov/vaccines/who/teens/for-hcp-tipsheet-hpv.pdf
- CDC’s HPV Toolkit is designed to help partners and programs increase HPV vaccination rates: https://www.cdc.gov/hpv/partners/index.html
From the John Stalker Institute:
4-Week Online Nutrition, Health and Wellness Courses from Framingham State University
Earning graduate credit is convenient and affordable with Framingham State’s online professional development courses. All courses count for one graduate credit and cost only $197 per course.
Each course provides 22.5 PDPs for Teachers, 15 PD hours for School Nutrition or 15 CPEUs for RDs.
Dates: January 16 – February 10, 2017
- Exploring Food Allergies
- Preventing Eating Disorders
- Shake the Sodium!
4-Week Online Nutrition, Health and Wellness Courses from Framingham State University
Earning graduate credit is convenient and affordable with Framingham State’s online professional development courses. All courses count for one graduate credit and cost only $197 per course.
Each course provides 22.5 PDPs for Teachers, 15 PD hours for School Nutrition or 15 CPEUs for RDs.
Dates: January 16 – February 10, 2017
- Exploring Food Allergies
- Preventing Eating Disorders
- Shake the Sodium!