“Children may be exempt from immunization requirements for medical or religious reasons, if the appropriate documentation is presented to the childcare facility or school,” explains the Hawaii Department of Health. “Religious exemption forms may be completed at the childcare facility or school that your child will attend. Medical exemptions must be obtained from your child’s healthcare provider. No other exemptions are allowed by the State.” Third, a Tuberculosis (TB) clearance is required to attend a childcare facility or school for the first time in Hawaii, unless the child is less than 12 months old. “For childcare or school, a clearance on or after 12 months of age is valid and this clearance does not expire for school attendance K-12th grade,” explains the Department of Health. The Department of Health’s Tuberculosis Control Branch (health.hawaii.gov/tb) outlines that an acceptable TB clearance for children includes a negative risk screen, a negative TB skin test, a negative TB blood test (QuantiFERON Gold In-Tube test for twoyear-olds and older), or a positive TB test with a negative chest X-ray. “Parents who do not want skin tests for children under 5 years of age need a physician letter stating the skin test is medically contraindicated,” states the Department of Health. A TB clearance is not needed for students only taking online or off-campus classes. And, if a high school student is taking college classes, they will need a new TB clearance after their sixteenth birthday. Dr. Vinson Diep, trusted pediatrician with an office at Kapiolani Medical Center for Women & Children, offers further insight into these three state-mandated school health requirements – along with a few tips to triumphantly tackle the tasks. What can parents expect during their child’s physical examination? While Hawaii childcare facilities and schools only require proof of two physical examinations (upon first attendance and when entering seventh grade) during a child’s schooling journey to high school graduation, the American Academy of Pediatrics (AAP) recommends these physical examinations – or well-child visits – much more frequently. AAP recommends babies and young toddlers to have a well-child visit at 3 to 5 days old and at 1, 2, 4, 6, 9, 12, 15, 18, 24 and 30 months. Starting at age 3, the well-child visit is recommended every year through the age of 21. “It is important for us to have these examinations routinely so that we can make sure our patients are healthy,” explains Dr. Diep. “General pediatricians act as the ‘medical home,’ which means that we help to coordinate referrals to specialists if necessary and to facilitate care for our patients. This also allows us to talk to parents and children about the latest updates in health information and how to navigate common problems that a child may go through as they get older.” “A physical exam is important because it allows us as pediatricians to check in on the health, growth, and development of our patients,” says Dr. Diep. “The exam generally consists of vital signs (temperature, heart rate, blood pressure, breathing rate), growth measurements (weight, length, and head size, if appropriate), hearing and vision testing (if the child is old enough to cooperate), questions parents or child(ren) may have, preventative care, the actual examination, and vaccinations.” “For the actual exam, we examine the May/June 2024 HAWAII PARENT 143 “From exams to vaccinations, let's prioritize our children's well‐being for a successful start."
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