Hoping to avoid a repeat of last year, public health officials are telling parents now is the time for their children to get immunized.

At the beginning of the 1999-2000 school year, scores of Stanislaus County students were kept out of classes or sent home because they hadn't had hepatitis B shots.

So interim Public Health Officer Dr. John Payne is urging parents to start taking their children in now to ensure that they complete the series of hepatitis B shots in time for the traditional start of the 2000-01 school year.

"The three-shot hepatitis B series takes four to six months to complete," Payne said. "We do not want to experience the last-minute anxiety as we did last fall when parents waited until the last minute. Some children were excluded from classrooms until they got their shots."

A law went into effect in July requiring hepatitis B shots and a second measles, mumps and rubella shot for students entering seventh grade. A similar law passed in 1997 required hepatitis B shots for kindergartners and children in child care and preschool.

Children who received hepatitis B shots at an earlier age do not need to receive the shots again as long as parents have proof of the immunizations.

Last fall in Stanislaus County, only two-thirds of the students requiring hepatitis B shots had received all three shots before school started, health officials said. School districts allowed students to attend classes if they had received at least one hepatitis B shot.

Health officials noted that compliance for the second measles, mumps and rubella shot was significantly better, with a 97 percent completion rate.

Hepatitis B is caused by a virus that attacks the liver. The disease can cause serious liver problems such as cirrhosis, liver failure and cancer and can be fatal. Its symptoms include loss of appetite, fatigue, diarrhea or vomiting and jaundice.

The U.S. Centers for Disease Control and Prevention estimates that 200,000 people are infected with hepatitis B annually. The disease kills about 4,000 annually.

Several years ago, the CDC recommended hepatitis B shots for people in high-risk groups: those having unprotected sex, intravenous drug users who share needles and people whose occupations put them in contact with human blood.

Because most people are infected with hepatitis B as adolescents or young adults, the CDC changed its recommendations, hoping to get young people vaccinated before they start engaging in risky behavior.

Stanislaus County's efforts are part of a statewide plan to alert families and health care providers of the requirements. Health officials have dubbed next week Preteen Vaccine Week. California has approximately 433,720 children in sixth grade this year.

Payne said parents also should be aware that California's immunization laws include an exemption.

"If getting immunizations are against your religious or personal beliefs, you are free to sign an exemption waiver at your child's school," Payne said. "The school will keep a record of this exemption, and your child may be excluded from school during a vaccine-preventable disease out- break."

Stanislaus County's public health division offers hepatitis B and MMR shots for $8 each for children. Health officials urge parents who want more information to contact their family doctors or school nurses. They also can call the Health Services Agency's immunization clinic at 558-4818. In Merced County, the number is 385-7710; in San Joaquin County, 468-3400; and in Tuolumne County, 533-7400.

Stanislaus County's Health Services Agency has posted on its Web site current information on state immunization requirements. After accessing the home page at www.schsa.org, click on the immunizations icon for more information and related links.

Reprinted by permission of Modesto Bee.