A MDPH Message from Karen Robitaille: 
Greetings from the School Health Unit!
This will be our last newsletter of 2021, and I can’t honestly say that I am sad to see the year end. Yet, I felt the same way last year, and this is a sense of déjà vu that is not only eerie, but also saddening. Although I remain confident that vaccination and the miracle of the swiftness of it will eventually lead us forward, I know you are exhausted and frustrated. Thank you for another year of being there for your school communities. My holiday wish is that you find a way to rest and connect with those whom you love and who love you back over the break. It is seeming more and more likely that January will be challenging, and that rest and connection can help to sustain you through it. The School Health Unit staff, The School Nurse Regional Consultants and BU SHIELD staff will all be here to keep supporting you.
On that note, the most wonderful Lesly Zapata from BU SHIELD has prepared a lovely one-pager of meetings and events for the remainder of the school year, with embedded links to register. I wanted to point out a couple of things:
- In order to accommodate as many people as possible, since it is a “live” training, our February 10th CSHS offering, “Defusing Tense Situations Workshop” was offered last week and will be offered again in January (on the 11th). If you are a CSHS grantee, and you attended the workshop in December or January, you do not need to attend in February.
- Our next regional meeting on January 26th is a virtual all-regions meeting, “Responding to Disclosures of Sexual Assault/Abuse: Considerations for School Nurses,” and it will be recorded in case you cannot make it live.
Our mental health series continues, and the vision screening series is now available as well. I hope the flexible learning options are helping to provide any credits you need, as well as valuable information, of course, in a way that works for you during this very busy time.
Please take good care of yourselves. John Barrymore said, “Happiness often sneaks in through a door you didn’t know you left open.” If you can do nothing else, try to leave a door open.
With great respect and gratitude,
Karen
Karen Robitaille, MBA, MSN, RN, NCSN
<she, her, hers>
Director of School Health Services
Division of Child/Adolescent Health and Reproductive Health
Massachusetts Department of Public Health
250 Washington St. 5th floor, Boston, MA 02108
karen.robitaille3@mass.gov
Cell: 781-675-0463
Personal Webex room: https://statema.webex.com/meet/Karen.Robitaille3
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INFORMATION ON INCOMING AFGHAN EVACUEES from the Division of Global Populations and Infectious Disease Prevention, Bureau of Infectious Disease and Laboratory Sciences | Massachusetts Department of Public Health
In late August 2021, over 100,000 Afghan nationals were evacuated from Afghanistan to military bases in the US and other transitional locations overseas. Evacuees included people who worked for the US in Afghanistan and other vulnerable individuals. Coordinated by the Department of Homeland Security, Operation Allies Welcome (OAW) is the mobilization of multiple federal agencies and non-governmental organizations to meet the immediate needs of Afghans on US bases and support their resettlement into local communities across the country.
As of December 14, over 800 Afghan evacuees have arrived in Massachusetts and we expect to welcome a total of 2,000 by mid-February of 2022. Nearly all will be connected with one of eight local resettlement agency offices in Massachusetts for initial resettlement assistance. These agencies, in turn, are working in partnership with volunteer networks to support and welcome Afghans. This outpouring of support, together with the short timeframe to prepare for resettlement and limited access to housing, has meant that Afghan families are resettling in many communities across the state and some will initially stay in temporary housing.
School enrollment is a critical step for children and families as they begin to rebuild their lives here in Massachusetts. Key points to remember include:
- Vaccinations:
- Age appropriate vaccinations per ACIP guidelines were initiated for nearly all children who stayed temporarily on US bases.
- DPH is uploading immunization records from US bases to the MIIS as they become available to us.
- Additional vaccinations given in Massachusetts should be in MIIS.
- Tuberculosis screening:
- All Afghans were screened for tuberculosis on US bases. The standard was an interferon gamma release assay (IGRA) for individuals age two and older. (At least one base screened by chest X-ray only.) Persons with signs or symptoms of tuberculosis are evaluated regardless of IGRA result.
- Medical screening in Massachusetts:
- Afghans are eligible for federal assistance as well as refugee benefits and services, including initial medical screening. Arrangements should be made for medical screening by the resettlement agency. These services are delivered through a network of providers with DPH contracts. Review of records from the base as well as updating immunizations, following up on tuberculosis screening results, and connections with primary care are key components of medical screening,
Below are a few key resources that we encourage you to review.
- Archived webinars:
- Switchboard: This is the landing page for the HHS Office of Refugee Resettlement (ORR) funded resource hub for refugee service providers. Switchboard offers tools and materials, learning opportunities, research, and technical assistance on resettlement-related topics. Switchboard maintains a Resource Page to support Afghan arrivals.
Thank you for your support and effort to welcome Afghan children into our school systems.
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VACCINATION REMINDERS
The definition of “fully vaccinated” has not changed. At this time, people are still considered fully vaccinated two weeks after their second dose in a 2-dose series, such as the Pfizer or Moderna vaccines, or two weeks after a single-dose vaccine, such as the J&J/Janssen vaccine.
MIIS reminders:
The Massachusetts Immunization Information System (MIIS) is a web-based immunization registry. The goal of the MIIS is to give health care providers and families a tool to help ensure that all individuals are immunized based on the latest recommendations. The MIIS will establish a complete, accurate, secure, real-time immunization record for residents of Massachusetts of all ages. Read the MIIS overview here.
Your school immunization surveys, generally due in late January, are done through MIIS. More information and training materials can be found at the links below:
MIIS Help Desk
Phone: 617-983-4335
Fax: 857-323-8321
Email questions to: miishelpdesk@mass.gov
MIIS Website
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Mandated Reporting for CSHS Funded Schools/Districts:
The link to the Monthly report survey is here and the end-of-year Status Report 21/22 survey is here. All reporting forms, worksheets and instructions were sent out to districts by Bob Leibowitz and worksheets for the monthly report can also be found here, and here is the CSHS end-of-year Status Report 21/22 worksheet. Questions related to CSHS mandated grant reporting should go to: DPH_ESHS_data@MassMail.State.MA.US
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Mandated Reporting for Non-CSHS Districts (public school)
Concussion Report Form: Not yet available.
BMI report form: BMI report. CSHS-funded districts and nonpublic schools should NOT submit a separate BMI report, as these data are included in the Status Report. Non-funded districts will use the same link that is used to access the Status Report form.
SBIRT report. CSHS-funded districts and nonpublic schools should NOT submit a separate SBIRT report, as these data are included in the Status Report. Non-funded districts will use the same link that is used to access the Status Report form.
A worksheet for non-funded districts can be found here.
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Mandated Reporting for ALL Schools/Districts
Asthma and Diabetes Survey questions may be directed via email to the project mailbox at DPH-BEH-Asthma@state.ma.us.
Epinephrine administration report form.
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Please note the following:
- The Performance Measures for public school districts in the Affiliated and Model programs have been modified and simplified.
- SBIRT data reporting has been simplified. Starting this year, the SBIRT report only requires district-level data for each grade screened, rather than individual-level data. An Excel spreadsheet with individual-level data will no longer be used to submit the data. Instead, the data will now be collected using the same online data collection tool that we use for collecting other district-level data. As a result, the SBIRT data report has been incorporated into the Status Report.
- School districts do not need to submit their SBIRT data until 60 days after completing the last SBIRT screening for the entire district. If submitting the SBIRT data prior to submitting CSHS end-of-year data, school districts can skip to the SBIRT section of the data report by clicking the option to submit “only SBIRT data”, enter the data, and then save the report so it can be edited later. When submitting CSHS Status Report data at the end of the school year, change the option from “only SBIRT data” to “CSHS program data.”
- All the district-wide data (SBIRT, BMI, and CSHS end-of-year data) should be submitted using the same data report, although it does not have to be submitted at the same time. For example, if the SBIRT screenings are completed in December, the SBIRT data can be submitted in January and the district can wait until July 15 to submit the other annual report data. That’s not a problem, as long as the person who submits the SBIRT data saves the link to their online data record by clicking the “Save and Exit” button and saves the report-specific link the pops up on screen. Without that link, you may not be able to edit the data submission, and you would have to submit a completely new record with all of the district’s data. Additional instructions are provided on the first page of the online data tool.
- If we receive multiple data submissions from the same district, we assume that the most recent submission has corrected, updated data, and any prior submissions are discarded.
There are no changes to the Monthly report or other data collection tools.
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2021/2022 COVID-19 Protocols and
Testing Information on DESE Website
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“Kindness is like snow. It beautifies everything it covers.”
–Kahlil Gibran
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School Health Screenings for PE Teachers 
BU SHIELD is excited to announce a new course offered: School Health Screenings for PE teachers. This free course is designed for PE teachers who are assisting with BMI and postural screenings.
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New Mental Health Training Series!
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SHIELD’s Mental Health Series for School Health Professionals is well underway. Four sessions have been delivered and recordings, which are ideal for self-paced learning, are being made available. Two recordings are currently open, with two more expected to open by the end of December:
Additional recordings in this series will be released in the new year. PDPs and discounts are being offered for attending the full series. For more information, visit SHIELD’s website here.
If you have SHIELD credit, it can be used for these courses. Please email BU SHIELD at shieldbu@bu.edu with any questions!
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New Vision Screening Protocols (to begin in FY23)
The new vision screening protocol is now up on the BU SHIELD website for your reference and can be found here. As a reminder, schools/districts are not mandated to use this protocol until the 2022/2023 school year. Additional health screening resources can be found here.
New Vision Screening Course is now open! The November Clinical Update focused on the new vision screening requirements. This course was recorded and is now available for self-paced learning. This course is ideal for districts to use as a local professional development option. To access the course, follow this link.
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Vision Screening during COVID. The National Center for Children's Vision and Eye Health at Prevent Blindness has updated the Considerations for Conducting Children's Vision Screening Safely in Schools, Head Start, and Early Care and Education Programs During the Covid-19 Pandemic. The resources includes a downloadable guide and FAQ. Please share these documents with your colleagues.
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GREAT NEWS! CSHS Affiliate grantees will see another boost in their funding this fiscal year; districts originally funded at $3000 (who got $10,500 in FY21) will receive $14,000 for FY22. Districts originally funded at $5000 (who got $20,000 last year) will get $29,600 in FY22. Model amounts will remain the same as last year. Non-public grantee amounts may have changed; email Juliet or Karen if you have any questions regarding your funding amount.
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Allowable use of CSHS grant funds for COVID-19 response during FY22:
- Consumable supplies needed to safely provide care during COVID (may include gloves, masks, eye protection, scrub/gowns), for school health staff ONLY. Not to exceed 10% of the total budget.
- Reallocation of case management staff hours to address COVID case management during school hours in the form of dedicated nursing staff performing contact tracing and/or case management for COVID cases in the school community (i.e. referral to testing, referral to community resources for isolation & quarantine) under an agreement with the LBOH.
- Health office equipment that addresses COVID-19 emergency response and that will be used in the health office, medical waiting room or AGP room (may include physical barriers and filtration units for those spaces ONLY). Not to exceed 15% of the total budget.
- Model and Affiliate grantees may also use grant funding to support staff that are conducting COVID-19 case management and/or contact tracing. This includes hiring of new staff, as well as paying stipends at hourly nursing rates for work doing COVID-19 contact tracing/case management outside of normal working hours. The intent of this expansion is to allow current nursing staff more time and flexibility to meet other CSHS grant requirements.
PLEASE USE THE FOLLOWING EMAIL ADDRESSES FOR THE APPROPRIATE DOCUMENTS:
Medication Registration: medication.delegation@MassMail.State.Ma.us
US Return of signed CSHS purchase vouchers: cshs.pv@mass.gov
Return of CSHS amendment forms: CSHS.Amendments@mass.gov
Return of CSHS reconciliation forms: CSHS.Reconciliation@mass.gov
Using the correct email address is essential to your documents being received and processed in a timely manner. Thank you!
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New School-Located Vaccine Clinic Resources
NASN partnered with the Association of Immunization Managers (AIM) to develop a checklist for school nurses to plan school-located vaccination and a tip-sheet for Immunization Program Managers. With the approval of COVID-19 vaccines for students under the age of 12 years, and flu season coming in fall and winter, SLVs are a strategy to improve the health of students. See resources.
Duke-Margolis partnered with the COVID Collaborative, the Council of the Great City Schools, National Rural Education Association, Rural Schools Collaborative, and AASA: The School Superintendents Association to develop an issue brief on Innovative Strategies for Leveraging Schools as Covid-19 Vaccination Sites.
The Duke-Margolis Center for Health Policy (Duke-Margolis) and the Association of Immunization Managers (AIM), with support from the Rockefeller Foundation, released a series of resources for school leaders on how schools can serve as critical access points for students and families to receive Covid-19 vaccines.
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COVID-19 Update:
MDPH has created a new webpage for pediatric vaccine information for the newest age group expected to gain vaccine approval.
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This webpage will be updated as more information is available. Vaxfinder will also be updated as pediatric vaccine becomes available for this age group.
Standing order template for Pfizer-BioNTech COVID-19 Vaccine: 5 Through 11 Years of Age:
Pfizer-BioNTech COVID-19 Vaccine: 5 Through 11 Years of Age • Standing Orders for Administering Vaccine (cdc.gov)
New Vaccine Education Center at Children’s Hospital of Philadelphia
Reminder: AAP COVID-19 Vaccine Campaign Toolkit
The American Academy of Pediatrics (AAP) has created a COVID-19 Vaccine Campaign Toolkit to assist pediatric healthcare professionals in addressing parent and caregiver COVID-19 vaccines questions and concerns. The Toolkit includes articles, graphics, social media messages, and videos. It is designed to reach parents and caregivers, who have not yet vaccinated their eligible children, to encourage them to talk to a trusted provider.
New: The Massachusetts Department of Public Health has updated its Children & Youth with Special Health Needs (CYSHN) and the COVID-19 Vaccine webpage to include FAQs for vaccinating this population.
New: The Massachusetts Interscholastic Athletic Association has released its Winter Masking Guidelines, which will be a continuation of the fall guidelines: Student-athletes, coaches, and officials that are indoors shall be masked. Read more here.
Lyft Offering Free or Discounted Rides to Vaccine Appointments: Getting access to the vaccine is a struggle for many. Lyft is mobilizing partners and community members to help provide access to millions of riders to and from vaccine appointments. Learn more and see if Lyft is available in your community here.
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CDC's School-Location Vaccination Clinics: Best Practices for School Districts
 This guide provides a roadmap for school district administrators to work directly with local health departments and other vaccine providers (e.g., pharmacies) to set up vaccination clinics in places that K–12 students and their parents know and trust. Find the resource here.
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The MDPH Immunization Division hosted a
Live Q&A: Pediatric COVID-19 Vaccination
Below are some of the additional information they provided.
Information on COVID-19 Vaccine storage, handling and administration access full training resources and supplemental resources below:
- MDPH COVID-19 Vaccine Traininghttps://macovidvax.populationhealthexchange.org/
- On 10/29/2021, the FDA amended Pfizer-BioNTech’s Emergency Use Authorization to allow the vaccine to be administered to children ages 5 to 11 years. FDA resources are available at:
For Individual case questions, please refer your questions to your local board of health. If you are unable to reach them, please call the Mass Epidemiology Line here: (617) 983-6800
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You may be seeing student and staff COVID-19 vaccination records, including those from other countries. AN IMPORTANT NOTE IN REGARD TO FOREIGN VACCINATION RECORDS: Unlike other vaccinations where we accept whatever the foreign formulation is, the U.S. is currently only accepting WHO-approved COVID vaccination formulations. Here is the link to the list of COVID-19 vaccines within the WHO EUL/PQ evaluation process; any vaccine marked “finalized” is accepted in the U.S. Please note, nurses should check this information frequently, as it is subject to change.
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Your students might appreciate this course designed by researchers at Boston University Wheelock College of Education & Human Development in partnership with Medway Public Schools: Stress and COVID-19: A Course for Teens
For School Health Professionals: The Emotional PPE Project connects healthcare workers in need with licensed mental health professionals who can help. No cost. No insurance. Just a trained professional to talk to.
More Self-Care Resources can be found on SHIELD's Website here.
Massachusetts tool to locate vaccination sites and open appointments by zip code.
Vaccine Communication Resources (18 and younger)
New COVID-19 vaccination for youth ages 12+
- For details, including information on parental consent, and FAQs, visit here.
- Youth aged 12 and above may be preregistered here.
- COVID-19 vaccine graphics for teens and young adults.
Public Service Announcements
- MA Medical Society newly-elected Massachusetts Medical Society president, Dr. Carole Allen, recorded video urging parents to get their children vaccinated.
- @MassDPH
Clinical Considerations from the CDC found here.
COVID-19 Vaccine Fact Sheet for Preteens and Teens can be found here.
School Nursing Staff may also find this contact tracing data collection spreadsheet.
The testing standing order template can be found on the BU SHIELD website front page under "COVID-19 Resources Page".
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For key information about managing COVID-19 in Massachusetts, see these websites.
SHIELD COVID-19/BinaxNow Resources.
MDPH Website.
SHAH Family Foundation Pooled Testing Website.
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For additional resources surrounding COVID-19, visit these websites.
NASN COVID-19 Resources.
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School Nurses in the News:
SHIELD Nurses in the News Feed.
Be mindful handling vape pens! "Sheriff: 2 officers, nurse given Narcan after being exposed to fentanyl found in student’s vape pen," article can be found here.
"Letter: School nurses are underappreciated, underpaid, and overworked and it’s time for change," article can be found here.
"Small pinches, brave kids, big grins: Vaccine clinics for 5- to 11-year-olds kick off in Berkshire County," article can be found here.
"'It doesn't hurt': Hundreds of kids get COVID vaccine at Weymouth clinic," article by Alexandra Weliever can be found here.
"FRCOG, area nurses join with state to bring Vax Bus clinics to schools," article can be found here.
Students at Shawsheen Valley Technical High School in Billerica constructed a partial replica of Fenway Park inside the school! It includes realistic graphics of the championship banners, windows, and doors. We encourage you to view the segment here.
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All Regions Regional Meeting
The next all regions regional meeting will take place via Zoom on January 26th, 2022 from 1:00-3:00 PM and will feature a presentation from the MDPH Pedi-SANE (Sexual Assault Nurse Examiner) program. Details will be here under "Regional Meetings."
Recurring Support Group for School Nurses
There is a recurring drop-in support group for school nurses happening every Monday at 7pm. The flyer with the Zoom link can be found here.
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