An estimated 12,000 Maryland middle and high school students are in danger of being turned away from school next week if they do not receive two required vaccinations this weekend, according to the Maryland State Department of Education.
The regulation "specifies that [administrators] have to do it," said Greg Reed, program manager for the state health department's Center for Immunization. "They can't knowingly admit a child or retain a child in the school if they don't have everything they need."
About half of those students are in Baltimore City, while other central Maryland counties range from none to hundreds of young people who might be sent home.
State regulations that were made final in 2005 require students through the ninth grade to receive immunizations for hepatitis B and chickenpox. For chickenpox, a doctor's verification of the dates a student had the illness will be accepted.
While most younger students were covered under previous requirements, the latest rule forced tens of thousands of sixth- through ninth-graders to catch up on their vaccinations over the past several months. A Jan. 1 deadline passed with at least 25,000 students lacking the necessary documentation. But many school systems kept students in class for two more weeks under a provision that allowed those with an appointment for the shots to avoid being excluded.
That provision ends today. Starting Monday, school administrators will have to send noncompliant students home.
School systems have been working with local health departments to whittle down the number of noncompliant students by alerting families with letters, phone calls, individual conversations, home visits, advertisements and directions to county clinics.
Baltimore City, Baltimore County and Harford County plan to offer clinics today. Howard County has scheduled clinics Tuesday and Wednesday, and other counties will continue to offer vaccinations through their health departments in the coming weeks.
Overall, about 4 percent of the 280,000 sixth- through ninth-graders in the state continue to lack the proper immunizations.
Yesterday morning, 6,135 Baltimore City students were given letters to take home saying they will not be allowed to return to school until they receive vaccinations.
Efforts, including ads on buses, radio spots and appeals to clergy, enabled the system to have 92 percent of its students through ninth grade meet the requirements.
"There really is no excuse for any child to be without the required vaccines," said Vanessa Pyatt, a Baltimore City public schools spokeswoman. "I think we've done everything we can possibly do to get the message out."
Baltimore County schools have reduced their count from 18,000 in need of vaccinations last spring to fewer than 900 as of yesterday. Howard County needs about 400 students to bring in their documentation, but those students will have an extra day because Monday is a staff development day and students will not attend.
Harford County started excluding students yesterday, according to Don Morrison, director of public information. The school system did not know the number of students, but Morrison said he has heard the number has dropped significantly from 1,700 on Jan. 12.
Harford County students have two extra days to get their shots because Monday and Tuesday are staff development days.
Because vaccination requirements are usually phased in with the youngest students, the use of midyear deadlines and possible exclusion is new to many people.
"There may be some disbelief," Morrison said. "Some parents may not be convinced the state department of education is serious."
In Anne Arundel County, where some students were excluded under a strict interpretation of the 20-day grace period, the school system was down to 59 students in need of vaccinations.
Carroll County's school system started excluding students Jan. 2 and now says all of its students have met the new regulations.
The hepatitis B vaccination requires a series of three shots. Depending on a child's age, two chickenpox vaccines might be needed.
Students may attend school after the first vaccination, said Reed of the state health department, but they will have to continue to meet individual deadlines to stay in school.
Bill Reinhard, a spokesman for the state education department, said there don't appear to be any common factors keeping students from getting vaccinated.
"It's really not a socioeconomic issue," he said. "There are kids from every neighborhood that haven't been immunized."
He added: "Some people are procrastinators. We would hope they won't be any more."
Sun reporters Ellie Baublitz, Ruma Kumar, Sara Neufeld and John-John Williams IV contributed to this article.