Ready for school? Add vaccines to your back to school to-do list. Here's what to do in Austin.

The start of school is just around the corner. Most local school districts return to the classroom Aug. 14-18.

At local pediatricians' offices, the appointment slots are filling up. Kids need sports physicals if they want to participate in middle school or high school sports; well-check visits to track growth and screen for potential mental and physical health concerns; and vaccinations.

School districts, including the Austin Independent School District, saw a dip in their vaccination rates during the pandemic. In 2022-23 school year, Austin kindergarteners had vaccination rates of between 86% and 92% depending on the vaccine. In the 2018-19 school year, the district's kindergarteners had rates between 94% and 96%.

"With COVID, we really got off track," said Alana Bejarano, executive director for health services and nursing at the Austin school district.

A lot of children didn't come in for their annual well-check visits, said local pediatricians including Dr. Elizabeth Knapp, a pediatric chief at Austin Regional Clinic. That has started to improve in the last year, she said.

Are kids required to be vaccinated in Texas?

There are two key times when schools look at vaccination records: kindergarten and seventh grade. Kids who haven't completed the required vaccine schedule for that grade cannot attend class, with a few exceptions.

Children can get exemptions for medical reasons or for what is called "Reasons of Conscience." A medical exemption happens because of cancer treatment or another immune-suppressing treatment that would cause the vaccine to be ineffective, said Dr. Meena Iyer, chief medical officer of Dell Children’s Medical Center. Kids with medical exemptions have their doctor sign an exemption form, which is good for one year, unless the child has a lifelong disease, which makes the exemption good for the rest of their school career.

"It's a very, very rare situation when a child should have a medical exemption," Knapp said.

For Reasons of Conscience, such as religious or other personal values that do not align with vaccinations, parents can ask the state to send them an affidavit form at this website: co-request.dshs.texas.gov. The affidavit form is good for two years only, then it must be resubmitted.

There is a big caveat with an exemption: During an outbreak of a disease for which there is a vaccine, like measles, mumps, chicken pox, at the child's school, the school can prevent your child from attending during the outbreak.

Why do we vaccinate children?

Vaccines help prevent diseases, such as measles, mumps, diphtheria and polio, Iyer said.

These diseases come with days or weeks of illness, horrible side effects and lifelong complications or death.

What happens if not enough kids are vaccinated?

"Any time vaccination rates are lower, the risk of illness goes up," said Dr. Danielle Grant, a pediatrician at Texas Children's Pediatrics in Spicewood.

Last year, New York state had cases of polio in an unvaccinated population.

In June, Texas reported a case of measles in Hood County — the first case in Texas since 2019. Measles is especially worrisome, said Grant, because if one person with measles comes into a room with 10 unvaccinated people, nine of those people will become infected, according to the World Health Organization.

Locally, Iyer has seen the occasional case of mumps, measles and chickenpox come through Dell Children's emergency room. While we have what is called "herd immunity," the idea that enough people are vaccinated to protect from an outbreak, "there's still a slight spike in disease that can come through," Iyer said.

That spike shows up in unvaccinated people, but it could infect kids who are being treated for illnesses that lower their immune system.

"If you have a healthy kid who can get vaccinated, vaccinate them as much as you can," Iyer said.

Is your school vaccinated? Click here to find out how many of students in your district or private school have an exemption.

How do you know which vaccines you need?

The U.S. Centers for Disease Control and Prevention has a schedule of which vaccine people get by age. The CDC also has a catch-up schedule for people who have never been vaccinated or are behind in their vaccines.

If parents have their children's shot records, they should bring those records to the appointment. Doctors also can look up a child's vaccine record through state and national immunization registries. Schools also might have a copy in the student's record if the child has been enrolled previously.

If no records can be found, Grant said, doctors will treat the child as if they've had no shots and use the catch-up schedule to get them fully vaccinated.

What are possible side effects of a vaccine?

Soreness, swelling or redness at the vaccine site is normal, as is a fever within the first 24 hours. If a child has persistent fever; neurologic problems such as an inability to move the arm or the leg or difficulty thinking; a shrill cry or are lethargic, they should go to the emergency room.

That type of reaction is rare, Iyer said. In her 25-year career in pediatrics, she hasn't seen one such case, she said: "Vaccines go through a safe process. It's very well-tested and approved."

More on fall boosters: Another rise in COVID-19 cases this summer? Why this year is different from last three.

Think beyond vaccines at the well-check

"The annual checkup with your doctor is really important," Knapp said. Doctors notice things that parents might not, such as hernias, scoliosis, hearing, vision problems, and can screen for mental health problems.

"A doctor has a window into a child's behavior that they don't always show parents," she said.

Well-checks also establish a relationship with a doctor, which is helpful when a child does get sick. That doctor knows something about what's normal for that child.

Where can I get vaccines if I don't have a pediatrician?

Austin Public Health's Shots for Tots clinics:

These clinics are for uninsured children or children with Medicaid. The shots are $10 a vaccination for children and $25 for adults, but no one is refused a vaccine if they cannot pay.

405 W. Stassney Lane and 7500 Blessing Ave.

Call for an appointment at 512-972-5520.

Bring your shot record with you and your Medicaid card if you have one.

Austin Public Health mobile vaccine clinics:

• 3-5 p.m. Monday, Webb Middle School, 601 E. St. John's Ave.

• 9 a.m.-noon Thursday, Burnet Middle School, 8401 Hathaway Drive.

• 3-6 p.m. Friday, Stonegate Mobile Home Park, 1401 E. Rundberg Lane.

Your school district:

The Austin district has traditionally had a back-to-school event in August, but it is planning on a similar event in September. It also plans to open vaccination hubs at local schools for the required vaccines as well as flu and COVID-19 shots. That event and hubs will be posted on austinisd.org/health-services once they are confirmed.

If you are outside of Austin, check with your local health department or school district to see what shot clinics are available.

More vaccine help: New Austin pediatric clinic Lirios gives free care — from doctor visit to prescriptions

This article originally appeared on Austin American-Statesman: Get back to school ready with vaccines. What to know in Austin, Texas