The Cowlitz County Health Department and local school districts want to remind parents to make sure their child’s immunizations are up-to-date before school starts.

“Immunizing kids is one of the most important things parents can do to keep them healthy,” county public health officer Dr. Jennifer Vines said Friday.

Several immunizations are required before children can attend school and child care, though exemptions are allowed for medical, religious or personal reasons.

Students entering sixth and seventh grades must get the tetanus, diphtheria and pertussis (Tdap) vaccine. This booster shot protects older kids against whooping cough (pertussis). Young children receive a vaccine that prevents the same diseases, but protection starts to wear off in the early teen years, so Tdap is important for preteens.

Kids starting second, third and sixth grades must get one dose of the chickenpox (varicella) vaccine or document that they’ve had the disease. Kindergartners and first-graders need two doses of the vaccine. Parent-reported history of chickenpox is not an acceptable alternative for kids entering kindergarten and first grade.

Children who are not fully immunized may be excluded from attending school, preschool or child care if a disease outbreak occurs, state health officials said.

The health department no longer provides childhood vaccinations for children whose private insurance covers vaccinations.

The health department does offer recommended immunizations to children without insurance, children with insurance that does not cover vaccinations, children on Medicaid and all children of Native American or Alaskan Native descent. The shots are available at the agency’s weekly immunization clinic, which is held from 3 to 5:30 p.m. Tuesdays.

The health department usually charges $5.50 per vaccination for those without Medicaid. Low-income waivers are available for the fee.

For more information, call the health department at (360) 414-5599.