Hundreds of students in North Carolina could face suspension for not being up to date on their vaccinations.
At least 400 students had not turned in their certificate of immunization form as of Wednesday to prove they had received a Tdap shot. The shot is a combination of three vaccines that provide protection against diphtheria, tetanus and pertussis (whooping cough).
Under a 2008 North Carolina law, all incoming sixth graders must get a Tdap booster shot within 30 days of the new school year.
Wednesday was the cutoff.
According to school officials, sixth graders in the state without the proper vaccination certificate or an approved exemption will be turned away from public school as of Thursday.
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In Guilford County, approximately 194 students had still not turned in their proof of immunization by Wednesday afternoon. Health clinics were open to students on Wednesday for free shots and on Thursday students could make appointments for free shots.
In the Winston-Salem/Forsythe School district, which is adjacent to the Guilford school district, another 260 students had not turned in their proof of immunization as of Wednesday.
Both school districts have been alerting parents by mail and phone of the deadline.
Theo Helm, spokesman for the Winston-Salem school district, said while students in other grades, such as kindergarten, were also required to have specific vaccinations before the school year, only the sixth graders consistently fell behind.
"It's like this every year. It's like trying to get them to turn in their homework," said Helm. "I don't know why it balloons like this in the sixth grade."
Students can be exempted from vaccinations for specific religious or health reasons.
While the Tdap vaccination protects against three diseases, it's an increase in cases of pertussis or whooping cough that have consistently worried health officials.
In August the North Carolina Department of Health and Human Services stressed the importance of getting vaccinated after an increase in cases of pertussis or whooping cough in the state. As of Aug. 31, there have been 416 reported cases of whooping cough, and 63 of those were infants.
Infants under the age of 6 months are particularly susceptible to whooping cough but are too young to receive the vaccination.
According to the U.S. Centers for Disease Control and Prevention, in those younger than 1 who get pertussis, about half are hospitalized. Of those infants who are hospitalized, one or two in 100 will die.