Brenda Isaac, Kanawha County Schools' head nurse, said the school system sent out 78 letters to students in 22 schools. The letters informed parents their children would not be allowed to attend class after Wednesday without updated shot records.

Kanawha County has about 28,000 students. About 5,000 were affected by the new vaccination requirements.

"It's not bad," Isaac said.

State law originally dictated seventh- and 12th-grade students could not start the 2012-2013 school year without tetanus, diphtheria, pertussis and meningitis vaccinations. Realizing many of those students still had not received the required shots, the state granted a two-week grace period.

School started in Kanawha County on Aug. 17, so the grace period ended here on Aug. 31. School officials delayed further, however, attempting to work with parents to get students vaccinated and keep them in school.

Isaac said she expects many of the 78 students to come to school today with updated shot records.

"We have not had anyone just say, 'We're not going to do this.' A lot of them thought they'd sent the records in, or they were in the child's backpack and never made it to school," she said.

Isaac said other parents have called school nurses and promised to get their children vaccinated at an upcoming doctor's appointment. In the meantime, those students are still allowed to attend.

"Parents are really working with us," she said.

Dr. Penny Fisher, Putnam County Schools' assistant superintendent for pupil services, said only about five students have missed school because of the vaccination requirements since the grace period ended there Sept. 6.

There are still two or three holdouts, she said, but no one there is protesting the requirements.

"Our parents, our community, nurses, administrators have come through with flying colors," she said. "I'm pleasantly surprised. I was expecting some problems with it."

Sue Peros, Boone County's head school nurse, said about 39 students in four schools could be kept home today because of vaccination requirements.

Like Isaac, however, she expects many to come to school with updated records.

There are about 600 seventh- and 12th-graders in Boone County. Peros said "a few" have protested the requirements, vowing never to get the shots, but said she couldn't give an exact number.

"That is so minimal that I can't give too much information; the person would be identified," she said.

The state Supreme Court last month declined to hear a lawsuit challenging the vaccination requirements.

The lawsuit, brought by six families from across the state, claimed the requirements are illegal because the state Department of Health and Human Resources does not have authority to make new vaccine mandates.

Patrick Lane, a Republican member of the House from Kanawha County, is representing the families. He recently filed a similar lawsuit in Kanawha Circuit Court.

Contact writer Zack Harold at 304-348-7939 or zack.har...@dailymail.com. Follow him at www.twitter.com/ZackHarold.