Maine
Rules for school, daycare and college entry
Grade School Rules:
In the absence of disease history or a valid exemption (pursuant to 20-A MRSA §6355), the following immunizations are required for attendance in Maine schools, K-12, public and private:
5 DTP/DTaP (diphtheria, tetanus, pertussis)
4 Polio
2 MMR (measles, mumps, rubella)
1-2 Varicella (chickenpox)* (Students under age 13 need only one dose; age 13 and over require two doses given 4 to 8 weeks apart.)
*Chickenpox vaccine (Varicella) or disease history is required for: K-12
College rules:
1 Td (tetanus, diphtheria) within 10 years prior to enrollment
2 MMR (measles, mumps, rubella)
Child Care Facilities:
Effective 6/2005, according to Rules adopted by the Maine Department of Human Services, age-appropriate immunization against the following diseases is required for children who attend licensed Child Care Facilities in Maine:
Measles, Mumps, Rubella, Diphtheria, Pertussis, Polio, Tetanus, Haemophilus, influenzae Type b, Varicella, Hepatitis B, and Pneumococcal conjugate.
These standards will apply to the following facilities:
Child Care Center,
Child Care Facility,
Small Child Care Facility,
Home Day Care,
Public Pre-school programs,
Nursery schools,
Pre-K programs,
Early Kindergarten,
4 year old programs or any child development program under the control of the State Department of Education or under the control of the Office of Child Care and Head Start.
Exemptions allowed are Medical, Religious, Philosophical
TITLE 20-A: EDUCATION. PART 3. ELEMENTARY AND SECONDARY EDUCATION
CHAPTER 223. HEALTH, NUTRITION AND SAFETY. SUBCHAPTER II. IMMUNIZATION
20-A M.R.S. § 6355. Enrollment in school
A superintendent may not permit any child to be enrolled in or to attend school without a certificate of immunization for each disease or other acceptable evidence of required immunization or immunity against the disease, except as follows.
1. WRITTEN ASSURANCE. The parent provides a written assurance the child will be immunized within 90 days by private effort or provides, where applicable, a written consent to the child’s immunization by a health officer, physician, nurse or other authorized person in public or private employ.
2. MEDICAL EXEMPTION. The parent or the child provides a physician’s written statement that immunization against one or more of the diseases may be medically inadvisable.
3. PHILOSOPHICAL OR RELIGIOUS EXEMPTION. The parent states in writing a sincere religious belief that is contrary to the immunization requirement of this subchapter or an opposition to the immunization for philosophical reasons.
20-A M.R.S. § 6359. Immunization of students
3. ENROLLMENT OF SCHOOL. No chief administrative officer may permit any student to be enrolled in or to attend school without a certificate of immunization for each disease or other acceptable evidence of required immunization or immunity against the disease, except as follows.
A. The parent or the student provides a physician’s written statement or a written statement from a school health provider that immunization against one or more of the diseases may be medically inadvisable.
B. The student or the parent, if the student is a minor, states in writing a sincere religious belief, which is contrary to the immunization equirement of this subchapter or an opposition to the immunization for philosophical reasons.
4. EXCLUSION FROM SCHOOL. When a public health official has reason to believe that the continued presence in a school of a student who has not been immunized against one or more diseases presents a clear danger to the health of others, the public health official shall notify the chief administrative officer of the school. The chief administrative officer shall cause the student to be excluded from school during the period of danger or until the student receives the necessary immunizing agent.
DEPARTMENT OF HEALTH AND HUMAN SERVICES. DIVISION OF LICENSING AND REGULATORY SERVICES. COMMUNITY SERVICES PROGRAMS
10-148: OFFICE OF CHILD AND FAMILY SERVICES
CHAPTER 32: RULES FOR LICENSING OF CHILD CARE FACILITIES
SECTION XVIII. HEALTH/MEDICAL
A. Immunization
1. Certificate of immunization for children. For each child who is not attending public or private school, the facility shall require and have on file, within thirty (30) days of the child’s first admission to the facility, and updated annually thereafter, a Certificate of Immunization which clearly illustrates each child’s present immunization status. Each child’s record must reflect an up-to-date status according to the Day Care Immunization Standards set forth by the Maine Bureau of Health Immunization Program (based on recommendations made by the Centers for Disease Control’s Advisory Committee on Immunization Practices).
Dates of immunization (month/day/year) and vaccine type shall be on file for each of the following vaccine-preventable diseases:
a) Measles;
b) Mumps;
c) Rubella;
d) Diphtheria;
e) Pertussis;
f) Polio;
g) Tetanus;
h) Haemophilus influenzae Type b;
i) Varicella;
j) Hepatitis B; and
k) Pneumococcal conjugate;
2. Blood test demonstrating immunity. A blood test demonstrating immunity to measles, mumps, and rubella can be provided as proof of immunity. Evidence of this shall be kept on file, and updated in a timely manner.
3. Exceptions to proof of immunity. No child shall be required under this rule to have any such immunization if his/her parent(s) states in writing a sincere religious or philosophical belief that it is contrary to the immunization requirements of this subsection or if the child’s physician submits documentation that immunization against one or more of the diseases is medically inadvisable. A written statement must be included in the record of any child for whom such an exemption is being claimed. In the event of a disease outbreak, children not vaccinated for religious, philosophical, or medical reasons must be excluded from the program until the outbreak no longer exists, or until the child receives the necessary immunization.
4. Certificate of immunization for staff. For staff born after 1956, the facility shall obtain and have available a Certificate of Immunization for measles, mumps, rubella, tetanus and diphtheria. A laboratory blood test proving immunity may also be accepted. Documentation of immunity against measles, mumps and rubella is not required for staff born prior to 1957. No person shall be required to provide such documentation if she/he provides in writing the opposition for sincere religious or philosophical reasons or provides written documentation from a physician that such immunization is medically inadvisable.
Maryland
Daycare and School Age Vaccine Mandates:
Title 10 DEPARTMENT OF HEALTH AND MENTAL HYGIENE.Subtitle 06 DISEASES. Chapter 04 School Health Services and Required Immunizations Before Entry into School.Authority: Education Article, §7-403, Annotated Code of Maryland
Student in Kindergarten Through 12th Grade.
(a) In order for the immunization status of a student enrolled in kindergarten through 12th grade to be
complete, the student’s parent or guardian shall provide proof of the immunizations or immunity as
outlined in §D(2)(b)—(j) of this regulation.
(b) Diphtheria.
(i) Four doses of diphtheria immunization vaccine are required for a student younger than 7
years old; and
(ii) Three doses of diphtheria immunization vaccine are required for a student 7 years old or
older.
(c) Tetanus.
(i) Four doses of tetanus immunization vaccine are required for a student younger than 7 years
old; and
(ii) Three doses of tetanus immunization vaccine are required for a student 7 years old or older.
(d) Pertussis. Four doses of pertussis immunization vaccine are required for a student younger than 7
years old.
(e) Poliomyelitis (Oral or Injectable).
(i) Three doses of poliomyelitis immunization vaccine are required for a student younger than 18 years old; or
(ii) Proof of immunity from poliomyelitis by blood test is required for a student younger than 18
years old.
(f) Rubella.
(i) One dose of live rubella virus vaccine is required when the student is 1 year old or older; or
(ii) Proof of immunity from rubella by blood test is required when the student is 1 year old or
older.
(g) Measles (rubeola).
(i) Two doses of live measles (rubeola) virus vaccine are required when the student is 1 year old
or older; or
(ii) Proof of immunity from rubeola by blood test is required when the student is 1 year old or
older.
(h) Mumps.
(i) One dose of live mumps virus vaccine is required when the student is 1 year old or older; or
(ii) Proof of immunity from mumps by blood test is required when the student is 1 year old or
older.
(i) Hepatitis B.
(i) Three doses of Hepatitis B vaccine is required per schedule of implementation in §E of this
regulation; or
(ii) Proof of immunity from Hepatitis B by blood test is required.
(j) Varicella.
(i) All doses of Varicella vaccine shall be given when the student is 1 year old or older.
(ii) Per the schedule of implementation in §E of this regulation and except as provided in
§D(2)(j)(iii) of this regulation, one dose of live Varicella vaccine is required for a student younger
than 13 years old, or two doses of live Varicellla vaccine are required for a student 13 years old
or older, if the student does not have proof of vaccination against Varicella at an age younger
than 13 years old.
(iii) Proof of immunity from Varicella by blood test or by medical diagnosis indicated by month
and year of diagnosis may be provided instead of meeting the requirements of §D(2)(j)(ii) of this
regulation.
(3) Record Review for Student in Preschool Through 12th Grade. A preschool or school, public or private, may count as valid, vaccine doses administered less than or equal to 4 days before the minimum interval or age.
E. Schedule of Implementation: Hepatitis B and Varicella Effective Immunization Dates for a Student in
Preschool Through 12th Grade.
(1) As set forth in §E(2) of this regulation, by the date listed in Column 1, the parent or guardian of a
student entering the grade listed in Column 2 shall provide proof to the preschool or school that the
student:
(a) Has received three doses of hepatitis B vaccine and age-appropriate vaccination with
varicella vaccine; or
(b) Is immune to hepatitis B and varicella by providing the results of a blood test or other test.
Exemption Allowed are Medical and Religious
.04 Medical Contraindications.
A. The requirements of Regulation .03 of this chapter do not apply to a student who presents a licensed
physician’s or health officer’s written statement that the student’s immunization against a disease in Regulation .03 of this chapter is medically contraindicated.
B. The physician or health officer shall indicate in the statement presented under §A of this regulation whether the contraindication is:
(1) Permanent; or
(2) Temporary.
C. If the contraindication is temporary:
(1) The physician or health officer shall provide in the statement presented under §A of this regulation an estimate of when the immunization may be obtained by the student; and
(2) The student’s parent or guardian shall furnish to the preschool or school evidence of the completion of the immunization in accordance with the estimate.
D. A preschool or school, public or private, shall maintain a current list of all students enrolled who have an exemption to immunizations on medical grounds.
E. Annually, by November 15, a preschool or school, public or private, shall report to the Secretary of Health and Mental Hygiene the number of students with a medical exemption enrolled in all grades.
.05 Religious Exemption.
A. Using the form provided by the Department of Health and Mental Hygiene, a student whose parent or guardian objects to immunization on the ground that the immunization conflicts with the parent’s or guardian’s bona fide religious beliefs and practices is exempt from the requirement to present a physician’s certificate of immunization in order that the student be admitted to school.
B. The exemption allowed under §A of this regulation does not apply when the Secretary declares an
emergency or epidemic of disease.
C. A preschool or school, public or private, shall maintain a current list of all students enrolled who have an
exemption to immunizations on religious grounds.
D. Annually, by November 15th, a preschool or school, public or private, shall report to the Secretary of Health and Mental Hygiene the number of students with a religious exemption enrolled in all grades.
.06 Temporary Admission or Retention.
A. Subject to the provisions of §B of this regulation, a preschool or school, public or private, shall temporarily admit a student to or retain a student in a preschool or school if:
(1) The student is homeless; or
(2) The student’s parent or guardian is unable to provide proof of immunization pursuant to the
requirements of Regulation .03 of this chapter.
B. In order for a student to be temporarily admitted to or retained in a preschool or school, the student’s parent or guardian shall present evidence of the student’s appointment with a health care provider or local health department to:
(1) Receive a required immunization;
(2) Reconstruct a lost record; or
(3) Acquire evidence of age-appropriate immunity on a form provided by the Department.
C. The date of the appointment pursuant to §B of this regulation may not be later than 20 calendar days
following the date the student was temporarily admitted or retained.
D. A preschool or school, public or private, shall exclude from school a student who has been temporarily
admitted or retained on the next school day following the appointment date if the student’s parent or guardian fails to provide evidence of required immunizations.
HEALTH-GENERAL. TITLE 18. DISEASE PREVENTION
SUBTITLE 4. MISCELLANEOUS PROVISIONS
Md. HEALTH-GENERAL Code Ann. § 18-403. Religious exemption
(a) In general. — Unless the Secretary declares an emergency or disease epidemic, the Department may not require the immunization of an individual if:
(1) The individual objects to immunization because it conflicts with the individual’s bona fide religious beliefs and practices; or
(2) The individual is a minor and the individual’s parent or guardian objects to immunization because it conflicts with the parent or guardian’s bona fide religious beliefs and practices.
(b) Rules and regulations. — The Secretary shall adopt rules and regulations for religious exemptions under this section.
* Effective May 2008: a child whose parent objects to immunization on the ground that it conflicts with the parent’s bona fide religious beliefs and practices may not be required to present a physician’s certification of immunization in order to be admitted to school.
Immunization Certificate Form and Medical and Religious Exemption
Massachusetts
CODE OF MASSACHUSETTS REGULATIONS. TITLE 105: DEPARTMENT OF PUBLIC HEALTH
CHAPTER 220.000: IMMUNIZATION OF STUDENTS BEFORE ADMISSION TO SCHOOL
105 CMR 220.500: Immunization Requirements for Preschool, Elementary, Middle and High School Students
(A) No student, as defined in 105 CMR 220.400, shall attend a preschool program without a certificate of immunization documenting that the child has been successfully immunized in accordance with current Department of Public Health (DPH) recommended schedules against diphtheria, tetanus, pertussis (whooping cough), poliomyelitis, measles, mumps, rubella, Haemophilus influenzae type b (Hib), hepatitis B, varicella and other communicable diseases as specified from time to time by the Department, in accordance with the recommendations of the Advisory Committee on Immunization Practices of the Centers for Disease Control, or any successor committee serving a comparable function.
(B) No student, as defined in 105 CMR 220.400, shall attend kindergarten through 12th grade without a certificate of immunization or a copy of a school immunization record that the student has received at least the following immunizations:
(1) five doses of diphtheria, tetanus, pertussis (DTP), or diphtheria, tetanus, acellular pertussis (DTaP) vaccines, unless the fourth dose has been administered after the fourth birthday, in which case only four doses are required;
(a) where pertussis vaccine is medically contraindicated, diphtheria-tetanus toxoid (DT) is to be substituted for DTP vaccine;
(b) where the student is seven or more years of age and requires additional immunizations to satisfy 105 CMR 220.500(B)(1), tetanus-diphtheria toxoid (Td) is to be substituted for DTP or DT vaccine;
(2) four doses of trivalent polio vaccine (unless the third dose of an all oral polio vaccine [OPV] or all inactivated polio vaccine [IPV] series has been administered after the fourth birthday, in which case only three doses are required);
(3) one dose of measles (live), mumps, rubella (MMR) vaccine given at or after 12 months of age. In addition, a second dose of a live, measles containing vaccine is required for students attending kindergarten and grade seven (or in the case of an ungraded classroom, students 12 years of age or older). Both doses of measles vaccine must be given at least one month apart beginning at or after 12 months of age. After September 1, 2001, this requirement shall apply to all students attending grades K through 12 and all students in ungraded classrooms;
(4) three doses of hepatitis B vaccine for students attending kindergarten. Beginning on September 1, 1999, this requirement shall apply to all students attending grade seven (or in the case of an ungraded classroom, students 12 years of age or older). Beginning on September 1, 2005, this requirement shall apply to all students attending grades K through 12 and all students in ungraded classrooms;
(5) beginning on September 1, 1999, varicella vaccine for students attending kindergarten and grade seven (or in the case of an ungraded classroom, students 12 years of age or older) is required, as follows:
(a) one dose is required for all students receiving vaccine at less than 13 years of age; and
(b) two doses are required for students receiving their first dose of vaccine at 13 years of age or older.
After September 1, 2005, this requirement shall apply to students attending grades kindergarten through 12 and all students in ungraded classrooms; and
(6) beginning on September 1, 1999, a booster of Td vaccine for students attending seventh grade (or in the case of an ungraded classroom, for students 12 years of age or older), if it is five years or more since the last dose.
(C) The requirements in 105 CMR 220.500(A) and (B) shall not apply:
(1) upon presentation of written documentation that the student meets the standards for medical or religious exemption set forth in M.G.L. c. 76, § 15;
(2) upon presentation of appropriate documentation, including a copy of a school immunization record, indicating receipt of the required immunizations:
(3) in the case of measles, mumps, rubella and hepatitis B, upon presentation of laboratory evidence of immunity; or
(4) in the case of varicella, upon presentation of laboratory evidence of immunity or a statement signed by a physician that the student has a history of chickenpox disease.
105 CMR 220.600: Immunization Requirements for Postsecondary Students
(A) No student, as specified in 105 CMR 220.400(C) and 220.600(B), shall attend a postsecondary institution without a certification of immunization, as specified in 105 CMR 220.600(C). For purposes of 105 CMR 220.600, “postsecondary institution” shall mean a college, university, institute or school accredited as a postsecondary institution by the New England Association of Schools and Colleges.
(B) The following students are subject to the requirements of 105 CMR 220.600(C):
(1) full-time undergraduate and graduate students;
(2) part-time undergraduate and graduate students in a health science program who may be in contact with patients; and
(3) beginning on January 1, 1999, any full or part-time student attending an institution of higher education in Massachusetts while on a student or other visa, including a student attending or visiting classes or programs as part of a formal academic visitation or exchange program.
(C) Each student subject to 105 CMR 220.600(B) must present a certificate of immunization that the student has received the following immunizations:
(1) at least one dose of mumps and rubella vaccine(s) given at or after 12 months of age;
(2) two doses of live measles vaccine given at least one month apart beginning at or after 12 months of age;
(3) a booster dose of Td within the last ten years;
(4) beginning on September 1, 2000, 3 doses of hepatitis B vaccine will be required for all students in a health science program who may be in contact with patients. After September 1, 2005, this requirement shall apply to all students subject to 105 CMR 220.600.
(D) The requirements of 105 CMR 220.600 shall not apply where:
(1) the student provides written documentation that he or she meets the standards for medical or religious exemption set forth in M.G.L. c. 76, ss 15C;
(2) the student provides appropriate documentation, including a copy of a school immunization record, indicating receipt of the required immunizations; or
(3) in the case of measles, mumps, rubella and hepatitis B, the student presents laboratory evidence of immunity.
(E) Whenever possible, such immunizations are to be obtained prior to enrollment or registration. However, students subject to 105 CMR 220.600 may be enrolled or registered provided that the required immunizations are obtained within 30 days of registration and provided, further, that the postsecondary institution has policies and procedures for ascertaining which students have failed to obtain the necessary immunizations within 30 days, and for taking appropriate follow up action to ensure compliance with 105 CMR 220.00.
Exemptions allowed are Medical and Religious
Daycare:
IMMUNIZATION REQUIREMENTS FOR GROUP DAY CARE AND
SCHOOL AGE CHILD CARE PROGRAMS
Regulations Of The Department of Early Education and Care
102 CMR 7.00: Standards For The Licensure Or Approval Of Group Day Care And School Age Child Care Programs (7/10/97)
Section 102 CMR 7.09(5)(a) Required Medical Examinations in Group Child Care Programs
“The licensee shall require, at admission, a physician’s certificate that each child has been successfully immunized in accordance with the current Department of Public Health’s recommended schedules against diphtheria, tetanus, pertussis (whooping cough), poliomyelitis, measles and such other communicable diseases as may be specified from time to time by the Office. No child shall be required, under 102 CMR 7.00 to have any such immunization if his parent(s) objects thereto, in writing, on the grounds that it conflicts with their religious beliefs or if the child’s physician submits documentation that such a procedure is contraindicated.”
School Age:
GENERAL LAWS OF MASSACHUSETTS.
PART I, TITLE XII, CHAPTER 76.
Section 15: Vaccination and immunization
No child shall, except as hereinafter provided, be admitted to school except upon presentation of a physician’s certificate that the child has been successfully immunized against diphtheria, pertussis, tetanus, measles and poliomyelitis and such other communicable diseases as may be specified from time to time by the department of public health.
A child shall be admitted to school upon certification by a physician that he has personally examined such child and that in his opinion the physical condition of the child is such that his health would be endangered by such vaccination or by any of such immunizations. Such certification shall be submitted at the beginning of each school year to the physician in charge of the school health program. If the physician in charge of the school health program does not agree with the opinion of the child’s physician, the matter shall be referred to the department of public health, whose decision will be final.
In the absence of an emergency or epidemic of disease declared by the department of public health, no child whose parent or guardian states in writing that vaccination or immunization conflicts with his sincere religious beliefs shall be required to present said physician’s certificate in order to be admitted to school.
College:
GENERAL LAWS OF MASSACHUSETTS
PART I, TITLE XII, CHAPTER 76.
Section 15C: Immunization of college health science students
No full-time student under thirty years of age or any full-time or part-time undergraduate or graduate students in a health science who is in contact with patients shall, except as hereinafter provided, be registered at an institution of higher education except upon presentation of a medical certificate that such student has been immunized against measles, mumps, rubella, tetanus and diphtheria; provided, however, that a student may be registered at such institution upon certification made, in writing, by a physician who has personally examined such student and in whose opinion the physical condition of such student is such that his health would be endangered by any such immunization; and provided, further, that students who have attended an elementary or secondary school in the commonwealth may submit a copy of their school immunization record, indicating receipt of the above required immunizations, in lieu of such certificate; and provided, further, that unimmunized students may be registered on the condition that the required immunizations be obtained within ten days of registration.
In the absence of an emergency or epidemic of disease declared by the department of public health, no student who states in writing that such immunization would conflict with his religious beliefs shall be required to present such medical certificate in order to be admitted to such institution.
Michigan
CHAPTER 333 HEALTH.PUBLIC HEALTH CODE. ARTICLE 9. SUPPORTIVE PERSONAL HEALTH SERVICES.PART 92. IMMUNIZATION
§ 333.9205. Child immunization; duty of parent, guardian, person in loco parentis.
A parent, guardian, or person in loco parentis of a child shall provide for the child’s immunization by an authorized health professional, physician, local health department, clinic, or other agency offering immunizations for diseases and within an age period prescribed by the department.
§ 333.9208. Certificate of immunization or statement of exemption; presentation to school officials; minimum doses of immunizing agent; updated certificate.
1) A parent, guardian, or person in loco parentis applying to have a child registered for the first time in a school in this state and, beginning in 2002-2003, a parent, guardian, or person in loco parentis of a child entering the sixth grade, shall present to school officials, at the time of registration or not later than the first day of school, a certificate of immunization or statement of exemption under section 9215.
(2) A teacher or principal shall not permit a child to enter or attend school unless a certificate indicating that a minimum of 1 dose of an immunizing agent against each of the diseases specified by the department has been received and certified to by a health professional or local health department. A parent, guardian, or person in loco parentis having a child registered with only these minimum doses of immunizing agents shall present an updated certificate of immunization within 4 months after initial attendance showing that the immunizations have been completed as prescribed by the department.
MCL § 333.9211. Preschool child immunization certificate, exemption statement; requirement of program registration; limitation on participation; minimum immunization, updated certificate; immunization status.
1) A parent, guardian, or person in loco parentis applying to have a preschool aged child registered in a program of group residence, care, or camping shall present to the operator of the program at the time of registration or not later than the first day of the program a certificate of immunization or a statement of exemption under section 9215. The operator of the group program shall not permit a child to attend the group activity unless a minimum of 1 dose of an immunizing agent against each of the diseases specified by the department has been received and certified to by a health professional or local health department. A parent, guardian, or person in loco parentis of a child registered with only these minimum doses of an immunizing agent and continuing enrollment in the group program shall present an updated certificate of immunization within 4 months after initial attendance showing that the immunizations have been completed as prescribed by the department, if the child remains in the program.
(2) Upon request by the department or local health department, a program operator shall report to the state and local health departments the immunization status of each child accepted.
Exemptions allowed are Medical, Religious, and Philosophical
Exemption Waiver Form-State
College or Employment Exemption Waiver
*Schools have no authority to challenge immunization exemptions.
* Selective vaccine exemptions permitted
§ 333.9215. Exemption of child; immunization detrimental to health or not appropriate, physician certificate; religious convictions or other objections, parent’s written statement.
(1) A child is exempt from the requirements of this part as to a specific immunization for any period of time as to which a physician certifies that a specific immunization is or may be detrimental to the child’s health or is not appropriate.
(2) A child is exempt from this part if a parent, guardian, or person in loco parentis of the child presents a written statement to the administrator of the child’s school or operator of the group program to the effect that the requirements of this part cannot be met because of religious convictions or other objection to immunization.
MICH. ADMIN. CODE R. 325.176 Immunizations required of children attending group programs or entering school.
Rule 6
(10) To satisfy the requirements in subrules (2) to (9) of this rule, each vaccine shall have been administered in accordance with the manufacturer’s instructions. A 4-day grace leniency is allowed on the minimum ages and intervals for each vaccine.
(11) If the requirements for immunization cannot be completed due to medical reasons within 4 months of admittance, a child shall be permitted to remain enrolled in a school or group program for a reasonable length of time that is consistent with good medical practice. A statement requesting the enrollment of the child beyond the exclusion date shall be signed by a physician or local health officer and shall certify that the child is in the process of complying with all immunization requirements. This medical exemption shall be filed with the child’s school or group program immunization records until it can be replaced with proof that the vaccines for which an exemption was granted have been received. Upon completion of the required immunizations, a parent shall present the school or group program with a certificate of immunization.
(12) When presented with a medical exemption, religious or other exemption, the administrator of a child’s school or operator of a child’s group program shall recognize the exemption status of the child.
(13) A standard record of the immunizations required by this rule and exemptions shall be maintained by every school for every pupil on forms supplied by the department. When a pupil transfers to another school or school district, the record of immunization, or a true copy of the record, shall be sent to the new school by the original school.
Minnesota
Exemptions allowed are Medical, Religious, and Philosophical
Child Care Immunization Record and Exemption Form
School Age Immunization Record and Exemption Form
ECFE Immunization Record and Exemption Form
ECFE Learning Readiness Immunization and Exemption Form
*selective vaccine exemptions permitted
*Forms must be notorized
Minnesota’s Childcare, School, and College Immunization Law
Minn. Stat. § 121A.15 Health standards; immunizations; school children
Subdivision 1. Except as provided in subdivisions 3, 4, and 10, no person over two months old may be allowed to enroll or remain enrolled in any elementary or secondary school or child care facility in this state until the person has submitted to the administrator or other person having general control and supervision of the school or child care facility, one of the following statements:
(1) a statement from a physician or a public clinic which provides immunizations stating that the person has received immunization, consistent with medically acceptable standards, against measles after having attained the age of 12 months, rubella, diphtheria, tetanus, pertussis, polio, mumps, haemophilus influenza type b, and hepatitis B; or
(2) a statement from a physician or a public clinic which provides immunizations stating that the person has received immunizations, consistent with medically acceptable standards, against measles after having attained the age of 12 months, rubella, mumps, and haemophilus influenza type b and that the person has commenced a schedule of immunizations for diphtheria, tetanus, pertussis, polio, and hepatitis B and which indicates the month and year of each immunization received.
Subdivision. 2. Schedule of immunizations. No person who has commenced a treatment schedule of immunization pursuant to subdivision 1, clause (2), may remain enrolled in any child care facility, elementary, or secondary school in this state after 18 months of enrollment unless there is submitted to the administrator, or other person having general control and supervision of the school or child care facility, a statement from a physician or a public clinic which provides immunizations that the person has completed the primary schedule of immunizations for diphtheria, tetanus, pertussis, polio, and hepatitis B. The statement must include the month and year of each additional immunization received. For a child less than seven years of age, a primary schedule of immunizations shall consist of four doses of vaccine for diphtheria, tetanus, and pertussis and three doses of vaccine for poliomyelitis and hepatitis B. For a child seven years of age or older, a primary schedule of immunizations shall consist of three doses of vaccine for diphtheria, tetanus, polio, and hepatitis B.
Subdivision. 3. Exemptions from immunizations.
(a) If a person is at least seven years old and has not been immunized against pertussis, the person must not be required to be immunized against pertussis.
(b) If a person is at least 18 years old and has not completed a series of immunizations against poliomyelitis, the person must not be required to be immunized against poliomyelitis.
(c) If a statement, signed by a physician, is submitted to the administrator or other person having general control and supervision of the school or child care facility stating that an immunization is contraindicated for medical reasons or that laboratory confirmation of the presence of adequate immunity exists, the immunization specified in the statement need not be required.
(d) If a notarized statement signed by the minor child’s parent or guardian or by the emancipated person is submitted to the administrator or other person having general control and supervision of the school or child care facility stating that the person has not been immunized as prescribed in subdivision 1 because of the conscientiously held beliefs of the parent or guardian of the minor child or of the emancipated person, the immunizations specified in the statement shall not be required. This statement must also be forwarded to the commissioner of the department of health.
(e) If the person is under 15 months, the person is not required to be immunized against measles, rubella, or mumps.
(f) If a person is at least five years old and has not been immunized against haemophilus influenza type b, the person is not required to be immunized against haemophilus influenza type b.
(g) If a person who is not a Minnesota resident enrolls in a Minnesota school online learning course or program that delivers instruction to the person only by computer and does not provide any teacher or instructor contact time or require classroom attendance, the person is not subject to the immunization, statement, and other requirements of this section.
Subdivision. 4. Substitute immunization statement.
(a) A person who is enrolling or enrolled in an elementary or secondary school or child care facility may substitute a statement from the emancipated person or a parent or guardian if the person is a minor child in lieu of the statement from a physician or public clinic which provides immunizations. If the statement is from a parent or guardian or emancipated person, the statement must indicate the month and year of each immunization given.
(b) In order for the statement to be acceptable for a person who is enrolling in an elementary school and who is six years of age or younger, it must indicate that the following was given: no less than one dose of vaccine each for measles, mumps, and rubella given separately or in combination; no less than four doses of vaccine for poliomyelitis, unless the third dose was given after the fourth birthday, then three doses are minimum; no less than five doses of vaccine for diphtheria, tetanus, and pertussis, unless the fourth dose was given after the fourth birthday, then four doses are minimum; and no less than three doses of vaccine for hepatitis B.
(c) In order for the statement to be consistent with subdivision 10 and acceptable for a person who is enrolling in an elementary or secondary school and is age seven through age 19, the statement must indicate that the person has received no less than one dose of vaccine each for measles, mumps, and rubella given separately or in combination, and no less than three doses of vaccine for poliomyelitis, diphtheria, tetanus, and hepatitis B.
(d) In order for the statement to be acceptable for a person who is enrolling in a secondary school, and who was born after 1956 and is 20 years of age or older, the statement must indicate that the person has received no less than one dose of vaccine each for measles, mumps, and rubella given separately or in combination, and no less than one dose of vaccine for diphtheria and tetanus within the preceding ten years.
(e) In order for the statement to be acceptable for a person who is enrolling in a child care facility and who is at least 15 months old but who has not reached five years of age, it must indicate that the following were given: no less than one dose of vaccine each for measles, mumps, and rubella given separately or in combination; no less than one dose of vaccine for haemophilus influenza type b; no less than four doses of vaccine for diphtheria, tetanus, and pertussis; and no less than three doses of vaccine for poliomyelitis.
(f) In order for the statement to be acceptable for a person who is enrolling in a child care facility and who is five or six years of age, it must indicate that the following was given: no less than one dose of vaccine each for measles, mumps, and rubella given separately or in combination; no less than four doses of vaccine for diphtheria, tetanus, and pertussis; and no less than three doses of vaccine for poliomyelitis.
(g) In order for the statement to be acceptable for a person who is enrolling in a child care facility and who is seven years of age or older, the statement must indicate that the person has received no less than one dose of vaccine each for measles, mumps, and rubella given separately or in combination and consistent with subdivision 10, and no less than three doses of vaccine for poliomyelitis, diphtheria, and tetanus.
(h) The commissioner of health, on finding that any of the above requirements are not necessary to protect the public’s health, may suspend for one year that requirement.
Subdivision. 5. Transfer of immunization statements.
If a person transfers from one elementary or secondary school to another, the school board of a public school district or the administrator of a nonpublic school may allow the person up to a maximum of 30 days to submit one or more of the statements as specified in subdivision 1 or 3, during which time the person may enroll in and attend the school. If a person enrolls in a child care facility in which at least 75 percent of children in the facility participate on a onetime only or occasional basis to a maximum of 45 hours per child, per month, or is placed in a facility by a crisis nursery, the person shall be exempt from all requirements of this section for up to five consecutive days, starting from the first day of attendance.
Mississippi
School Age Vaccine Mandates:
Students born after 1957 must show acceptable proofs of immunization upon admission to Mississippi Universities.
Two doses of measles-containing vaccine (usually administered as MMR vaccine) are required for all first-time enterers to member institutions of the Mississippi university system. Other colleges and junior colleges in the state have chosen to implement a measles-rubella immunity standard for college admission. Students should check with their college for required immunization. After the student’s heath care provider completes the Certificate of Immunization Compliance (form 121), the student must send the form (in a timely manner) to the admissions/registration office of the college or university that they plan to attend.
All students must have one of the following on file in their individual records at the institutions they are attending:
Certificate of Immunization Compliance (form 121). This form MUST be signed by the District Health Officer, a physician, nurse, or designee.
Certificate of Exemption from Immunization Requirements for Adults (form 132)
Proof of Measles Immunity for College Students
Students born before 1957 are assumed to have natural immunity to measles.
However, students born after 1957 must demonstrate immunity to measles in one of the following ways:
Case history – A physician’s statement documenting prior measles infection
Blood test – Serological confirmation of measles immunity
Vaccine history – A record of two doses of measles-containing vaccine (usually given as MMR) given on or after the first birthday and on or after 01/01/68. There must be a minimum time interval of 30 days between the two doses of measles vaccine.
Proof of Rubella Immunity for college
Students regardless of age must show proof of immunity to rubella in one of the following
ways:
Blood test – Serological confirmation of rubella immunity
Vaccine history – A rubella vaccination received at or after12 months of age and on or after 01/01/69.
Exemption allowed is Medical only.
*Home schooled children are exempt from vaccine mandates.
Miss. Code Ann. § 41-23-37. Immunization practices for control of vaccine preventable diseases; attendance by unvaccinated children
A certificate of exemption from vaccination for medical reasons may be offered on behalf of a child by a duly licensed physician and may be accepted by the local health officer when, in his opinion, such exemption will not cause undue risk to the community.
Certificates of vaccination shall be issued by local health officers or physicians on forms specified by the Mississippi State Board of Health. These forms shall be the only acceptable means for showing compliance with these immunization requirements, and the responsible school officials shall file the form with the child’s record.
If a child shall offer to enroll at a school without having completed the required vaccinations, the local health officer may grant a period of time up to ninety (90) days for such completion when, in the opinion of the health officer, such delay will not cause undue risk to the child, the school or the community. No child shall be enrolled without having had at least one (1) dose of each specified vaccine.
Within thirty (30) days after the opening of the fall term of school (on or before October 1 of each year) the person in charge of each school shall report to the county or local health officer, on forms provided by the Mississippi State Board of Health, the number of children enrolled by age or grade or both, the number fully vaccinated, the number in process of completing vaccination requirements, and the number exempt from vaccination by reason for such exemption.
Within one hundred twenty (120) days after the opening of the fall term (on or before December 31), the person in charge of each school shall certify to the local or county health officer that all children enrolled are in compliance with immunization requirements.
For the purpose of assisting in supervising the immunization status of the children the local health officer, or his designee, may inspect the children’s records or be furnished certificates of immunization compliance by the school.
It shall be the responsibility of the person in charge of each school to enforce the requirements for immunization. Any child not in compliance at the end of ninety (90) days from the opening of the fall term must be suspended until in compliance, unless the health officer shall attribute the delay to lack of supply of vaccine or some other such factor clearly making compliance impossible.
Failure to enforce provisions of this section shall constitute a misdemeanor and upon conviction be punishable by fine or imprisonment or both.
1. IN GENERAL.
Missouri
Immunization of School Children 167.181
Contagious Diseases Excluded from School 167.191 –
Immunization of Children in Day Care 210.003 –
Code of State Regulations:
Exclusion from School and Readmission 19 CSR 20-20.030
Day Care Immunization Rule 19 CSR 20-28.040 –
Exemptions allowed are Medical and Religious
*selective vaccine exemptions allowed
Medical, Religious, and In Progress Exemption Forms (pg 4)
MISSOURI.TITLE 11. EDUCATION AND LIBRARIES. CHAPTER 167. PUPILS AND SPECIAL SERVICES. PUPILS
§ 167.181. Immunization of pupils against certain diseases compulsory — exceptions — records — to be at public expense, when — fluoride treatments administered, when — rulemaking authority, procedure
1. The department of health and senior services, after consultation with the department of elementary and secondary education, shall promulgate rules and regulations governing the immunization against poliomyelitis, rubella, rubeola, mumps, tetanus, pertussis, diphtheria, and hepatitis B, to be required of children attending public, private, parochial or parish schools. Such rules and regulations may modify the immunizations that are required of children in this subsection. The immunizations required and the manner and frequency of their administration shall conform to recognized standards of medical practice. The department of health and senior services shall supervise and secure the enforcement of the required immunization program.
2. It is unlawful for any student to attend school unless he has been immunized as required under the rules and regulations of the department of health and senior services, and can provide satisfactory evidence of such immunization; except that if he produces satisfactory evidence of having begun the process of immunization, he may continue to attend school as long as the immunization process is being accomplished in the prescribed manner. It is unlawful for any parent or guardian to refuse or neglect to have his child immunized as required by this section, unless the child is properly exempted.
3. This section shall not apply to any child if one parent or guardian objects in writing to his school administrator against the immunization of the child, because of religious beliefs or medical contraindications. In cases where any such objection is for reasons of medical contraindications, a statement from a duly licensed physician must also be provided to the school administrator.
4. Each school superintendent, whether of a public, private, parochial or parish school, shall cause to be prepared a record showing the immunization status of every child enrolled in or attending a school under his jurisdiction. The name of any parent or guardian who neglects or refuses to permit a nonexempted child to be immunized against diseases as required by the rules and regulations promulgated pursuant to the provisions of this section shall be reported by the school superintendent to the department of health and senior services.
5. The immunization required may be done by any duly licensed physician or by someone under his direction. If the parent or guardian is unable to pay, the child shall be immunized at public expense by a physician or nurse at or from the county, district, city public health center or a school nurse or by a nurse or physician in the private office or clinic of the child’s personal physician with the costs of immunization paid through the state Medicaid program, private insurance or in a manner to be determined by the department of health and senior services subject to state and federal appropriations, and after consultation with the school superintendent and the advisory committee established in section 192.630, RSMo. When a child receives his or her immunization, the treating physician may also administer the appropriate fluoride treatment to the child’s teeth.
6. Funds for the administration of this section and for the purchase of vaccines for children of families unable to afford them shall be appropriated to the department of health and senior services from general revenue or from federal funds if available.
7. No rule or portion of a rule promulgated under the authority of this section shall become effective unless it has been promulgated pursuant to the provisions of chapter 536, RSMo. Any rule or portion of a rule, as that term is defined in section 536.010, RSMo, that is created under the authority delegated in this section shall become effective only if it complies with and is subject to all of the provisions of chapter 536, RSMo, and, if applicable, section 536.028, RSMo. This section and chapter 536, RSMo, are nonseverable and if any of the powers vested with the general assembly pursuant to chapter 536, RSMo, to review, to delay the effective date or to disapprove and annul a rule are subsequently held unconstitutional, then the grant of rulemaking authority and any rule proposed or adopted after August 28, 2001, shall be invalid and void.
TITLE 12. PUBLIC HEALTH AND WELFARE. CHAPTER 210. CHILD PROTECTION AND REFORMATION
§ 210.003. Immunizations of children required, when, exceptions–duties of administrator, report.
1. No child shall be permitted to enroll in or attend any public, private or parochial day care center, preschool or nursery school caring for ten or more children unless such child has been adequately immunized against vaccine-preventable childhood illnesses specified by the department of health and senior services in accordance with recommendations of the Immunization Practices Advisory Committee (ACIP). The parent or guardian of such child shall provide satisfactory evidence of the required immunizations.
2. A child who has not completed all immunizations appropriate for his age may enroll, if:
(1) Satisfactory evidence is produced that such child has begun the process of immunization. The child may continue to attend as long as the immunization process is being accomplished according to the ACIP/Missouri department of health and senior services recommended schedule; or
(2) The parent or guardian has signed and placed on file with the day care administrator a statement of exemption which may be either of the following:
(a) A medical exemption, by which a child shall be exempted from the requirements of this section upon certification by a licensed physician that such immunization would seriously endanger the child’s health or life; or
(b) A parent or guardian exemption, by which a child shall be exempted from the requirements of this section if one parent or guardian files a written objection to immunization with the day care administrator. Exemptions shall be accepted by the day care administrator when the necessary information as determined by the department of health and senior services is filed with the day care administrator by the parent or guardian. Exemption forms shall be provided by the department of health and senior services.
3. In the event of an outbreak or suspected outbreak of a vaccine-preventable disease within a particular facility, the administrator of the facility shall follow the control measures instituted by the local health authority or the department of health and senior services or both the local health authority and the department of health and senior services, as established in Rule 19 CSR 20-20.040, “Measures for the Control of Communicable Diseases”.
4. The administrator of each public, private or parochial day care center, preschool or nursery school shall cause to be prepared a record of immunization of every child enrolled in or attending a facility under his
jurisdiction. An annual summary report shall be made by January fifteenth showing the immunization status of each child enrolled, using forms provided for this purpose by the department of health and senior services. The immunization records shall be available for review by department of health and senior services personnel upon request.
5. For purposes of this section, satisfactory evidence of immunization means a statement, certificate or record from a physician or other recognized health facility or personnel, stating that the required immunizations have been given to the child and verifying the type of vaccine and the month, day and year of administration.
6. Nothing in this section shall preclude any political subdivision from adopting more stringent rules regarding the immunization of preschool children.
TITLE 11. EDUCATION AND LIBRARIES. CHAPTER 174. STATE COLLEGES AND UNIVERSITIES
§ 174.335. Meningococcal disease, all on-campus students provided information on–election to receive vaccination–records to be maintained.
1. Beginning with the 2004-2005 school year and for each school year thereafter, every public institution of higher education in this state shall require all students who reside in on-campus housing to sign a written waiver stating that the institution of higher education has provided the student, or if the student is a minor, the student’s parents or guardian, with detailed written information on the risks associated with meningococcal disease and the availability and effectiveness of the meningococcal vaccine.
2. Any student who elects to receive the meningococcal vaccine shall not be required to sign a waiver referenced in subsection 1 of this section and shall present a record of said vaccination to the institution of higher education.
3. Each public university or college in this state shall maintain records on the meningococcal vaccination status of every student residing in on-campus housing at the university or college, including any written waivers executed pursuant to subsection 1 of this section.
4. Nothing in this section shall be construed as requiring any institution of higher education to provide or pay for vaccinations against meningococcal disease.
Montana
MONTANA ADMINISTRATIVE RULES. TITLE 37. PUBLIC HEALTH AND HUMAN SERVICES. CHAPTER 95. LICENSURE OF DAY CARE FACILITIES
MONT. ADMIN. R. 37.95.140 IMMUNIZATION
(1) Before a child under the age of five may attend a Montana day care facility, that facility must be provided with the documentation required by (4) that the child has been immunized as required for the child’s age group against measles, rubella, mumps, poliomyelitis, diphtheria, pertussis (whooping cough) , tetanus, and Haemophilus influenza type B, unless the child qualifies for conditional attendance in accordance with (9) :
Age at Entry Number of Doses-Vaccine Type:
-under 2 months old no vaccinations required
-by 3 months of age 1 dose of polio vaccine
1 dose of DTP vaccine
1 dose of Hib vaccine
-by 5 months of age 2 doses of polio vaccine
2 doses of DTP vaccine
2 doses of Hib vaccine
-by 7 months of age 2 doses of polio vaccine
3 doses of DTP vaccine
*2 or 3 doses of Hib vaccine
-by 16 months of age 2 doses of polio vaccine
3 doses of DTP vaccine
1 dose of MMR vaccine administered no earlier than 12 months of age
*1 dose of Hib vaccine given after 12 or 15 months of age
-by 19 months of age 1 dose of varicella vaccine
3 doses of polio vaccine
4 doses of DTP vaccine
1 dose of MMR vaccine administered no earlier than 12 months of age
*1 dose of Hib vaccine given after 12 or 15 months of age
(*) varies depending on vaccine type used.
(2) If the child is at least 12 months old but not less than 60 months of age and has not received any Hib vaccine, the child must receive a dose prior to entry.
(3) DT vaccine administered to a child less than seven years of age is acceptable for purposes of this rule only if accompanied by a medical exemption meeting the requirements of ARM 37.114.715 that exempts the child from pertussis vaccination.
(4) Before a child between the ages of five and 12 may attend a day care facility providing care to school aged children, that facility must be provided with documentation required by (5) that the child has been immunized as required for the child’s age group against measles, rubella, mumps, poliomyelitis, diphtheria, pertussis (whopping cough), tetanus, and Haemophiles influenza type B, unless the child qualifies for conditional attendance in accordance with (9) .
Vaccine Dosages Required by Age:
Polio- Each child must receive at least three doses of polio vaccine, one of which is administered after age four.
DTP or DTaP- Each child must receive at least four doses of DTP or DTaP (diphtheria, tetanus and pertussis) vaccines by age four and one dose of DTaP after age four but before age seven, unless a licensed health care provider has issued a medical exemption for the pertussis portion of the DTP or DTaP vaccine. If a medical exemption has been issued for pertussis, the child must receive at least four doses of DT vaccine or a combination of four doses of DT, DTP, and DTaP vaccines before age four and one dose of the DT vaccine after age four but before age seven. Because neither DTP nor DTaP vaccines are recommended or required for a child older than age seven, a child in the day care age seven or older who has not received the four doses of DTaP or DTP vaccinations described above must receive a Td vaccine (tetanus and diphtheria vaccine intended for persons seven years of age or older) as soon as possible and must then receive sufficient additional Td doses to reach a minimum of three doses of any combination of DTP, DTaP, DT, or Td.
Td- Each child in the day care must receive a Td tetanus diphtheria vaccine intended for children younger than seven years of age booster shot unless the child has had a DTP, DTaP, DT, or Td shot within the previous five years or the child received a Td shot at seven years of age or older.
(5) Documentation of immunization status for purposes of this rule consists of a completed Montana certificate of immunization form (HPS-101) , including the date of birth, the name of each vaccine provided, and the month, day and year of each vaccination.
(6) In order to continue to attend a day care facility, a child must continue to be immunized on the schedule described in (1) and must be immediately excluded from attendance in the day care facility if the child is not vaccinated on that schedule with all of the required vaccines, or does not have on file at the day care facility a record of medical exemption or a conditional enrollment form which indicates that no vaccine dose is past due.
(7) Hib vaccine is not required or recommended for children five years of age and older.
(8) Doses of MMR vaccine, to be acceptable under this rule, must be given no earlier than 12 months of age and a child who received a dose prior to 12 months of age must be revaccinated before attending a day care facility.
(9) A child may initially conditionally attend a day care facility if:
(a) the child has received at least one dose of each of the vaccines required for the child’s age;
(b) a form prescribed by the department documenting the child’s conditional immunization status is on file at the day care facility and is attached to the department’s Montana certificate of immunization (HPS-101) ; and
(c) the child is not past due for the next required dose (as noted on the conditional enrollment form) of the vaccine in question.
(10) If a child in attendance at the day care facility, a resident of the day care facility, or a staff member, or volunteer contracts any of the diseases for which this rule requires immunization, all individuals infected and all persons attending the day care facility who are not completely immunized against the disease in question or who are exempted from immunization must be excluded from the day care facility until the local health authority indicates to the day care facility that the outbreak is over.
(11) The day care facility must maintain a written record of immunization status of each enrolled child and each child of a staff member who resides at the day care facility. The facility must make those records available during normal working hours to representatives of the department or the local health authority.
(12) A child seeking to attend a day care facility is not required to have any immunizations which are medically contraindicated. A written and signed statement from a physician that an immunization is medically contraindicated will exempt a person from the applicable immunization requirements of this rule.
(13) A child under five years of age seeking to attend a day care facility is not required to be immunized against Haemophilus influenza type B if the parent or guardian of the child objects thereto in a signed, written statement indicating that the proposed immunization interferes with the free exercise of the religious beliefs of the person signing the statement.
(14) The department adopts and incorporates by reference ARM 37.114.715 which sets the requirements for a medical exemption from vaccination. A copy of ARM 37.114.715 may be obtained from the Department of Public Health and Human Services, Public Health and Safety Division, P.O. Box 202951, Helena, MT 59620-2951.
Exemptions allowed are Medical and Religious
*NOTE: Religious exemptions in daycare applies only to Hib vaccine
Montana Code 52-2-735. Health protection — certification required.
(1) The department shall adopt rules for the protection of children in day-care centers from the health hazards of inadequate food preparation, poor nutrition, and communicable diseases. Rules adopted by the department must include rules requiring children under 5 years of age to be immunized against Haemophilus influenza type “b” before being admitted for care in the facility unless an exemption has been claimed as provided in 20-5-405.
(2) Local public health authorities shall arrange to provide training to day-care center providers and employees regarding health hazards. Upon successful completion of the training the local public health authorities shall issue certificates to the providers and employees.
(3) In lieu of training, local public health authorities may elect to inspect facilities and issue certificates of approval to child-care center providers.
(4) Each applicant for a license to operate a day-care center shall submit to the department a certificate issued pursuant to subsection (2) or (3) before the department will issue a license.
(5) The local public health authority may charge the applicant a reasonable fee, not to exceed $25, for any inspection necessary to issue a certificate of approval, or a fee not to exceed the documented cost for training it provides under this section.
See Also: Daycare Mandates
TITLE 20 EDUCATION.CHAPTER 5 PUPILS
PART 4 HEALTH
Mont. Code Anno. §20-5-403 Immunization required — release and acceptance of immunization records.
(1) The governing authority of any school other than a postsecondary school may not allow a person to attend as a pupil unless the person:
(a) has been immunized against diphtheria, pertussis, tetanus, poliomyelitis, rubella, mumps, and measles (rubeola) in the manner and with immunizing agents approved by the department, except that pertussis vaccination is not required for a person 7 years of age or older;
(b) has been immunized against Haemophilus influenza type “b” before enrolling in a preschool if under 5 years of age;
(c) qualifies for conditional attendance; or
(d) files for an exemption.
(2)
( a) The governing authority of a postsecondary school may not allow a person to attend as a pupil unless the person:
(i) has been immunized against rubella and measles (rubeola) in the manner and with immunizing agents approved by the department; or
(ii) files for an exemption.
(b) The governing authority of a postsecondary school may impose immunization requirements as a condition of attendance that are more stringent than those required by this part.
(3) A pupil who transfers from one school district to another may photocopy immunization records in the possession of the school of origin. The school district to which a pupil transfers shall accept the photocopy as evidence of immunization. Within 30 days after a transferring pupil ceases attendance at the school of origin, the school shall retain a certified copy for the permanent record send the original immunization records for the pupil to the school district to which the pupil transfers.
Mont. Code Anno., § 20-5-404. Conditional attendance.
The governing authority of a school other than a postsecondary school may allow the commencement of attendance in school by a person who has not been immunized against each disease listed in 20-5-403 if that person has received one or more doses of polio, measles (rubeola), mumps, rubella, diphtheria, pertussis, Haemophilus influenza type “b”, and tetanus vaccine, except that pertussis vaccine is not required for a person 7 years of age or older and Haemophilus influenza type “b” vaccine is required only for children under 5 years of age.
Mont. Code Anno. § 20-5-405 Medical or religious exemption.
(1) When a parent, guardian, or adult who has the responsibility for the care and custody of a minor seeking to attend school or the person seeking to attend school, if an adult, signs and files with the governing authority, prior to the commencement of attendance each school year, a notarized affidavit on a form prescribed by the department stating that immunization is contrary to the religious tenets and practices of the signer, immunization of the person seeking to attend the school may not be required prior to attendance at the school. The statement must be maintained as part of the person’s immunization records. A person who falsely claims a religious exemption is subject to the penalty for false swearing provided in 45-7-202.
(2) When a parent, guardian, or adult who has the responsibility for the care and custody of a minor seeking to attend school, or the person seeking to attend school, if an adult, files with the governing authority a written statement signed by a physician licensed to practice medicine in any jurisdiction of the United States or Canada stating that the physical condition of the person seeking to attend school or medical circumstances relating to him indicate that some or all of the required immunizations are not considered safe and indicating the specific nature and probable duration of the medical condition or circumstances which contraindicate immunization, he is exempt from the requirements of this part to the extent indicated by the physician’s statement. The statement must be maintained as part of the person’s immunization records.
(3) Whenever there is good cause to believe that a person for whom an exemption has been filed under this section has a disease or has been exposed to a disease listed in 20-5-403 or will as the result of school attendance be exposed to such disease, the person may be excluded from the school by the local health officer or the department until the excluding authority is satisfied that the person no longer risks contracting or transmitting that disease.
ARM ARM 37.114.715 Medical exemption.
ARM ARM 37.114.716 Religious exemption.
Challenges to Mandatory Immunization on Religious Grounds — Restraint Advisable: Although a school district has an undeniable compelling interest in protecting students from communicable diseases, it does not have unlimited discretion to determine the legitimacy or sincerity of the religious tenets and practices of one seeking an exemption pursuant to this section. Absent established uniform standards or procedures, a school district should refrain from challenging an affidavit claiming a religious exemption from mandatory immunization. 44 A.G. Op. 7 (1991).
Religious Exemption to Mandatory Immunization Not Limited to Established or Recognized Religion: The religious exemption to mandatory immunization of students in this section is not limited to beliefs or tenets of an established or recognized traditional religion but also encompasses sincerely held personal religious beliefs. 44 A.G. Op. 7 (1991).
MONT. ADMIN. R. 37.114.715 MEDICAL EXEMPTION
(1) A prospective pupil seeking to attend school is not required to have any immunizations which are medically contraindicated. A written and signed statement from a physician that an immunization is medically contraindicated will exempt a prospective pupil from those immunizations as deemed necessary by the physician. The required vaccines are listed in 20-5-403, MCA.
(2) The statement must include:
(a) which specific immunization is contraindicated;
(b) the period of time during which the immunization is contraindicated;
(c) the reasons for the medical contraindication; and
(d) when deemed necessary by a physician, the results of immunity testing performed on a pupil entering kindergarten through grade 12. The tests must indicate serological evidence of immunity and must be performed by a CLIA approved lab. A copy of the test result must be attached to HES101, beginning with school enterers in the school year 2005-2006.
(3) It is preferred, but not mandatory, that a physician’s medical exemption be recorded on HES 101.
(4) The physician’s written statement must be maintained by the school as part of the immunization record of the pupil qualifying for the exemption. In pre-school and kindergarten through grade 12 settings, the written statement must be attached to HES 101 beginning with the 2005-2006 school year.
MONT. ADMIN. R. 37.114.716 RELIGIOUS EXEMPTION
(1) A prospective pupil seeking to attend school is exempt from all or part of the immunization requirements if the parent or guardian of that prospective pupil, an adult responsible for that prospective pupil, or the prospective pupil himself if an adult or an emancipated minor, objects thereto in a signed, written statement indicating that the proposed immunization interferes with the free exercise of the religious beliefs of the person signing the statement.
(2) In any school other than a secondary school, a claim of exemption from immunization requirements on religious grounds must be notarized annually and maintained on a form HES 113. Affidavit of Exemption on Religious Grounds, provided by the department. The form must be provided to the school prior to each school year by the parent or guardian or adult responsible for the pupil. If the pupil is 18 years of age or older or emancipated, in which case the pupil may claim the exemption.
(3) In a postsecondary setting, a religious exemption must be maintained on orm HES 113 and signed, notarized and submitted each year of attendance, beginning with the date of initial attendance at the school. The form must be completed and resubmitted each year thereafter.
(4) The original copy of the claim of religious exemption must be kept by the school as part of the pupil’s school record.
College:
ADMINISTATIVE RULES (OLD 16.28.707-708) TITLE 37: DEPARTMENT OF PUBLIC HEALTH AND HUMAN SERVICES. CHAPTER 114: COMMUNICABLE DISEASE CONTROL
SUB-CHAPTER 7: IMMUNIZATION OF SCHOOL CHILDREN
MONT. ADMIN. R. 37.114.709 REQUIREMENTS FOR UNCONDITIONAL ATTENDANCE AT A POSTSECONDARY SCHOOL
(1) Before a prospective pupil may enter a Montana postsecondary school, the prospective pupil must provide the school with the proof of measles (rubeola) and rubella immunity as specified in (2) or (3), whichever is applicable.
(2) If a prospective pupil was born in 1957 or later, the school must receive either:
(a) adequate documentation that:
(i) the prospective pupil was administered two doses of live MMR or MR vaccine, or any equivalent combination of measles and rubella vaccines, subject to the restrictions in ARM 37.114.712(2); and
(ii) dose one was administered at or after 12 months of age, and dose two was administered at least 28 days after dose one; or
(b) a CLIA approved laboratory report that meets the requirements of ARM 37.114.712(2) and indicates the prospective pupil is immune to measles and rubella.
(3) If a prospective pupil was born prior to 1957, the school must receive either:
(a) one of the forms of proof of measles and rubella immunity cited in (2); or
(b) the evidence of date of birth before January 1, 1957, required by ARM 37.114.712(2).
(4) In the event of an outbreak of either measles or rubella, a pupil must provide the documentation required by either (2)(a) or (b) or be excluded from classes and other school sponsored activities until the local health officer indicates to the school that the outbreak is over. If the laboratory documentation required by (2)(b) is provided, the laboratory report need only show immunity to whichever of the two diseases is the cause of the outbreak.
(5) The school must maintain a list of pupils who were born prior to 1957 and who provide the school only with the documentation specified in (3)(b). In the event of an outbreak of measles or rubella, the school must exclude those pupils as required by (4).
(6) A pupil who enters a postsecondary school may be conditionally enrolled as allowed by ARM 37.114.711 if that pupil has received only one dose of MMR or MR, but must have received the second dose before being eligible to attend during the next school term.
Provisional (Conditional) Form for Daycare
Provisional (Conditional) Form for School Age
Provisional (Conditional) Form for College
Nebraska
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES TITLE 173 CONTROL OF COMMUNICABLE DISEASE CHAPTER 4 IMMUNIZATION IN LICENSED CHILD CARE PROGRAMS
4-003 REQUIRED IMMUNIZATION INFORMATION; EXCLUSION FROM ATTENDANCE; NOTICE
4-003.01 Each program must require the parent or guardian of each child enrolled in such program to present within 30 days of enrollment and periodically thereafter:
1. Proof that the child is protected by age-appropriate immunization against measles, mumps, rubella, poliomyelitis, diphtheria, pertussis, tetanus, haemophilus influenzae type B, hepatitis B, varicella, and invasive pneumococcal disease;
2. Certification by a physician, advanced practice registered nurse, or physician assistant that immunization is not appropriate for a stated medical reason;
3. A written statement that the parent or guardian does not wish to have the child so immunized and the reasons therefor; or
4. Parental or clinical documentation of disease with year of infection for varicella. The documentation must include one of the following:
a. Signature of the parent or legal guardian and the date (year) of the child’s varicella illness, or
b. Signature of a health care provider and the date (year) of the child’s varicella illness, or
c. Laboratory evidence of a child’s varicella immunity.
4-003.02 If one of the documents described in 173 NAC 4-003.01 is not presented within 30 days of enrollment, the program must exclude a child from attendance until such proof, certification, or written statement is provided.
4-003.03 At the time the parent or guardian is notified that such information is required, he or she must be notified in writing of his or her rights to submit a certification or a written statement as described in 173 NAC 4-003.01.
4-004 REQUIRED LEVELS OF PROTECTION: For the purposes of complying with the requirement of immunization against the diseases listed in 173 NAC 4-003 and in recognition of the fact that immunization needs vary depending on the age of the child, the required minimum number of doses of each vaccine is indicated in the Childhood Immunization Schedule, Attachment 1, which is incorporated in these regulations by this reference.
4-004.01 For purposes of compliance with the immunization requirement, the licensee of a child care program must require the presentation of an immunization history which contains:
1. Names of the vaccines;
2. Month and year of administration for DTaP, DTP, DT, Td, Tdap, polio, Hep B, Hib, and pneumococcal vaccine;
3. Day, month, and year of administration of MMR, MMRV, and/or varicella;
4. Name of the health practitioner or agency where the immunizations were obtained; and
5. Signature of the physician, parent, guardian or of other such person maintaining the immunization history of the child, verifying that the child has received these vaccines.
Children with a reliable history of chickenpox (validated by written parental/clinical documentation including year of infection) can be assumed to be immune to varicella and therefore need not receive the varicella vaccination.
4-005 FREQUENCY OF REVIEW AND REPORTS; RECORDKEEPING
4-005.01 Each program must review the status of immunization for all children on entry. The immunization status of children under 20 months of age must be reviewed again in March and September to insure compliance with age-specific requirements. Records of children who are 20 months of age or older need not be reviewed again until kindergarten entry except as noted in 173 NAC 4-005.02.
4-005.02 Parents/guardians submitting written statements refusing immunizations for children are required to resubmit, sign, and date that statement on an annual basis.
4-005.03 Each program must keep as part of each child’s file the immunization history, or the certification by the medical provider, or the written statement from the parent or guardian. These records must be available to the Department for inspection and review.
4-005.04 The licensee of each program must report to the Department by November 1 of each year the records of immunization for all children enrolled as of September 30 of that year. Children who have reached kindergarten age and who are enrolled in a public or private school need not be included in the report. Each report must consist of the following items:
1. The name, address, and telephone number of the licensee and the number of children enrolled on September 30;
2. For each child enrolled, a report of the name of the child, the child’s date of birth, and the child’s immunization record; and
3. Copy of refusal of immunization or medical certification if the child is not up to date.
The copy of the certification from the medical professional must state the medical reason(s) for not immunizing the child. The copy of the written statement from the parent or guardian must state the reason(s) why the parent or guardian does not wish to have the child immunized.
NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES
TITLE 173 CONTROL OF COMMUNICABLE DISEASE
CHAPTER 3 SCHOOL HEALTH, COMMUNICABLE DISEASE CONTROL, AND PHYSICAL.EXAMINATION AND IMMUNIZATION STANDARDS
3-006 PHYSICAL EXAMINATION STANDARDS: A printed or typewritten form signed by a
licensed physician, physician assistant, or nurse practitioner indicating that a physical
examination was administered on a specific date within the previous six-month period on a
specifically named individual constitutes sufficient evidence of a physical examination by a
qualified physician within six months prior to the entrance of a child into the beginner grade and
the seventh grade. A physical exam is also required in the case of a transfer from out of state to
any other grade of the local school. As a substitute for such evidence of a physical, an
objection in writing to a physical examination of such child signed and dated by a parent or
guardian of such child may be submitted to the local school.
3-007 IMMUNIZATION STANDARDS: Each student must be protected by immunization
against the following diseases, unless otherwise exempted from this requirement under the
provisions of 173 NAC 3-009:
Measles Diphtheria
Mumps Tetanus
Rubella Pertussis
Polio Haemophilus Influenzae type b (Hib)
Hepatitis B Varicella
3-007.01 For the purposes of complying with the requirement of immunization against
the diseases listed above:
3-007.01A Students 2 – 5 years of age enrolled in a school-based program not licensed as a child care provider are considered to be immunized if they have received –
3 doses of hepatitis B vaccine,
4 doses of DTaP, DTP, or DT, vaccine,
3 doses of polio vaccine,
1 dose of MMR vaccine given no earlier than 4 days before the first
birthday,
3 doses of hib vaccine or 1 dose of hib vaccine given at or after 15
months of age, and
1 dose of varicella vaccine.
3-007.01B Students enrolling for the first time (kindergarten or 1st grade depending on the school district’s entering grade), enrolling in 7th grade, and all transfer students from outside the state regardless of the grade they are entering are considered immunized if they have received –
3 doses DTaP, DTP, DT, or Td vaccine with at least 1 dose given no
earlier than 4 days before 4 years of age,
3 doses of polio vaccine,
2 doses of MMR vaccine with the first dose given no earlier than 4 days
before the first birthday and the 2 doses separated by at least 28 days,
3 doses of pediatric hepatitis B vaccine, or, if the alternate hepatitis B
vaccination schedule is used, 2 doses of a licensed adult hepatitis B
vaccine specified for adolescents 11-15 years of age, and
The number of doses for varicella is dependent on the age of the child – 1
dose of varicella vaccine before the 13th birthday; or 2 doses of varicella
vaccine administered at least 28 days apart if the first dose was given on
or after the 13th birthday.
Varicella immunization is being phased in beginning with the 2004-2005 school year. Varicella will be included as a required vaccine in each subsequent grade as the child progresses from kindergarten (1st grade) or 7th grade through the remaining grades.
3-007.01C All other students are considered immunized if they have received –
3 doses of DTaP, DTP, DT, or Td vaccine,
3 doses of polio vaccine, and
2 doses of MMR vaccine given no earlier than 4 days before the first
birthday and the 2 doses separated by at least 28 days.
Beginning July 1, 2005, all students grades K-12 will be required to
present evidence of 3 doses of pediatric hepatitis B vaccine, or, if the
alternate hepatitis B vaccination schedule is used, 2 doses of a licensed
adult hepatitis B vaccine specified for adolescents 11-15 years of age.
3-008 REQUIRED EVIDENCE OF IMMUNIZATION
3-008.01 For purposes of compliance with the immunization requirement, the board of education or school board or other governing authority, must require the presentation of an immunization history containing the name of the vaccine, the month and year of administration (the month, day, and year for MMR vaccine and varicella vaccine), the name of the health practitioner, the agency where the immunization was obtained, and the signature of physician, parent, guardian, or of such other person maintaining the immunization history of the student, verifying that the student has received these vaccines.
3-008.02 Laboratory evidence of circulating antibodies for measles, mumps, or rubella
constitutes evidence of immunity against those diseases provided the following information is supplied: name of laboratory, date of test, name of test, test result, signature of laboratory technician performing the test or of the laboratory director, and date of signature. For purposes of compliance with this rule, clinical history of measles, mumps, or rubella without laboratory or epidemiologic confirmation does not constitute evidence of immunity.
3-008.04 A documented history of varicella disease from a parent or health care provider with the year of infection constitutes evidence of immunity to varicella. The documentation must include one of the following –
1. Signature of the parent or legal guardian and the date (year) of the child’s
varicella illness, or
2. Signature of a health care provider and the date (year) of the child’s
varicella illness, or
3. Laboratory evidence of a child’s varicella immunity.
Exemptions allowed are Medical and Religious
3-009 MEDICAL AND RELIGIOUS EXEMPTION; PROVISIONAL ENROLLMENT:
Each student must be protected against the diseases listed using the standards described in 173 NAC 3-007 and submit evidence of immunization as described in 173 NAC 3-008. Any student who does not comply with these requirements must not be permitted to enroll in school, except as provided in 173 NAC 3-009.01 through 3-009.03.
3-009.01 Immunization is not required for a student’s enrollment in any school in this state if he or she submits to the admitting official either of the following:
3-009.01A A statement signed by a physician, physician assistant, or nurse practitioner stating that, in the health care provider’s opinion, the specified immunization(s) required would be injurious to the health and well-being of the student or any member of the student’s family or household; or
3-009.01B A notarized affidavit signed by the student or, if he or she is a minor, by a legally authorized representative of the student, stating that the immunization conflicts with the tenets and practice of a recognized religious denomination of which the student is an adherent or member or that immunization conflicts with the personal and sincerely followed religious beliefs of the student.
3-009.02 A student may be provisionally enrolled in a school in Nebraska if he or she has begun the immunizations against the specified diseases prior to enrollment and continues the necessary immunizations as rapidly as is medically feasible. For purposes of complying with these requirements:
3-009.02A A student is considered to have begun immunizations against polio, diphtheria, tetanus, pertussis, hepatitis B, measles, mumps, and rubella if he or she has had at least one dose of DTaP/DTP/DT/Td, one dose of hepatitis B, one dose of either trivalent OPV or one dose of IPV, either one dose of the combined measles, mumps, and rubella vaccine or one dose of each vaccine for measles,
mumps, and rubella, and one dose of varicella vaccine if the child is over 13 years of age.
3-009.02B Continuation of necessary immunizations as rapidly as is medically feasible must be documented by a written statement from the student’s immunization provider which shows the scheduled dates to complete the required immunization series. Failure to receive the necessary immunizations as
rapidly as is medically feasible will result in exclusion of the student from attending school until either documentation of immunization or a medical statement or religious affidavit is provided to the school. The time interval for the completion of the required immunization series must not exceed nine months.
3-009.03 A student may also be provisionally enrolled in a school in Nebraska if he or she is the child or legal ward of an officer or enlisted person, or the child or legal ward of the spouse of such officer or enlisted person on active duty in any branch of the military services of the United States, and said student is enrolling in a Nebraska school following residence in another state or in a foreign country.
3-009.03A As a condition for the provisional enrollment of a student under this Section, a parent or adult legal guardian of the student must provide the school with a signed written statement certifying that the student has completed the course of immunizations required by 173 NAC 3-007.
3-009.03B The provisional enrollment of a student qualified for such enrollment under 173 NAC 3-009.03 must not continue beyond 60 days from the date of such enrollment. At such time, the school must be provided, with regard to said student, written evidence of compliance with 173 NAC 3-007. The student must not be permitted to continue in school after such date until evidence of compliance is provided.
Nevada
Immunization Against Disease.
NAC 432A.500 Mumps. (NRS 432A.230, 439.200)
1. The State Board of Health hereby declares the disease of mumps to be a communicable disease.
2. Unless excused because of religious belief or medical condition, a child may not be enrolled in a child care facility in this State unless he has been immunized against the mumps.
(Added to NAC by Bd. of Health, eff. 6-30-88; A 8-1-91)
NAC 432A.505 Haemophilus influenzae type b. (NRS 432A.230, 439.200)
1. The State Board of Health hereby declares infection with Haemophilus influenzae type b to be a communicable disease.
2. Unless excused because of religious belief or medical condition, a child may not be enrolled in a child care facility in this State unless he has been immunized against Haemophilus influenzae type b.
(Added to NAC by Bd. of Health, eff. 8-1-91)
NAC 432A.510 Documents to be submitted by parent who resides outside county. (NRS 432A.077, 432A.230)
1. If the operator of a facility conditionally admits a child whose parent has not established permanent residence in the county in which the facility is located, the operator shall keep the proof submitted by the parent that he has not established a permanent residence in the county on file at the facility for 1 year. The proof must be in the form designated by the licensing authority and may include a driver’s license.
2. In any case governed by this section, the parent shall submit a written statement of the immunization status of his child to the operator of the facility. The statement must be signed by the parent.
(Added to NAC by Bd. for Child Care, eff. 12-19-89)
TITLE 38. PUBLIC WELFARE. CHAPTER 432A. SERVICES AND FACILITIES FOR CARE OF CHILDREN.IMMUNIZATION OF CHILDREN ADMITTED TO CHILD CARE FACILITIES
NRS § 432A.230 Certificate of immunization prerequisite to admission to child care facility; conditional admission; report to Health Division. Except as otherwise provided in NRS 432A.235 for accommodation facilities:
1. Except as otherwise provided in subsection 3 and unless excused because of religious belief or medical condition, a child may not be admitted to any child care facility within this State, including a facility licensed by a county or city, unless his parents or guardian submit to the operator of the facility a certificate stating that the child has been immunized and has received proper boosters for that immunization or is complying with the schedules established by regulation pursuant to NRS 439.550 for the following diseases:
(a) Diphtheria;
(b) Tetanus;
(c) Pertussis if the child is under 6 years of age;
(d) Poliomyelitis;
(e) Rubella;
(f) Rubeola; and
(g) Such other diseases as the local board of health or the State Board of Health may determine.
2. The certificate must show that the required vaccines and boosters were given and must bear the signature of a licensed physician or his designee or a registered nurse or his designee, attesting that the certificate accurately reflects the child’s record of immunization.
3. A child whose parent or guardian has not established a permanent residence in the county in which a child care facility is located and whose history of immunization cannot be immediately confirmed by a physician in this State or a local health officer, may enter the child care facility conditionally if the parent or guardian:
(a) Agrees to submit within 15 days a certificate from a physician or local health officer that the child has received or is receiving the required immunizations; and
(b) Submits proof that he has not established a permanent residence in the county in which the facility is located.
4. If a certificate from the physician or local health officer showing that the child has received or is receiving the required immunizations is not submitted to the operator of the child care facility within 15 days after the child was conditionally admitted, the child must be excluded from the facility.
5. Before December 31 of each year, each child care facility shall report to the Health Division of the Department, on a form furnished by the Division, the exact number of children who have:
(a) Been admitted conditionally to the child care facility; and
(b) Completed the immunizations required by this section.
School Age Vaccine Mandates:
NEVADA.TITLE 34. EDUCATION. CHAPTER 392. PUPILS
HEALTH AND SAFETY; PARENTAL INVOLVEMENT; SCHOOL UNIFORMS
NRS § 392.435. Immunization of pupils: Certificate prerequisite to enrollment; conditional enrollment, effect of failure to immunize; report to health division; inclusion of certificate in pupil’s record
1. Unless excused because of religious belief or medical condition, a child may not be enrolled in a public school within this state unless his parents or guardian submit to the board of trustees of the school district in which the child resides or the governing body of the charter school in which the child has been accepted for enrollment a certificate stating that the child has been immunized and has received proper boosters for that immunization or is complying with the schedules established by regulation pursuant to NRS 439.550 for the following diseases:
(a) Diphtheria;
(b) Tetanus;
(c) Pertussis if the child is under 6 years of age;
(d) Poliomyelitis;
(e) Rubella;
(f) Rubeola; and
(g) Such other diseases as the local board of health or the state board of health may determine.
2. The certificate must show that the required vaccines and boosters were given and must bear the signature of a licensed physician or his designee or a registered nurse or his designee, attesting that the certificate accurately reflects the child’s record of immunization.
3. If the requirements of subsection 1 can be met with one visit to a physician or clinic, procedures for conditional enrollment do not apply.
4.A child may enter school conditionally if the parent or guardian submits a certificate from a physician or local health officer that the child is receiving the required immunizations. If a certificate from the physician or local health officer showing that the child has been fully immunized is not submitted to the appropriate school officers within 90 school days, or its equivalent in a school district operating under an alternative schedule authorized pursuant to NRS 388.090, after the child was conditionally admitted, the child must be excluded from school and may not be readmitted until the requirements for immunization have been met. A child who is excluded from school pursuant to this section is a neglected child for the purposes of NRS 432.0999 to 432.130, inclusive, and chapter 432B of NRS.
5. Before December 31 of each year, each school district and the governing body of each charter school shall report to the health division of the department of human resources, on a form furnished by the division, the exact number of pupils who have completed the immunizations required by this section.
6. The certificate of immunization must be included in the pupil’s academic or cumulative record and transferred as part of that record upon request.
Exemptions allowed are Medical and Religious
NRS § 392.437. Immunization of pupils: Exemption if prohibited by religious belief
A public school shall not refuse to enroll a child as a pupil because the child has not been immunized pursuant to NRS 392.435 if the parents or guardian of the child has submitted to the board of trustees of the school district or the governing body of a charter school in which the child has been accepted for enrollment a written statement indicating that their religious belief prohibits immunization of such child or ward.
NRS § 392.439. Immunization of pupils: Exemption if prevented by medical condition
If the medical condition of a child will not permit him to be immunized to the extent required by NRS 392.435 and a written statement of this fact is signed by a licensed physician and by the parents or guardian of the child, the board of trustees of the school district or governing body of the charter school in which the child has been accepted for enrollment shall exempt the child from all or part of the provisions of NRS 392.435, as the case may be, for enrollment purposes.
§ 392.443. Immunization of pupils: Additional requirements imposed after enrollment; additional certificate required
If, after a child has been enrolled in a public school and before registration for any subsequent school year additional immunization requirements are provided by law, the child’s parents or guardian shall submit an additional certificate or certificates to the board of trustees or the governing body of the charter school in which the child is enrolled stating that the child has met the new immunization requirements.
NRS § 432A.240 Exemption from immunization when contrary to religious belief.
If the religious belief of a child’s parents or guardian prohibits the immunization of the child as required by NRS 432A.230 or 432A.235, a written statement of this fact signed by the parents or guardian and presented to the operator of the facility exempts the child from the provisions of that section for purposes of admission.
NRS § 432A.250 Exemption from immunization because of medical condition.
If the medical condition of a child will not permit him to be immunized to the extent required by NRS 432A.230 or 432A.235, a written statement of this fact signed by a licensed physician and presented to the operator of the facility by the parents or guardian of such child exempts such child from all or part of the provisions of NRS 432A.230 or 432A.235, as the case may be, for purposes of admission.
NRS § 432A.270 Protection of child exempt from immunization if dangerous disease exists in facility.
Whenever the State Board of Health or a local board of health determines that there is a dangerous contagious disease in a child care facility attended by a child for whom exemption from immunization is claimed pursuant to the provisions of NRS 432A.240 or 432A.250, the operator of the facility shall require either:
1. That the child be immunized; or
2. That he remain outside the school environment and the local health officer be notified.
*No state form for exemption. An example of what to write.
*Understanding the different Statutes- Use the statute that applies to your situation:
Pursuant to Nevada Revised Statutes:
392.435/392.437 (Public School)
394.192/394.193 (Private School)
432A.230/432A.240 (Child Care)
422.2932 (Recipients of public assistance)
College Vaccine Mandates:
NEVADA ADMINISTRATIVE CODE.CHAPTER 441A. COMMUNICABLE DISEASES
NAC § 441A.755 University students: Proof of immunity to certain communicable diseases required; exceptions; exclusion from university. (NRS 441A.120)
1. Except as otherwise provided in subsection 9 or unless excused because of religious belief or medical condition, a person shall not attend a university until he submits to the university proof of immunity to tetanus, diphtheria, measles, mumps, rubella and any other disease specified by the State Board of Health. The Division shall establish the immunization schedule required for admission of the student.
2. A student may enroll in the university conditionally if the student, or if the student is a minor, the parent or legal guardian of the student, submits a record of mmunization stating that the student is in the process of obtaining the required immunizations, and that record shows that the student has made satisfactory progress toward obtaining those immunizations.
3. The university shall retain the proof of immunity on a computerized record or on a form provided by the Division.
4. The university shall not refuse to enroll a student because he has not been immunized if the student, or if the student is a minor, the parent or legal guardian of the student, has submitted to the university a written statement indicating that his religious belief prohibits immunizations. The university shall keep the statement on file.
5. If the medical condition of a student does not permit him to be immunized to the extent required, the student, or if the student is a minor, the parent or legal guardian of the student, must submit to the university a statement of that fact written by a licensed physician. The university shall keep the statement on file.
6. If additional requirements of immunity are imposed by law after a student has been enrolled in the university, the student, or if the student is a minor, the parent or legal guardian of the student, shall submit an additional proof of immunity to the university stating that the student has met the new requirements of immunity.
7. If the health authority determines that, at the university, there is a case having a communicable disease against which immunity is required for admission to the university, and a student who has not submitted proof of immunity to that disease is attending that university, the president of the university shall require that:
(a) The student be immunized; or
(b) The student be excluded from the university until allowed to return by the health authority.
8. A student shall not attend a university from which he is excluded until allowed to return by the health authority. The parent or legal guardian of a student, if the student is a minor, shall not allow thestudent to attend a university from which he is excluded until allowed to return by the health authority.
9. Any student who is enrolled in a program of distance education and who does not attend a class on
New Hampshire
Exemptions allowed for Medical and Religious
For more information about NH immunization exemptions refer to:
A child shall be exempt from immunization if:
Medical Exemption:
To receive an exemption of immunization for medical reasons, the parent or legal guardian of the child must acquire written documentation from a licensed physician or authorized health care provider that certifies that immunization against a particular disease may be detrimental to the child’s health. The exemption shall exist only for the length of time, in the opinion of the physician; such immunization would be detrimental to the child. An exemption from immunization for one disease shall not affect other required immunizations.
Religious Exemption:
Religious exemptions can be granted when a parent or legal guardian objects to immunization because of religious beliefs. The parent or legal guardian shall sign a notarized form stating that the child has not been immunized because of religious beliefs.
Religious Exemption Form. * complete and submit to the appropriate school administrators or school health officials.
Exclusion During Outbreak of Disease:
During an outbreak of a communicable disease for which immunization is required children exempted shall not attend the school or childcare agency threatened by the communicable disease.
New Jersey
Daycare, Preschool and School Age Vaccine Mandates
Also see note on Grace periods on the bottom of the chart.
School-Age Vaccine Mandates:
DTaP: 5 doses or titer evidence of immunity accepted
Tdap: 6th grade-1 dose
Polio: 4 doses or titer evidence of immunity accepted
Measles: 2 doses or titer evidence of immunity accepted
Rubella and Mumps: 1 dose or titer evidence of immunity accepted
Varicella: 1 dose or titer evidence of immunity accepted or parental statement of previous history of the disease accepted.
HepB: 3 doses or 2 doses accepted for children 11-15 years old or titer evidence of immunity accepted.
Meningococcal: 6th grade- 1 dose after 9-1-08 or born after 1-1-97
TITLE 18A. EDUCATION.SUBTITLE 8A. HIGHER EDUCATION;
PUBLIC AND NONPUBLIC INSTITUTIONS.
CHAPTER 61D. RULES AND REGULATIONS
N.J. Stat. § 18A:61D-1. Immunization record
1. Every public and independent institution of higher education in this State shall, as a condition of admission or continued enrollment, require every graduate and undergraduate student who is 30 years of age or less and is enrolled full-time or part-time in a program or course of study leading to an academic degree, to submit to the institution a valid immunization record which documents the administration of all required immunizations against vaccine-preventable disease, or evidence of immunity from these diseases, in accordance with regulations promulgated by the Department of Health. The institution shall keep the records on file in such form and manner as prescribed by the department.
Exemptions allowed are Medical and Religious:
N.J. Stat. § 18A:61D-3. Conflict with religious beliefs
A student who submits to the institution of higher education a written statement that immunization conflicts with his religious beliefs shall not be required to submit a list of immunizations to the institution as a condition of admission or continued enrollment.
N.J. Stat. § 18A:61D-4. Contraindication
A student who submits to the institution a written statement that an immunization is medically contraindicated shall submit a valid immunization record of other administered immunizations in accordance with regulations promulgated by the department.
New Jersey State Sanitary Code Immunization of Pupils in Schools
(New Jersey Administrative Code Citation 8:57-4.1 to 8:57-4.20)
8:57-4.2 Proof of immunization
A principal, director or other person in charge of a school, preschool, or child care facility shall
not knowingly admit or retain any child whose parent or guardian has not submitted acceptable
evidence of the child’s immunization, according to the schedules specified in this subchapter.
Exemptions to this requirement are identified at 8:57-4.3 and 8:57-4.4.
8:57-4.3 Medical exemptions
(a) A child shall not be required to have any specific immunization(s), which are medically
contraindicated.
(b) A written statement submitted to the school, preschool, or child care center from a
physician licensed to practice medicine or osteopathy or an advanced practice nurse
(certified registered nurse practitioner or clinical nurse specialist) in any jurisdiction of
the United States indicating that an immunization is medically contraindicated for a
specific period of time, and the reason(s) for the medical contraindication, based upon
valid medical reasons as enumerated by the Advisory Committee on Immunization
Practices (ACIP) of the United States Public Health Service or the American Academy of
Pediatrics (AAP) guidelines, will exempt a pupil from the specific immunization
requirement for the stated period of time…
(c) The physician’s or an advanced practice nurses (certified registered nurse practitioner or
clinical nurse specialist) statement shall be retained as part of the child’s immunization
record and shall be reviewed annually by the school, preschool, or child care facility.
When the child’s medical condition permits immunization, this exemption shall thereupon
terminate and the child shall be required to obtain the immunization(s) from which he or
she has been exempted.
(d) Those children with medical exemptions to receiving specific immunizations may be
excluded from the school, preschool, or child care facility during a vaccine-preventable
disease outbreak or threatened outbreak as determined by the Commissioner, Health and
Senior Services or his or her designee.
(e) As provided by N.J.S.A. 26:4-6, “Any body having control of a school may, on account
of the prevalence of any communicable disease, or to prevent the spread of
communicable diseases, prohibit the attendance of any teacher or pupil of any school
under their control and specify the time during which the teacher or scholar shall remain
away from school.” The Department of Health and Senior Services shall provide
guidance to the school of the appropriateness of any such prohibition. All schools are
required to comply with the provisions of N.J.A.C. 8:61-1.1 regarding attendance at
school by pupils or adults infected by Human Immunodeficiency Virus (HIV).
8:57-4.4 Religious exemptions
(a) A child shall be exempted from mandatory immunization if the parent or guardian objects
thereto in a written statement submitted to the school, preschool, or child care center,
signed by the parent or guardian, explaining how the administration of immunizing
agents conflicts with the pupil’s exercise of bona fide religious tenets or practices.
General philosophical or moral objection to immunization shall not be sufficient for an
exemption on religious grounds.
(b) Religious affiliated schools or child care centers shall have the authority to withhold or
grant a religious exemption from the required immunizations for pupils entering or
attending their institutions without challenge from any secular health authority.
(c) This statement will be kept by the school, preschool, or child care center as part of the
child’s immunization record.
(d) Those children with religious exemptions from receiving immunizing agents may be
excluded from the school, preschool, or child care center during a vaccine-preventable
disease outbreak or threatened outbreak as determined by the Commissioner, Department
of Health and Senior Services or his or her designee.
(e) As provided by N.J.S.A. 26:4-6, “Any body having control of a school may, on account
of the prevalence of any communicable disease, or to prevent the spread of
communicable diseases, prohibit the attendance of any teacher or pupil of any school
under their control and specify the time during which the teacher or scholar shall remain
away from school.” The Department of Health and Senior Services shall provide
guidance to the school on the appropriateness of any such prohibition. All schools are
required to comply with the provisions of N.J.A.C. 8:61:1.1 regarding attendance at
school by pupils or adults infected by Human Immunodeficiency Virus (HIV).
(f) Those children enrolled in school, preschool, or child care centers before September 1,
1991, and who have previously been granted a religious exemption, shall not be required
to reapply for a new religious exemption under 8:57-4.4(a).
8:57-4.5 Provisional admission
(a) A child may be admitted to a school, preschool, or child care center on a provisional basis
if a physician, an advanced practice nurse (certified registered nurse practitioner or
clinical nurse specialist) or health department can document that at least one dose of each
required age-appropriate vaccine(s) or antigen(s) has been administered and that the pupil
is in the process of receiving the remaining immunization(s).
(b) Provisional admission for children under age five shall be granted in compliance with the
specific requirements set forth in N.J.A.C. 8:57-4.10 through 4.15 for a period of time
consistent with the current Advisory Committee on Immunization Practices (ACIP) of the
United States Public Health Service or the American Academy of Pediatrics (AAP)
immunization schedule, but shall not exceed 17 months for completion of all
immunization requirements.
(c) Provisional admission for children five years of age or older shall be granted in
compliance with the specific requirements set forth in N.J.A.C. 8:57-4.10 through 4:14
and 4:16 for a period of time consistent with the current Advisory Committee on
Immunization Practices (ACIP) of the United States Public Health Service or the
American Academy of Pediatrics (AAP) immunization schedule, but shall not exceed one
year for completion of all immunization requirements.
(d) Provisional status shall only be granted one time to children entering or transferring into
schools, preschools, or child care centers in New Jersey. Information on this status shall
be sent by the original school, preschool, or child care center to the new school,
preschool, or child care center pursuant to N.J.A.C. 8:57-4.7(b).
(e) Those children transferring into a New Jersey school, preschool, or child care center from
out-of-State or out-of-country may be allowed a 30-day grace period in order to obtain
past immunization documentation before provisional status shall begin.
(f) The school, preschool, or child care center shall ensure that the required
vaccines/antigens are being received on schedule. If at the end of the provisional
admission period, the child has not completed the required immunizations, the
administrative head of the school, preschool or child care center shall exclude the child
from continued school attendance until appropriate documentation has been presented.
(g) Those children in provisional status may be temporarily excluded from the school,
preschool, or child care center during a vaccine-preventable disease outbreak or
threatened outbreak as determined by the Commissioner, Department of Health and
Senior Services or his or her designee.
Higher Education/College Mandates and Exemptions
New Mexico
Daycare and School Age Vaccine Mandates:
Exemptions allowed are Medical, Religious, and Philosophical
*Must be notarized
CHAPTER 24. HEALTH AND SAFETY.ARTICLE 5. IMMUNIZATION
N.M. Stat. Ann. § 24-5-1. Immunization regulations
The public health division of the department of health shall, after consultation with the state board of education, promulgate rules and regulations governing the immunization against diseases deemed to be dangerous to the public health, to be required of children attending public, private, home or parochial schools in the state. The immunizations required and the manner and frequency of their administration shall conform to recommendations of the advisory committee on immunization practices of the United States department of health and human services and the American academy of pediatrics. The public health division shall supervise and secure the enforcement of the required immunization program.
N.M. Stat. Ann. § 24-5-2. Unlawful to enroll in school unimmunized; unlawful to refuse to permit immunization
It is unlawful for any student to enroll in school unless he has been immunized, as required under the rules and regulations of the health services division of the health and environment department [department of health], and can provide satisfactory evidence of such immunization. Provided that, if he produces satisfactory evidence of having begun the process of immunization, he may enroll and attend school as long as the immunization process is being accomplished in the prescribed manner. It is unlawful for any parent to refuse or neglect to have his child immunized, as required by this section, unless the child is properly exempted.
N.M. Stat. Ann. § 24-5-3. Exemption from immunization
A. Any minor child through his parent or guardian may file with the health authority charged with the duty of enforcing the immunization laws:
(1) a certificate of a duly licensed physician stating that the physical condition of the child is such that immunization would seriously endanger the life or health of the child; or
(2) affidavits or written affirmation from an officer of a recognized religious denomination that such child’s parents or guardians are bona fide members of a denomination whose religious teaching requires reliance upon prayer or spiritual means alone for healing; or
(3) affidavits or written affirmation from his parent or legal guardian that his religious beliefs, held either individually or jointly with others, do not permit the administration of vaccine or other immunizing agent.
B. Upon filing and approval of such certificate, affidavits or affirmation, the child is exempt from the legal requirement of immunization for a period not to exceed nine months on the basis of any one certificate, affidavits or affirmation.
Please review your immunization records. The UNM immunization requirement is met if you have documentation of one of the following:
Two MMR shots after 12 months of age
A blood test proving immunity
Physician’s verification of disease
Date of birth prior to 1957
New York
Immunization Requirements for Daycare, Preschool and School Age:
*There is a 14-30 day grace period to catch-up children on immunizations if they are not current. This also applies to submitting an exemption if applicable.
PUBLIC HEALTH LAW. ARTICLE 21. CONTROL OF ACUTE COMMUNICABLE DISEASES
TITLE VI. POLIOMYELITIS AND OTHER DISEASES
NY CLS Pub Health § 2164. Definitions; immunization against poliomyelitis, mumps, measles, diphtheria, rubella, varicella, Haemophilus influenzae type b(Hib), pertussis, tetanus, pneumococcal disease, and hepatitis B.
7. (a) No principal, teacher, owner or person in charge of a school shall permit any child to be admitted to such school, or to attend such school, in excess of fourteen days, without the certificate provided for in subdivision five of this section or some other acceptable evidence of the child’s immunization against poliomyelitis, mumps, measles, diphtheria, rubella, hepatitis B, varicella and, where applicable, Haemophilus influenza type b(Hib); provided, however, such fourteen day period may be extended to not more than thirty days for an individual student by the appropriate principal, teacher, owner or other person in charge where such student is transferring from out-of-state or from another country an can show a good faith effort to get the necessary certification or other evidence of immunization.
(b) A parent, a guardian or any other person in parental relationship to a child denied school entrance or attendance may appeal by petition to the commissioner of education in accordance with the provisions of section three hundred ten of the education law.
8. If any physician licensed to practice medicine in this state certifies that such immunization may be detrimental to a child’s health, the requirements of this section shall be inapplicable until such immunization is found no longer to be detrimental to the child’s health.
8-a. Whenever a child has been refused admission to, or continued attendance at, a school as provided for in subdivision seven of this section because there exists no certificate provided for in subdivision five of this section or other acceptable evidence of the child’s immunization against poliomyelitis, mumps, measles, diphtheria, rubella, varicella, hepatitis B, pertussis, tetanus, and, where applicable, Haemophilus influenzae type b (Hib) and pneumococcal disease, the principal, teacher, owner or person in charge of the school shall: a. forward a report of such exclusion and the name and address of such child to the local health authority and to the person in parental relation to the child together with a notification of the responsibility of such person under subdivision two of this section and a form of consent as prescribed by regulation of the commissioner, and
b. provide, with the cooperation of the appropriate local health authority, for a time and place at which an immunizing agent or agents shall be administered, as required by subdivision two of this section, to a child for whom a consent has been obtained. Upon failure of a local health authority to cooperate in arranging for a time and place at which an immunizing agent or agents shall be administered as required by subdivision two of this section, the commissioner shall arrange for such administration and may recover the cost thereof from the amount of state aid to which the local health authority would otherwise be entitled.
9. This section shall not apply to children whose parent, parents, or guardian hold genuine and sincere religious beliefs which are contrary to the practices herein required, and no certificate shall be required as a prerequisite to such children being admitted or received into school or attending school.
Exemptions allowed are Medical and Religious:
Exemption Form for New York School Districts
New York state vaccination law§ 2164. (Part 9 addresses exemption for religious)
9. This section shall not apply to children whose parent, parents, or guardian hold genuine and sincere religious beliefs which are contrary to the practices herein required, and no certificate shall be required as a prerequisite to such children being admitted or received into school or attending school.
*you must exempt ALL vaccines as selective vaccines are not allowed. Your religious exemption letter must be worded specifically and carefully for sincere and genuine language based on your religious beliefs.
*Vaccination mandates for children apply solely to children enrolled in school, and homeschooled children do not apply. Public Health Law 21659(1)(a): “The term ‘school’ includes any public, private or parochial, child caring center, day nursery, day care agency, nursery school, kindergarten, elementary, intermediate or secondary school.”
Medical Exemption:
8. If any physician licensed to practice medicine in this state certifies that such immunization may be detrimental to a child's health, the requirements of this section shall be inapplicable until such immunization is found no longer to be detrimental to the child's health. Daycare and Preschool Exemption Laws: 418-1.11 Health and Infection Control- (1) Any child not yet immunized may be admitted provided the child's immunizations are in process, in accordance with the requirements of the New York State Department of Health, and the parent gives the provider specific appointment dates for subsequent immunizations.
(2) Any child who is not immunized because of the parent’s genuine and sincere religious beliefs may be admitted if the parent furnishes the child day care center with a written statement to this effect.
(3) Any child who is missing one or more of the required immunizations may be admitted if a physician licensed to practice medicine in New York State furnishes the child day care center with a written statement that such immunizations may be detrimental to the child’s health.
(4) With the exception of children meeting the criteria of paragraphs (2) or (3) of this subdivision, children enrolled in the child day care center must remain current with their immunizations in accordance with the current schedule for immunizations established by the New York State Department of Health.
*It is against the law for a daycare or preschool to deny your child admittance by simply telling you on the phone they would not be accepted if you do not vaccinate! They have to review your exemption first and even then see #2. North Carolina
Mandated Vaccines:
School Age-College- April 2008:
Also See: College
Child Care–Effective Jan 2008
Daycare Mandated Vaccines:
Diphtheria, Tetanus and Pertussis:
Five doses. Three doses by age seven months and two booster doses, one by age 19 months and the second dose on or after the fourth birthday and before enrolling in school for the first time. If the fourth dose was administered on or after the fourth birthday, the fifth dose is not required.
Polio:
Four doses. Two doses by age five months, a third dose by 19 months of age and a booster dose before enrolling in school for the first time. If the third dose was administered on or after the fourth birthday, the fourth dose is not required.
Measles:
Two doses. One dose on or after 12 months of age and before 16 months of age and a second dose before enrolling in school for the first time. As long as the doses are separated by at least 28 days, the second dose may be given at any time before beginning school. A person who has been diagnosed prior to January 1, 1994 by a physician as having measles or an individual who has documented laboratory results of a protective antibody titer against measles is not required to receive vaccine. Lacking such proof, vaccination is required.
Mumps:
Two doses. One dose on or after 12 months of age and before 16 months of age and a second dose before enrolling in school for the first time. A physician’s diagnosis is not acceptable for mumps disease(s). The person must be immunized or have documented laboratory results of a protective antibody titer against the specific disease.
Rubella:
One dose on or after 12 months of age and before 16 months of age. A physician’s diagnosis is not acceptable for rubella disease(s). The person must be immunized or have documented laboratory results of a protective antibody titer against the specific disease.
Haemophilus influenzae type b (Hib):
Three doses of HbOC or two doses of PRP-OMP by age seven months and a final dose of any type on or after age 12 months and by age 16 months. Persons who receive the first dose of Hib on or after 12 months of age and before 15 months of age are required to have only two doses. Persons who received the first dose of Hib vaccine on or after 15 months of age are required to have only one dose. Persons who have passed their fifth birthday are not required to be vaccinated against Hib.
*Note – Due to the shortage of Hib vaccine caused by manufacturing issues, the requirement for a booster dose of Hib vaccine on or after the age of 12 months has been temporarily suspended, until further notice. (1/18/08)
Hepatitis B:
Three doses. One dose by age three months, second dose by age five months and a third dose by age 19 months. Persons born on or after July 1, 1994 are required to receive the hepatitis B vaccine. The last dose of hepatitis B vaccine series shall not be administered prior to 24 weeks of age.
Varicella:
One dose. One dose of varicella vaccine – on or after 12 months of age and before age 19 months – is required for children born on or after April 1, 2001. However, an individual with laboratory tests showing immunity or a history of chickenpox documented by a health care provider, parent, guardian or person in loco parentis shall not be required to receive varicella vaccine. Documentation of prior history of chickenpox disease must be on or attached to the lifetime immunization card or certificate of immunization. Ask your health care provider for more information.
Medical and Religious Exemptions:
G.S.130A-156. Medical Exemption- The Commission for Health Services shall adopt by rule medical contraindications to immunizations required by G.S. 130A-152. If a physician licensed to practice medicine in this State certifies that a required immunization is or may be detrimental to a person’s health due to the presence of one of the contraindications adopted by the Commission, the person is not required to receive the specified immunization as long as the contraindication persists. The State Health Director may, upon request by a physician licensed to practice medicine in this State, grant a medical exemption to a required immunization for a contraindication not on the list adopted by the Commission.
Medical exemptions can only be requested by a physician licensed to practice medicine in North Carolina. If a physician determines the need to request a medical exemption from a required immunization for a patient and needs assistance, they should contact the North Carolina Immunization Branch at (919) 707-5550. Medical Exemption Statement (DHHS 3987)
G.S.130A-157. Religious Exemption – If the bona fide religious beliefs of an adult or the parent, guardian or person in loco parentis of a child are contrary to the immunization requirements contained in this Part, the adult or the child shall be exempt from the requirements. Upon submission of a written statement of the bona fide religious beliefs and opposition to the immunization requirements, the person may attend the college, university, school or facility without presenting a certificate of immunization.
A written statement must be maintained in the student’s record containing, at a minimum, the following – student’s name; parent(s), guardian’s or person in loco parentis statement of bona fide religious objection; and parent(s), guardian or person in loco parentis signature and date signed. (If a student is at least 18 years old, his/her statement and signature are required.)
There is no form for requesting religious exemptions in North Carolina. To claim a religious exemption, the parent or person requesting the exemption must write a statement of their religious objection to immunization, including the name and date of birth of the person for whom the exemption is being requested. This statement would then be provided to schools, child care programs, camps, etc. in place of an immunization record. If a family is requesting a religious exemption for more than one child, a separate statement should be prepared for each child. Statements of religious objection to immunization do not need to be notarized or prepared by an attorney. They do not need to be submitted to the state for review or approval.
*Note: An objection based upon a “scientific” belief (i.e. a foreign substance or chemical may be harmful) or non-religious personal belief or philosophy (i.e. clean living, fresh air, pure water) is not considered to be a religious exemption and is not allowed under North Carolina law.
10A NCAC 41A .0403 Non-Religious Personal Belief No Exemption
Except as provided in G.S. 130A-156 and G.S. 130A-157, and 10A NCAC 41A .0404 and .0405, no child shall be exempt from the requirements of 10A NCAC 41 .0401; there is no exception to these requirements for the case of a personal belief or philosophy of a parent or guardian not founded upon a religious belief.
*Note-If Your Child is Behind in the Requirements:
The school must notify the parent(s), guardian or person in loco parentis that they have 30 calendar days from the first day of attendance to present the required up-to-date immunization record for the child. If the child’s immunizations are not up-to-date, the required immunizations must be obtained within the same 30 day period.
At the end of the 30 calendar day period, any child without a Certificate of Immunization showing that the child has received the required vaccines shall be prohibited from attending school until he/she provides a Certificate of Immunization as required by law or shows that he/she has begun the immunization process.
When Immunizations are “In Process”
As long as a child is on an accelerated schedule of immunizations, he/she may remain in school while completing the immunizations. To support the need for additional time (beyond the 30 day period), the parent(s), guardian or person in loco parentis must provide a physician’s or health department’s written statement which indicates the date when immunizations will be administered. This documentation indicates that the child is in process and he/she will be allowed to remain in school as long as the child receives the required vaccine(s) as scheduled.
North Dakota
School Age Vaccine Mandates:
Exemptions allowed are Medical, Religious, and Philosophical
N.D. Cent. Code, § 23-07-17.1. Inoculation required before admission to school
1.A child may not be admitted to any public, private, or parochial school, or day care center, child care facility, head start program, or nursery school operating in this state or be supervised through home-based instruction unless the child’s parent or guardian presents to the institution authorities a certification from a licensed physician or authorized representative of the state department of health that the child has received age appropriate immunization against diphtheria, pertussis, tetanus, measles, rubella (German measles), mumps, hepatitis B, haemophilus influenza type b (Hib), varicella (chickenpox), poliomyelitis, pneumococcal disease, meningococcal disease, rotovirus, and hepatitis A. In the case of a child receiving home-based instruction, the child’s parent or legal guardian shall file the certification with the public school district in which the child resides.
2. A child may enter an institution upon submitting written proof from a licensed physician or authorized representative of the state department of health stating that the child has started receiving the required immunization or has a written consent by the child’s parent or guardian for a local health service or department to administer the needed immunization without charge or has complied with the requirements for certificate of exemption as provided for in subsection 3.
3. Any minor child, through the child’s parent or guardian, may submit to the institution authorities either a certificate from a licensed physician stating that the physical condition of the child is such that immunization would endanger the life or health of the child or a certificate signed by the child’s parent or guardian whose religious, philosophical, or moral beliefs are opposed to such immunization. The minor child is then exempt from the provisions of this section.
4. The enforcement of subsections 1, 2, and 3 is the responsibility of the designated institution authority.
5. The immunizations required, and the procedure for their administration, as prescribed by the state department of health, must conform to recognized standard medical practices in the state. The state department of health shall administer the provisions of this section and shall promulgate rules and regulations in the manner prescribed by chapter 28-32 for the purpose of administering this section.
6. When, in the opinion of the health officer, danger of an epidemic exists from any of the communicable diseases for which immunization is required under this section, the exemptions from immunization against such disease may not be recognized and children not immunized must be excluded from an institution listed in subsection 1 until, in the opinion of the health officer, the danger of the epidemic is over. The designated institution authority shall notify those parents or guardians taking legal exception to the immunization requirements that their children are excluded from school during an epidemic as determined by the state department of heal
7. When, in the opinion of the health officer, extenuating circumstances make it difficult or impossible to comply with immunization requirements, the health officer may authorize children who are not immunized to be admitted to an institution listed in subsection 1 until the health officer determines that the extenuating circumstances no longer exist. Extenuating circumstances include a shortage of vaccine and other temporary circumstances.
Exploring Vaccines 
Leave a comment