Ohio
Daycare and School Age Vaccine Mandates:
College Information and Form
Exemptions allowed are Medical, Religious and Philosophical l (Good Cause)
*selective vaccine exemptions allowed
*there are no state exemption forms but the ones listed below may be used by the individual school districts:
Bath Local School District (pg123)
*Also used for the following schools:
Hilltop Elementary School
Bryden Elementary School
Fairmount Early Childhood Center
TITLE XXXIII [33] EDUCATION.CHAPTER 3313: BOARDS OF EDUCATION
ORC Ann. § 3313.67 Immunization of pupils; records, reports.
(C) The board of education shall keep an immunization record for each pupil, available in writing to the pupil’s parent or guardian upon request, which shall include:
(1) Immunizations against the diseases mentioned in division (A) of section 3313.671 of the Revised Code;
(2) Any tuberculin tests given pursuant to section 3313.71 of the Revised Code;
(3) Any other immunizations required by the board pursuant to division (A) of this section.
(D) Annually by the fifteenth day of October, the board shall report a summary, by school, of the immunization records of all initial entry pupils in the district to the director of health, on forms prescribed by the director.
ORC Ann. 3313.671 Proof of required immunizations – exceptions.
(A)
(1) Except as otherwise provided in division (B) of this section, no pupil, at the time of initial entry or at the beginning of each school year, to an elementary or high school for which the state board of education prescribes minimum standards pursuant to division (D) of section 3301.07 of the Revised Code, shall be permitted to remain in school for more than fourteen days unless the pupil presents written evidence satisfactory to the person in charge of admission, that the pupil has been immunized by a method of immunization approved by the department of health pursuant to section 3701.13 of the Revised Code against mumps, poliomyelitis, diphtheria, pertussis, tetanus, rubeola, and rubella or is in the process of being immunized.
(2) Except as provided in division (B) of this section, no pupil who begins kindergarten at an elementary school subject to the state board of education ‘s minimum standards shall be permitted to remain in school for more than fourteen days unless the pupil presents written evidence satisfactory to the person in charge of admission that the pupil has been immunized by a department of health-approved method of immunization or is in the process of being immunized against both of the following:
(a) During or after the school year beginning in 1999, hepatitis B;
(b) During or after the school year beginning in 2006, chicken pox.
(3) As used in divisions (A)(1) and (2) of this section, “in the process of being immunized” means the pupil has been immunized against mumps, rubeola, rubella, and chicken pox, and if the pupil has not been immunized against poliomyelitis, diphtheria, pertussis, tetanus, and hepatitis B, the pupil has received at least the first dose of the immunization sequence, and presents written evidence to the pupil’s building principal or chief administrative officer of each subsequent dose required to obtain immunization at the intervals prescribed by the director of health. Any student previously admitted under the “in process of being immunized” provision and who has not complied with the immunization intervals prescribed by the director of health shall be excluded from school on the fifteenth day of the following school year. Any student so excluded shall be readmitted upon showing evidence to the student’s building principal or chief administrative officer of progress on the director of health’s interval schedule.
(B)
(1) A pupil who has had natural rubeola, and presents a signed statement from the pupil’s parent, guardian, or physician to that effect, is not required to be immunized against rubeola.
(2) A pupil who has had natural mumps, and presents a signed statement from the pupil’s parent, guardian, or physician to that effect, is not required to be immunized against mumps.
(3) A pupil who has had natural chicken pox, and presents a signed statement from the pupil’s parent, guardian, or physician to that effect, is not required to be immunized against chicken pox.
(4) A pupil who presents a written statement of the pupil’s parent or guardian in which the parent or guardian declines to have the pupil immunized for reasons of conscience, including religious convictions, is not required to be immunized.
(5) A child whose physician certifies in writing that such immunization against any disease is medically contraindicated is not required to be immunized against that disease.
(C) As used in this division, “chicken pox epidemic” means the occurrence of cases of chicken pox in numbers greater than expected in the school’s population or for a particular period of time. Notwithstanding division (B) of this section, a school may deny admission to a pupil otherwise exempted from the chicken pox immunization requirement if the director of the state department of health notifies the school’s principal or chief administrative officer that a chicken pox epidemic exists in the school’s population. The denial of admission shall cease when the director notifies the principal or officer that the epidemic no longer exists. The board of education or governing body of each school subject to this section shall adopt a policy that prescribes methods whereby the academic standing of a pupil who is denied admission during a chicken pox epidemic may be preserved.
(D) Boards of health, legislative authorities of municipal corporations, and boards of township trustees on application of the board of education of the district or proper authority of any school affected by this section, shall provide at the public expense, without delay, the means of immunization against mumps, poliomyelitis, rubeola, rubella, diphtheria, pertussis, tetanus, and hepatitis B to pupils who are not so provided by their parents or guardians.
OHIO ADMINISTRATIVE CODE. CHAPTER 5101:2 DIVISION OF SOCIAL SERVICES
CHAPTER 5101:2-12 LICENSING OF CHILD CARE CENTERS
OAC § 5101:2-12-37 Children’s medical and enrollment records for licensed child care centers.
(A) Each child attending the center who is not attending a grade of kindergarten or above shall secure and have on file verification of a medical exam.
(1) The medical statement shall verify a date of exam within the past twelve months and be on file within thirty days of the child’s date of admission and every thirteen months thereafter, until the children are attending a grade of kindergarten or above.
(2) The medical statement shall contain the following information:
(a) The child’s name and birth date.
(b) The date of examination.
(c) The signature, business address and telephone number of the licensed physician, physician’s assistant or certified nurse practitioner who examined the child.
(d) The statement that a record of the immunizations that the child has had, specifying the month, day and year of each immunization is included and that the physician, physician’s assistant or certified nurse practitioner has reviewed the child’s record against the immunizations recommended by the Ohio department of health. The Ohio department of health’s recommended immunization schedule is available as appendix A to this rule.
(e) The statement that the child has been examined and is in suitable condition for participation in group care.
(B) Centers shall maintain enrollment records which include health records, emergency transportation information, and parent or guardian roster permissions for all children attending the center on the JFS 01234 “Child Enrollment and Health Information” (rev. 09/2006).
(1) The center shall secure and have on file all children’s enrollment records no later than the first day of attendance. All records shall be immediately accessible to the administrator or designee, and shall be reviewed and updated annually.
(2) Immunizations may be waived by the administrator for religious reasons upon submission of the parent or guardian’s written request for exemption or for medical reasons upon submission of a physician’s or certified nurse practitioner’s written request for exemption. These statements shall be on file at the center.
(3) The center shall set its own policy regarding the admittance of children whose parents or guardians refuse to grant consent for transportation for emergency treatment.
(C) Children’s records shall be confidential, except that they shall be available to the director’s representative for the purpose of administering Chapter 5104. of the Revised Code and Chapter 5101:2-12 of the Administrative Code. The immunization records shall be subject to review by the health department’s representative for disease outbreak control and for immunization level assessment purposes.
TITLE XVII [17] CORPORATIONS-PARTNERSHIP.CHAPTER 1713: EDUCATIONAL CORPORATIONS
ORC Ann. § 1713.55 Meningitis and hepatitis B vaccination.
(B) Beginning with the academic year that commences on or after July 1, 2005, a nonprofit institution of higher education shall not permit a student to reside in on-campus student housing unless the student, or, if the student is younger than eighteen years of age, the student’s parent, discloses to the institution whether the student has been vaccinated against meningococcal meningitis and hepatitis B by submitting to the institution the meningitis and hepatitis B vaccination status statement described in div ision (B) of section 3701.133 of the Revised Code or a meningitis status statement form provided by the institution that meets the requirements of division (B) of section 3701.133 of the Revised Code. The statement may be submitted in written form or, if the institution has a secure web site, in electronic form.
(C) On receipt of an application for residence in on-campus student housing, a nonprofit institution of higher education shall do both of the following:
(1) Inform the student of the disclosure requirement;
(2) Provide the student in either written or, if the school has a secure web site, electronic form the meningitis and hepatitis B vaccination status statement described in division (B) of section 3701.133 of the Revised Code or a meningitis status statement form provided by the institution that meets the requirements of division (B) of section 3701.133 of the Revised Code.
(D) This section does not require an institution to provide or pay for a meningococcal meningitis or hepatitis B vaccination for any student.
Oklahoma
Exemptions allowed are Medical, Religious, and Philosophical
IMMUNIZATION OF CHILDREN. TITLE 10. CHILDREN
CHAPTER 18 – OKLAHOMA CHILD CARE FACILITIES LICENSING ACT.
10 Okl. St. § 411 – Certificate of Immunization as Condition for Admission to Day Care Facility – Waiver
A. No person, firm, corporation, partnership or other legal entity operating a day care center or day care home in this state shall cause or permit a minor child two (2) months of age or older to be admitted to such facility unless and until the parent, guardian, or other related person of such child presents certification from a licensed physician or authorized representative of any state or local department of public health that such child has received or will receive immunization at the medically appropriate time against diphtheria, pertussis, tetanus, haemophilus influenzae type B (HIB), measles (rubeola), rubella, hepatitis A, varicella, and poliomyelitis; or presents such certification that the child is likely to be immune as a result of the disease. Provided, however, that in the event the parent, guardian, or other person presenting a child for admission to a day care center or day care home certifies in writing that a family emergency exists, the requirement imposed by this section may be waived for a period not to exceed thirty (30) days. Such certification shall be made prior to the provision of care. No such waiver shall be knowingly permitted more than once for any child.
B. The State Board of Health, by rule, may alter the list of immunizations required under this section after notice and hearing. Any change in the list of immunizations required shall be submitted to the next regular session of the Legislature and such change shall remain in force and effect unless and until a concurrent resolution of disapproval is passed. Hearings shall be conducted by the State Board of Health, or such officer, agents or employees as the State Board of Health may designate for that purpose. The State Board of Health shall give appropriate notice of the proposed change in the list of immunizations required and of the time and place for hearing. The change shall become effective on a date fixed by the State Board of Health. Any change in the list of immunizations required may be amended or repealed in the same manner as provided for its adoption. Proceedings pursuant to this subsection shall be governed by the Administrative Procedures Act.
10 Okl. St. § § 413. Exemptions.
Any minor child, through his or her parent or guardian, may submit to the health authority charged with the enforcement of the immunization laws, a certificate of 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 upon receipt of a written statement by the parent or guardian objecting to such immunizations because of religious or other reasons, then such child shall be exempt from the provisions of this act.
TITLE 70. SCHOOLS. CHAPTER 15 – HEALTH AND SAFETY. IMMUNIZATIONS
70 Okl. St. § 1210.191 – Title 70. Schools
A. No minor child shall be admitted to any public, private, or parochial school operating in this state unless and until certification is presented to the appropriate school authorities from a licensed physician, or authorized representative of the State Department of Health, that such child has received or is in the process of receiving, immunizations against diphtheria, pertussis, tetanus, haemophilus influenzae type B (HIB), measles (rubeola), (rubella), poliomyelitis, varicella, and hepatitis A or is likely to be immune as a result of the disease.
B. Immunization tests required, and the manner and frequency of their administration, as prescribed by the State Board of Health, shall conform to recognized standard medical practices in the state. The State Department of Health shall supervise and secure the enforcement of the required immunization program. The State Department of Education and the governing boards of the school districts of this state shall render reasonable assistance to the State Department of Health in the enforcement of the provisions hereof.
C. The State Board of Health, by rule, may alter the list of immunizations required after notice and hearing. Any change in the list of immunizations required shall be submitted to the next regular session of the Legislature and such change shall remain in force and effect unless and until a concurrent resolution of disapproval is passed. Hearings shall be conducted by the State Board of Health, or such officer, agents or employees as the Board may designate for that purpose. The State Board of Health shall give appropriate notice of the proposed change in the list of immunizations required and of the time and place for hearing. The change shall become effective on a date fixed by the State Board of Health. Any change in the list of immunizations required may be amended or repealed in the same manner as provided for its adoption. Proceedings pursuant to this subsection shall be governed by the Administrative Procedures Act.
D. The State Department of Education and the governing boards of the school districts of this state shall provide for release to the Oklahoma Health Care Authority of the immunization records of school children covered under Title XIX or Title XXI of the federal Social Security Act who have not received the required immunizations at the appropriate time. The information received pursuant to such release shall be transmitted by the Oklahoma Health Care Authority to medical providers who provide services to such children pursuant to Title XIX or Title XXI to assist in their efforts to increase the rate of childhood immunizations pursuant to the requirements of the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) services provisions. The provisions of this subsection shall not be construed to prohibit or affect the eligibility of any child to receive benefits pursuant to Title XIX or Title XXI of the Social Security Act or to require the immunization of any child if such child is exempt from immunization pursuant to Section 1210.192 of this title shall not be included in the information transmitted pursuant to this subsection.
70 Okl. St. § 1210.192. Exemptions
Any minor child, through the parent, guardian, or legal custodian of the child, may submit to the health authority charged with the enforcement of the immunization laws of this state:
1. A certificate of a licensed physician as defined in Section 725.2 of Title 59 of the Oklahoma Statutes, stating that the physical condition of the child is such that immunization would endanger the life or health of the child; or
2. A written statement by the parent, guardian or legal custodian of the child objecting to immunization of the child; whereupon the child shall be exempt from the immunization laws of this state.
TITLE 70. SCHOOLS.CHAPTER 50. HIGHER EDUCATION COD. ARTICLE II- OKLAHOMA STATE SYSTEM OF HIGHER EDUCATION
70 Okl. St. § 3244- Student Vaccinations Against Hepatitis B, Measles, Mumps, and Rubella – Documentation – Exemptions
A. 1. Beginning with the 2004-2005 academic year, in order to enroll as a full-time or part-time student in an institution within The Oklahoma State System of Higher Education or a private institution of higher learning located within this state and accredited pursuant to Section 4103 of Title 70 of the Oklahoma Statutes, an individual shall provide written documentation of vaccinations against hepatitis B, measles, mumps, and rubella (MMR).
2. The requirement shall not apply to students enrolling in courses delivered via the Internet or distance learning in which the student is not required to attend class on campus.
B. Beginning with the 2004-2005 academic year, institutions shall notify students of the requirements of subsection A of this section and provide students with educational information on hepatitis B, measles, mumps, and rubella (MMR) upon enrollment. Such information shall also include the risks and benefits of the vaccination. Institutions shall not be required to provide or pay for vaccinations against hepatitis B, measles, mumps, and rubella (MMR).
C. A written statement from a licensed physician indicating that a vaccine is medically contraindicated shall exempt a student from the vaccination. A student shall be exempt from the vaccination if the student submits a written, signed statement declaring that the administration of the vaccine conflicts with the student’s moral or religious tenets or, if the student is a minor, the student’s parent or guardian provides a written statement that the administration of the vaccine conflicts with the parent’s or guardian’s moral or religious tenets.
D. It shall be the responsibility of the governing body or board of regents for each public or private postsecondary institution or group of institutions to adopt policies for the implementation of this section. In adopting these policies the relevant governing body or board of regents may include exceptions for certain categories of students at its discretion.
Oregon
Daycare and School Age Vaccine Mandates:
Exemptions allowed are Medical and Religious
Immunization and Exemption Form
*Selective vaccine exemptions allowed
*Guide to exempting vaccines in Oregon
*Immunization Law Handbook for Daycare and Preschool Age
College Vaccine Exemption Brochure
TITLE 36. PUBLIC HEALTH AND SAFETY. CHAPTER 433. DISEASE AND CONDITION CONTROL; MASS GATHERINGS; INDOOR AIR
ORS § 433.267. Immunization of school children; rules; exceptions; effect of failure to comply.
(1) As a condition of attendance in any school or children’s facility in this state, every child through grade 12 shall submit to the administrator one of the following statements unless the school or facility which the child attends already has on file a record which indicates that the child has received immunizations against the restrictable diseases prescribed by rules of the Department of Human Services as provided in ORS 433.273:
(a) A statement signed by the parent, a practitioner of the healing arts who has within the scope of the practitioner’s license the authority to administer immunizations or a representative of the local health department certifying the immunizations the child has received;
(b) A statement signed by a physician or a representative of the local health department that the child should be exempted from receiving specified immunization because of indicated medical diagnosis; or
(c) A statement signed by the parent that the child has not been immunized as described in paragraph (a) of this subsection because the child is being reared as an adherent to a religion the teachings of which are opposed to such immunization.
(2
(a) A newly entering child or a transferring child shall be required to submit the statement described in subsection (1) of this section prior to attending the school or facility.
(b) Notwithstanding paragraph (a) of this subsection, a child transferring from a school in the United States must submit the statement required by subsection (1) of this section not later than the exclusion date set by rule of the department.
(3) Persons who have been emancipated pursuant to ORS 419B.558 or who have reached the age of consent for medical care pursuant to ORS 109.640 may sign those statements on their own behalf otherwise requiring the signatures of parents under subsection (1) of this section.
(4) The administrator shall conduct a primary evaluation of the records submitted pursuant to subsection (1) of this section to determine whether
the child is entitled to begin attendance by reason of having submitted a statement that complies with the requirements of subsection (1) of this section.
(5) If the records do not meet the initial minimum requirements established by rule, the child may not be allowed to attend until the requirements are met. If the records meet the initial minimum requirements, the child shall be allowed to attend.
(6) At the time specified by the department by rule, records for children meeting the initial minimum requirements and records previously on file shall be reviewed for completion of requirements by the administrator to determine whether the child is entitled to continue in attendance. If the records do not comply, the administrator shall notify the local health
department and shall transmit any records concerning the child’s immunization status to the local health department.
(7) The local health department shall provide for a secondary evaluation of the records to determine whether the child should be excluded for noncompliance with the requirements stated in subsection (1)(a) or (b) of this section. If the child is determined to be in noncompliance, the local
health department shall issue an exclusion order and shall send copies of the order to the parent or the person who is emancipated or has reached the age of majority and the administrator. On the effective date of the order, the administrator shall exclude the child from the school or facility and not allow the child to attend the school or facility until the requirements of this section have been met.
(8) The administrator shall readmit the child to the school or facility when in the judgment of the local health department the child is in compliance with the requirements of this section.
(9) The administrator shall be responsible for updating the statement described in subsection (1)(a) of this section as necessary to reflect the current status of the immunization of the child and the time at which the child comes into compliance with immunizations against the restrictable diseases prescribed by rules of the department pursuant to ORS 433.273.
(10) Nothing in this section shall be construed as relieving agencies, in addition to school districts, which are involved in the maintenance and evaluation of immunization records on April 27, 1981, from continuing
responsibility for these activities.
(11) All statements required by this section shall be on forms approved or provided by the department.
(12) In lieu of signed statements from practitioners of the healing arts, the department may accept immunization record updates using practitioner documented immunization records generated by electronic means or on practitioner letterhead but unsigned, if the department determines such records are accurate.
(13) As used in this section:
(a) “Newly entering child” means a child who is initially attending:
(A) A facility in this state;
(B) A school at the entry grade level;
(C) Either a school at any grade level or a facility from homeschooling; or
(D) A school at any grade level or a facility after entering the United States from another country.
(b) “Transferring child” means a child moving from:
(A) One facility to another facility;
(B) One school in this state to another school in this state when the move is not the result of a normal progression of grade level; or
(C) A school in another state to a school in this state.
ORS § 433.282 Required immunizations at certain post-secondary educational institutions; rules.
(1) The Department of Human Services may require each post-secondary educational institution, except a community college or a career school, to require that each entering full-time student has current immunizations, as required for children attending school pursuant to rules adopted by the department under ORS 433.273, prior to the student’s second quarter or semester of enrollment on an Oregon campus, using procedures developed by the institution.
(2) Notwithstanding subsection (1) of this section, the department may require each post-secondary educational institution, except a community college or a career school, to document, using procedures developed by the institution, that each entering full-time student has current immunizations, as required for children attending school pursuant to rules adopted by the department under ORS 433.273, prior to the student attending classes if the student will be attending the institution pursuant to a nonimmigrant visa.
(3) The department by rule shall establish immunization schedules and may further limit the students and programs to which the requirement applies.
(4) The department may conduct validation surveys to ensure compliance with this section.
ORS § 433.283 Immunizations against measles for certain students at community colleges; rules.
(1) The Department of Human Services may require each community college to require that students involved in clinical experiences in allied health programs, practicum experiences in education and child care programs and membership on intercollegiate sports teams have current immunizations for measles prior to each student’s participation. The requirement shall apply only to those students born on or after January 1, 1957.
(2) The State Board of Education by rule shall define clinical experiences in allied health programs, practicum experiences in education and child care programs and membership on intercollegiate sports teams at the community colleges. The Department of Human Services by rule shall establish immunization schedules and may further limit the students and programs to which the requirement applies. Each community college shall develop procedures to implement and maintain this requirement.
(3) The Department of Human Services may conduct validation surveys to insure compliance with this section. Community colleges shall be required to keep immunization records only while the student is involved in the program.
ORS § 433.284 Adoption of more stringent immunization requirements.
Private schools, children’s facilities and post-secondary educational institutions may adopt additional or more stringent requirements as long as medical and religious exemptions are included and the requirements are in compliance with the United States Public Health Service Advisory Committee on Immunization Practices recommendations.
Pennsylvania
Daycare and School Age Mandates:
§ 23.83. Immunization requirements.
(a) Required for entry. The following immunizations are required for entry into school for the first time at the kindergarten or first grade level, at public, private or parochial schools in this Commonwealth, including special education and home education programs:
(1) Hepatitis B. Three properly-spaced doses of hepatitis B vaccine or a history of hepatitis B immunity proved by laboratory testing.
(2) Diphtheria. Four or more properly-spaced doses of diphtheria toxoid, which may be administered as a single antigen vaccine, in combination with tetanus toxoid or in combination with tetanus toxoid and pertussis vaccine. One dose shall be administered on or after the 4th birthday.
(3) Tetanus. Four or more properly-spaced doses of tetanus toxoid, which may be administered as a single antigen vaccine, in combination with diphtheria toxoid or in combination with diphtheria toxoid and pertussis vaccine. One dose shall be administered on or after the 4th birthday.
(4) Poliomyelitis. Three or more properly-spaced doses of any combination of oral polio vaccine or enhanced inactivated polio vaccine.
(5) Measles (rubeola). Two properly-spaced doses of live attenuated measles vaccine, the first dose administered at 12 months of age or older, or a history of measles immunity proved by serological evidence showing antibody to measles as determined by the hemagglutination inhibition test or a comparable test. Each dose of measles vaccine may be administered as a single antigen vaccine.
(6) German measles (rubella). One dose of live attenuated rubella vaccine, administered at 12 months of age or older or a history of rubella immunity proved by serological evidence showing antibody to rubella determined by the hemagglutination inhibition test or any comparable test. Rubella vaccine may be administered as a single antigen vaccine.
(7) Mumps. One dose of live attenuated mumps vaccine, administered at 12 months of age or older or a physician diagnosis of mumps disease indicated by a written record signed by the physician or the physician’s designee. Mumps vaccine may be administered as a single antigen vaccine.
(8) Chickenpox (varicella). One of the following:
(i) One dose of varicella vaccine, administered at 12 months of age or older.
(ii) A history of chickenpox immunity proved by laboratory testing or a written statement of history of chickenpox disease from a parent, guardian or physician.
(b) Required for attendance. The following immunizations are required as a condition of attendance at school in this Commonwealth if the child has not received the immunizations required for school entry listed in subsection (a).
(1) Diphtheria. Three or more properly spaced doses of diphtheria toxoid, which may be administered as a single antigen vaccine, in combination with tetanus toxoid or in combination with tetanus toxoid and pertussis vaccine.
(2) Tetanus. Three or more properly spaced doses of tetanus toxoid, which may be administered as a single antigen vaccine, in combination with diphtheria toxoid or in combination with diphtheria toxoid and pertussis vaccine.
(3) Poliomyelitis. Three or more properly spaced doses of either oral polio vaccine or enhanced inactivated polio vaccine. If a child received any doses of inactivated polio vaccine administered prior to 1988, a fourth dose of inactivated polio vaccine is required.
(4) Measles (rubeola). Two properly spaced doses of live attenuated measles vaccine, administered at 12 months of age or older or a history of measles immunity proved by serological evidence showing antibody to measles determined by the hemagglutination inhibition test or a comparable test. Each dose of measles vaccine may be administered as a single antigen vaccine.
(5) German measles (rubella). One dose of live attenuated rubella vaccine, administered at 12 months of age or older or a history of rubella immunity proved by serological evidence showing antibody to rubella determined by the hemagglutination inhibition test or any comparable test. Rubella vaccine may be administered as a single antigen vaccine.
(6) Mumps. One dose of live attenuated mumps vaccine, administered at 12 months of age or older or a physician diagnosis of mumps disease indicated by a written record signed by the physician or the physician’s designee. Mumps vaccine may be administered as a single antigen vaccine.
(c) Required for entry into 7th grade. In addition to the immunizations listed in subsection (b), the following immunizations are required at any public, private, parochial or vocational school in this Commonwealth, including special education and home education programs, as a condition of entry for students entering the 7th grade; or, in an ungraded class, for students in the school year that the student is 12 years of age:
(1) Hepatitis B. Three properly-spaced doses of hepatitis B vaccine or a history of hepatitis B immunity proved by laboratory testing.
(2) Chickenpox (varicella). One of the following:
(i) One dose of varicella vaccine, administered at 12 months of age or older.
(ii) Two properly-spaced doses of varicella vaccine for children 13 years of age and older.
(iii) A history of chickenpox immunity proved by laboratory testing, or a written statement of history of chickenpox disease from the parent, guardian, emancipated child or physician.
Source: The provisions of this § 23.83 amended through September 17, 1982, effective August 1, 1983, 12 Pa.B. 3288; amended August 22, 1997, effective August 23, 1997, 27 Pa.B. 4317; amended September 28, 2001, effective September 29, 2001, 31 Pa.B. 5525. Immediately preceding text appears at serial pages (232756) to (232758).
Cross References: This section cited in 28 Pa. Code § 23.85 (relating to responsibilities of schools and school administrators); and 28 Pa. Code § 27.77 (relating to immunization requirements for children in child care group settings).
Exemptions allowed are Medical, Religious and /or with Personal Belief
§ 23.84. Exemption from immunization.
(a) Medical exemption. Children need not be immunized if a physician or the physician’s designee provides a written statement that immunization may be detrimental to the health of the child. When the physician determines that immunization is no longer detrimental to the health of the child, the child shall be immunized according to this subchapter.
(b) Religious exemption. Children need not be immunized if the parent, guardian or emancipated child objects in writing to the immunization on religious grounds or on the basis of a strong moral or ethical conviction similar to a religious belief.
Source : The provisions of this § 23.84 amended through September 17, 1982, effective August 1, 1983, 12 Pa.B. 3288; amended August 22, 1997, effective August 23, 1997, 27 Pa.B. 4317. Immediately preceding text appears at serial pages (164332) to (164333) and (129145).
§ 23.85. Responsibilities of schools and school administrators.
(d) A child not previously admitted to or not allowed to continue attendance at school because the child has not had the required immunizations shall be admitted to or permitted to continue attendance at school only upon presentation to the school administrator or school administrator’s designee of a completed certificate of immunization or immunization record, upon submission of information sufficient for an exemption under § 23.84, or upon compliance with subsection (e).
(e) If a child has not received all the antigens described in § 23.83, the child may be provisionally admitted to school only if evidence of the administration of at least one dose of each antigen described in § 23.83 is given to the school administrator or the administrator’s designee and the parent or guardian’s plan for completion of the required immunizations is made part of the child’s health record. The plan for completion of the required immunizations shall be reviewed every 60 days by the school administrator or the administrator’s designee. Subsequent immunizations shall be entered on the certificate of immunization or entered in the school’s computer database. Immunization requirements described in § 23.83 shall be completed within 8 months of the date of provisional admission to school. If the requirements are not met, the school administrator may not admit the child to school or permit continued attendance.
See Also: School Immunization Regulation Procedure Manual (pdf)
Health form with Medical Exemption and Religious/Personal Belief Exemption Included (appendix B)
Rhode Island
Daycare and School Age Vaccine Mandates:
RULES AND REGULATIONS PERTAINING TO IMMUNIZATION AND TESTING FOR
COMMUNICABLE DISEASES.(R23-1-IMM)
School Entry Requirements:
3.3 Each student, upon initial entry to any school, shall furnish evidence as required in section 3.4
herein of having received the vaccines described below:
3.3.1 Diphtheria, Tetanus, and Pertussis
(a) Upon initial entry to a school, a student is required to have received a primary series of at least three (3) doses of a vaccine against diphtheria, tetanus and pertussis, with at least four (4) weeks between doses, and two (2) boosters, the first at least six (6) months after the third primary dose, and the second after age four (4) (total of five (5) doses). If the first booster is given after age four (4), a second booster is not required (total of four (4) doses).
(i) For any student who is seven (7) years of age or older and requires additional vaccine doses to satisfy this requirement, adult Td (Tetanus-diphtheria toxoid) is to be used.
(ii) If the primary series is begun on or after the seventh (7th) birthday, two (2) primary doses of adult Td at least four (4) weeks apart, with a third (3rd) dose of adult Td six (6) months after the second (2nd) primary dose are to be used.
(iii) Pertussis vaccine is not required for students seven (7) years of age or older.
(iv) Pediatric Diphtheria-Tetanus toxoid (DT), instead of a vaccine against diphtheria, tetanus and pertussis, shall only be used when the provider is following current acceptable guidelines for valid contraindications for pertussis vaccine, as recommended by the Advisory Committee on Immunization Practices (ACIP) or the American Academy of Pediatrics (AAP).
(b) Upon entering seventh grade (or in the case of an ungraded classroom, for students twelve years of age or older), a student is required to have received a booster of Td vaccine, if it has been five years or more since the last dose of a diphtheria-tetanus containing vaccine.
3.3.2 Poliomyelitis Vaccine
(a) Upon initial entry to a school, a student is required to have received a total of four (4) doses of any combination of either oral poliovirus vaccine (OPV) or inactivated poliovirus vaccine (IPV), with at least four (4) weeks between doses. If the third (3rd) dose was given after the fourth (4th) birthday, a fourth (4th) dose is not necessary (total of three (3) doses), as long as all three (3) doses were either all OPV or all IPV; or a series administered in accordance with ACIP recommendations.
(b) For students 18 years of age and older, poliovirus vaccine is not required.
3.3.3 Measles, Mumps, and Rubella Vaccines
(a) Upon initial entry to a school, a student is required to have received two (2) doses of a measles-containing vaccine (preferably MMR vaccine), one (1) dose of a mumps vaccine, and one (1) dose of a rubella vaccine in accordance with ACIP recommendations. The second dose of a measles-containing vaccine must be given at least one (1) month after the first dose.
3.3.4 Hepatitis B Vaccine
(a) Upon initial entry to the following grades, a student is required to have received three (3) doses of hepatitis B vaccine, in accordance with ACIP recommendations. The following dates are in effect for the grades, as specified below:
August 1, 1999
August 1, 2000 K,1,7
August 1, 2001 K,1,2,7,8
August 1, 2002 K,1,2,3,7,8,9
August 1, 2003 K,1,2,3,4,7,8,9,10
August 1, 2004 K,1,2,3,4,5,7,8,9,10,11
August 1, 2005 K,1,2,3,4,5,6,7,8,9,10,11,12
(b) Effective August 1, 2005, all students, upon initial entry to a school, are required to have received three (3) doses of hepatitis B vaccine, in accordance with ACIP recommendations.
3.3.5 Varicella (Chickenpox) Vaccine
(a) Upon initial entry to the following grades, a student is required to have received one (1) dose of varicella (chickenpox) vaccine on or after his or her first birthday or, if the first dose is given on or after the student’s thirteenth (13th) birthday, two (2) doses of varicella (chickenpox) vaccine, in accordance with ACIP recommendations. The following dates are in effect for the grades, as specified below:
August 1, 1999 K
August 1, 2000 K,1,7
August 1, 2001 K,1,2,7,8
August 1, 2002 K,1,2,3,7,8,9
August 1, 2003 K,1,2,3,4,7,8,9,10
August 1, 2004 K,1,2,3,4,5,7,8,9,10,11
August 1, 2005 K,1,2,3,4,5,6,7,8,9,10,11,12
(b) Effective August 1, 2005, all students upon initial entry to a school, are required to have received one (1) dose of varicella (chickenpox) vaccine on or after his or her first birthday or, if the first dose is given on or after the student’s thirteenth (13th) birthday, two (2) doses of varicella (chickenpox) vaccine, in accordance with ACIP recommendations.
3.4 Immunization Records
3.4.1(a) Acceptable evidence of completion of immunizations shall include the day, month, year and
type/name of each dose of vaccine administered. Such evidence shall consist of a record
signed by a physician or his/her designee (the signature of the student’s parents is not
acceptable). This record may be submitted to the preschool or school by a health care
provider, another preschool or school, a parent or a guardian. Or
(b) an official immunization record card, preschool or school immunization record, Medical
Passport, World Health Organization immunization record, or other official immunization
records acceptable to the Department; or
(c) an electronically stored and/or transmitted documentary record (facsimile transmission,
computerized record, including, but not limited to, a record obtained from the KIDS NET
statewide registry or other statewide registry, record on magnetic media or similar record)
as may be utilized by a preschool or school; or
(d) presentation of laboratory evidence of immunity is made in the case of measles, mumps,
rubella, hepatitis B and varicella (chickenpox); or,
(e) For chickenpox (varicella), a physician, a physician assistant, a certified registered nurse
practitioner, or other licensed practitioner acting within his/her scope of practice signs a
statement that the student has a history of chickenpox disease (varicella).
(f) telephone confirmation by the preschool or school of the existence of immunization records
as defined above, provided all of the following conditions are met:
(i) an acceptable documentary record is on file with the preschool or school officials at
a preschool or school which the student previously attended, or is on file with a
health provider, public health agency, other health professional or preschool or
school official responsible for maintenance of immunization records; and
(ii) telephone confirmation is obtained by a preschool or school official at the preschool
or school in which the student enrolls; and
(iii) telephone confirmation is sought and obtained within one (1) working day of the
student’s initial entry; and
(iv) written documentation is made in the student’s preschool or school health record of
the telephone confirmation call, including the date and time of the call, the name,
address, and telephone number of the person who confirmed the immunization
status; and
(v) a written documentary record of immunization is received by the preschool or
school in which the student has enrolled within ten (10) working days of initial
entry; and
(vi) the preschool or school shall implement the telephone confirmation as described
above, if a student is seeking entry and does not present a copy of immunization
records.
3.5 Provisions for Exclusions, Waiting Periods and Exemptions
(a) Students who have not received the minimum number of required immunizations, who
are not in a prescribed waiting period between doses, as specified in section 3.5.2 (a)
herein and who are not exempt pursuant to section 3.5.3 herein, shall be excluded from
the preschool or school by the administrative head of the preschool or school, pending
the completion of the required dose(s) of vaccine(s).
(b) Students upon initial entry to any preschool or school shall be excluded unless evidence
is submitted that the student has received initial dose(s) of required vaccine(s) for preschool or school entry as set forth in these rules and regulations herein.
(c) If an outbreak of vaccine -preventable disease should occur, an exempt student shall be
excluded from school by the administrative head of school for a period of time as
determined by the Health Department based on a case-by-case analysis of public health
risk.
(d) The preschool or school shall have a written protocol in place for the exclusion of
unvaccinated students in the event of an outbreak. An accurate and current listing of
unvaccinated students shall be maintained by the preschool or school for this purpose.
3.5.2 Waiting Periods
(a) If at initial preschool or school entry a student is within a waiting period for the
minimum number of doses for a given vaccine, the student shall be registered and/or
admitted to preschool or school. It shall be the responsibility of the administrative head
of the preschool or school or his/her designee to ensure the completion of at least the
minimum number of immunizations, following the prescribed waiting period(s) and
consistent with the provisions of these rules and regulations.
(i) The administrative head of the preschool or school or his/her designee shall sign a
Temporary Immunization Exemption Certificate, provided by the school, indicating
that an appointment with a health care provider for the required immunization(s)
has been made. This temporary exemption shall expire on the date of the
immunization appointment.
(b) At initial preschool or school entry a student who is under the care of the state
Department of Children, Youth and Families (DCYF) shall be enrolled in school upon
presentation of a completed intra-state education identification card in accordance with
the requirements of section 42-72.4-1 of the Rhode Island General Laws, as amended, or
as stipulated in section 3.4.1 (f) herein.
3.5.3 Exemptions
(a) A student may only be exempt from the immunization requirements described herein for
either of the two (2) reasons stated below:
(i) a physician, a physician assistant, a certified registered nurse practitioner, or other
licensed practitioner acting within his/her scope of practice signs the Rhode Island Department of Health’s “Medical Immunization Exemption Certificate” provided by the school attesting that the student is exempt from a specific vaccine because of medical reasons, in accordance with ACIP recommendations, AAP guidelines, or package insert instructions; or
(ii) a parent or guardian completes and signs the Department’s “Religious Immunization Exemption Certificate” provided by the school, attesting that immunization conflicts with the tenets of their religious beliefs.
Exemptions allowed are Medical and Religious
TITLE 16. EDUCATION.CHAPTER 38. OFFENSES PERTAINING TO SCHOOLS
R.I. Gen. Laws § 16-38-2. Immunization
(a) Every person upon entering any public or private school including any college or university in this state as a pupil shall furnish to the administrative head of the school evidence that the person has been immunized against any diseases that may from time to time be prescribed by regulation of the director of health and tested for tuberculosis, or a certificate from a licensed physician stating that the person is not a fit subject for immunization for medical reasons, or a certificate signed by the pupil, if over eighteen (18) years of age, or by the parent or guardian stating that immunization and/or testing for communicable diseases is contrary to that person’s religious beliefs. It shall be the responsibility of the administrative head of the school to secure compliance with these regulations.
(b) Every child more than twenty-four (24) months of age, resident in the state of Rhode Island, shall be eligible to receive the immunization against meningococcal disease. The Department of Health shall include meningococcal vaccine in the department’s immunization program, established by § 23-1-44.
TITLE 16. EDUCATION. CHAPTER 38. OFFENSES PERTAINING TO SCHOOLS
R.I. Gen. Laws § 16-38-2. Immunization
(a) Every person upon entering any public or private school including any college or university in this state as a pupil shall furnish to the administrative head of the school evidence that the person has been immunized against any diseases that may from time to time be prescribed by regulation of the director of health and tested for tuberculosis, or a certificate from a licensed physician stating that the person is not a fit subject for immunization for medical reasons, or a certificate signed by the pupil, if over eighteen (18) years of age, or by the parent or guardian stating that immunization and/or testing for communicable diseases is contrary to that person’s religious beliefs. It shall be the responsibility of the administrative head of the school to secure compliance with these regulations.
(b) Every child more than twenty-four (24) months of age, resident in the state of Rhode Island, shall be eligible to receive the immunization against meningococcal disease. The Department of Health shall include meningococcal vaccine in the department’s immunization program, established by § 23-1-44.
South Carolina
Daycare and School Age Vaccine Mandates:
Exemptions allowed are Medical and Religious
Immunization and Exemption Question and Answer
*Exemption forms required and notarization for both daycare and school age. Religious Exemption form-DHEC form 1126-must be requested in person from any county public health department. Contact numbers for county public health departments can be found at http://www.scdhec.gov/health/countymap.htm.
Exemptions
Students may be exempt from these immunization requirements for the following reasons:
1. Medical Contraindication
An exemption from these immunization requirements due to a medical contraindication described on the South Carolina Certificate of Immunization, signed by an individual licensed to practice medicine or osteopathy, or his/her authorized representative, may be granted to a child when the physician or osteopath has determined that a particular vaccine(s) required by this schedule is not advisable for the child. If it is determined that this particular vaccine(s) is no longer contraindicated, the child will be required to have the vaccine(s). The temporary or permanent nature of this exemption shall be noted in the appropriate spaces on the South Carolina Certificate of Immunization (DHEC form 1148).
2. Religious Exemption
A South Carolina Certificate of Religious Exemption may be granted to any student whose parents, parent, guardian, or person in loco parentis signs the appropriate section of the South Carolina Certificate of Religious Exemption stating they are members of a recognized religious denomination in which the tenets and practices of the religious denomination conflict with immunizations.
3. Special Exemptions
A South Carolina Certificate of Special Exemption, signed by the school principal or his/her authorized representative, may be issued to transfer students while awaiting arrival of medical records from their former area of residence or to other students who have been unable to secure immunizations or documentation of immunizations already received. A South Carolina Certificate of Special Exemption may be issued only once and shall be valid for only thirty (30) calendar days from the date of enrollment. At the expiration of this special exemption, the student must present a valid South Carolina Certificate of Immunization or a valid South Carolina Certificate of Religious Exemption.
The South Carolina Certificate of Religious Exemption may be obtained from the Department of Health and Environmental Control. The Department of Health and Environmental Control also provides blank forms of the South Carolina Certificate of Immunization to immunization providers, and blank forms of the South Carolina Certificate of Special Exemption to schools.
South Dakota
Daycare and School Age Mandates:
South Dakota law (SDCL 13-28-7.1) requires students entering school or early childhood programs to present certification that they have been adequately immunized, according to the recommendations of the Department of Health. The law applies to all children entering school for the first time, including transfer students. Minimum immunization requirements are defined as:
- Four or more doses of diphtheria, pertussis and tetanus containing vaccine, with at lease one dose administered on or after age 4. Children 7 and older needing the primary series are required to have Td and only need three doses, with at least 6 months between dose two and three. If the child is 11 or older, the first dose of the primary series should be Tdap and the second and third doses should be Td, with at least 6 months between dose two and three. Children receiving 6 doses before age 4 do not require any additional doses for school requirements.
- 3 or more doses of poliovirus vaccine, at least 1 dose on or after age 4; or 4 or more doses of any combination of OPV/IPV given by 4 years of age.
- At least 2 doses of a measles-containing vaccine separated by at least 28 days, on or after 1st birthday. 2nd dose usually given as a measles/mumps/rubella vaccination.
- At least 2 doses of a rubella-containing vaccine, separated by at least 28 days, on or after 1st birthday.
- At least 2 doses of a mumps-containing vaccine, separated by at least 28 days, on or after 1st birthday.
- NOTE: Additional immunization requirement for kindergarten entry only (including students repeating kindergarten): Effective August 2007, two doses of varicella (chickenpox) vaccine administered after the age of 12 months, or history of disease. Parental history is acceptable, and physician documentation is not necessary.
NOTE: Haemophilus Influenzae B, Hepatitis A, Hepatitis B, and Pneumococcal vaccines are recommended but not required.
Exemptions allowed are Medical and Religious
TITLE 13. EDUCATION. CHAPTER 13-28. SCHOOL ATTENDANCE PRIVILEGES AND TUITION
S.D. Codified Laws § 13-28-7.1. Tests and immunizations for communicable diseases required for admission to school or early childhood program — Exceptions — Rules
Any pupil entering school or an early childhood program in this state, shall, prior to admission, be required to present to the appropriate school authorities certification from a licensed physician that the child has received or is in the process of receiving adequate immunization against poliomyelitis, diphtheria, pertussis, rubeola, rubella, mumps, tetanus, and varicella, according to recommendations provided by the Department of Health. The Department of Health may modify or delete any of the required immunizations. As an alternative to the requirement for a physician’s certification, the pupil may present:
(1) Certification from a licensed physician stating the physical condition of the child would be such that an immunization would endanger the child’s life or health; or
(2) A written statement signed by one parent or guardian that the child is an adherent to a religious doctrine whose teachings are opposed to such immunization; or
(3) A written statement signed by one parent or guardian requesting that the local health department give the immunization because the parents or guardians lack the means to pay for such immunization.
The Department of Health may promulgate reasonable rules, in accordance with chapter 1-26, to require compliance and documentation of adequate immunization, to define appropriate certification, and to specify standard procedure.
College:
TITLE 13. EDUCATION. CHAPTER 13-53. ADMINISTRATION OF STATE INSTITUTIONS
S.D. Codified Laws § 13-53-47. Immunizations required for students entering public or private postsecondary educational institutions–Alternatives.
Any student entering a public or private postsecondary education institution in this state for the first time after July 1, 2008, shall, within forty-five days after the start of classes, present to the appropriate institution certification from a licensed physician that the student has received or is in the process of receiving the required two doses of immunization against measles, rubella, and mumps. As an alternative to the requirement for a physician’s certification, the student may present:
(1) Certification from a licensed physician stating the physical condition of the student would be such that immunization would endanger the student’s life or health;
(2) Certification from a licensed physician stating the student has experienced the natural disease against which the immunization protects;
(3) Confirmation from a laboratory of the presence of adequate immunity; or
(4) A written statement signed by the student that the student is an adherent to a religious doctrine whose teachings are opposed to such immunizations. If the student is under the age of eighteen, the written statement shall be signed by one parent or guardian.
Tennessee
Daycare and School age Vaccine Mandates:
State law (T.C.A. 49-6-5002) requires child care facilities and schools through 12th grade to accept only an Official Immunization Certificate provided by the Department of Health, completed and signed by a physician or health care provider administering immunizations, as proof of immunization for enrollment purposes. Official certificates may be completed by local health departments or by a Tennessee health care provider. It is not acceptable to staple records to a copy of the official certificate or to use any unofficial version of a certificate for enrollment.
TENN. RULES AND REG. § 1200-14-1-.29. Immunization against certain diseases prior to school attendance in Tennessee.
(1) No person shall be permitted to attend any nursery school, day care center, Head Start center, Kindergarten, or other pre-school, day care or grades kindergarten through twelve of any public, private, or church related school until proof of adequate immunization against diphtheria, measles (rubeola), pertussis (whooping cough), poliomyelitis, rubella, mumps and tetanus is presented to the admissions officer of the school (unless otherwise exempted as provided by law). It shall be the duty of the school to enforce the provisions of this regulation, subject to the exemptions as set out in T.C.A. §49-6-5001(b).
(2) The state and county health departments are authorized to provide proof of immunization to the admissions officer of any school in the state of Tennessee. For the purpose of this subsection, the term school shall include nursery schools, kindergartens, other pre-schools, day care centers and facilities, after school day care facilities, grades kindergarten through twelve of any public, private or church elated schools, vocational schools, technical schools, colleges and universities in the state of Tennessee. The Commissioner has further determined that in order to more efficiently bring about compliance with the immunization law, the state and county health departments are further authorized to provide proof of immunization to physicians who are evaluating a school-aged patient’s immunization status.
(3)
(a) Effective July 1, 1998, proof of immunization with two doses of Measles, Mumps and Rubella vaccines, administered on or after the first birthday, will be required for admission into grades kindergarten, four, eight, and twelve.
(b) Effective July 1, 2001, proof of immunization with two doses of Measles, Mumps and Rubella vaccines, administered on or after the first birthday, will be required for attendance in grades kindergarten through twelve.
(4) Effective May 1, 1999, proof of immunization with two doses of Measles, Mumps and Rubella vaccines, administered on or after the first birthday, will be required for full-time students, defined as COMMUNICABLE AND ENVIRONMENTAL DISEASES CHAPTER 1200-14-1 (Rule 1200-14-1-.29, continued) November, 2004 (Revised) 16 students taking 12 hours or more of academic credits or other hours as defined as full-time by institutional policy, at all universities and colleges with an enrollment greater than two hundred students.
(5) Effective July 1, 1999, proof of adequate immunization against Hepatitis B will be required prior to entry into kindergarten.
(6) Effective September 1, 1999, for all children born on or after September 1, 1998, proof of adequate immunization against varicella, or a history of varicella illness, will be required for attendance in licensed child care facilities.
(7) Reserved
(8) Effective July 1, 2002, proof of immunization against varicella, or a history of the disease provided by a parent or physician, will be required prior to entry into kindergarten.
(9) Effective July 1, 2002, proof of adequate immunization against Hepatitis B will be required prior to entry into the seventh grade.
Exemptions allowed are Medical and Religious
TITLE 37. JUVENILES CHAPTER 10. MISCELLANEOUS PROVISIONS
PART 4. CHILDHOOD IMMUNIZATIONS
Tenn Code Ann § 37-10-402.Conflict with religious tenets and practices of parent
In the absence of an epidemic or immediate threat thereof, this section does not apply to any child whose parent or guardian files with proper authorities a signed written statement that such immunization and other preventative measures conflict with the religious tenets and practices of the parent or guardian affirmed under penalties of perjury.
TITLE 49. EDUCATION CHAPTER 6. ELEMENTARY AND SECONDARY EDUCATION
PART 50. IMMUNIZATION OF SCHOOL CHILDREN
Tenn. Code Ann. § 49-6-5001. General provisions. –
(a) The commissioner of health is authorized, subject to the approval of the public health council, to designate diseases against which children must be immunized prior to attendance at any school, nursery school, kindergarten, preschool or child care facility of Tennessee.
(b)
(1) It is the responsibility of the parents or guardian of children to have their children immunized, as required by subsection (a).
(2) In the absence of an epidemic or immediate threat thereof, this section shall not apply to any child whose parent or guardian shall file with school authorities a signed, written statement that such immunization and other preventive measures conflict with the parent’s or guardian’s religious tenets and practices, affirmed under the penalties of perjury.
(c)
(1) No children shall be permitted to attend any public school, nursery school, kindergarten, preschool or child care facility until proof of immunization is given the admissions officer of the school, nursery school, kindergarten, preschool or child care facility except as provided in subsection (b).
(2) No child shall be denied admission to any school or school facility if such child has not been immunized due to medical reasons if such child has a written statement from the child’s doctor excusing the child from such immunization.
(3) No child or youth determined to be homeless shall be denied admission to any school or school facility, if the child or youth has not yet been immunized or is unable to produce immunization records due to being homeless. The enrolling school shall comply with any and all federal laws pertaining to the educational rights of homeless children and youth, including the McKinney-Vento Homeless Assistance Act, 42 U.S.C. § 1141 et seq.
(d) Each child attending any school, nursery school, kindergarten, preschool or child care facility without furnishing proof of immunization or exception under subsection (b) and/or (e), shall not be counted in the average daily attendance of students for the distribution of state school funds.
(e) Any immunization specified hereunder shall not be required if a qualified physician shall certify that administration of such immunization would be in any manner harmful to the child involved.
Exemption Form:
*Your local school or Health Department can mail you a green form: TCA 49-6-5001 (b)(2). Some schools may accept a parent letter and some schools may provide their own forms.
*Have it notarized. Your child will need a yearly physical through 3rd grade.
*Form looks like this:
Communicable and Environmental Disease Section
Vaccination(s) Refusal Due To Personal Religious Beliefs
Address___________________________________________ ____State______Zip___________
Phone(____)_______________
I have been advised my child or ward (named above) should receive the following vaccines but I am declining to have my child immunized.
Declined(Check all that apply)
__Hepatitis B Vaccine
__Measles, Mumps, Rubella Vaccine(MMR)
__Diphtheria, Tetanus, acellular Pertussis Vaccine(DTaP)
__Varicella(chickenpox) Vaccine
__Diphtheria, Tetanus Vaccine (DT or Td
__Influenza (flu)Vaccine
__Haemophilus Influenzae type B Vaccine (Hib)
__Meningococcal Vaccine
__Pneumococcal conjugate Vaccine
__Hepatitis A Vaccine
__Polio Vaccine (IPV)
__Other__________________________
I have been given the opportunity to read the Centers for Disease Control and Prevention’s (CDC) Vaccine information Sheet(s) (VIS) explaining the above vaccine(s) and the disease(s) they may prevent. I have had the opportunity to discuss these with my child’s health care provider or the health department and to have my questions, if any, answered. By signing below, I acknowledge and I understand the following:
The purpose and the need for the recommended vaccine(s)
The risks and benefits of the recommended vaccine(s)
If my child does not receive the vaccine(s), I accept the consequences of my decision, which may include:
My child contracting the illness the vaccine should prevent.
My child transmitting the disease to others.
The need for my child to stay out of daycare or school during disease outbreaks.
Parent or Gaurdian Date
Witness Date
Notary Public____________________________
Date Commission Expires__________________
*Hamblen County Exemption Form
Texas
Mandated Vaccines:
Title 25 Health Services, §§97.61-97.72 of the Texas Administrative Code.
Daycare Exemption: Medical, Religious, Conscience
The law allows (a) physicians to write a statement stating that the vaccine(s) required is medically contraindicated or poses a significant risk to the health and well-being of the child or any member of the child’s household, and (b) parents/guardians to choose an exemption from immunization requirements for reasons of conscience, including a religious belief. Schools and child-care facilities should maintain an up-to-date list of students with exemptions, so they can be excluded from attending school if an outbreak occurs.
Instructions for the affidavit to be signed by parents/guardians choosing the exemption for reasons of conscience, including a religious belief can be found at Welcome to ImmunizeTexas.com
For children needing medical exemptions, a written statement by the physician should be submitted to the school or child-care facility.
Provisional Enrollment
All immunizations should be completed by the first date of attendance. The law requires that students be fully vaccinated against the specified diseases. A student may be enrolled provisionally if the student has an immunization record that indicates the student has received at least one dose of each specified age-appropriate vaccine required by this rule. To remain enrolled, the student must complete the required subsequent doses in each vaccine series on schedule and as rapidly as is medically feasible and provide acceptable evidence of vaccination to the school. A school nurse or school administrator shall review the immunization status of a provisionally enrolled student every 30 days to ensure continued compliance in completing the required doses of vaccination. If, at the end of the 30-day period, a student has not received a subsequent dose of vaccine, the student is not in compliance and the school shall exclude the student from school attendance until the required dose is administered.
*HPV for 6th grade girls is not listed. If opting-out, you would just exempt.
School-Age Medical, Religious and Personal Belief Exemptions:
Title 25 RULE §97.62 of the Texas Administrative Code.
Exclusions from compliance are allowable on an individual basis for medical contraindications, reasons of conscience, including a religious belief, and active duty with the armed forces of the United States. Children and students in these categories must submit evidence for exclusion from compliance as specified in the Health and Safety Code, §161.004(d), Health and Safety Code, §161.0041, Education Code, Chapter 38, Education Code, Chapter 51, and the Human Resources Code, Chapter 42.
(1) To claim an exclusion for medical reasons, the child or student must present a statement signed by the child’s physician (M.D. or D.O.), duly registered and licensed to practice medicine in the United States who has examined the child, in which it is stated that, in the physician’s opinion, the vaccine required is medically contraindicated or poses a significant risk to the health and well-being of the child or any member of the child’s household. Unless it is written in the statement that a lifelong condition exists, the exemption statement is valid for only one year from the date signed by the physician.
(2) To claim an exclusion for reasons of conscience, including a religious belief, a signed affidavit must be presented by the child’s parent or legal guardian, stating that the child’s parent or legal guardian declines vaccinations for reasons of conscience, including because of the person’s religious beliefs. The affidavit will be valid for a two-year period. The child, who has not received the required immunizations for reasons of conscience, including religious beliefs, may be excluded from school in times of emergency or epidemic declared by the commissioner of public health.
(A) A person claiming exclusion for reasons of conscience, including a religious belief, from a required immunization may only obtain the affidavit form by submitting a written request to the department. The request must include the following:
(i) full name of child; and
(ii) child’s date of birth (month/day/year).
(B) Requests for affidavit forms must be submitted to the department through one of the following methods:
(i) written request through the United States Postal Service (or other commercial carrier) to the department at: DSHS Immunization Branch, Mail code 1946, P.O. Box 149347, Austin, Texas 78714-9347;
(ii) by facsimile at (512) 458-7544;
(iii) by hand-delivery at the department’s physical address at 1100 West 49th Street, Austin, Texas 78756; or
(iv) via the department’s Immunization program Internet website (go to http://www.ImmunizeTexas.org).
(C) Upon request, one affidavit form for each child will be mailed unless otherwise specified (shall not exceed a maximum of five forms per child).
(D) The department shall not maintain a record of the names of individuals who request an affidavit and shall return the original request (where applicable) with the forms requested.
(3) To claim an exclusion for armed forces, persons who can prove that they are serving on active duty with the armed forces of the United States are exempted from the requirements in these sections.
Also see:
2008-2009 Texas Vaccine Exemption Information
Vaccine Exemption for Reasons of Conscience-Question and Answer
Sample letter for requesting an exemption form
Guidelines for Requesting an Exemption for Reasons of Conscience
Exploring Vaccines 
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