While many medical issues have received significant consideration, mass vaccination appears to have been largely neglected by modern biomedical ethicist.

Eighteen states allow for conscientious parental choice exemptions: AR, AZ, CA, CO, ID, LA, ME, MI, MN, NM, ND, OH, OK, TX, UT, VT, WA, AND WI. Only Mississippi and West Virginia have no religious or philosophical exemptions. However, Mississippi does allow an automatic exemption for home school students.

Utilitarianism
It’s an important concept to understand, because it’s the main justification that vaccine proponents use to promote recommendations and mandates. Utilitarian theory means that the value of a certain rule must be that which secures the greatest benefit for the greatest number. Accordingly, they say, inflicting pain, damage, disease, or death upon some individuals may be justified if, in doing so, the majority benefit.

One Big Flaw
That’s why the evidence against the utilitarian promise of safety, effectiveness and necessity is essential to bring reason into the discussion and formulation of our laws. Individual good cannot be separated legitimately from the good of society precisely because society is nothing more than a congregation of individuals. And, as you may find after your careful study of this subject, there is no conclusive evidence that mandatory vaccination are essential to protect public health, nor are they the least restrictive means to fulfill the State’s interest in protecting the public health. Certainly, the most effective deterrent to infectious disease has been the enactment and enforcement of public sanitation laws.

Precedents
Ethical principles, already accepted in other areas of health care, can serve as precedents for evaluating mass immunization. These principles are: respect for autonomy (human rights), non-maleficience (no harm), beneficience (benefit), and justice. For instance: During the late 1950’s, two anti-nausea medications were distributed to pregnant women; Thalidomide and Benedictine. Both drugs were still distributed even after their adverse effects (limb reduction defects in fetus) were known, thereby violating the principle of non-maleficence.

Crimes of Omission
Most of the information available for study on this site is not passed to parents. But everyone who is responsible for the administration of any vaccine has a legal duty of care obligation to warn of all adverse effects that could occur (Rogers vs Whitaker 1992 175 CLR 479). To violate this obligation is to commit common assault.

Where Does It Stop?
What if “authorities” or “officials” decide to mandate an AIDS vaccine? What if they decide that Prozac is the best thing for everyone, or just you? Do we want the government mandating what goes into everyone’s bodies whenever they think it’s in the “public’s best interest?”

Errors in Judgement
Unfortunately, the precedent needed for widespread forced drugging with neuroleptics may be set in the case of Charles Thomas Sell, D.D.S., now incarcerated in Springfield, MO (see AAPS News Nov 2001 and Apr 2002). In its amicus brief it states: “… the State may inject mind-altering drugs into a prisoner against his will, based on government testimony.” The panel majority even rejected any limits on the type or quantity of drugs injected, and implicitly allowed drugs that have not been fully tested and approved for the specific purpose.
http://www.aapsonline.org/newsletters/may02.htm
Legal loopholes like this, the Feres Doctrine (Executive order 13139) and a few misguided case rulings do exist — and attempt to obstruct our freedoms from human and constitutional rights abuse.

Fortunately, we have The Declaration of Independence as the foundational doctrine of our country; it emphasizes “We hold these truths to be self-evident, that all Men were created equal, that they are endowed by their Creator with certain inalienable Rights, that among these are Life, Liberty and the Pursuit of Happiness. And stemming from this core historical document arises many laws that stand to protect us from harm and injustice.
The First Amendment [of the U.S. Constitution] clearly defines the free exercise of religious beliefs and the moral rights of individuals to obey the judgement of their conscience in matters of life and death. Religious exemption statutes simply codify the protections of an individual’s right to freely exercise his/her religious belief as guaranteed by the First Amendment of the U.S. Constitution and parallel portions of the state constitutions. These religious exemption statutes have been in place for decades without posing any risk to public health. Faith-based decisions concerning immunizing one’s children have consistently been protected by the courts. See Berg v. Glen Cove City School District, 853 F.Supp. 651 (E.D.N.Y. 1994); Sherr v. Northport-East Northport Union Free School District, 672 F. Supp. 81 (E.D.N.Y. 1987).
The Fourth Amendment to the United State’s Constitution protects American’s right to privacy. Article IV of the Bill of Rights states, “The right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be violated. American citizens are protected from the threat of bodily damage from unwanted chemicals and contaminants under this amendment.

 
exemptions by state

View Laws & Exemptions by State / Country

A

Allows:

  • Medical exemptions
  • Religious exemptions

TITLE 16. EDUCATION
CHAPTER 30. IMMUNIZATION OF SCHOOL CHILDREN
Code of Alabama § 16-30-1 (2002)
§ 16-30-1. Designation of diseases
The State Health Officer is authorized, subject to the approval of the State Board of Health, to designate diseases against which children must be immunized or for which they must be tested prior to, or, in certain instances after entry into the schools of Alabama.
Code of Alabama § 16-30-2 (2002)
§ 16-30-2. Parental responsibility
It shall be the responsibility of the parents or guardians of children to have their children immunized or tested as required by Section 16-30-1.

Code of Alabama § 16-30-3 (2002)
§ 16-30-3. Exemptions
The provisions of this chapter shall not apply if:
(1) In the absence of an epidemic or immediate threat thereof, the parent or guardian of the child shall object thereto in writing on grounds that such immunization or testing conflicts with his religious tenets and practices; or
(2) Certification by a competent medical authority providing individual exemption from the required immunization or testing is presented the admissions officer of the school.

Code of Alabama § 16-30-4 (2002)
§ 16-30-4. Certificate of immunization
The boards of education and the governing authority of each private school shall require each pupil who is otherwise entitled to admittance to kindergarten or first grade, whichever is applicable, or any other entrance into an Alabama public or private school, to present a certification of immunization or testing for the prevention of those communicable diseases designated by the State Health Officer, except as provided in Section 16-30-3. Provided, however, that any student presently enrolled in a school in this state, not having been immunized upon initial entrance to school, is hereby required to present a certification of immunization as described in this section upon commencement of the next school year. Section 16-30-1 and this section shall apply only to kindergarten through 12th grade and not to the institutions of higher learning.
Code of Alabama § 16-30-5 (2002)
§ 16-30-5. Rules and regulations
The State Health Officer shall promulgate rules and regulations necessary to carry out this chapter.

ALABAMA ADMINISTRATIVE CODE
ALABAMA STATE BOARD OF HEALTH
ALABAMA DEPARTMENT OF PUBLIC HEALTH; DIVISION OF DISEASE CONTROL
Alabama Admin. Code r. 420-6-1-.01 (2002)
420-6-1-.01 Authority.
This regulation is promulgated by the State Health Officer and approved by the State Board of Health on October 17, 1979, pursuant to Code of Ala. 1975, § 16-30-5.
Alabama Admin. Code r. 420-6-1-.02 (2002)
420-6-1-.02 General Provisions.
(1) The board of education and the governing authority of each private school shall require each pupil, prior to entering kindergarten or first grade or prior to re-entering the higher grades of the schools of Alabama, to present a certificate of immunization for the prevention of diphtheria, tetanus, pertussis, poliomyelitis, measles, rubella and mumps (Code of Ala. 1975, § 16-30-4). Pupils who have passed their seventh birthday are exempt from a requirement for pertussis immunization.
(2) Such certificate shall be on the form approved by the Alabama Department of Public Health and shall be made a part of the pupil’s school record. When a student leaves a school upon graduation, transfer, relocation or otherwise; the school may return the original certificate to the student’s parents/guardians and retain a legible copy in the school record.
(3) A written objection from the parent or guardian of a student based on religious tenets and practices shall be submitted in person by the parent or guardian to the County Health Department for issuance of a Certificate of Religious Exemption from the required immunizations or testing. A licensed physician can provide individual exemption from the required immunizations or testing on a Certificate of Medical Exemption. The Certificate of Religious Exemption and the Certificate of Medical Exemption will be on forms approved by the Alabama Department of Public Health and will be accepted in lieu of the Certificate of Immunization.
Alabama Admin. Code r. 420-6-1-.03 (2002)
420-6-1-.03 Immunization Schedule.
(1) Except as provided in Rule 420-6-1-.02 and Code of Ala. 1975, § 16-30-5, each pupil, prior to entering Alabama school grade kindergarten through twelfth grade shall receive;
(a) at a minimum, four (4) doses of diphtheria, tetanus and pertussis vaccination. The last dose must be administered after the child’s fourth birthday. Booster doses of tetanus-diptheria toxoid vaccine must be given 5-10 years after the preschool booster.
(b) at least three (3) doses of polio vaccine with the last dose administered after the pupil’s fourth birthday.
(c) immunization against mumps and rubella. This dose shall be administered at 12 months of age or later.
(d) two (2) doses of measles-containing vaccine. The first dose shall be administered at 12 months of age or later and the second dose shall be administered at least 30 days later.
(e) varicella vaccine subject to the following schedule unless there is documentation of a positive varicella titer or a date of varicella disease. This requirement is effective for students entering kindergarten beginning fall of 2001 and will escalate by one successive grade each year for the following 12 years to include all grades, kindergarten through twelfth, beginning fall of 2013:
(i) one dose of varicella vaccine at 12 months of age or older for persons less than 13 years of age;
(ii) two doses of varicella vaccine separated by at least 28 days for persons 13 years of age or older beginning the vaccination series.

Allows:

  • Medical exemptions
  • Religious exemptions

TITLE 14. EDUCATION, LIBRARIES, AND MUSEUMS
CHAPTER 30. PUPILS AND EDUCATIONAL PROGRAMS FOR PUPILS
ARTICLE 2. PHYSICAL EXAMINATIONS AND SCREENING EXAMINATIONS
Alaska Stat. § 14.30.065 (2002)
Sec. 14.30.065. Supervision
The program of physical examination and immunizations prescribed by AS 14.30.065 — 14.30.127 shall be under the general supervision and in accordance with regulations of the Department of Health and Social Services.
Alaska Stat. § 14.30.125 (2002)
Sec. 14.30.125. Immunization
If in the judgment of the commissioner of health and social services it is necessary for the welfare of the children or the general public in an area, the governing body of the school district shall require the children attending school in that area to be immunized against the diseases the commissioner of health and social services may specify.
Alaska Stat. § 14.45.100 (2002)
Sec. 14.45.100. Exemption
A religious or other private school that complies with AS 14.45.100 — 14.45.130 is exempt from other provisions of law and regulations relating to education except law and regulations relating to physical health, fire safety, sanitation, immunization, and physical examinations.
TITLE 4. EDUCATION AND EARLY DEVELOPMENT
CHAPTER 6. GOVERNMENT OF SCHOOLS
ARTICLE 1. GENERAL ADMINISTRATION
4 Alaska Admin. Code 06.055 (2002)
4 AAC 06.055. Immunizations required
(a) Before entry in a state public school district or nonpublic school offering pre-elementary education through the 12th grade, or any combination of these grades, a child shall be immunized against
(1) diphtheria, tetanus, polio, pertussis, measles, and rubella, except that pertussis is not required in children over six and rubella is not required in children 12 years or older; and
(2) beginning July 1, 2001, mumps, hepatitis A, and hepatitis B.
(b) This section does not apply if the child
(1) has a valid immunization certificate consisting of
(A) a statement by a physician listing the date that each required immunization was given; or
(B) a copy of a clinic or health center record listing the date that each required immunization was given;
(2) has a statement signed by a doctor of medicine (M.D.), doctor of osteopathy (D.O.), physician assistant, or advanced nurse practitioner licensed to practice in this state, stating that immunizations would, in that individual’s professional opinion, be injurious to the health of the child or members of the child’s family or household; or
(3) has an affidavit signed by his parent or guardian affirming that immunization conflicts with the tenets and practices of the church or religious denomination of which the applicant is a member.
(c) A student registering in a school in a community where regular medical services are not available on at least a weekly basis and who does not have the required immunizations, may be provisionally admitted to a pre-elementary, elementary or secondary program for a reasonable period of time for the prevailing circumstances but not exceeding 90 days after enrollment. No children will be provisionally admitted except in exceptional circumstances. Where exceptions are granted, they shall be reported to and discussed with the communicable disease section of the division of public health, Department of Health and Social Services, who will then be responsible for determining that the required immunizations are completed during the provisional period.
(d) If a parent or guardian is unable to pay the cost of immunization, or immunization is not available in the district or community, immunization shall be provided by state or federal public health services.
(e) Immunizations shall be recorded on each pupil’s permanent health record form.
(f) School districts shall initiate action to exclude from school any child to whom this section applies but who has not been immunized as required by this section.
AUTHORITY: AS 14.07.020; AS 14.30.125
TITLE 4. EDUCATION AND EARLY DEVELOPMENT
CHAPTER 62. CHILD CARE FACILITIES LICENSING
ARTICLE 5. CARE AND SERVICES
4 Alaska Admin. Code 62.450 (2002)
4 AAC 62.450. Health in child care facilities
(a) At or before admission of a child, a child care facility shall obtain from the child’s parent
(1) a valid immunization certificate; or
(2) evidence that the child is exempt from immunization.
(b) A valid immunization certificate is a copy of the child’s original immunization record showing that, in a manner consistent with the timetable prescribed by the Department of Health and Social Services childhood immunization schedule, the child has received, or has begun and is continuing to receive, immunizations for the child’s age against
(1) diphtheria, tetanus, polio, measles, and rubella;
(2) if the child is less than seven years of age, pertussis; and
(3) beginning July 1, 2001, mumps, hepatitis A, hepatitis B, chicken pox, and Haemophilus influenzae type B. The immunization record is limited to either or both a statement by a physician, listing the date that each required immunization was given, or a clinic or health center record, listing the date that each required immunization was given.
(c) Evidence of exemption from immunization must include one of the following:
(1) a statement signed by a doctor of medicine (M.D.), doctor of osteopathy (D.O.), physician assistant, or advanced nurse practitioner licensed in this state, stating that immunizations would, in that individual’s professional opinion, be injurious to the health of the child or members of the child’s family or household;
(2) an affidavit signed by the child’s parent or guardian, affirming that immunization conflicts with the tenets and practices of the church or religious denomination of which the parent or guardian is a member; or
(3) entry for a one day exemption that the child is attending the child care facility for the first time.
(d) A child care facility in a community where medical services are not available on at least a weekly basis may provisionally admit a child who does not have the immunization certificate required under (a) of this section until the certificate can be obtained, but for no longer than 60 days.
(e) A satisfactory immunization audit report from the Department of Health and Social Services division of public health during the previous licensure period will be accepted as evidence that the child care facility satisfied the requirements of (a) — (d) of this section.

Allows:

  • Medical exemptions
  • Religious exemptions
  • Philosophical (conscientious objector, personal belief) exemptions

TITLE 36. PUBLIC HEALTH AND SAFETY
CHAPTER 7.1. CHILD CARE PROGRAMS
ARTICLE 1. DAY CARE CENTERS
A.R.S. § 36-883 (2002)
§ 36-883. Standards of care; rules; classifications
A. The director of the department of health services shall prescribe reasonable rules regarding the health, safety and well being of the children to be cared for in a child care facility. These rules shall include standards for the following:
C. Any rule that relates to educational activities, physical examination, medical treatment or immunization shall include appropriate exemptions for children whose parents object on the ground that it conflicts with the tenets and practices of a recognized church or religious denomination of which the parent or child is an adherent or member.
TITLE 15. EDUCATION
CHAPTER 8. SCHOOL ATTENDANCE
ARTICLE 6. SCHOOL IMMUNIZATION
A.R.S. § 15-872 (2002)
§ 15-872. Proof of immunization; noncompliance; notice to parents; civil immunity
A. The director of the department of health services, in consultation with the superintendent of public instruction, shall develop by rule standards for documentary proof.
B. A pupil shall not be allowed to attend school without submitting documentary proof to the school administrator unless the pupil is exempted from immunization pursuant to section 15-873.
C. Each public school shall make full disclosure of the requirements and exemptions as prescribed in sections 15-872 and 15-873.
D. On enrollment, the school administrator shall suspend that pupil if the administrator does not have documentary proof and the pupil is not exempted from immunization pursuant to section 15-873.
E. Notwithstanding subsections B and D of this section, a pupil may be admitted to or allowed to attend a school if the pupil has received at least one dose of each of the required immunizations prescribed pursuant to section 36-672 and has established a schedule for the completion of required immunizations. The parent, guardian or person in loco parentis of a pupil shall present to the school administrator documentary proof of the immunizations received and a schedule prepared by the pupil’s physician or a health agency for completion of additional required immunizations.
F. The school administrator shall review the school immunization record for each pupil admitted or allowed to continue attendance pursuant to subsection E of this section at least twice each school year until the pupil receives all of the required immunizations and shall suspend a pupil as prescribed in subsection G of this section who fails to comply with the immunization schedule. Immunizations received by a pupil shall be entered in the pupil’s school immunization record.
G. Unless proof of an exemption from immunization pursuant to section 15-873 is provided, a pupil who is admitted or allowed to continue to attend and who fails to comply with the immunization schedule within the time intervals specified by the schedule shall be suspended from school attendance until documentary proof of the administration of another dose of each appropriate immunizing agent is provided to the school administrator.
H. The provisions of subsections B, D and E of this section do not apply to homeless pupils until the fifth calendar day after enrollment.
I. A school and its employees are immune from civil liability for decisions concerning the admission, readmission and suspension of a pupil which are based on a good faith implementation of the requirements of this article.
A.R.S. § 15-873 (2002)
§ 15-873. Exemptions; nonattendance during outbreak
A. Documentary proof is not required for a pupil to be admitted to school if one of the following occurs:
1. The parent or guardian of the pupil submits a signed statement to the school administrator stating that the parent or guardian has received information about immunizations provided by the department of health services, understands the risks and benefits of immunizations and the potential risks of non-immunization and that due to personal beliefs, the parent or guardian does not consent to the immunization of the pupil.
2. The school administrator receives written certification which is signed by the parent or guardian and by a physician, which states that one or more of the required immunizations may be detrimental to the pupil’s health and which indicates the specific nature and probable duration of the medical condition or circumstance which precludes immunization.
B. An exemption pursuant to subsection A, paragraph 2 is only valid during the duration of the circumstance or condition which precludes immunization.
C. Pupils who lack documentary proof of immunization shall not attend school during outbreak periods of communicable immunization-preventable diseases as determined by the department of health services or local health department. The department of health services or local health department shall transmit notice of this determination to the school administrator responsible for the exclusion of the pupils.
§ 36-672. Immunizations; department rules
A. Consistent with section 15-873, the director shall adopt rules prescribing required immunizations for school attendance, the approved means of immunization and indicated reinforcing immunizations for diseases, and identifying types of health agencies and health care providers which may sign a laboratory evidence of immunity. The rules shall include the required doses, recommended optimum ages for administration of the immunizations, persons who are authorized representatives to sign on behalf of a health agency and other provisions necessary to implement this article.
B. The director, in consultation with the superintendent of public instruction, shall develop by rule standards for documentary proof.
A.R.S. § 36-674 (2002)
§ 36-674. Providing proof of immunization
A physician, local health department or school nurse administering an immunization shall furnish documentary proof of immunization to the person immunized or, if that person is a child, to the child’s parent or guardian or the person in loco parentis of the child.

ARIZONA ADMINISTRATIVE CODE
TITLE 9. HEALTH SERVICES
CHAPTER 6. DEPARTMENT OF HEALTH SERVICES: COMMUNICABLE DISEASES
ARTICLE 7. VACCINE-PREVENTABLE DISEASES
A.A.C. § R9-6-702 (2002)
R9-6-702. Required Immunizations for Child Care or School Entry
A. Except as provided in R9-6-706, a school administrator or child care administrator shall:
1. Ensure that a child attending a school or child care has been immunized against each of the following diseases according to Table 1 or Table 2:
a. Diphtheria;
b. Tetanus;
c. Hepatitis A, for a child 2 through 5 years of age in child care in Maricopa County;
d. Hepatitis B;
e. Pertussis;
f. Poliomyelitis;
g. Measles (rubeola);
h. Mumps;
i. Rubella (German Measles); and
j. Haemophilus influenzae type b; and
2. If a child does not have proof of immunization according to Table 1 or Table 2, exclude the child from:
a. School entry; or
b. Child care, unless the child is immunized against the diseases listed in subsection (A)(1) within 15 days following entry.

B. Unless exempt according to R9-6-706, a child who has received a first dose of MMR but has not received a second dose of MMR shall:
1. Receive the second dose according to Table 2 and the following:
a. By September 1, 2002 for a child attending kindergarten through 4th grade or 7th through 9th grade;
b. By September 1, 2003 for a child attending kindergarten through 5th grade or 7th through 10th grade;
c. By September 1, 2004 for a child attending kindergarten through 11th grade; and
d. By September 1, 2005 for a child attending kindergarten through 12th grade; and
2. Be excluded from school entry by a school administrator until the requirements in Table 2 are met.

C. Unless exempt according to R9-6-706, a child who has not completed the three-dose Hep B series specified in Table 1 or 2 shall:
1. Receive the remaining doses according to Table 2 and the schedule in subsection (B)(1)(a) through (B)(1)(d), and
2. Be excluded from school entry by a school administrator until the requirements in Table 2 are met.

D. If the Department receives written notification from the CDC that there is a shortage of a vaccine for a disease listed in subsection (A)(1), or that the CDC is limiting the amount of a vaccine for a disease listed in subsection (A)(1), the Department shall:
1. Provide written notification to each school and child care in this state of the shortage or limitation of the vaccine;
2. Suspend compliance with subsections (A), (B), and (C); and
3. Upon receiving written notification from the CDC that the vaccine is available, notify each school and child care in this state:
a. That the vaccine is available, and
b. Of the time by which an individual is required to comply with subsections (A), (B), and (C).

E. The Department shall notify each school and child care in this state that the Department no longer requires compliance with subsections (A), (B), and (C) for a disease listed in subsection (A)(1) if:
1. The disease is declared eradicated by:
a. The World Health Organization, and
b. The Advisory Committee on Immunization Practices; and
2. The Department no longer recommends immunization against the disease.
A.A.C. § R9-6-706 (2002)
R9-6-706. Exemptions to Immunizations
A. A child who has reached a 5th birthday is exempt from the Hib immunization requirement.

B. A child who has reached a 7th birthday is exempt from the pertussis immunization requirement.

C. A child who submits laboratory evidence of immunity to a disease to a school or child care is not required to be immunized against that disease as a condition for school or child care entry.

D. A child attending a school, who submits documentary proof of exemption from immunization for personal beliefs that contains the information in A.R.S. § 15-873(A)(1), is exempt from the immunization requirements in this Article.

E. A child attending child care, who submits a written document for exemption from immunization that contains the child’s name, the child’s date of birth, a statement that the exemption is based upon religious beliefs, and the responsible person’s signature is exempt from the immunization requirements in this Article.

F. If a medical exemption is obtained, a physician shall identify each vaccine that is exempted.
1. The physician shall designate the exemption as either permanent or temporary.
2. If designated as a permanent medical exemption, the medical exemption lasts indefinitely.
3. If designated as a temporary medical exemption, a physician shall specify the date of termination of the temporary medical exemption.
a. A school or child care shall allow a child with a temporary medical exemption to attend school or child care until the exemption terminates.
b. A school administrator or a child care administrator shall notify the responsible person in writing of the date by which the child is required to complete all immunizations for which the child has a temporary medical exemption.

G. A school administrator or child care administrator shall record an exemption on the child’s immunization record.

Allows:

  • Medical exemptions
  • Religious exemptions
  • Philosophical (conscientious objector, personal belief) exemptions

Arkansas was the first state to add a philosophical exemption to vaccination in over 20 years.

ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS:
[*1] SECTION 1. Arkansas Code Section 6-18-702(d), requiring immunization of children, is amended to read as follows:
(d)(1) (A) THE STATE BOARD OF HEALTH SHALL PROMULGATE RULES AND REGULATIONS TO ENSURE THAT ALL EXEMPTIONS PROVIDED BY THIS SECTION SHALL HAVE A MINIMAL EFFECT ON THE HEALTH AND SAFETY OF ALL CHILDREN ATTENDING DAYCARE OR KINDERGARTEN THROUGH GRADE TWELVE (K-12).
(B) THE RULES SHALL PROVIDE FOR, BUT ARE NOT LIMITED TO, THE TRACKING OF THOSE CHILDREN WITH EXEMPTIONS SO THAT APPROPRIATE STEPS MAY BE TAKEN IN THE EVENT OF AN OUTBREAK OR EPIDEMIC.
(2) THE DEPARTMENT OF HEALTH, AND NO OTHER DEPARTMENT OR ENTITY, SHALL GRANT EXEMPTIONS PROVIDED FOR BY THIS SECTION.
(3) If, in the discretion of the health authority having jurisdiction or of any physician licensed to practice by the Arkansas State Medical Board, any person to whom this section applies shall be deemed to have a physical disability which may contraindicate vaccination, a certificate to that effect issued by the health officer may be accepted in lieu of a certificate of vaccination, provided that the exemption shall not apply when the disability shall have been removed.
(4)(A) The provisions of this section shall not apply if the parents or legal guardian of that child object thereto on the grounds that immunization conflicts with the religious tenets and practices of a recognized church or religious denomination of which OR PHILOSOPHICAL BELIEFS OF the parent or guardian is an adherent or member.
(B) THE PARENTS OR LEGAL GUARDIAN OF THE CHILD SHALL COMPLETE AN ANNUAL APPLICATION PROCESS DEVELOPED IN THE RULES AND REGULATIONS OF THE DEPARTMENT OF HEALTH FOR MEDICAL, RELIGIOUS, AND PHILOSOPHICAL EXEMPTIONS.
(C) THE RULES AND REGULATIONS DEVELOPED BY THE DEPARTMENT OF HEALTH FOR MEDICAL, RELIGIOUS, AND PHILOSOPHICAL EXEMPTIONS SHALL INCLUDE, BUT NOT BE LIMITED TO:
(I) NOTARIZED STATEMENT REQUESTING A RELIGIOUS, PHILOSOPHICAL, OR MEDICAL EXEMPTION FROM THE DEPARTMENT OF HEALTH BY THE PARENTS OR LEGAL GUARDIAN OF THE CHILD REGARDING THE OBJECTION;
(II) COMPLETION OF AN EDUCATIONAL COMPONENT DEVELOPED BY THE DEPARTMENT OF HEALTH THAT INCLUDES INFORMATION ON THE RISKS AND BENEFITS OF VACCINATION;
(III) AN INFORMED CONSENT FROM THE PARENTS OR GUARDIAN THAT SHALL INCLUDE A SIGNED STATEMENT OF REFUSAL TO VACCINATE BASED ON THE DEPARTMENT OF HEALTH REFUSAL TO VACCINATE FORM; AND
(IV) A SIGNED STATEMENT OF UNDERSTANDING THAT:
(A) AT THE DISCRETION OF THE DEPARTMENT OF HEALTH, THE UNIMMUNIZED CHILD OR INDIVIDUAL MAY BE REMOVED FROM DAYCARE OR SCHOOL DURING AN OUTBREAK IF THE CHILD OR INDIVIDUAL IS NOT FULLY VACCINATED; AND
(B) THE CHILD OR INDIVIDUAL SHALL NOT RETURN TO SCHOOL UNTIL THE OUTBREAK HAS BEEN RESOLVED AND THE DEPARTMENT OF HEALTH APPROVES THE RETURN TO SCHOOL.
(D) NO EXEMPTIONS MAY BE GRANTED UNDER THIS SUBDIVISION (D)(4), UNTIL THE APPLICATION PROCESS HAS BEEN IMPLEMENTED BY THE DEPARTMENT OF HEALTH AND COMPLETED BY THE APPLICANT.
(3) (5) Furthermore, the provisions of this section requiring pertussis vaccination shall not apply to any child with a sibling, either whole blood or half blood, who has had a serious adverse reaction to the pertussis antigen, which reaction resulted in a total permanent disability.
[*2] SECTION 2. Arkansas Code Section 6-60-504(b), concerning religious objections to immunization of college and university students, is amended to read as follows:
(b) (1) The provisions of this subchapter shall not apply if the individual furnishes to the college or university written proof from a church or denomination official that the immunization conflicts with the religious tenets and practices of the recognized church or religious denomination of A LETTER OF EXEMPTION FROM THE DEPARTMENT OF HEALTH.
(2)(A) THE INDIVIDUAL SHALL COMPLETE AN ANNUAL APPLICATION PROCESS DEVELOPED IN THE RULES AND REGULATIONS OF THE DEPARTMENT OF HEALTH FOR MEDICAL, RELIGIOUS, AND PHILOSOPHICAL EXEMPTIONS.
(B) THE RULES AND REGULATIONS DEVELOPED BY THE DEPARTMENT OF HEALTH FOR MEDICAL, RELIGIOUS, AND PHILOSOPHICAL EXEMPTIONS SHALL INCLUDE, BUT NOT BE LIMITED TO:
(I) NOTARIZED STATEMENT REQUESTING A RELIGIOUS, PHILOSOPHICAL, OR MEDICAL EXEMPTION FROM THE DEPARTMENT OF HEALTH BY THE INDIVIDUAL REGARDING THE OBJECTION
(II) COMPLETION OF AN EDUCATIONAL COMPONENT DEVELOPED BY THE DEPARTMENT OF HEALTH THAT INCLUDES INFORMATION ON THE RISKS AND BENEFITS OF VACCINATION;
(III) AN INFORMED CONSENT FROM THE INDIVIDUAL THAT SHALL INCLUDE A SIGNED STATEMENT OF REFUSAL TO VACCINATE BASED ON THE DEPARTMENT OF HEALTH REFUSAL TO VACCINATE FORM; AND
(IV) A SIGNED STATEMENT OF UNDERSTANDING THAT:
(A) AT THE DISCRETION OF THE DEPARTMENT OF HEALTH, THE UNIMMUNIZED CHILD OR INDIVIDUAL MAY BE REMOVED FROM DAYCARE OR SCHOOL DURING AN OUTBREAK IF THE CHILD OR INDIVIDUAL IS NOT FULLY VACCINATED; AND
(B) THE CHILD OR INDIVIDUAL SHALL NOT RETURN TO SCHOOL UNTIL THE OUTBREAK HAS BEEN RESOLVED AND THE DEPARTMENT OF HEALTH APPROVES THE RETURN TO SCHOOL.
(3) NO EXEMPTIONS MAY BE GRANTED UNDER THIS SUBSECTION (B), UNTIL THE APPLICATION PROCESS HAS BEEN IMPLEMENTED BY THE DEPARTMENT OF HEALTH AND COMPLETED BY THE APPLICANT.
[*3] SECTION 3. Arkansas Code Section 20-78-206(a)(2)(B), concerning exemptions from immunization in child care facilities, is amended to read as follows:
(B)(i) The provisions of subdivision (a)(2)(A) of this section pertaining to immunizations shall not apply if the parents or legal guardian of that child object thereto on the grounds that such immunization conflicts with the religious tenets and practices of a recognized church or religious denomination of which OR PHILOSOPHICAL BELIEFS OF the parent or guardian is an adherent or member.
(II) THE PARENTS OR LEGAL GUARDIAN OF THE CHILD SHALL COMPLETE AN ANNUAL APPLICATION PROCESS DEVELOPED IN THE RULES AND REGULATIONS OF THE DEPARTMENT OF HEALTH FOR MEDICAL, RELIGIOUS AND PHILOSOPHICAL EXEMPTIONS.
(A) THE RULES AND REGULATIONS DEVELOPED BY THE DEPARTMENT OF HEALTH FOR MEDICAL, RELIGIOUS AND PHILOSOPHICAL EXEMPTIONS SHALL INCLUDE BUT NOT BE LIMITED TO:
(1) NOTARIZED STATEMENT REQUESTING A RELIGIOUS, PHILOSOPHICAL, OR MEDICAL EXEMPTION FROM THE DEPARTMENT OF HEALTH BY THE PARENTS OR LEGAL GUARDIAN OF THE CHILD REGARDING THE OBJECTION;
(II) COMPLETION OF AN EDUCATIONAL COMPONENT DEVELOPED BY THE DEPARTMENT OF HEALTH THAT INCLUDES INFORMATION ON THE RISKS AND BENEFITS OF VACCINATION;
(3) AN INFORMED CONSENT FROM THE PARENTS OR GUARDIAN THAT SHALL INCLUDE A SIGNED STATEMENT OF REFUSAL TO VACCINATE BASED ON THE DEPARTMENT OF HEALTH REFUSAL TO VACCINATE FORM; AND
(4) A SIGNED STATEMENT OF UNDERSTANDING THAT:
(A) AT THE DISCRETION OF THE DEPARTMENT OF HEALTH, THE UNIMMUNIZED CHILD OR INDIVIDUAL MAY BE REMOVED FROM DAYCARE OR SCHOOL DURING AN OUTBREAK IF THE CHILD OR INDIVIDUAL IS NOT FULLY VACCINATED; AND
(B) THE CHILD OR INDIVIDUAL SHALL NOT RETURN TO SCHOOL UNTIL THE OUTBREAK HAS BEEN RESOLVED AND THE DEPARTMENT OF HEALTH APPROVES THE RETURN TO SCHOOL.
(B) NO EXEMPTIONS MAY BE GRANTED UNDER THIS SUBDIVISION (D)(4), UNTIL THE APPLICATION PROCESS HAS BEEN IMPLEMENTED BY THE DEPARTMENT OF HEALTH AND COMPLETED BY THE APPLICANT.
(ii)
(III) Furthermore, the provisions of subdivision (a)(2)(A) of this section requiring pertussis vaccination shall not apply to any child with a sibling, either whole blood or half blood, who has had a serious adverse reaction to the pertussis antigen, which reaction resulted in a total permanent disability.
[*4] SECTION 4. Arkansas Code Section 20-7-306, concerning reports and assistance by the Department of Health to the House and Senate Interim Committees on Public Health, Welfare, and Labor, is amended to add an additional subsection to read as follows:
(C)(1)(A) WITH REGARD TO SECTIONS 6-18-702(D), 6-60-504(B), AND 20-78-206(A)(2)(B), THE DEPARTMENT OF HEALTH SHALL REPORT EVERY SIX (6) MONTHS TO THE HOUSE AND SENATE INTERIM COMMITTEES OF PUBLIC HEALTH, WELFARE, AND LABOR REGARDING.
(I) THE GEOGRAPHIC PATTERNS OF EXEMPTIONS, VACCINATION RATES, AND EXEMPTIONS IN THOSE AREAS AS WELL AS THE REST OF THE STATE, AND
(II) DISEASE INCIDENCE OF VACCINE PREVENTABLE DISEASE COLLECTED BY THE DEPARTMENT OF HEALTH.
(B) THE COLLECTIONS OF EXEMPTION INFORMATION SHALL BEGIN JANUARY 4, 2004.
(C) REPORTS SHALL BEGIN AT THE FIRST INTERIM MEETING OF THE HOUSE AND SENATE INTERIM COMMITTEES OF PUBLIC HEALTH, WELFARE, AND LABOR.
(2) THE DEPARTMENT OF HEALTH SHALL FACILITATE A STUDY TO INCLUDE RELIGIOUS, PHILOSOPHICAL, AND MEDICAL EXEMPTION PATTERNS AND THE INCIDENCE OF DISEASE IN THE STATE.
(A) THE STUDY SHALL INCLUDE:
(I) AN EVALUATION OF THE STATE’S IMMUNIZATION POLICIES;
(II) THE INCIDENCE OF DISEASE IN ARKANSAS AND OTHER STATES; AND
(III) A RISK EVALUATION OF SPECIFIC POPULATIONS IN ARKANSAS.
(B) THE STUDY SHALL BEGIN JULY 3, 2003, AND SHALL BE COMPLETED BY DECEMBER 31, 2004.
(C) THE STUDY SHALL BE A COLLABORATIVE EFFORT COORDINATED BY THE DEPARTMENT OF HEALTH.
(3) THE DEPARTMENT OF HEALTH SHALL ISSUE A FINAL ASSESSMENT ON THE IMPACT OF THIS SUBSECTION (C) TO THE SENATE AND HOUSE PUBLIC HEALTH, WELFARE, AND LABOR COMMITTEES DURING THE 2005 REGULAR SESSION OF THE GENERAL ASSEMBLY.
[*5] SECTION 4. EMERGENCY CLAUSE. IT IS FOUND AND DETERMINED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS THAT THE FEDERAL DISTRICT COURTS FOR THE EASTERN AND WESTERN DISTRICTS OF ARKANSAS HAVE HELD THE STATE’S SCHOOL IMMUNIZATION STATUTE TO BE UNCONSTITUTIONAL, THAT THE COURTS HAVE STAYED THE EFFECT OF THE FINDING, THAT IF THE STAY IS LIFTED BEFORE THIS ACT BECOMES EFFECTIVE, SOME STUDENTS WILL BE EXCLUDED FROM SCHOOL ATTENDANCE. THEREFORE, AN EMERGENCY IS DECLARED TO EXIST AND THIS ACT BEING IMMEDIATELY NECESSARY FOR THE PRESERVATION OF THE PUBLIC PEACE, HEALTH, AND SAFETY SHALL BECOME EFFECTIVE ON: April 1, 2000

Contact:

Australian Council for Immunization Information
Post Office Box 721
Turramurra, NSW 2074
Pager 02-9962-5127
Fax 02-9487-2275
Email acii@ozemail.com.au

The Australian Vaccination Network
Post Office Box 177
Bangalow NSW 2479
Phone 02-6687-1699
Fax 02-668-2032
Email van@mypostbox.com

Exemption forms
http://www.humanservices.gov.au/spw/customer/forms/resources/immu11.1310p.pdf

 

C

Allows:

  • Medical exemptions
  • Religious exemptions
  • Philosophical (conscientious objector, personal belief) exemptions

Contact:
Vaccine Information & Awareness (VIA)
12799 La Tortola
San Diego, CA 92129
Contact Name Karin Schumacher
Phone 619-484-3197
Fax 619-484-1187

California Department of Health Services, Division of Communicable Disease Control- Immunization Branch:
EDUCATION CODE
TITLE 2. ELEMENTARY AND SECONDARY EDUCATION
DIVISION 4. Instruction and Services
PART 27. Pupils
CHAPTER 2. Compulsory Education Law
ARTICLE 2. Persons Excluded
Cal Ed Code § 48216 (2003)
§ 48216. Exclusion of pupil who has not been immunized; Notice to parents
(a) The county office of education or the governing board of the school district of attendance shall exclude any pupil who has not been immunized properly pursuant to Chapter 1 (commencing with Section 120325) of Part 2 of Division 105 of the Health and Safety Code.

(b) The governing board of the district shall notify the parent or guardian of the pupil that they have two weeks to supply evidence either that the pupil has been properly immunized, or that the pupil is exempted from the immunization requirement pursuant to Section 120365 or 120370 of the Health and Safety Code

(c) The governing board of the district, in the notice, shall refer the parent or guardian of the pupil to the pupil’s usual source of medical care to obtain the immunization, or if no usual source exists, either refer the parent or guardian to the county health department, or notify the parent or guardian that the immunizations will be administered at a school of the district.
EDUCATION CODE
TITLE 1. General Education Code Provisions
DIVISION 1. General Education Code Provisions
PART 6. Education Programs–State Master Plans
CHAPTER 2. Child Care and Development Services Act
ARTICLE 10. Administration
Cal Ed Code § 8263 (2003)
§ 8263. Rules and regulations on eligibility and other matters; Transfer of enrollment prior to termination; Physical examination; Fees; Guidelines
(d) A physical examination and evaluation, including age-appropriate immunization, shall be required prior to, or within six weeks of, enrollment. No standard, rule, or regulation shall require medical examination or immunization for admission to a child care and development program of a child whose parent or guardian files a letter with the governing board of the child care and development program stating that the medical examination or immunization is contrary to his or her religious beliefs, or provide for the exclusion of a child from the program because of a parent or guardian having filed the letter. However, whenever there is good cause to believe that a child is suffering from a recognized contagious or infectious disease, the child shall be temporarily excluded from the program until the governing board of the child care and development program is satisfied that any contagious or infectious disease does not exist.
HEALTH AND SAFETY CODE
DIVISION 105. Communicable Disease Prevention And Control
PART 2. Immunizations
CHAPTER 1. Educational and Child Care Facility Immunization Requirements
Cal Health & Saf Code § 120325 (2003)
§ 120325. Legislative intent
In enacting Chapter 1 (commencing with Section 120325, but excluding Section 120380) and in enacting Sections 120400, 120405, 120410, and 120415, it is the intent of the Legislature to provide:

(a) A means for the eventual achievement of total immunization of appropriate age groups against the following childhood diseases:

(1) Diphtheria.
(2) Hepatitis B.
(3) Haemophilus influenzae type b.
(4) Measles.
(5) Mumps.
(6) Pertussis (whooping cough).
(7) Poliomyelitis.
(8) Rubella.
(9) Tetanus.
(10) Varicella (chickenpox). This paragraph shall be operative only to the extent that funds for this purpose are appropriated in the annual Budget Act.
(11) Any other disease that is consistent with the most current recommendations of the United States Public Health Services’ Centers for Disease Control Immunization Practices Advisory Committee and the American Academy of Pediatrics Committee of Infectious Diseases, and deemed appropriate by the department.

(b) That the persons required to be immunized be allowed to obtain immunizations from whatever medical source they so desire, subject only to the condition that the immunization be performed in accordance with the regulations of the department and that a record of the immunization is made in accordance with the regulations.

(c) Exemptions from immunization for medical reasons or because of personal beliefs.

(d) For the keeping of adequate records of immunization so that health departments, schools, and other institutions, parents or guardians, and the persons immunized will be able to ascertain that a child is fully or only partially immunized, and so that appropriate public agencies will be able to ascertain the immunization needs of groups of children in schools or other institutions.

(e) Incentives to public health authorities to design innovative and creative programs that will promote and achieve full and timely immunization of children
Cal Health & Saf Code § 120335 (2003)
§ 120335. “Governing authority”; Unconditional admission; Immunization requirements; Documentation; Specification of immunizing agents
(a) As used in Chapter 1 (commencing with Section 120325, but excluding Section 120380), and as used in Sections 120400, 120405, 120410, and 120415, the term “governing authority” means the governing board of each school district or the authority of each other private or public institution responsible for the operation and control of the institution or the principal or administrator of each school or institution.

(b) The governing authority shall not unconditionally admit any person as a pupil of any private or public elementary or secondary school, child care center, day nursery, nursery school, family day care home, or development center, unless prior to his or her first admission to that institution he or she has been fully immunized. The following are the diseases for which immunizations shall be documented:

(1) Diphtheria.
(2) Haemophilus influenzae type b, except for children who have reached the age of four years and six months.
(3) Measles.
(4) Mumps, except for children who have reached the age of seven years.
(5) Pertussis (whooping cough), except for children who have reached the age of seven years.
(6) Poliomyelitis.
(7) Rubella.
(8) Tetanus.
(9) Hepatitis B for all children entering the institutions listed in this subdivision at the kindergarten level or below on or after August 1, 1997.
(10) Varicella (chickenpox), effective July 1, 2001. Persons already admitted into California public or private schools at the kindergarten level or above before July 1, 2001, shall be exempt from the varicella immunization requirement for school entry. This paragraph shall be operative only to the extent that funds for this purpose are appropriated in the annual Budget Act.

The department may adopt emergency regulations to implement this paragraph including, but not limited to, requirements for documentation and immunization status reports, in accordance with the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code). The initial adoption of emergency regulations shall be deemed to be an emergency and considered by the Office of Administrative Law as necessary for the immediate preservation of the public peace, health and safety, or general welfare. Emergency regulations adopted pursuant to this paragraph shall remain in effect for no more than 180 days.

(11) Any other disease deemed appropriate by the department, taking into consideration the recommendations of the United States Public Health Services’ Centers for Disease Control Immunization Practices Advisory Committee and the American Academy of Pediatrics Committee of Infectious Diseases.

(c) On and after July 1, 1999, the governing authority shall not unconditionally admit any pupil to the 7th grade level, nor unconditionally advance any pupil to the 7th grade level, of any of the institutions listed in subdivision (b) unless the pupil has been fully immunized against hepatitis B.

(d) The department may specify the immunizing agents which may be utilized and the manner in which immunizations are administered
Cal Health & Saf Code § 120360 (2003)
§ 120360. Exceptions
The requirements of Chapter 1 (commencing with Section 120325, but excluding Section 120380) and of Sections 120400, 120405, 120410, and 120415 shall not apply to any person 18 years of age or older, or to any person seeking admission to a community college.

Cal Health & Saf Code § 120365 (2003)
§ 120365. Letter or affidavit stating beliefs opposed to immunization; Temporary exclusion from school
Immunization of a person shall not be required for admission to a school or other institution listed in Section 120335 if the parent or guardian or adult who has assumed responsibility for his or her care and custody in the case of a minor, or the person seeking admission if an emancipated minor, files with the governing authority a letter or affidavit stating that the immunization is contrary to his or her beliefs. However, whenever there is good cause to believe that the person has been exposed to one of the communicable diseases listed in subdivision (a) of Section 120325, that person may be temporarily excluded from the school or institution until the local health officer is satisfied that the person is no longer at risk of developing the disease.
Cal Health & Saf Code § 120370 (2003)
§ 120370. Statement by physicians contraindicating immunization
If the parent or guardian files with the governing authority a written statement by a licensed physician to the effect that the physical condition of the child is such, or medical circumstances relating to the child are such, that immunization is not considered safe, indicating the specific nature and probable duration of the medical condition or circumstances that contraindicate immunization, that person shall be exempt from the requirements of Chapter 1 (commencing with Section 120325, but excluding Section 120380) and Sections 120400, 120405, 120410, and 120415 to the extent indicated by the physician’s statement.
TITLE 17. PUBLIC HEALTH
DIVISION 1. STATE DEPARTMENT OF HEALTH SERVICES
CHAPTER 4. PREVENTIVE MEDICAL SERVICE
SUBCHAPTER 8. IMMUNIZATION AGAINST POLIOMYELITIS, DIPHTHERIA, PERTUSSIS, TETANUS, MEASLES (RUBEOLA), RUBELLA, HAEMOPHILUS INFLUENZAE TYPE B (HIB), MUMPS, AND HEPATITIS B
ARTICLE 1. DEFINITIONS
17 CCR 6000 (2003)
§ 6000. Admission
“Admission” means a pupil’s first entry in a given public or private elementary or secondary school, child care center, day nursery, nursery school, family day care home, or development center. “Admission” also denotes a pupil’s re-entry to one of these institutions after withdrawing from a previous enrollment.
(a) “Unconditional admission” is admission based upon documentation of receipt of all required immunizations or upon documentation of a permanent medical exemption or of a personal beliefs exemption to immunization in accordance with Section 6051.
(b) “Conditional admission” is admission based upon either documentation of having received some but not all required immunizations and of not being due for any vaccine dose at the time of entry or upon documentation of a temporary medical exemption to immunization in accordance with Section 6050. Continued attendance after conditional admission is contingent upon receipt of the remaining required immunizations in accordance with Sections 6020 and 6035.
17 CCR 6020 (2003)
§ 6020. Required Immunizations
(a) The required immunizations for admission to and attendance at a public or private elementary or secondary school, child care center, day nursery, nursery school, family day care home, or developmental center shall be those set forth, according to age, in Table 1.
(b) In Table 1 of Section 6020 and in Table 2 of Section 6035, DTP (or DPT) means diphtheria and tetanus toxoids and pertussis vaccine, including DTaP vaccine. DT (or TD) and Td (or dT) means diphtheria and tetanus toxoids.
(c) For pupils who have reached their seventh birthday, a history of any preparations containing both diphtheria and tetanus toxoids (DTP, DT, Td, etc.) shall be acceptable as meeting the requirement for tetanus and diphtheria toxoids that is set forth in Table 1.
(d) Pupils who have reached their seventh birthday shall be exempt from the pertussis and mumps immunization requirements.
(e) Combination vaccines that include measles, mumps, and rubella components shall be acceptable as meeting the requirements for these vaccines that are set forth in Table 1.
(f) For pupils entering or advancing to the seventh grade, immunization requirements are set forth in Table 1.
(g) Pupils already admitted to California public and private schools at the Kindergarten level or above before July 1, 2001 are exempt from the Varicella (chickenpox) requirement as set forth in Table 1.
1 Oral polio vaccine (OPV) or inactivated polio vaccine (IPV) or any combination of these vaccines is acceptable.
2 Applies only to children entering at kindergarten level (or at first grade level if kindergarten skipped) or below on or after August 1, 1997.
3 Required only for children who have not reached the age of 4 years 6 months.
4 Applies only to children (of any age) entering or advancing to the seventh grade on or after July 1, 1999.
5 Children admitted to California schools at the Kindergarten level or above before July 1, 2001 are exempt from this requirement.
17 CCR 6025 (2003)
§ 6025. Unconditional Admission
Any pupil age 18 months or older who has received all the immunizations against poliomyelitis, diphtheria, tetanus, pertussis, measles (rubeola), rubella, Haemophilus influenzae type B, mumps, hepatitis B and varicella (chickenpox) required for his or her age, as defined in Table 1, Section 6020, or who has documented a permanent medical exemption or a personal beliefs exemption to immunization in accordance with Section 6051, shall be admitted unconditionally as a pupil to a given public or private elementary or secondary school, child care center, day nursery, nursery school, family day care home, or development center. However, for some pupils admitted unconditionally to a child care center, day nursery, nursery school, family day care home, or development center, an additional dose of DTP and/or polio vaccine will be required for admission to school at kindergarten level and above, as indicated in Table 1, Section 6020.
17 CCR 6051 (2003)
§ 6051. Unconditional Admission with Permanent Medical Exemption or Personal Beliefs Exemption
A pupil with a permanent medical exemption or a personal beliefs exemption to immunization shall be admitted unconditionally. A permanent medical exemption shall be granted upon the filing with the governing authority of a written statement from a licensed physician to the effect that the physical condition of the pupil or medical circumstances relating to the pupil are such that immunization is permanently not indicated. The fact of the permanent medical exemption shall be recorded on the California School Immunization Record, PM 286 (1/02) as provided in Section 6070. A permanent medical exemption may be provided for one or more vaccines. A physician may provide a written statement that the pupil is medically exempt from the measles (rubeola) and/or varicella (chickenpox) requirements as a result of having had measles (rubeola) and/or varicella (chickenpox) disease, respectively. A physician may provide a written statement that the pupil is medically exempt from the rubella and/or mumps requirement as a result of having had laboratory confirmed illness with the corresponding disease. A personal beliefs exemption shall be granted upon the filing with the governing authority of a letter or affidavit from the pupil’s parent or guardian or adult who has assumed responsibility for his or her care and custody in the case of a minor, or the person seeking admission if an emancipated minor, that such immunization is contrary to his or her beliefs. The fact of the personal beliefs exemption shall be recorded on the California School Immunization Record, PM 286 (1/02). A pupil with an exemption which is not based on pre-existing immunity to disease may be subject to exclusion pursuant to Section 6060.

Contact:
Association for Vaccine Damaged Children
67 Shier
Winnipeg, Manitoba R3R 2H2
Phone 204-895-9192 or 204-896-0971
Call or write for information.

Current Statutes & Laws (English):
http://www.e-laws.gov.on.ca/html/statutes/english/elaws_statutes_90i01_e.htm

Current Statutes & Laws (French):
http://www.e-laws.gov.on.ca/html/statutes/french/elaws_statutes_90i01_f.htm

HEALTH CANADA STATEMENT ON IMMUNIZATION
“Unlike some countries, immunization is not mandatory in Canada; it cannot be made mandatory because of the Canadian Constitution. Only three provinces have legislation or regulations under their health-protection acts to require proof of immunization for school entrance. Ontario and New Brunswick require proof for diphtheria, tetanus, polio, measles, mumps, and rubella immunization. In Manitoba, only measles vaccination is covered. It must be emphasized that, in these three provinces, exceptions are permitted for medical or religious grounds and reasons of conscience; legislation and regulations must not be interpreted to imply compulsory immunization. ”

Allows:

  • Medical exemptions
  • Religious exemptions
  • Philosophical (conscientious objector, personal belief) exemptions

TITLE 25. HEALTH
DISEASE CONTROL
ARTICLE 4. DISEASE CONTROL
PART 9. SCHOOL ENTRY IMMUNIZATION
C.R.S. 25-4-902 (2002)
25-4-902. Immunization prior to attending school
(1) Except as provided in section 25-4-903, no child shall attend any school in the state of Colorado on or after the dates specified in section 25-4-906 (4) unless he or she has presented the following to the appropriate school official:
(a) An up-to-date certificate of immunization from a licensed physician or authorized representative of the department of public health and environment or local health department stating that such child has received immunization against communicable diseases as specified by the state board of health, based on recommendations of the advisory committee on immunization practices of the United States department of health and human services or the American academy of pediatrics; or
(b) A written authorization signed by one parent or guardian or an authorization signed by the emancipated child requesting that local health officials administer the immunizations.
(c) (Deleted by amendment, L. 97, p. 408, § 1, effective July 1, 1997.)
(2) If the student’s certificate of immunization is not up-to-date according to the requirements of the state board of health, the parent or guardian or the emancipated student or the student eighteen years of age or older shall submit to the school, within fourteen days after receiving direct personal notification that the certificate is not up-to-date, documentation that the next required immunization has been given and a written plan for completion of all required immunizations. The scheduling of immunizations in the written plan shall follow medically recommended minimum intervals approved by the state board of health. If the student begins but does not continue or complete the written plan, he or she shall be suspended or expelled pursuant to this part 9.
C.R.S. 25-4-903 (2002)
25-4-903. Exemptions from immunization
(1) (Deleted by amendment, L. 97, p. 409, § 2, effective July 1, 1997.)
(2) It is the responsibility of the parent or legal guardian to have his or her child immunized unless the child is exempted pursuant to this section. A student shall be exempted from receiving the required immunizations in the following manner:
(a) By submitting to the student’s school certification from a licensed physician that the physical condition of the student is such that one or more specified immunizations would endanger his or her life or health or is medically contraindicated due to other medical conditions; or
(b) By submitting to the student’s school a statement of exemption signed by one parent or guardian or the emancipated student or student eighteen years of age or older that the parent, guardian, or student is an adherent to a religious belief whose teachings are opposed to immunizations or that the parent or guardian or the emancipated student or student eighteen years of age or older has a personal belief that is opposed to immunizations.
(3) The state board of health may provide, by regulation, for further exemptions to immunization based upon sound medical practice.
(4) All information distributed to parents by school districts regarding immunization shall inform them of their rights under subsection (2) of this section.
C.R.S. 25-4-904 (2002)
25-4-904. Rules and regulations – immunization rules – rule-making authority of state board of health
(1) The state board of health shall establish rules and regulations for administering this part 9. Such rules and regulations shall establish which immunizations shall be required and the manner and frequency of their administration and shall conform to recognized standard medical practices. Such rules and regulations may also require the reporting of statistical information and names of non-compliers by the schools. The department of public health and environment shall administer and enforce the immunization requirements.
(2) All rule-making authority granted to the state board of health under the provisions of this article is granted on the condition that the general assembly reserves the power to delete or rescind any rule of the board. All rules promulgated pursuant to this subsection (2) shall be subject to sections 24-4-103 (8) (c) and (8) (d) and 24-4-108, C.R.S.

25-4-908. When exemption from immunization not recognized
If at any time there is, in the opinion of the state department of public health and environment or local department of health, danger of an epidemic from any of the communicable diseases for which an immunization is required pursuant to the rules and regulations promulgated pursuant to section 25-4-904, no exemption or exception from immunization against such disease shall be recognized. Quarantine by the state department of public health and environment or local department of health is hereby authorized as a legal alternative to immunization.
C.R.S. 25-4-1704 (2002)
25-4-1704. Infant immunization program – delegation of authority to immunize minor
(1) There is hereby created in the department an infant immunization program which is established to immunize infants against vaccine preventable disease. Such program shall be implemented on and after January 1, 1993.
(2) Every parent, legal guardian, or person vested with legal custody or decision-making responsibility for the medical care of a minor, or person otherwise responsible for the care of an infant residing in this state, shall be responsible for having such infant vaccinated in compliance with the schedule of immunization established by the board of health; except that, failure to vaccinate a child in accordance with this subsection (2) shall not constitute sufficient grounds for any insurance company to deny a claim submitted on behalf of a child who develops a vaccine preventable disease.
(2.5) (a) Subject to the provisions of this subsection (2.5), a parent, legal guardian, person vested with legal custody of a minor or decision-making responsibility for the medical care of a minor, or such other adult person responsible for the care of a minor in this state, other than any employee of a licensed child care center in which the minor is enrolled, may delegate, verbally or in writing, that person’s authority to consent to the immunization of a minor to a stepparent, an adult relative of first or second degree of kinship, or an adult child care provider who has care and control of the minor. Any immunization administered pursuant to a delegation of authority under this subsection (2.5) shall be administered only at a health care clinic, hospital, office of a private practitioner, or county public health clinic.
(b) If a parent, legal guardian, person vested with legal custody of a minor or decision-making responsibility for the medial care of a minor, or other adult person responsible for the care of a minor in this state verbally delegates his or her authority to consent to the immunization of a minor under this subsection (2.5), the person to whom such authority is thereby delegated shall confirm the verbal delegation in writing and shall verbally relay any relevant health history to the administering practitioner. The practitioner administering the vaccination shall include the written confirmation in the minor’s medical record. If a parent, legal guardian, person vested with legal custody of a minor or decision-making responsibility for the medical care of a minor, or other adult person responsible for the care of a minor in this state delegates his or her authority to consent to the immunization of a minor under this subsection (2.5) in writing, such writing shall include the relevant health history, and the practitioner administering the vaccination shall include a copy of the written delegation of authority in the minor’s medical record.
(c) A person who consents to the immunization of a minor pursuant to a delegation of authority under this subsection (2.5) shall provide the practitioner with sufficient and accurate health information about the minor for whom the consent is given and, if necessary, sufficient and accurate health information about the minor’s family to enable the practitioner to assess adequately the risks and benefits inherent in the proposed immunization and to determine whether the immunization is advisable.
(d) A person may not consent to the immunization of a minor pursuant to this subsection (2.5) if:
(I) The person has actual knowledge that the parent, legal guardian, person vested with legal custody of a minor or decision-making responsibility for the medical care of a minor, or other adult person responsible for the care of a minor in this state has expressly refused to give consent to the immunization; or
(II) The parent, legal guardian, person vested with legal custody of a minor or decision-making responsibility for the medical care of a minor, or other adult person responsible for the care of a minor in this state has told the person that the person may not consent to the immunization of the minor or, in the case of a written authorization, has withdrawn the authorization in writing.
(3) In addition to the immunization obligations set forth in section 25-4-905, relating to the immunization of indigent children, and except as provided in subsection (4) of this section, the department shall provide at public expense, subject to available appropriations, systematic immunizations to those infants that are not exempt from such immunization pursuant to paragraph (a) or (b) of subsection (4) of this section. The manner and frequency of vaccine administration shall conform to recognized standards of medical practice which are necessary for the protection of public health.
(4) An infant shall be exempted from receiving the required immunizations:
(a) Upon submitting certification from a licensed physician that the physical condition of the infant is such that one or more specified immunizations would endanger the infant’s life or health; or
(b) Upon submitting a statement signed by one parent or guardian that such parent or guardian adheres to a religious belief whose teachings are opposed to immunizations, or that such parent or guardian has a personal belief that is opposed to immunization.

Allows:

  • Medical exemptions
  • Religious exemptions

TITLE 10 EDUCATION
DEPARTMENT OF PUBLIC HEALTH
SCHOOL-RELATED IMMUNIZATIONS
Regs., Conn. State Agencies § 10-204a-1 (2003)
Sec. 10-204a-1. Definitions
As used in Sections 10-204a-2 through 10-204a-4 of the Regulations of Connecticut State Agencies:
(a) “Commissioner” means the commissioner of public health.
(b) “Department” means the department of public health.
(c) “Local health authority” means and includes the town, city, borough and local district director of health, local superintendent and commissioner of public health and any officer or person having the usual powers and duties of a local director of health.
(d) “Medically contraindicated immunization” means an immunization that is not in the best health interest of an individual as determined by a physician licensed to practice medicine in the United States and in accordance with:
(1) the then current recommendation of the United States Public Health Service Advisory Committee on Immunization Practices, Centers for Disease Control or American Academy of Pediatrics Committee on Infectious Diseases; or
(2) written approval of the commissioner for any case not resolvable by reference to the recommendations specified in subdivision (1) of this subsection.
REGULATIONS OF CONNECTICUT STATE AGENCIES
TITLE 10 EDUCATION
DEPARTMENT OF PUBLIC HEALTH
IMMUNIZATION OF SCHOOL CHILDREN
Regs., Conn. State Agencies § 10-204a-2a (2003)
Sec. 10-204a-2a. Adequate immunization
(a) Measles. An individual shall be considered adequately protected against measles if that individual:
(1) is enrolled in preschool and is less than four (4) years of age and was immunized by use of live attenuated measles vaccine on or after that individual’s first birthday; or
(2) is or has been enrolled in kindergarten on or after August 2000 and was immunized against measles by use of two (2) doses of a live attenuated measles vaccine given at least thirty (30) days apart, the first on or after that individual’s first birthday; or
(3) is or has been enrolled in seventh grade after September 1992 and had two (2) doses of a live attenuated measles vaccine, the first on or after that individual’s first birthday; or
(4) has had protection against measles confirmed in writing by a physician, physician assistant or advanced practice registered nurse based on specific blood testing by a certified laboratory.
(b) Rubella. An individual shall be considered adequately protected against rubella, if that individual:
(1) was immunized at one (1) year or older with a rubella vaccine; or
(2) has had protection against rubella confirmed in writing by specific blood testing conducted by a certified laboratory.
(c) Poliomyelitis
(1) An individual eighteen (18) months of age or older shall be considered adequately protected against poliomyelitis if that individual has had a minimum of (3) doses of either trivalent oral polio vaccine (TOPV) or inactivated polio vaccine (IPV), two (2) doses of polio vaccine given at least four (4) weeks apart and a third dose given at least two (2) months after the previous dose.
(2) For individuals enrolled in grades kindergarten through twelve (12) and at least forty-eight (48) months of age, at least one (1) dose of polio vaccine must been given on or after the fourth birthday.
(d) Diphtheria, Tetanus, Pertussis (DTP)
(1) An individual eighteen to seventy-one (18-71) months of age shall be considered adequately protected against diphtheria, tetanus and pertussis if such individual was immunized with a minimum of four (4) doses of diphtheria, tetanus, and pertussis toxoid, three (3) doses given at a minimum of four (4) week intervals followed by a fourth DTP dose at least six (6) months after the third.
(2) For individuals forty eight (48) to seventy-one (48-71) months of age and enrolled in grades kindergarten and above, at least one (1) dose of DTP vaccine must have been given on or after the fourth birthday.
(3) An individual seventy-two (72) months of age or older shall be considered adequately protected if such individual was immunized with a minimum of two (2) doses of tetanus, diphtheria toxoid (td) at a minimum of four (4) week intervals, followed by a third dose of tetanus, diphtheria toxoid at least six (6) months after the second dose and on or after the fourth birthday.
(e) Mumps. An individual shall be considered adequately protected against mumps if such individual:
(1) was immunized at one (1) year of age or older with live mumps vaccine, or
(2) has protection against mumps confirmed in writing by a physician based on specific blood testing by a certified laboratory.
(f) Hemophilus influenzae Type b (Hib). An individual shall be considered adequately protected against Hib invasive disease if such individual:
(1) was immunized before age five (5) years with a single dose of Hib vaccine given at age twelve (12) months or older, or
(2) is currently age five (5) years or older, or
(3) had a natural laboratory confirmed infection with hemophilus influenzae type b at age twenty-four (24) months or older confirmed in writing by a physician.
(g) Hepatitis B (HBV)
(1) An individual born January 1, 1994, or later shall be considered adequately protected against Hepatitis B if that individual:
(A) was immunized with three (3) doses of Hepatitis B vaccine, as follows two (2) doses given at least four (4) weeks apart followed by a third dose at least four (4) months after the second; or
(B) has had protection against Hepatitis B confirmed in writing by a physician based on specific blood testing conducted by a certified laboratory.
An individual born before January 1, 1994, and enrolled in seventh (7th) grade in August 2000 or later, shall have begun vaccination against Hepatitis B to enter seventh (7th) grade. Such individual shall be considered to have begun vaccination against Hepatitis B if that individual:
(A) was immunized with at least one (1) dose of Hepatitis B vaccine at the time of seventh (7th) grade entry; or
(B) has had protection against Hepatitis B confirmed in writing by specific blood testing conducted by a certified laboratory.
(3) An individual born before January 1, 1994 and enrolled in eighth (8th) grade in August 2001 or later, shall be adequately protected against Hepatitis B to enter eighth (8th) grade. Such individual shall be considered adequately protected against Hepatitis B if that individual:
(A) was immunized with at least three (3) doses of Hepatitis B vaccine, two (2) doses given at least four weeks apart followed by a third dose at least four (4) months after the second; or
(B) has had protection against Hepatitis B confirmed in writing by specific blood testing conducted by a certified laboratory.
(h) Varicella. An individual shall be considered adequately protected against Varicella if that individual:
(1) was born January 1, 1997 or later and was immunized with one (1) dose of Varicella vaccine on or after that individual’s first birthday and before that individual’s thirteenth birthday or two (2) doses of Varicella vaccine given at least four weeks apart if the first dose was given on or after the individual’s thirteenth birthday; or
(2) was born before January 1, 1997 and is enrolled in seventh (7th) grade in August 2000 or later and was immunized with one (1) dose of Varicella vaccine on or after that individual’s first birthday and before that individual’s thirteenth birthday or two (2) doses of Varicella vaccine given at least four weeks apart if the first dose was given on or after the individual’s thirteenth birthday; or
(3) has a written statement signed and dated by a physician, physician assistant or advanced practice registered nurse indicating that the individual has already had Varicella based on family and/or medical history; or
(4) has had protection against Varicella confirmed in writing by specific blood testing conducted by a certified laboratory.
(i) Religious exemption. Any individual whose parents or guardian presents a statement that such immunization is contrary to the religious beliefs of such child is exempted from immunization requirements.

TITLE 10. EDUCATION AND CULTURE
CHAPTER 169 SCHOOL HEALTH AND SANITATION
Conn. Gen. Stat. § 10-204a (2001)
§ 10-204a. Required immunizations.
(a) Each local or regional board of education, or similar body governing a nonpublic school or schools, shall require each child to be protected by adequate immunization against diphtheria, pertussis, tetanus, poliomyelitis, measles, mumps, rubella, hemophilus influenzae type B and any other vaccine required by the schedule for active immunization adopted pursuant to section 19a-7f before being permitted to enroll in any program operated by a public or nonpublic school under its jurisdiction. Before being permitted to enter seventh grade, a child shall receive a second immunization against measles. Any such child who (1) presents a certificate from a physician or local health agency stating that initial immunizations have been given to such child and additional immunizations are in process under guidelines and schedules specified by the Commissioner of Public Health; or (2) presents a certificate from a physician stating that in the opinion of such physician, such immunization is medically contraindicated because of the physical condition of such child; or (3) presents a statement from the parents or guardian of such child that such immunization would be contrary to the religious beliefs of such child; or (4) in the case of measles, mumps or rubella, presents a certificate from a physician or from the director of health in such child’s present or previous town of residence, stating that the child has had a confirmed case of such disease; or (5) in the case of hemophilus influenzae type B has passed his fifth birthday or (6) in the case of pertussis, has passed his sixth birthday, shall be exempt from the appropriate provisions of this section. If the parents or guardians of any children are unable to pay for such immunizations, the expense of such immunizations shall, on the recommendations of such board of education, be paid by the town.
(b) The definitions of adequate immunization shall reflect the schedule for active immunization adopted pursuant to section 19a-7f and be established by regulation adopted in accordance with the provisions of chapter 54 by the Commissioner of Public Health, who shall also be responsible for providing procedures under which said boards and said similar governing bodies shall collect and report immunization data on each child to the Department of Public Health for compilation and analysis by said department.

TITLE 19A. PUBLIC HEALTH AND WELL-BEING
CHAPTER 368a DEPARTMENT OF PUBLIC HEALTH
Conn. Gen. Stat. § 19a-7f (2001)
§ 19a-7f. Childhood immunization schedule.
The standard of care for immunization for the children of this state shall be the recommended schedule for active immunization for normal infants and children published by the committee on infectious diseases of the American Academy of Pediatrics or the schedule published by the National Immunization Practices Advisory Committee, as determined by the Commissioner of Public Health. The commissioner shall establish, within available appropriations, an immunization program which shall: (1) Provide vaccine at no cost to health care providers in Connecticut to administer to children so that cost of vaccine will not be a barrier to age-appropriate vaccination in this state; (2) with the assistance of hospital maternity programs, provide all parents in this state with the recommended immunization schedule for normal infants and children, a booklet to record immunizations at the time of the infant’s discharge from the hospital nursery and a list of sites where immunization may be provided; (3) inform in a timely manner all health care providers of changes in the recommended immunization schedule; (4) assist hospitals, local health providers and local health departments to develop and implement record-keeping and outreach programs to identify and immunize those children who have fallen behind the recommended immunization schedule or who lack access to regular preventative health care and have the authority to gather such data as may be needed to evaluate such efforts; (5) assist in the development of a program to assess the vaccination status of children who are clients of state and federal programs serving the health and welfare of children and make provision for vaccination of those who are behind the recommended immunization schedule; (6) access available state and federal funds including, but not limited to, any funds available through the federal Childhood Immunization Reauthorization or any funds available through the Medicaid program; (7) solicit, receive and expend funds from any public or private source; and (8) develop and make available to parents and health care providers public health educational materials about the benefits of timely immunization.
Conn. Gen. Stat. § 19a-7g (2003)
§ 19a-7g. Childhood Immunization Advisory Council.
There is established a Childhood Immunization Advisory Council consisting of the Commissioners of Public Health, Education and Social Services or their designees; a representative of the Commission on Children; a representative of the American Academy of Pediatrics, to be appointed by the president pro tempore of the Senate; a representative of the Association of Primary Health Care Providers, to be appointed by the minority leader of the Senate; a representative of the Legal Aid Society, to be appointed by the speaker of the House of Representatives; and a public member who is a parent of a child who is eligible for Medicaid or uninsured, to be appointed by the minority leader of the House of Representatives. The chairperson and the vice-chairperson of the council shall be elected by the full membership of the council and shall serve for a term of one year. The council shall meet at least twice a year. Council members shall serve without compensation. The council shall advise the Department of Public Health on the development, implementation, monitoring and evaluation of the universal childhood immunization program established pursuant to section 19a-7f.

Conn. Gen. Stat. § 19a-79 (2001)
§ 19a-79. (Formerly Sec. 19-43d). Regulations. Exemptions.
(a) The Commissioner of Public Health shall adopt regulations, in accordance with the provisions of chapter 54, to further the purposes of sections 19a-77 to 19a-80, inclusive, and 19a-82 to 19a-87, inclusive, and to assure that child day care centers and group day care homes shall meet the health, educational and social needs of children utilizing such centers and group day care homes. Such regulations shall (1) specify that before being permitted to attend any child day care center or group day care home, each child must be protected as age-appropriate by adequate immunization against diphtheria, pertussis, tetanus, poliomyelitis, measles, mumps, rubella, hemophilus influenzae type B and any other vaccine required by the schedule of active immunization adopted pursuant to section 19a-7f including appropriate exemptions for children for whom such immunization is medically contraindicated and for children whose parents object to such immunization on religious grounds, (2) specify conditions under which child day care center directors and teachers and group day care home providers may administer tests to monitor glucose levels in a child with diagnosed diabetes mellitus, and administer medicinal preparations, including controlled drugs specified in the regulations by the commissioner, to a child receiving child day care services at such center or group day care home pursuant to the written order of a physician licensed to practice medicine or a dentist licensed to practice dental medicine in this or another state, or an advanced practice registered nurse licensed to prescribe in accordance with section 20-94a, or a physician assistant licensed to prescribe in accordance with section 20-12d, and the written authorization of a parent or guardian of such child, (3) specify that an operator of a child day care center or group day care home, licensed before January 1, 1986, or an operator who receives a license after January 1, 1986, for a facility licensed prior to January 1, 1986, shall provide a minimum of thirty square feet per child of total indoor usable space, free of furniture except that needed for the children’s purposes, exclusive of toilet rooms, bathrooms, coatrooms, kitchens, halls, isolation room or other rooms used for purposes other than the activities of the children, and (4) specify that a child day care center or group day care home licensed after January 1, 1986, shall provide thirty-five square feet per child of total indoor usable space.
(b) The Commissioner of Public Health may adopt regulations, pursuant to chapter 54, to establish civil penalties of not more than one hundred dollars per day for each day of violation and other disciplinary remedies that may be imposed, following a contested-case hearing, upon the holder of a license issued under section 19a-80 to operate a child day care center or group day care home or upon the holder of a license issued under section 19a-87b to operate a family day care home.
(c) The Commissioner of Public Health shall exempt Montessori schools accredited by the American Montessori Society or the Association Montessori Internationale from any provision in regulations adopted pursuant to subsection (a) of this section which sets requirements on group size or child to staff ratios or the provision of cots.

 

D

Allows:

  • Medical exemptions
  • Religious exemptions

TITLE 14. EDUCATION
PART I. FREE PUBLIC SCHOOLS
CHAPTER 1. DEPARTMENT OF EDUCATION
SUBCHAPTER II. POWERS AND DUTIES
14 Del. C. § 131 (2002)
§ 131. Public school enrollees’ immunization program; exemptions
(a) The Department shall from time to time, with advice from the Division of Public Health, adopt and promulgate rules and regulations to establish an immunization program to protect pupils enrolled in public schools from certain diseases. Such rules and regulations shall include at least the following:
(1) The designation of a basic series of immunizations to be administered according to these rules;
(2) The requirement that all persons enrolling in the public schools at any age or level as authorized by this title shall have:
a. Been immunized according to the required program prior to the time of enrollment in the Delaware schools;
b. Begun the series of immunizations not later than the time of enrollment to be completed within a reasonable time as prescribed by the Department in relation to the particular immunization involved; or
c. Presented written documentation of any claim of prior immunization in the form of a statement from the immunizing physician or agency or such other form as may from time to time be approved by regulation of the Department;
(3) Provision that persons seeking to be enrollees of the public school who have not been immunized or do not meet the requirements for immunization within the time prescribed shall be denied further attendance in the public schools;
(4) Provision for written notification of the parent, or legal guardian of an enrollee, of a pending exclusion;
(5) Provision for exemption from any or all of the immunization program prescribed for a particular enrollee upon a written statement from a physician, i.e., medical doctor or doctor of osteopathy, stating that the enrollee should not receive the prescribed immunization or immunizations required in the basic series because of the reasonable certainty of a reaction detrimental to that person. A history of clinical illness of measles or rubella shall not be accepted as cause for exemption;
(6) Provision for exemption from the immunization program for an enrollee whose parents or legal guardian, because of individual religious beliefs, reject the concept of immunization. Such a request for exemption shall be supported by the affidavit herein set forth.

Allows:

  • Medical exemptions
  • Religious exemptions

TITLE 38. EDUCATIONAL INSTITUTIONS
SUBTITLE I. PUBLIC EDUCATION — PRIMARY AND SECONDARY
CHAPTER 5. IMMUNIZATION OF SCHOOL STUDENTS
D.C. Code § 38-501 (2002)
§ 38-501. Definitions [Formerly § 31-501] For the purpose of this chapter:
(1) The term “admit” or the term “admission” means the official enrollment at any level by a school of a student that entitles the student to attend the school regularly, whether full-time or part-time, and to participate fully in all the activities established for a student of his or her age, educational level, or other appropriate classification.
(2) The term “certification of immunization” means written certification by a private physician, his or her representative, or the public health authorities that the student is immunized.
(3) The term “student” means any person who seeks admission to school, or for whom admission to school is sought by a parent or guardian, and who will not have attained the age of 26 years by the start of the school term for which admission is sought.
(4) The term “immunized” or the term “immunization” means initial immunization and any boosters or reimmunization required to maintain immunization against diphtheria, poliomyelitis, tetanus, rubella, measles, and mumps in accordance with the immunization standards issued by the public health authorities pursuant to this chapter.
(5) The term “Mayor” means the Mayor of the District of Columbia.
(6) The term “public health authorities” means the official or officials of the executive branch of the government of the District of Columbia designated by the Mayor pursuant to this chapter.
(7) The term “responsible person” means, in the case of a student under 18 years of age, a parent or guardian of the student, but in the case of a student 18 years of age or older, the student himself or herself.
(8) The term “school” means:
(A) Any public school through the 12th grade operated under the authority of the Board of Education of the District of Columbia;
(B) Any private or parochial school that offers instruction at any level or grade from kindergarten through 12th;
(C) Any private or parochial nursery school or preschool, or any private or parochial day-care facility required to be licensed by the District of Columbia; and
(D) Any college or university created or incorporated by special act of Congress or the Council of the District of Columbia or required to be licensed by the District of Columbia.
D.C. Code § 38-502 (2002)
§ 38-502. Certification of immunization required [Formerly § 31-502] No student shall be admitted by a school unless the school has certification of immunization for that student, or unless the student is exempted pursuant to § 38-506.
D.C. Code § 38-503 (2002)
§ 38-503. Immunization standards; list of immunizations [Form§ 31-503] The Mayor shall, by regulations, specify the immunization standards to be used for compliance with this chapter, and may also, by regulation, revise the list of requested immunizations.
D.C. Code § 38-505 (2002)
§ 38-505. Attendance without certification [Formerly § 31-505] A school shall permit a student to attend for not more than 10 days while the school does not have certification of immunization for that student. If immunization requires a series of treatments that cannot be completed within the 10 days, the student shall be permitted to attend school while the treatments are continuing if, within the 10 days, the school receives written notification from whomever is administering it that the immunization is in progress.
D.C. Code § 38-506 (2002)
§ 38-506. Exemption from certification [Formerly § 31-506] No certification of immunization shall be required for the admission to a school of a student:
(1) For whom the responsible person objects in good faith and in writing, to the chief official of the school, that immunization would violate his or her religious beliefs; or
(2) For whom the school has written certification by a private physician, his or her representative, or the public health authorities that immunization is medically inadvisable.

 

F

Allows:

  • Medical exemptions
  • Religious exemptions

TITLE 29. PUBLIC HEALTH
CHAPTER 381. PUBLIC HEALTH: GENERAL PROVISIONS
Fla. Stat. § 381.001 (2002)
§ 381.001. Legislative intent; public health system
(1) It is the intent of the Legislature that the Department of Health be responsible for the state’s public health system which shall be designed to promote, protect, and improve the health of all people in the state. The mission of the state’s public health system is to foster the conditions in which people can be healthy, by assessing state and community health needs and priorities through data collection, epidemiologic studies, and community participation; by developing comprehensive public health policies and objectives aimed at improving the health status of people in the state; and by ensuring essential health care and an environment which enhances the health of the individual and the community. The Legislature recognizes that the state’s public health system must be founded on an active partnership between federal, state, and local government and between the public and private sectors, and, therefore, assessment, policy development, and service provision must be shared by all of these entities to achieve its mission.
(2) It is the intent of the Legislature that the department, in carrying out the mission of public health, focus attention on identifying, assessing, and controlling the presence and spread of communicable diseases; on monitoring and regulating factors in the environment which may impair the public’s health, with particular attention to preventing contamination of drinking water, the air people breathe, and the food people consume; and ensuring availability of and access to preventive and primary health care, including, but not limited to, acute and episodic care, prenatal and postpartum care, child health, family planning, school health, chronic disease prevention, child and adult immunization, dental health, nutrition, and health education and promotion services.
(3) It is, furthermore, the intent of the Legislature that the public health system include comprehensive planning, data collection, technical support, and health resource development functions. These functions include, but are not limited to, state laboratory and pharmacy services, the state vital statistics system, the State Center for Health Statistics, emergency medical services coordination and support, and recruitment, retention, and development of preventive and primary health care professionals and managers.
(4) It is, furthermore, the intent of the Legislature that the department provide public health services through the 67 county health departments in partnership with county governments, as specified in part I of chapter 154, and in so doing make every attempt possible to solicit the support and involvement of private and not-for-profit health care agencies in fulfilling the public health mission.
Fla. Stat. § 381.003 (2002)
§ 381.003. Communicable disease and AIDS prevention and control
(1) The department shall conduct a communicable disease prevention and control program as part of fulfilling its public health mission. A communicable disease is any disease caused by transmission of a specific infectious agent, or its toxic products, from an infected person, an infected animal, or the environment to a susceptible host, either directly or indirectly. The communicable disease program must include, but need not be limited to:
(a) Programs for the prevention and control of tuberculosis in accordance with chapter 392.
(b) Programs for the prevention and control of human immunodeficiency virus infection and acquired immune deficiency syndrome in accordance with chapter 384 and this chapter.
(c) Programs for the prevention and control of sexually transmissible diseases in accordance with chapter 384.
(d) Programs for the prevention, control, and reporting of diseases of public health significance as provided for in this chapter.
(e) Programs for the prevention and control of vaccine-preventable diseases, including programs to immunize school children as required by s. 1003.22(3)-(11) and the development of an automated, electronic, and centralized database or registry of immunizations. The department shall ensure that all children in this state are immunized against vaccine-preventable diseases. The immunization registry shall allow the department to enhance current immunization activities for the purpose of improving the immunization of all children in this state.
1. Except as provided in subparagraph 2., the department shall include all children born in this state in the immunization registry by using the birth records from the Office of Vital Statistics. The department shall add other children to the registry as immunization services are provided.
2. The parent or guardian of a child may refuse to have the child included in the immunization registry by signing a form obtained from the department, or from the health care practitioner or entity that provides the immunization, which indicates that the parent or guardian does not wish to have the child included in the immunization registry. The decision to not participate in the immunization registry must be noted in the registry.
3. The immunization registry shall allow for immunization records to be electronically transferred to entities that are required by law to have such records, including schools, licensed child care facilities, and any other entity that is required by law to obtain proof of a child’s immunizations.
4. Any health care practitioner licensed under chapter 458, chapter 459, or chapter 464 in this state who complies with rules adopted by the department to access the immunization registry may, through the immunization registry, directly access immunization records and update a child’s immunization history or exchange immunization information with another authorized practitioner, entity, or agency involved in a child’s care. The information included in the immunization registry must include the child’s name, date of birth, address, and any other unique identifier necessary to correctly identify the child; the immunization record, including the date, type of administered vaccine, and vaccine lot number; and the presence or absence of any adverse reaction or contraindication related to the immunization. Information received by the department for the immunization registry retains its status as confidential medical information and the department must maintain the confidentiality of that information as otherwise required by law. A health care practitioner or other agency that obtains information from the immunization registry must maintain the confidentiality of any medical records in accordance with s. 456.057 or as otherwise required by law.
(2) The department may adopt, repeal, and amend rules related to the prevention and control of communicable diseases and the administration of the immunization registry. Such rules may include procedures for investigating disease, timeframes for reporting disease, definitions, procedures for managing specific diseases, requirements for followup reports of known or suspected exposure to disease, and procedures for providing access to confidential information necessary for disease investigations. For purposes of the immunization registry, the rules may include procedures for a health care practitioner to obtain authorization to use the immunization registry, methods for a parent or guardian to elect not to participate in the immunization registry, and procedures for a health care practitioner licensed under chapter 458, chapter 459, or chapter 464 to access and share electronic immunization records with other entities allowed by law to have access to the records. Fla. Stat. § 1002.20 (2002)
§ 1002.20. K-12 student and parent rights
K-12 students and their parents are afforded numerous statutory rights including, but not limited to, the following:
(3) HEALTH ISSUES.
(a) School-entry health examinations. –The parent of any child attending a public or private school shall be exempt from the requirement of a health examination upon written request stating objections on religious grounds in accordance with the provisions of s. 1003.22(1) and (2).
(b) Immunizations. –The parent of any child attending a public or private school shall be exempt from the school immunization requirements upon meeting any of the exemptions in accordance with the provisions of s. 1003.22(5).
TITLE 48. K-20 EDUCATION CODE
CHAPTER 1003. PUBLIC K-12 EDUCATION
PART II. SCHOOL ATTENDANCE
Fla. Stat. § 1003.22 (2002)
§ 1003.22. School-entry health examinations; immunization against communicable diseases; exemptions; duties of Department of Health
(1) Each district school board and the governing authority of each private school shall require that each child who is entitled to admittance to kindergarten, or is entitled to any other initial entrance into a public or private school in this state, present a certification of a school-entry health examination performed within 1 year prior to enrollment in school. Each district school board, and the governing authority of each private school, may establish a policy that permits a student up to 30 school days to present a certification of a school-entry health examination. A homeless child, as defined in s. 1003.01, shall be given a temporary exemption for 30 school days. Any district school board that establishes such a policy shall include provisions in its local school health services plan to assist students in obtaining the health examinations. However, any child shall be exempt from the requirement of a health examination upon written request of the parent of the child stating objections to the examination on religious grounds.
(2) The State Board of Education, subject to the concurrence of the Department of Health, shall adopt rules to govern medical examinations and immunizations performed under this section.
(3) The Department of Health may adopt rules necessary to administer and enforce this section. The Department of Health, after consultation with the Department of Education, shall adopt rules governing the immunization of children against, the testing for, and the control of preventable communicable diseases. The rules must include procedures for exempting a child from immunization requirements. Immunizations shall be required for poliomyelitis, diphtheria, rubeola, rubella, pertussis, mumps, tetanus, and other communicable diseases as determined by rules of the Department of Health. The manner and frequency of administration of the immunization or testing shall conform to recognized standards of medical practice. The Department of Health shall supervise and secure the enforcement of the required immunization. Immunizations required by this section shall be available at no cost from the county health departments.
(4) Each district school board and the governing authority of each private school shall establish and enforce as policy that, prior to admittance to or attendance in a public or private school, grades kindergarten through 12, each child present or have on file with the school a certification of immunization for the prevention of those communicable diseases for which immunization is required by the Department of Health and further shall provide for appropriate screening of its students for scoliosis at the proper age. Such certification shall be made on forms approved and provided by the Department of Health and shall become a part of each student’s permanent record, to be transferred when the student transfers, is promoted, or changes schools. The transfer of such immunization certification by Florida public schools shall be accomplished using the Florida Automated System for Transferring Education Records and shall be deemed to meet the requirements of this section.
(5) The provisions of this section shall not apply if:
(a) The parent of the child objects in writing that the administration of immunizing agents conflicts with his or her religious tenets or practices;
(b) A physician licensed under the provisions of chapter 458 or chapter 459 certifies in writing, on a form approved and provided by the Department of Health, that the child should be permanently exempt from the required immunization for medical reasons stated in writing, based upon valid clinical reasoning or evidence, demonstrating the need for the permanent exemption;
(c) A physician licensed under the provisions of chapter 458, chapter 459, or chapter 460 certifies in writing, on a form approved and provided by the Department of Health, that the child has received as many immunizations as are medically indicated at the time and is in the process of completing necessary immunizations;
(d) The Department of Health determines that, according to recognized standards of medical practice, any required immunization is unnecessary or hazardous; or
(e) An authorized school official issues a temporary exemption, for a period not to exceed 30 school days, to permit a student who transfers into a new county to attend class until his or her records can be obtained. A homeless child, as defined in s. 1003.01, shall be given a temporary exemption for 30 school days. The public school health nurse or authorized private school official is responsible for follow up of each such student until proper documentation or immunizations are obtained. An exemption for 30 days may be issued for a student who enters a juvenile justice program to permit the student to attend class until his or her records can be obtained or until the immunizations can be obtained. An authorized juvenile justice official is responsible for follow up of each student who enters a juvenile justice program until proper documentation or immunizations are obtained.
(6) (a) No person licensed by this state as a physician or nurse shall be liable for any injury caused by his or her action or failure to act in the administration of a vaccine or other immunizing agent pursuant to the provisions of this section if the person acts as a reasonably prudent person with similar professional training would have acted under the same or similar circumstances.
(b) No member of a district school board, or any of its employees, or member of a governing board of a private school, or any of its employees, shall be liable for any injury caused by the administration of a vaccine to any student who is required to be so immunized or for a failure to diagnose scoliosis pursuant to the provisions of this section.
(7) The parents of any child admitted to or in attendance at a Florida public or private school, grades kindergarten through 12, are responsible for assuring that the child is in compliance with the provisions of this section.
(8) Each public school, including public kindergarten, and each private school, including private kindergarten, shall be required to provide to the county health department director or administrator annual reports of compliance with the provisions of this section. Reports shall be completed on forms provided by the Department of Health for each kindergarten, and other grade as specified; and the reports shall include the status of children who were admitted at the beginning of the school year. After consultation with the Department of Education, the Department of Health shall establish by administrative rule the dates for submission of these reports, the grades for which the reports shall be required, and the forms to be used.
(9) The presence of any of the communicable diseases for which immunization is required by the Department of Health in a Florida public or private school shall permit the county health department director or administrator or the State Health Officer to declare a communicable disease emergency. The declaration of such emergency shall mandate that all students in attendance in the school who are not in compliance with the provisions of this section be identified by the district school board or by the governing authority of the private school; and the school health and immunization records of such children shall be made available to the county health department director or administrator. Those children identified as not being immunized against the disease for which the emergency has been declared shall be temporarily excluded from school by the district school board, or the governing authority of the private school, until such time as is specified by the county health department director or administrator.
(10) Each district school board and the governing authority of each private school shall:
(a) Refuse admittance to any child otherwise entitled to admittance to kindergarten, or any other initial entrance into a Florida public or private school, who is not in compliance with the provisions of subsection (4).
(b) Temporarily exclude from attendance any student who is not in compliance with the provisions of subsection (4).
(11) The provisions of this section do not apply to those persons admitted to or attending adult education classes unless the adult students are under 21 years of age.

 

G

Allows:

  • Medical exemptions
  • Religious exemptions

TITLE 20. EDUCATION
CHAPTER 2. ELEMENTARY AND SECONDARY EDUCATION
ARTICLE 16. STUDENTS
PART 3. HEALTH
O.C.G.A. § 20-2-771 (2002)
§ 20-2-771. Immunization of students
(a) As used in this Code section, the term:
(1) “Certificate of immunization” means certification by a physician licensed under the laws of this state or by an appropriate official of a local board of health, on a form provided by the Department of Human Resources, that a named person has been immunized in accordance with the applicable rules and regulations of the Department of Human Resources.
(2) “Facility” means any public or private day-care center or nursery intended for the care, supervision, or instruction of children.
(3) “Responsible official” means a county school superintendent, a school principal, or a chief operating officer of a school or facility.
(4) “School” means any public or private educational program or institution instructing children at any level or levels, kindergarten through twelfth grade, or children of ages five through 19 if grade divisions are not used.
(b) No child shall be admitted to or attend any school or facility in this state unless the child shall first have submitted a certificate of immunization to the responsible official of the school or facility. The responsible official of any school or facility may grant a 30 calendar day waiver of the certification requirement for a justified reason. The waiver may be extended from the date of first admittance or of first attendance, whichever is earlier, for up to 90 calendar days provided documentation is on file at the school or facility from the local health department or a physician specifying that an immunization sequence has been started and that this immunization time schedule can be completed within the 90 day waiver period, provided confirmation is received during the waiver period from the health department or physician that immunizations are being received as scheduled, and provided the student under waiver is a transfer student, who is defined as a student who moves from an out-of-state school system to a Georgia school system, or a student entering kindergarten or first grade from out of state. The waiver may not be extended beyond 90 calendar days; and upon expiration of the waiver, the child shall not be admitted to or be permitted to attend the school or facility unless the child submits a certificate of immunization.
(c) The Department of Human Resources shall promulgate rules and regulations specifying those diseases against which immunization is required and the standards for such immunizations. The school or facility shall maintain on file the certificates of immunization for all children attending the school or facility. All facilities shall file a report annually with the Department of Human Resources. The report shall be filed on forms prepared by the Department of Human Resources and shall state the number of children attending the school or facility, the number of children who did not submit certificates of immunization within the waiver period, and the number of children who are exempted from the certification requirement for medical or religious reasons.
(d) If, after examination by the local board of health or any physician licensed under the laws of this state or of any other state having comparable laws governing the licensure of physicians, any child to whom this Code section applies is found to have any physical disability which may make vaccination undesirable, a certificate to that effect issued by the local board of health or such physician licensed under the laws of this or such other state may be accepted in lieu of a certificate of immunization and shall exempt the child from the requirement of obtaining a certificate of immunization until the disability is relieved.
(e) This Code section shall not apply to a child whose parent or legal guardian objects to immunization of the child on the grounds that the immunization conflicts with the religious beliefs of the parent or guardian; however, the immunization may be required in cases when such disease is in epidemic stages. For a child to be exempt from immunization on religious grounds, the parent or guardian must first furnish the responsible official of the school or facility an affidavit in which the parent or guardian swears or affirms that the immunization required conflicts with the religious beliefs of the parent or guardian.
(f) During an epidemic or a threatened epidemic of any disease preventable by an immunization required by the Department of Human Resources, children who have not been immunized may be excluded from the school or facility until (1) they are immunized against the disease, unless they present valid evidence of prior disease, or (2) the epidemic or threat no longer constitutes a significant public health danger.
(g) The requirement of a certificate of immunization shall become effective for all children entering or attending facilities on or after April 7, 1981. The certification requirement shall apply to all children entering or attending schools:
(1) On September 1, 1981, for all such children entering or attending kindergarten or the first, ninth, tenth, eleventh, or twelfth grades, or of the equivalent ages if grade divisions are not used;
(2) On September 1, 1982, for all such children entering or attending all grades, or of all ages if grade divisions are not used.
(h) Any responsible official permitting any child to remain in a school or facility in violation of this Code section, and any parent or guardian who intentionally does not comply with this Code section, shall be guilty of a misdemeanor and, upon conviction thereof, shall be punished by a fine of not more than $100.00 or by imprisonment for not more than 12 months. The Department of Human Resources may adopt rules and regulations for the enforcement of this Code section. The Department of Human Resources and the local board of health, or either of them, may institute a civil action in the superior court of the county in which the defendant resides for injunctive relief to prevent a threatened or continuing violation of any provision of this Code section.
and upon the school authorities the duty of fixing the rules and regulations under which they shall attend.

TITLE 31. HEALTH
CHAPTER 12. CONTROL OF HAZARDOUS CONDITIONS, PREVENTABLE DISEASES, AND METABOLIC DISORDERS
O.C.G.A. § 31-12-3 (2002) 31-12-3. Power to require immunization and other preventive measures
(a) The department and all county boards of health are empowered to require, by appropriate rules and regulations, persons located within their respective jurisdictions to submit to vaccination against contagious or infectious disease where the particular disease may occur, whether or not the disease may be an active threat. The department may, in addition, require such other measures to prevent the conveyance of infectious matter from infected persons to other persons as may be necessary and appropriate. The department shall promulgate appropriate rules and regulations for the implementation of the provisions for the Code section in the case of a declaration of a public health emergency and shall include provisions permitting consideration of the opinion of a person’s personal physician as to whether the vaccination is medically appropriate or advisable for such person. Such rules and regulations shall be adopted pursuant to Chapter 13 of Title 50, the “Georgia Administrative Procedure Act,” but shall be automatically referred by the Office of Legislative Counsel to the House of Representatives and Senate Committees on the Judiciary.
(b) In the absence of an epidemic or immediate threat thereof, this Code section shall not apply to any person who objects in writing thereto on grounds that such immunization conflicts with his religious beliefs.

 

H

Allows:

  • Medical exemptions
  • Religious exemptions

DIVISION 1. GOVERNMENT
TITLE 18. EDUCATION
CHAPTER 302A. EDUCATION
[PART IV.] PROVISIONS AFFECTING SYSTEM STRUCTURE
C. ORGANIZATION
HRS § 302A-1154 (2002)
§ 302A-1154. Immunization upon entering school; tuberculosis clearance
(a) No child shall attend any school in the State unless the child presents to the appropriate school official documentation satisfactory to the department of health that the child has received immunizations against communicable diseases as required by the department of health.
(b) No child shall be admitted to attend any school for the first time in the State unless the child presents to the appropriate school official documentation satisfactory to the department of health that the child has been examined and tested according to the rules of the department, and is free from tuberculosis in a communicable form.
HRS § 302A-1155 (2002)
§ 302A-1155. Provisional entrance to school
(a) A child may enter school provisionally upon submitting written documentation from a licensed physician, advanced practice registered nurse, or an authorized representative of the department of health stating that the child is in the process of receiving the required immunizations. Further documentation showing that the required immunizations have been completed shall be submitted to the appropriate school official no later than three months after the child first entered the school. If all of the required immunizations cannot be completed within three months due to the length of the minimum intervals between doses of a particular vaccine required by the department of health, provisional admission may be extended so long as the child’s parent or guardian provides documentation that appointments for required immunizations have been made and that progress toward completing the immunizations continues in accordance with the requirements of the department of health.
(b) Provisional entrance to school may be suspended by the department of health when there is danger of an epidemic from any of the communicable diseases for which immunization is required.
HRS § 302A-1156 (2002)
[§ 302A-1156]. Exemptions
A child may be exempted from the required immunizations:
(1) If a licensed physician certifies that the physical condition of the child is such that immunizations would endanger the child’s life or health; or
(2) If any parent, custodian, guardian, or any other person in loco parentis to a child objects to immunization in writing on the grounds that the immunization conflicts with that person’s bonafide religious tenets and practices. Upon showing the appropriate school official satisfactory evidence of the exemption, no certificate or other evidence of immunization shall be required for entry into school.
HRS § 302A-1157 (2002)
[§ 302A-1157]. Exemptions from immunization; not recognized; epidemic conditions
If at any time there is, in the opinion of the department of health, danger of an epidemic from any of the communicable diseases for which immunization is required under sections 302A-1154 to 302A-1163, no exemption from immunization against the disease shall be recognized. Quarantine shall be a legal alternative to immunization.
HRS § 302A-1162 (2003)
§ 302A-1162. Rules
(a) The department of health shall adopt rules under chapter 91 relating to immunization, physical examination, and tuberculin testing under sections 302A-1154 to 302A-1163. Immunizations required, and the manner and frequency of their administration, shall conform with recognized standard medical practices. The list of diseases and minimum requirements for protection under sections 302A-1154 to 302A-1163 may be revised whenever the department of health deems it necessary for the protection of public health.
(b) The department shall establish by rule standards for documentation of compliance with school health requirements under sections 302A-1154 through 302A-1163.
HRS § 302A-1163 (2003)
[§ 302A-1163]. Enforcement
The department of health shall administer and enforce the immunization and tuberculin test requirements under sections 302A-1154 to 302A-1163.

DIVISION 1. GOVERNMENT
TITLE 19. HEALTH
CHAPTER 325. INFECTIOUS AND COMMUNICABLE DISEASES
PART II. VACCINATION AND IMMUNIZATION
§ 325-32. Immunization against infectious diseases
The department of health may adopt rules requiring and governing immunization against typhoid fever, pertussis (whooping cough), diphtheria, tetanus, poliomyelitis, measles, mumps, hepatitis B, rubella, haemophilus influenzae type B, and any other communicable disease, if a suitable immunizing agent is available for the disease and a need for immunization against it exists within the State. The department may also provide vaccines and other immunizing agents to private and public health care providers for administration to the general public.
§ 325-34. Exemptions
Section 325-32 shall be construed not to require the vaccination or immunization of any person for three months after a duly licensed physician or an authorized representative of the department of health has signed two copies of a certificate stating the name and address of the person and that because of a stated cause the health of the person would be endangered by the vaccination or immunization, and has forwarded the original copy of the certificate to the person or, if the person is a minor or under guardianship, to the person’s parent or guardian, and has forwarded the duplicate copy of the certificate to the department for its files.
No person shall be subjected to vaccination, revaccination or immunization, who shall in writing object thereto on the grounds that the requirements are not in accordance with the religious tenets of an established church of which the person is a member or adherent, or, if the person is a minor or under guardianship, whose parent or guardian shall in writing object thereto on such grounds, but no objection shall be recognized when, in the opinion of the director of health, there is danger of an epidemic from any communicable disease.
HRS § 325-35 (2003)
§ 325-35. Forms and procedures
The department of health may prescribe forms and procedures to achieve the purposes of sections 325-32 to 325-34 and shall maintain a complete roster of all exemptions from vaccination or immunization.

 

I

Allows:

  • Medical exemptions
  • Religious exemptions
  • Philosophical (conscientious objector, personal belief) exemptions

GENERAL LAWS
TITLE 39. HEALTH AND SAFETY
CHAPTER 48. IMMUNIZATION
Idaho Code § 39-4801 (2002)
§ 39-4801. Immunization required
Except as provided in section 39-4802, Idaho Code, any child in Idaho of school age may attend grades preschool and kindergarten through twelve of any public, private or parochial school operating in this state if otherwise eligible, provided that upon admission, the parent or guardian shall provide a statement to the school authorities regarding the child’s immunity to certain childhood diseases. This statement shall provide a certificate signed by a physician or his representative, that such child has received, or is in the process of receiving immunizations as specified by the board of health and welfare, or can effectively demonstrate, through verification in a form approved by the department of health and welfare, immunity gained through prior contraction of the disease.

Immunizations required and the manner and frequency of their administration shall be as prescribed by the state board of health and welfare and shall conform to recognized standard medical practices in the state. The state board of health and welfare, in cooperation with the state board of education and the Idaho school boards association, shall promulgate appropriate rules and regulations for the enforcement of the required immunization program and specify reporting requirements of schools, pursuant to the provisions of chapter 52, title 67, Idaho Code.
§ 39-4802. Exemptions
(1) Any minor child whose parent or guardian has submitted to school officials a certificate signed by a physician licensed by the state board of medicine stating that the physical condition of the child is such that all or any of the required immunizations would endanger the life or health of the child shall be exempt from the provisions of this chapter.
(2) Any minor child whose parent or guardian has submitted a signed statement to school officials stating their objections on religious or other grounds shall be exempt from the provisions of this chapter.
§ 39-4803. Immunization registry
(1) The department of health and welfare shall provide for the establishment of a voluntary registry of the immunization status of Idaho children against childhood diseases. The registry may be maintained and its data disclosed as set out herein to further the following purposes:
(a) To make immunizations readily available to every Idaho citizen that desires to have their child immunized;
(b) To increase the voluntary immunization rate in Idaho to the maximum extent possible without mandating such immunizations;
(c) To recognize and respect the rights of parents and guardians to make health care decisions for their children;
(d) To provide for timely reminders to parents of children in the registry.
(2) The name of a child or information relating to the immunization status of that child may be collected or included in the registry only upon the separate and specific written authorization of a parent, guardian or other person legally responsible for the care of the child. Such authorization may not be part of a general authorization or release. The registry may contain only the following information for each child:
(a) The child’s name, address and birth date;
(b) The name and address of each parent of the child;
(c) The month, day, year and type of each immunization that has been administered to the child;
(d) The name, address and phone number of each provider that has administered an immunization to the child;
(e) If requested by a parent or guardian, any statement made pursuant to subsection (4) of this section;
(f) Other information as authorized or requested by a parent or guardian.
(3) The department of health and welfare may only disclose information relating to an individual child in the registry to the following upon a specific request:
(a) Employees of the health district in which the child resides or seeks medical services;
(b) Health records staff of the school or school district in which the child is enrolled;
(c) The operator of a licensed child care facility in which the child is enrolled;
(d) Persons who are legally responsible for the long-term care of the child, including operators of licensed ICF/MR’s and residential or assisted living facilities, adoptive and foster parents and a guardian appointed pursuant to chapter 5, title 15, Idaho Code;
(e) Any health care provider rendering treatment to the child, and the provider’s agents;
(f) Any person possessing a lawful release, properly executed by the child’s parent or guardian;
(g) A parent of the child;
(h) Any hospital where the child is receiving care.
(4) A parent or guardian of the child shall have free and open access to all information in the registry that relates to their child or themselves. Upon the written request of a parent or guardian, the department of health and welfare shall:
(a) Cause all information relating to the child to be removed from the registry and any databases or files of other entities or persons to which information in the database has been disclosed;
(b) Include in the registry the statement of a physician or parent pursuant to section 39-4802(2) or 39-1118(2), Idaho Code.
(5) All information contained in the registry or disclosed from it is confidential and may not be sold and may only be disclosed as specifically authorized in this section. A person or entity to whom information is disclosed from the registry may not thereafter disclose it to others. Any person who discloses or authorizes disclosure of any information contained in the registry, except as authorized in this section is guilty of a misdemeanor and is liable for civil damages in the amount of one hundred dollars ($ 100) for each violation.

§ 39-4804. Notification to parent or guardian
Before an immunization is administered to any child in this state, the parent or guardian of the child shall be notified that:
(1) Immunizations are not mandatory and may be refused on religious or other grounds;
(2) Participation in the immunization registry is voluntary;
(3) The parent or guardian is entitled to an accurate explanation of the complications known to follow such immunization.

GENERAL LAWS
TITLE 39. HEALTH AND SAFETY
CHAPTER 11. BASIC DAY CARE LICENSE
Idaho Code § 39-1118 (2002)
§ 39-1118. Immunization required
(1) Within fourteen (14) days of a child’s initial attendance at any licensed day care facility, the parent or guardian shall provide a statement to the operator of the day care facility regarding the child’s immunity to certain childhood diseases. This statement shall provide a certificate signed by a physician or a representative of a health district, that the child has received, or is in the process of receiving immunizations as specified by the board of health and welfare; or can effectively demonstrate, through verification in a form approved by the department of health and welfare, immunity gained through prior contraction of the disease.
Immunizations required and the manner and frequency of their administration shall be as prescribed by the state board of health and welfare and shall conform to recognized standard medical practices in the state. The state board of health and welfare shall promulgate appropriate rules and regulations for the enforcement of the required immunization program and specify reporting requirements of day care centers, pursuant to the provisions of chapter 52, title 67, Idaho Code.
(2) Any minor child whose parent or guardian has submitted to officials of a licensed day care facility a certificate signed by a physician licensed by the state board of medicine stating that the physical condition of the child is such that all or any of the required immunizations would endanger the life or health of the child shall be exempt from the provisions of this section. Any minor child whose parent or guardian has submitted a signed statement to officials of the day care facility stating their objections on religious or other grounds shall be exempt from the provisions of this section.

Allows:

  • Medical exemptions
  • Religious exemptions

CHAPTER 20. EXECUTIVE BRANCH
EXECUTIVE DEPARTMENTS
CIVIL ADMINISTRATIVE CODE OF ILLINOIS (PART 1)
ARTICLE 5. DEPARTMENTS OF STATE GOVERNMENT
20 ILCS 5/5-565 (2003)
[This section derived from: Ill. Rev. Stat., Ch. 127, para. 6.06] § 20 ILCS 5/5-565. In the Department of Public Health
Sec. 5-565. In the Department of Public Health. (a) The General Assembly declares it to be the public policy of this State that all citizens of Illinois are entitled to lead healthy lives. Governmental public health has a specific responsibility to ensure that a system is in place to allow the public health mission to be achieved. To develop a system requires certain core functions to be performed by government. The State Board of Health is to assume the leadership role in advising the Director in meeting the following functions:
(1) Needs assessment.
(2) Statewide health objectives.
(3) Policy development.
(4) Assurance of access to necessary services.
There shall be a State Board of Health composed of 17 persons, all of whom shall be appointed by the Governor, with the advice and consent of the Senate for those appointed by the Governor on and after June 30, 1998, and one of whom shall be a senior citizen age 60 or over. Five members shall be physicians licensed to practice medicine in all its branches, one representing a medical school faculty, one who is board certified in preventive medicine, and 2 who are engaged in private practice. One member shall be a dentist; one an environmental health practitioner; one a local public health administrator; one a local board of health member; one a registered nurse; one a veterinarian; one a public health academician; one a health care industry representative; and 4 shall be citizens at large.
In the appointment of the first Board of Health members appointed after September 19, 1991 (the effective date of Public Act 87-633), the Governor shall appoint 5 members to serve for terms of 5 years; 5 members to serve for terms of 2 years; and 5 members to serve for a term of one year. Members appointed thereafter shall be appointed for terms of 3 years, except that when an appointment is made to fill a vacancy, the appointment shall be for the remaining term of the position vacated. The initial terms for the 2 additional members of the board who are citizens at large appointed under Public Act 90-607 shall be for 3 years each, with these positions thereafter being filled as with other members appointed by the Governor. All members shall be legal residents of the State of Illinois. The duties of the Board shall include, but not be limited to, the following:
(9) To review the final draft of all proposed administrative rules, other than emergency or preemptory rules and those rules that another advisory body must approve or review within a statutorily defined time period, of the Department after September 19, 1991 (the effective date of Public Act 87-633). The Board shall review the proposed rules within 90 days of submission by the Department. The Department shall take into consideration any comments and recommendations of the Board regarding the proposed rules prior to submission to the Secretary of State for initial publication. If the Department disagrees with the recommendations of the Board, it shall submit a written response outlining the reasons for not accepting the recommendations.
In the case of proposed administrative rules or amendments to administrative rules regarding immunization of children against preventable communicable diseases designated by the Director under the Communicable Disease Prevention Act [410 ILCS 315/0.01 et seq.], after the Immunization Advisory Committee has made its recommendations, the Board shall conduct 3 public hearings, geographically distributed throughout the State. At the conclusion of the hearings, the State Board of Health shall issue a report, including its recommendations, to the Director. The Director shall take into consideration any comments or recommendations made by the Board based on these hearings.
20 ILCS 2305/8.4 (2003)
§ 20 ILCS 2305/8.4. Immunization Advisory Committee
Sec. 8.4. Immunization Advisory Committee. The Director of Public Health shall appoint an Immunization Advisory Committee to advise the Director on immunization issues. The Director shall take into consideration any comments or recommendations made by the Advisory Committee. The Immunization Advisory Committee shall be composed of the following members with knowledge of immunization issues: a pediatrician, a physician licensed to practice medicine in all its branches, a family physician, an infectious disease specialist from a university based center, 2 representatives of a local health department, a registered nurse, a school nurse, a public health provider, a public health officer or administrator, a representative of a children’s hospital, 2 representatives of immunization advocacy organizations, a representative from the State Board of Education, a person with expertise in bioterrorism issues, and any other individuals or organization representatives designated by the Director. The Director shall designate one of the Advisory Committee members to serve as the Chairperson of the Advisory Committee.

105 ILCS 5/27-8.1 (2002)
[Prior to 1/1/93 cited as: Ill. Rev. Stat., Ch. 122, para. 27-8.1] § 105 ILCS 5/27-8.1. Health examinations and immunizations
Sec. 27-8.1. Health examinations and immunizations.
(1) In compliance with rules and regulations which the Department of Public Health shall promulgate, and except as hereinafter provided, all children in Illinois shall have a health examination as follows: within one year prior to entering kindergarten or the first grade of any public, private, or parochial elementary school; upon entering the fifth and ninth grades of any public, private, or parochial school; prior to entrance into any public, private, or parochial nursery school; and, irrespective of grade, immediately prior to or upon entrance into any public, private, or parochial school or nursery school, each child shall present proof of having been examined in accordance with this Section and the rules and regulations promulgated hereunder.
A tuberculosis skin test screening shall be included as a required part of each health examination included under this Section if the child resides in an area designated by the Department of Public Health as having a high incidence of tuberculosis. Additional health examinations of pupils, including dental and vision examinations, may be required when deemed necessary by school authorities. Parents are encouraged to have their children undergo dental examinations at the same points in time required for health examinations.
(2) The Department of Public Health shall promulgate rules and regulations specifying the examinations and procedures that constitute a health examination and may recommend by rule that certain additional examinations be performed. The rules and regulations of the Department of Public Health shall specify that a tuberculosis skin test screening shall be included as a required part of each health examination included under this Section if the child resides in an area designated by the Department of Public Health as having a high incidence of tuberculosis.
Physicians licensed to practice medicine in all of its branches, advanced practice nurses who have a written collaborative agreement with a collaborating physician which authorizes them to perform health examinations, or physician assistants who have been delegated the performance of health examinations by their supervising physician shall be responsible for the performance of the health examinations, other than dental examinations and vision and hearing screening, and shall sign all report forms required by subsection (4) of this Section that pertain to those portions of the health examination for which the physician, advanced practice nurse, or physician assistant is responsible. If a registered nurse performs any part of a health examination, then a physician licensed to practice medicine in all of its branches must review and sign all required report forms. Licensed dentists shall perform all dental examinations and shall sign all report forms required by subsection (4) of this Section that pertain to the dental examinations. Physicians licensed to practice medicine in all its branches, or licensed optometrists, shall perform all vision exams required by school authorities and shall sign all report forms required by subsection (4) of this Section that pertain to the vision exam. Vision and hearing screening tests, which shall not be considered examinations as that term is used in this Section, shall be conducted in accordance with rules and regulations of the Department of Public Health, and by individuals whom the Department of Public Health has certified.
(3) Every child shall, at or about the same time as he or she receives a health examination required by subsection (1) of this Section, present to the local school, proof of having received such immunizations against preventable communicable diseases as the Department of Public Health shall require by rules and regulations promulgated pursuant to this Section and the Communicable Disease Prevention Act [410 ILCS 315/0.01 et seq.].
(4) The individuals conducting the health examination shall record the fact of having conducted the examination, and such additional information as required, on uniform forms which the Department of Public Health and the State Board of Education shall prescribe for statewide use. The examiner shall summarize on the report form any condition that he or she suspects indicates a need for special services. The individuals confirming the administration of required immunizations shall record as indicated on the form that the immunizations were administered.
(5) If a child does not submit proof of having had either the health examination or the immunization as required, then the child shall be examined or receive the immunization, as the case may be, and present proof by October 15 of the current school year, or by an earlier date of the current school year established by a school district. To establish a date before October 15 of the current school year for the health examination or immunization as required, a school district must give notice of the requirements of this Section 60 days prior to the earlier established date. If for medical reasons one or more of the required immunizations must be given after October 15 of the current school year, or after an earlier established date of the current school year, then the child shall present, by October 15, or by the earlier established date, a schedule for the administration of the immunizations and a statement of the medical reasons causing the delay, both the schedule and the statement being issued by the physician, advanced practice nurse, physician assistant, registered nurse, or local health department that will be responsible for administration of the remaining required immunizations. If a child does not comply by October 15, or by the earlier established date of the current school year, with the requirements of this subsection, then the local school authority shall exclude that child from school until such time as the child presents proof of having had the health examination as required and presents proof of having received those required immunizations which are medically possible to receive immediately. During a child’s exclusion from school for noncompliance with this subsection, the child’s parents or legal guardian shall be considered in violation of Section 26-1 [105 ILCS 5/26-1 and subject to any penalty imposed by Section 26-10 [105 ILCS 5/26-10].
(6) Every school shall report to the State Board of Education by November 15, in the manner which that agency shall require, the number of children who have received the necessary immunizations and the health examination as required, indicating, of those who have not received the immunizations and examination as required, the number of children who are exempt from health examination and immunization requirements on religious or medical grounds as provided in subsection (8). This reported information shall be provided to the Department of Public Health by the State Board of Education.
(7) Upon determining that the number of pupils who are required to be in compliance with subsection (5) of this Section is below 90% of the number of pupils enrolled in the school district, 10% of each State aid payment made pursuant to Section 18-8 [105 ILCS 5/18-8] to the school district for such year shall be withheld by the regional superintendent until the number of students in compliance with subsection (5) is the applicable specified percentage or higher.
(8) Parents or legal guardians who object to health examinations or any part thereof, or to immunizations, on religious grounds shall not be required to submit their children or wards to the examinations or immunizations to which they so object if such parents or legal guardians present to the appropriate local school authority a signed statement of objection, detailing the grounds for the objection. If the physical condition of the child is such that any one or more of the immunizing agents should not be administered, the examining physician, advanced practice nurse, or physician assistant responsible for the performance of the health examination shall endorse that fact upon the health examination form. Exempting a child from the health examination does not exempt the child from participation in the program of physical education training provided in Sections 27-5 through 27-7 of this Code [105 ILCS 5/27-5 through 105 ILCS 5/27-7].
(9) For the purposes of this Section, “nursery schools” means those nursery schools operated by elementary school systems or secondary level school units or institutions of higher learning.

§ 410 ILCS 315/2. [Regulations; public hearings; exemptions] Sec. 2. The Department of Public Health shall promulgate rules and regulations requiring immunization of children against preventable communicable diseases designated by the Director. Before any regulation or amendment thereto is prescribed, the Department shall conduct a public hearing regarding such regulation. In addition, before any regulation or any amendment to a regulation is adopted, and after the Immunization Advisory Committee has made its recommendations, the State Board of Health shall conduct 3 public hearings, geographically distributed throughout the State, regarding the regulation or amendment to the regulation. At the conclusion of the hearings, the State Board of Health shall issue a report, including its recommendations, to the Director. The Director shall take into consideration any comments or recommendations made by the Board based on these hearings. The Department may prescribe additional rules and regulations for immunization of other diseases as vaccines are developed.
The provisions of this Act shall not apply if:
1. The parent or guardian of the child objects thereto on the grounds that the administration of immunizing agents conflicts with his religious tenets or practices or,
2. A physician employed by the parent or guardian to provide care and treatment to the child states that the physical condition of the child is such that the administration of one or more of the required immunizing agents would be detrimental to the health of the child.

Allows:

  • Medical exemptions
  • Religious exemptions

TITLE 20. EDUCATION
ARTICLE 8.1. PUPILS
CHAPTER 7. HEALTH MEASURES
Burns Ind. Code Ann. § 20-8.1-7-2 (2002)
§ 20-8.1-7-2. Objections to health treatment
(a) Except as otherwise provided, a school child may not be required to undergo any testing, examination, immunization, or treatment required under this chapter when the child’s parent objects on religious grounds. A religious objection does not exempt a child from any testing, examination, immunization, or treatment required under this chapter unless the objection is:
(1) Made in writing;
(2) Signed by the child’s parent; and
(3) Delivered to the child’s teacher or to the individual who might order a test, an exam, an immunization, or a treatment absent the objection.
(b) A teacher may not be compelled to undergo any testing, examination, or treatment under this chapter when the teacher objects on religious grounds. A religious objection will not exempt an objecting individual from any testing, examination, or treatment required under this chapter unless the objection is:
(1) Made in writing;
(2) Signed by the objecting individual; and
(3) Delivered to the principal of the school in which the objecting individual teaches.
Burns Ind. Code Ann. § 20-8.1-7-2.5 (2002)
§ 20-8.1-7-2.5. Exception where immunization may be harmful to child
If any physician certifies that a particular immunization required by this chapter is or may be detrimental to the child’s health, the requirements of this chapter for that particular immunization is inapplicable for that child until it is found no longer detrimental to the child’s health.
§ 20-8.1-7-9.5. Immunization against specific diseases required
(a) Every child residing in Indiana shall be immunized against:
(1) diphtheria;
(2) pertussis (whooping cough);
(3) tetanus;
(4) measles;
(5) rubella;
(6) poliomyelitis; and
(7) mumps.
(b) Every child residing in Indiana who enters kindergarten or grade 1 shall be immunized against hepatitis B.
(c) The state department of health may expand or otherwise modify the list of communicable diseases that require documentation of immunity as medical information becomes available that would warrant the expansion or modification in the interest of public health.
(d) The state department of health shall adopt rules under IC 4-22-2 specifying the:
(1) required immunizations;
(2) child’s age for administering each vaccine;
(3) adequately immunizing doses; and
(4) method of documentation of proof of immunity.
(e) Each school shall notify each parent of a child who enrolls in the school of the requirement that the child must be immunized and that the immunization is required for the child’s continued enrollment, attendance, or residence at the school unless:
(1) the parent or child provides the appropriate documentation of immunity; or
(2) section 2 or 2.5 [IC 20-8.1-7-2 or IC 20-8.1-7-2.5] of this chapter applies.
§ 20-8.1-7-10.1. Statement of immunization history
(a) Each school shall require the parents of a child who has enrolled in the school to furnish no later than the first day of school a written statement of the child’s immunization, accompanied by the physician’s certificates or other documentation, unless a written statement of this nature is on file with the school.
(b) The statement must show, except for a child covered by section 2 or 2.5 [IC 20-8.1-7-2 or IC 20-8.1-7-2.5] of this chapter, that the child has been immunized as required under section 9.5 [IC 20-8.1-7-9.5] of this chapter. The statement must include the child’s date of birth and the date of each immunization.
(c) A child may not be permitted to attend school beyond the first day of school without furnishing this written statement, unless:
(1) The school gives the parents of the child a waiver; or
(2) The local health department or a physician determines that the child’s immunization schedule has been delayed due to extreme circumstances and that the required immunizations will not be completed before the first day of school.

The waiver referred to in subdivision (1) may not be granted for a period that exceeds twenty (20) days. If subdivision (2) applies, the parent of the child shall furnish the written statement and a time schedule, approved by a physician or the local health department, for the completion of the remainder of the immunizations.
(d) The state department of health may commence an action against a school under IC 4-21.5-3-6 or IC 4-21.5-4 for the issuance of an order of compliance for failure to enforce this section.
(e) Neither a religious objection under section 2 [IC 20-8.1-7-2] of this chapter nor an exception for the child’s health under section 2.5 [IC 20-8.1-7-2.5] of this chapter shall relieve any parent from the reporting requirements imposed under this section.
(f) The state department of health shall adopt rules under IC 4-22-2 to implement this section.

Allows:

  • Medical exemptions
  • Religious exemptions

SUBTITLE 2. HEALTH-RELATED ACTIVITIES
CHAPTER 139A. COMMUNICABLE AND INFECTIOUS DISEASES AND POISONINGS
SUBCHAPTER I. GENERAL PROVISIONS
Iowa Code § 139A.8 (2002)
139A.8 Immunization of children.
1. A parent or legal guardian shall assure that the person’s minor children residing in the state are adequately immunized against diphtheria, pertussis, tetanus, poliomyelitis, rubeola, and rubella, according to recommendations provided by the department subject to the provisions of subsections 3 and 4.
2. a. A person shall not be enrolled in any licensed childcare center or elementary or secondary school in Iowa without evidence of adequate immunizations against diphtheria, pertussis, tetanus, poliomyelitis, rubeola, and rubella.
b. Evidence of adequate immunization against haemophilus influenza B shall be required prior to enrollment in any licensed childcare center.
c. Evidence of hepatitis type B immunization shall be required of a child born on or after July 1, 1994, prior to enrollment in school in kindergarten or in a grade.
d. Immunizations shall be provided according to recommendations provided by the department subject to the provisions of subsections 3 and 4.
3. Subject to the provision of subsection 4, the state board of health may modify or delete any of the immunizations in subsection 2.
4. Immunization is not required for a person’s enrollment in any elementary or secondary school or licensed child care center if either of the following applies:
a. The applicant, or if the applicant is a minor, the applicant’s parent or legal guardian, submits to the admitting official a statement signed by a physician, who is licensed by the state board of medical examiners, that, in the physician’s opinion, the immunizations required would be injurious to the health and well-being of the applicant or any member of the applicant’s family.
b. The applicant, or if the applicant is a minor, the applicant’s parent or legal guardian, submits an affidavit signed by the applicant, or if the applicant is a minor, the applicant’s parent or legal guardian, stating that the immunization conflicts with the tenets and practices of a recognized religious denomination of which the applicant is an adherent or member.
The exemptions under this subsection do not apply in times of emergency or epidemic as determined by the state board of health and as declared by the director of public health.
5. A person may be provisionally enrolled in an elementary or secondary school or licensed child care center if the person has begun the required immunizations and if the person continues to receive the necessary immunizations as rapidly as is medically feasible. The department shall adopt rules relating to the provisional admission of persons to an elementary or secondary school or licensed childcare center.
6. The local board shall furnish the department, within sixty days after the first official day of school, evidence that each person enrolled in any elementary or secondary school has been immunized as required in this section subject to subsection 4. The department shall adopt rules pursuant to chapter 17A relating to the reporting of evidence of immunization.
7. Local boards shall provide the required immunizations to children in areas where no local provision of these services exists.
8. The department, in consultation with the director of the department of education, shall adopt rules for the implementation of this section and shall provide those rules to local school boards and local boards.

 

K

Allows:

  • Medical exemptions
  • Religious exemptions
  • Philosophical (conscientious objector, personal belief) exemptions

MATERNITY AND CHILD CARE FACILITIES
K.S.A. § 65-508 (2001)
65-508. Equipment, supplies, accommodations; immunizations.
(d) Each child cared for in a child care facility, including children of the person maintaining the facility, shall be required to have current such immunizations as the secretary of health and environment considers necessary. The person maintaining a child care facility shall maintain a record of each child’s immunizations and shall provide to the secretary of health and environment such information relating thereto, in accordance with rules and regulations of the secretary, but the person maintaining a child care facility shall not have such person’s license revoked solely for the failure to have or to maintain the immunization records required by this subsection.
(e) The immunization requirement of subsection (d) shall not apply if one of the following is obtained:
(1) Certification from a licensed physician stating that the physical condition of the child is such that immunization would endanger the child’s life or health; or
(2) a written statement signed by a parent or guardian that the parent or guardian is an adherent of a religious denomination whose teachings are opposed to immunizations.

K.S.A. § 65-519 (2001)
65-519. Certificate of registration; conditions; application for; immunizations; renewal; fees.

(c) (1) Each child cared for in a family day care home, including children of the person maintaining the home, shall be required to have current such immunizations as the secretary of health and environment considers necessary. The person maintaining a family day care home shall maintain a record of each child’s immunizations, and shall provide to the secretary of health and environment such information relating thereto, in accordance with rules and regulations of the secretary, but the person maintaining a family day care home shall not have such person’s certificate of registration revoked solely for the failure to have or to maintain the immunization records required by this subsection.
(2) The immunization requirement of subsection (c)(1) shall not apply if one of the following is obtained:
(A) Certification from a licensed physician stating that the physical condition of the child is such that immunization would endanger the child’s life or health; or
(B) a written statement signed by a parent or guardian that the parent or guardian is an adherent of a religious denomination whose teachings are opposed to immunizations.
(d) The secretary of health and environment shall provide to each person maintaining a registered family day care home a list of the requirements for registration of family day care homes. The person maintaining a family day care home shall provide a copy of such list to the parent or guardian of each child cared for in such home and shall maintain on the premises a copy of the list which has been signed and dated by the parent or guardian.
(e) The certificate of registration shall be renewed annually in the same manner provided for in this section.
(f) The secretary of health and environment shall remit all moneys received by the secretary from fees under the provisions of this act to the state treasurer in accordance with the provisions of K.S.A. 75-4215, and amendments thereto. Upon receipt of each such remittance, the state treasurer shall deposit the entire amount in the state treasury to the credit of the state general fund.
K.S.A. § 65-531 (2001)
65-531. Immunization information and records; disclosure.
On and after July 1, 1996: (a) Except as provided further, information and records which pertain to the immunization status of persons against childhood diseases as required by K.S.A. 65-508 and 65-519, and amendments thereto, may be disclosed and exchanged without a parent or guardian’s written release authorizing such disclosure, to the following, who need to know such information to assure compliance with state statutes or to achieve age appropriate immunization status for children:
(1) Employees of public agencies or departments;
(2) health records staff of child care facilities and family day care homes, including, but not limited to, facilities licensed by the secretary of health and environment;
(3) persons other than public employees who are entrusted with the regular care of those under the care and custody of a state agency including, but not limited to, operators of day care facilities, group homes, residential care facilities and adoptive or foster homes; and
(4) health care professionals.
(b) Notwithstanding K.S.A. 60-427 and amendments thereto or any other Kansas statute which provides for privileged information between a patient and a health care provider, there shall be no privilege preventing the furnishing of information and records as authorized by this section by any health care provider.
(c) Information and records which pertain to the immunization status of persons against childhood diseases as required by K.S.A. 65-508 and 65-519, and amendments thereto, whose parent or guardian has submitted a written statement of religious objection to immunization as provided in K.S.A. 65-508 or 65-519, and amendments thereto, may not be disclosed or exchanged without a parent or guardian’s written release authorizing such disclosure.

SCHOOL REGISTRATION
CHAPTER 72. SCHOOLS
ARTICLE 52. HEALTH PROGRAMS
IMMUNIZATION
K.S.A. § 72-5208 (2001)
72-5208. Health tests and inoculations; definitions.
As used in this act:
(a) “School board” means the board of education of a school district and the governing authority of any nonpublic school;
(b) “school” means all elementary, junior high, or high schools within the state;
(c) “local health department” means any county or joint board of health established under the laws of Kansas and having jurisdiction over the place where any pupil affected by this act may reside;
(d) “secretary” means the secretary of the state department of health and environment;
(e) “physician” means a person licensed to practice medicine and surgery.

K.S.A. § 72-5209 (2001)
72-5209. Health tests and inoculations; certification of completion required, alternatives; duties of school boards.
(a) In each school year, every pupil enrolling or enrolled in any school for the first time in this state, and each child enrolling or enrolled for the first time in a preschool or day care program operated by a school, and such other pupils as may be designated by the secretary, prior to admission to and attendance at school, shall present to the appropriate school board certification from a physician or local health department that the pupil has received such tests and inoculations as are deemed necessary by the secretary by such means as are approved by the secretary. Pupils who have not completed the required inoculations may enroll or remain enrolled while completing the required inoculations if a physician or local health department certifies that the pupil has received the most recent appropriate inoculations in all required series. Failure to timely complete all required series shall be deemed non-compliance.
(b) As an alternative to the certification required under subsection (a), a pupil shall present:
(1) An annual written statement signed by a licensed physician stating the physical condition of the child to be such that the tests or inoculations would seriously endanger the life or health of the child, or
(2) a written statement signed by one parent or guardian that the child is an adherent of a religious denomination whose religious teachings are opposed to such tests or inoculations.
(c) On or before May 15 of each school year, the school board of every school affected by this act shall notify the parents or guardians of all known pupils who are enrolled or who will be enrolling in the school of the provisions this act and any policy regarding the implementation of the provisions of this act adopted by the school board.
(d) If a pupil transfers from one school to another, the school from which the pupil transfers shall forward with the pupil’s transcript the certification or statement showing evidence of compliance with the requirements of this act to the school to which the pupil transfers.
K.S.A. § 72-5211a (2001)
72-5211a. Exclusion of pupils from school attendance; adoption of policy; notice; hearing; compulsory attendance law not applicable.
(a) The school board of every school affected by this act may exclude from school attendance, or by policy adopted by any such school board authorize any certificated employee or committee of certificated employees to exclude from school attendance, any pupil who has not complied with the requirements of K.S.A. 72-5209. A pupil shall be subject to exclusion from school attendance under this section until such time as the pupil shall have complied with the requirements of K.S.A. 72-5209. The policy shall include provisions for written notice to be given to the parent or guardian of the involved pupil. The notice shall (1) indicate the reason for the exclusion from school attendance, (2) state that the pupil shall continue to be excluded until the pupil has complied with the requirements of K.S.A. 72-5209, and (3) inform the parent or guardian that a hearing thereon shall be afforded the parent or guardian upon request therefore.
(b) The provisions of K.S.A. 72-1111 do not apply to any pupil while subject to exclusion from school attendance under the provisions of this section.

Allows:

  • Medical exemptions
  • Religious exemptions

TITLE XIII. EDUCATION
CHAPTER 158. CONDUCT OF SCHOOLS — SPECIAL PROGRAMS
CONDUCT OF SCHOOLS
KRS § 158.035 (2002)
§ 158.035. Certificate of immunization
Except as provided in KRS 214.036, no child shall be eligible to enroll as a student in any public or private elementary or secondary school without first presenting a certificate from a medical or osteopathic physician licensed in any state. The certificate shall state that the child has been immunized against diphtheria, tetanus, poliomyelitis, rubeola, and rubella in accordance with the provisions of this section and KRS 214.010, 214.020, 214.032 to 214.036, and 214.990 and the regulations of the secretary for health services. The governing body of private and public schools shall enforce the provisions of this section.

TITLE XVIII. PUBLIC HEALTH
CHAPTER 214. DISEASES
GENERAL PROVISIONS
KRS § 214.034 (2002)
§ 214.034. Immunization of children — Testing and treatment of children for tuberculosis — Requirement for reception and retention of current immunization certificate by schools and child-care facilities Except as otherwise provided in KRS 214.036:
(1) All parents, guardians, and other persons having care, custody, or control of any child shall have the child immunized against diphtheria, tetanus, poliomyelitis, pertussis, measles, rubella, mumps, hepatitis B, and haemophilis influenzae disease in accordance with testing and immunization schedules established by regulations of the Cabinet for Health Services. Additional immunizations may be required by the Cabinet for Health Services through the promulgation of an administrative regulation pursuant to KRS Chapter 13A if recommended by the United States Public Health Service or the American Academy of Pediatrics. All parents, guardians, and other persons having care, custody, or control of any child shall also have any child found to be infected with tuberculosis examined and treated according to administrative regulations of the Cabinet for Health Services promulgated under KRS Chapter 13A. The persons shall also have booster immunizations administered to the child in accordance with the regulations of the Cabinet for Health Services.
(2) A local health department may, with the approval of the Department of Public Health, require all first-time enrollees in a public or private school within the health department’s jurisdiction to be tested for tuberculosis prior to entering school. Following the first year of school, upon an epidemiological determination made by the state or local health officer in accordance with administrative regulations promulgated by the Cabinet for Health Services, all parents, guardians, and other persons having care, custody, or control of any child shall have the child tested for tuberculosis, and shall have any child found to be infected with tuberculosis examined and treated according to administrative regulations of the Cabinet for Health Services. Nothing in this section shall be construed to require the testing for tuberculosis of any child whose parent or guardian is opposed to such testing, and who objects by a written sworn statement to the testing for tuberculosis of the child on religious grounds. However, in a suspected case of tuberculosis, a local health department may require testing of this child.
(3) All public or private primary or secondary schools, and preschool programs shall require a current immunization certificate for any child enrolled as a regular attendee, as provided by administrative regulation of the Cabinet for Health Services, promulgated under KRS Chapter 13A, to be on file within two (2) weeks of the child’s attendance.
(4) All public or private primary schools shall require a current immunization certificate for hepatitis B for any child enrolled as a regular attendee in the sixth grade, as provided by administrative regulation of the Cabinet for Health Services, promulgated under KRS Chapter 13A, to be on file within two (2) weeks of the child’s attendance. This provision shall sunset following the 2008-2009 school year unless otherwise authorized by the General Assembly.
(5) For each child cared for in a day-care center, certified family child-care home, or any other licensed facility which cares for children, a current immunization certificate, as provided by administrative regulation of the Cabinet for Health Services, promulgated under KRS Chapter 13A, shall be on file in the center, home, or facility within thirty (30) days of entrance into the program or admission to the facility.
(6) Any forms relating to exemption from immunization requirements shall be available at public or private primary or secondary schools, preschool programs, day-care centers, certified family child-care homes, or other licensed facilities which care for children.

KRS § 214.036 (2002)
§ 214.036 Exceptions to testing or immunization requirement
Nothing contained in KRS 158.035, 214.010, 214.020, 214.032 to 214.036, and 214.990 shall be construed to require the testing for tuberculosis or the immunization of any child at a time when, in the written opinion of his attending physician, such testing or immunization would be injurious to the child’s health. Nor shall KRS 158.035, 214.010, 214.020, 214.032 to 214.036, and 214.990 be construed to require the immunization of any child whose parents are opposed to medical immunization against disease, and who object by a written sworn statement to the immunization of such child on religious grounds. Provided, however, that in the event of an epidemic in a given area, the Cabinet for Health Services may, in an emergency regulation, require the immunization of all persons within the area of the epidemic, against the disease responsible for such epidemic.

 

L

Allows:

  • Medical exemptions
  • Religious exemptions
  • Philosophical (conscientious objector, personal belief) exemptions

REVISED STATUTES
TITLE 17. EDUCATION
CHAPTER 1. GENERAL SCHOOL LAW
PART III. PUBLIC SCHOOLS AND SCHOOL CHILDREN
SUBPART A. GENERAL PROVISIONS
La. R.S. 17:170 (2002)
§ 170 Immunization of persons entering schools, kindergartens, colleges, proprietary or vocational schools, and day care centers for the first time
A. (1) All persons entering any school within the state for the first time, including elementary and secondary schools, kindergartens, colleges, universities, proprietary schools, vocational schools, and licensed day care centers, at the time of registration or entry shall present satisfactory evidence of immunity to or immunization against vaccine-preventable diseases according to a schedule approved by the office of public health, Department of Health and Hospitals, or shall present evidence of an immunization program in progress.

(2) The schedule shall include but not be limited to measles, mumps, rubella, diphtheria, tetanus, whooping cough, poliomyelitis, and haemophilus influenzae Type B invasive infections.

(3) The schedule may provide specific requirements based on age, grade in school, or type of school. At its own discretion and with the approval of the office of public health, an educational institution or licensed day care center may require immunizations or proof of immunity more extensive than required by the schedule approved by the office of public health.

B. A person transferring from another school system in or out of the state shall submit either a certificate of immunization or a letter from his personal physician or a public health clinic indicating immunizations against the diseases in the schedule approved by the office of public health in accordance with Subsection A of this Section having been performed, or a statement that such immunizations are in progress.

C. If booster immunizations for the diseases enumerated in the schedule approved by the office of public health are advised by that office, such booster immunizations shall be administered before the person enters a school system within the state.

D. Chief administrators of all elementary and secondary schools, kindergartens, colleges, universities, proprietary schools, vocational schools, and licensed day care centers within this state shall be responsible for checking students’ records to see that the provisions of this Section are enforced.

E. No person seeking to enter any school or facility enumerated in Subsection A of this Section shall be required to comply with the provisions of this Section if the student or his parent or guardian submits either a written statement from a physician stating that the procedure is contraindicated for medical reasons, or a written dissent from the student or his parent or guardian is presented.

F. In the event of an outbreak of a vaccine-preventable disease at the location of an educational institution or facility enumerated in Subsection A of this Section, the administrators of that institution or facility are empowered, upon the recommendation of the office of public health, to exclude from attendance un-immunized students and clients until the appropriate disease incubation period has expired or the un-immunized person presents evidence of immunization.
LOUISIANA REVISED STATUTES
TITLE 40. PUBLIC HEALTH AND SAFETY
CHAPTER 1. DIVISION OF HEALTH AND HEALTH OFFICERS
PART IV. IMMUNIZATION REGISTRY

La. R.S. 40:31.11 (2003)
§ 31.11 Purpose
The office of public health of the Department of Health and Hospitals and parish health units are hereby authorized to establish immunization registries for the purpose of improving the immunization rates of the state’s children and young adults in order to prevent the spread of diseases at which the immunizations are directed. Registries established in accordance with this Part shall provide for a method of informing the parent, guardian, or registrant when the registrant is due or is late for a recommended immunization and shall serve as a means for persons and institutions that either provide immunization services or are required to ensure that persons are immunized to receive prompt and accurate immunization information. Such persons and institutions shall include but not be limited to public health units, health care providers, schools, and day care centers.
La. R.S. 40:31.16 (2003)
§ 31.16 Parental consent; parental responsibility for immunization; exemptions
A. (1) Nothing in this Part shall be construed to restrict the registry from providing tracking and recall information to the parent or guardian that provides the consent for the child to be entered into an immunization registry.

(2) General consent for treatment and release of information to other providers or to the office of public health shall be considered parental consent for sharing historical, current, and future immunization information. In addition, each immunization provider shall comply with at least one of the following requirements:

(a) Place a poster in the patient registration area notifying parents that the site is participating in the state immunization registry and that childhood data is being shared with the registry.

(b) Provide each parent a brochure supplied by the office of public health describing the purposes of the registry and notifying parents that they can prohibit data sharing by notifying the health care provider not to submit their child’s immunization information.

(3) In the event of a public health emergency as declared by the state health officer, including a natural disaster, bioterrorist attack, epidemic, or other event affecting the public health, the requirement to obtain consent for placement on a registry shall be waived for mass immunizations performed in response to such declaration.

B. The immunization record of a child shall be purged from the registry at any time that the child’s custodial parent or legal guardian requests, in writing, that the immunization record be purged from the registry.

C. Nothing in this Part shall be construed to mitigate the responsibility of a parent or guardian to have a child of that parent or guardian properly immunized.

D. Nothing in this Part shall be construed to require immunization or tracking of any child otherwise exempt from immunization requirements for medical or religious reasons.

LOUISIANA ADMINISTRATIVE CODE
TITLE 51 PUBLIC HEALTH-SANITARY CODE
PART II THE CONTROL OF DISEASES
CHAPTER 7 PUBLIC HEALTH IMMUNIZATION REQUIREMENTS
LAC 51:II.701
§ 701. Immunization Schedule
A. Appropriate immunizations for age for regulatory purposes shall be determined using the current immunization schedule from the Advisory Committee for Immunization Practice (ACIP) of the United States Public Health Service. Compliance will be based on the individual having received an appropriate number of immunizations for his/her age of the following types:
1. vaccines which contain tetanus and diphtheria toxoids, including DTP, DtaP, DT, or Td or combinations which include these components;
2. polio vaccine, including OPV, eIPV, IPV, or combinations which include these components;
3. vaccines which contain measles antigen, including MMR and combinations which include these components.
B. A two-month period will be allowed from the time the immunization is due until it is considered overdue. Medical, religious, and philosophic exemptions will be allowed for compliance with regulations concerning day care attendees and school enterers. Only medical and religious exemptions will be allowed for compliance with regulations concerning public assistance recipients. A copy of the current Office of Public Health immunization schedule can be obtained by writing to the Immunization Program, Office of Public Health, 4747 Earhart Boulevard, Suite 107, New Orleans, Louisiana 70125 or by telephone (504) 483-1905 or toll free 1-800-251-2229.
C. [Formerly paragraph 2:025-1] Any child 18 years or under, admitted to any day care center or residential facility shall have verification that the child has had all appropriate immunizations for age of the child according to the Office of Public Health schedule unless presenting a written statement from a physician stating that the procedure is contraindicated for medical reasons, or a written dissent from parents. The operator of any day care center shall report to the state health officer through the health unit of the parish or municipality where such day care center is located any case or suspected case of reportable disease. Health records, including immunization records, shall be made available during normal operating hours for inspection when requested by the state health officer. When an outbreak of a communicable disease occurs in a day care center or residential facility, the operator of said day care center or residential facility shall comply with outbreak control procedures as directed by the state health officer.
D. [Formerly paragraph 2:025-2] On or before October 1 of each year, the operator of each day care center, nursery school, or residential facility enrolling or housing any child 18 years or under, shall submit a preliminary immunization status report of all children enrolled or housed as of that date. Forms for submittal shall be provided by the state health officer, and shall include identifying information for each child, and for each dose of vaccine received by the child since birth. Any child exempt from the immunization requirement shall also be identified, and the reason for exemption given on the form. After review of the form(s) by the state health officer or his or her designee, the day care center, nursery school, or residential facility operator will notify, on or before December 31 of each year, the parent or guardian of all enrolled or housed children, who are not compliant, with the immunization requirement of §§ 701.A and 701.C of this Part.
AUTHORITY NOTE: Promulgated in accordance with the provisions of R.S. 40:4(A)(2) and R.S. 40:5. Also see R.S. 17:170, R.S. 22:215.14, R.S. 40:31.15 and R.S. 44:17.

 

M

Allows:

  • Medical exemptions
  • Religious exemptions
  • Philosophical (conscientious objector, personal belief) exemptions

PART 3. ELEMENTARY AND SECONDARY EDUCATION
CHAPTER 223. HEALTH, NUTRITION AND SAFETY
SUBCHAPTER II. IMMUNIZATION
20-A M.R.S. § 6354 (2003)
§ 6354. Immunization
1. IMMUNIZATION REQUIRED. Except as otherwise provided under this subchapter, every parent shall cause to be administered to his child an adequate dosage of an immunizing agent against each disease.

2. IMMUNIZING AGENT TO MEET STANDARDS. Any such immunizing agent shall meet standards for such biological products, approved by the United States Public Health Service and the dosage requirement specified by the Department of Human Services.
20-A M.R.S. § 6355 (2001)
§ 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. § 6358 (2003)
§ 6358. Rules; requirements; reports
1. RULES AUTHORIZED. The commissioner and the Director of the Bureau of Health, Department of Human Services, shall jointly issue rules necessary for the effective implementation of this subchapter, including, but not limited to, rules specifying those diseases for which immunization is required and establishing school record keeping and reporting requirements or guidelines and procedures for the exclusion of non-immunized children from school. Rules adopted pursuant to this subchapter specifying the diseases for which immunization is required are major substantive rules as defined in Title 5, chapter 375, subchapter II-A.

2. LOCAL REQUIREMENTS AUTHORIZED. Immunization requirements more stringent than the provisions of this subchapter may be adopted by ordinance enacted by a municipality, by regulation of a school board or by policy of a private school’s governing board.
20-A M.R.S. § 6359 (2001)
§ 6359. Immunization of students
1. DEFINITIONS. As used in this section, unless the context indicates otherwise, the following terms have the following meanings.

A. “Certificate of immunization” means a written statement from a
physician, nurse or public health official who has administered an
immunizing agent to a student, specifying the dosage administered and
the date it was administered.

B. “Chief administrative officer” means the person designated by the
legal governing authority as president, administrator or director of
a public or private post-secondary school.

C. “Disease” means those conditions that are preventable by
immunizing agent, as specified in rules.

D. “Immunizing agent” means a vaccine, toxoid or other substance used
to increase an individual’s immunity to a disease.

E. “Parent” means a student’s parent, legal guardian or custodian.
A person shall be regarded as a student’s custodian if that person is
an adult and has assumed legal charge and care of the student.

F. “Public health official” means the Director of the Bureau of
Health or any designated employee or agent of the Department of Human
Services.

G. “School” means any public or private, post-secondary school in the
State including, but not limited to colleges, universities, technical
colleges and schools for the health professions.

G-1. “School health provider” means a physician, physician’s
assistant, registered nurse or nurse practitioner licensed to
practice by the State and appointed by the chief administrative
officer to provide health care to the student population.

H. “Student” means any person born after 1956 who attends school full
time or who is a candidate for a degree, diploma or graduate
certificate.

2. IMMUNIZATION. Except as otherwise provided under this section, every student shall have administered an adequate dosage of an immunizing agent against each disease as specified by rule.

Any such immunizing agent shall meet standards for the biological products, approved by the United States Public Health Service and the dosage requirement specified by the Department of Human Services.

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 requirement 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.

5. RECORDS; REPORT. Each chief administrative officer shall keep uniform records of the immunizations and immunization status of each student, based on the certificate of immunization, other acceptable evidence and other available documents. The records shall be part of the student’s permanent records.

By December 15th of each year, each chief administrative officer shall submit to the Director of the Bureau of Health a summary report of immunization status of the students entering school, as prescribed by rule. A blank summary report form will be provided to each chief administrative officer by the Bureau of Health.

6. RULES; REQUIREMENTS; REPORTS. The Director of the Bureau of Health shall adopt rules necessary for the effective implementation of this subchapter, including, but not limited to, rules establishing immunization requirements and medical exceptions to receiving vaccines or toxoids for each disease, school record keeping and reporting requirements or guidelines and procedures for the exclusion of nonimmunized students from school.

Immunization requirements more stringent than the provisions of this subchapter may be adopted by a school board or by policy of a private school’s governing board.

A student who is enrolled in a distance education program offered by a school and who does not physically attend any classes or programs at a school facility, including a campus, center or site of that school, or at a school facility, including a campus, center or site of any other school, is exempt from the provisions of this section.

Maryland – Legal Rights

EDUCATION DIVISION II.
ELEMENTARY AND SECONDARY EDUCATION
TITLE 7. PUBLIC SCHOOLS
SUBTITLE 4. HEALTH AND SAFETY OF STUDENTS
Md. EDUCATION Code Ann. § 7-403 (2002)
FIRST OF TWO VERSIONS OF THIS SECTION
§ 7-403. Immunizations [Amendment subject to abrogation] (a) Rules and regulations.
(1) In cooperation with the State Board and the Statewide Advisory Commission on Immunizations, the Department of Health and Mental Hygiene shall adopt rules and regulations regarding the immunizations and blood tests for lead poisoning required of children entering schools.
(2) These rules and regulations shall:
(i) Be adopted in compliance with the Administrative Procedure Act;
(ii) Provide that any child may have the immunization administered by his personal physician; and
(iii) 1. By September 2003, in areas designated as at risk for lead poisoning, as determined under § 18-106 of the Health-General Article, when a child enters a public pre-kindergarten program, kindergarten program, or first grade, require the parent or legal guardian of the child to provide evidence of the results of the child’s blood tests for lead poisoning administered in accordance with the guidelines of the Centers for Disease Control and Prevention in the screening of young children for lead poisoning: Guidance for State and Local Public Health Officials (November 1997) and any subsequent guidelines; and
2. By September 2003, require a program or school to report the information received under sub-subparagraph 1 of this subparagraph to the local health department in the jurisdiction where the child resides.
(3) Any requirement for the administration of pertussis vaccine shall be consistent with § 18-332 (b) of the Health-General Article.
(b) Exception.
(1) Unless the Secretary of Health and Mental Hygiene declares an emergency or an epidemic of disease, a child whose parent or guardian objects to immunization on the ground that it conflicts with the parent’s or guardian’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.
(2) The Secretary of Health and Mental Hygiene shall adopt rules and regulations for religious exemptions under this subsection.

SECOND OF TWO VERSIONS OF THIS SECTION
§ 7-403. Immunizations (Abrogation of amendment effective May 31, 2005.)

(a) Rules and regulations.
(1) In cooperation with the State Board and the Medical and Chirurgical Faculty of Maryland, the Department of Health and Mental Hygiene shall adopt rules and regulations regarding the immunizations and blood tests for lead poisoning required of children entering schools.
(2) These rules and regulations shall:
(i) Be adopted in compliance with the Administrative Procedure Act;
(ii) Provide that any child may have the immunization administered by his personal physician; and
(iii) 1. By September 2003, in areas designated as at risk for lead poisoning, as determined under § 18-106 of the Health-General Article, when a child enters a public pre-kindergarten program, kindergarten program, or first grade, require the parent or legal guardian of the child to provide evidence of the results of the child’s blood tests for lead poisoning administered in accordance with the guidelines of the Centers for Disease Control and Prevention in the screening of young children for lead poisoning: Guidance for State and Local Public Health Officials (November 1997) and any subsequent guidelines; and
2. By September 2003, require a program or school to report the information received under sub-subparagraph 1 of this subparagraph to the local health department in the jurisdiction where the child resides.
(3) Any requirement for the administration of pertussis vaccine shall be consistent with § 18-332 (b) of the Health-General Article.
(b) Exception.
(1) Unless the Secretary of Health and Mental Hygiene declares an emergency or an epidemic of disease, a child whose parent or guardian objects to immunization on the ground that it conflicts with the parent’s or guardian’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.
(2) The Secretary of Health and Mental Hygiene shall adopt rules and regulations for religious exemptions under this subsection.

HEALTH-GENERAL
TITLE 18. DISEASE PREVENTION
SUBTITLE 4. MISCELLANEOUS PROVISIONS
Md. HEALTH-GENERAL Code Ann. § 18-403 (2002)
§ 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.

Allows:

  • Medical exemptions
  • Religious exemptions

EDUCATION DIVISION II.
ELEMENTARY AND SECONDARY EDUCATION
TITLE 7. PUBLIC SCHOOLS
SUBTITLE 4. HEALTH AND SAFETY OF STUDENTS
Md. EDUCATION Code Ann. § 7-403 (2002)
FIRST OF TWO VERSIONS OF THIS SECTION
§ 7-403. Immunizations [Amendment subject to abrogation] (a) Rules and regulations.
(1) In cooperation with the State Board and the Statewide Advisory Commission on Immunizations, the Department of Health and Mental Hygiene shall adopt rules and regulations regarding the immunizations and blood tests for lead poisoning required of children entering schools.
(2) These rules and regulations shall:
(i) Be adopted in compliance with the Administrative Procedure Act;
(ii) Provide that any child may have the immunization administered by his personal physician; and
(iii) 1. By September 2003, in areas designated as at risk for lead poisoning, as determined under § 18-106 of the Health-General Article, when a child enters a public pre-kindergarten program, kindergarten program, or first grade, require the parent or legal guardian of the child to provide evidence of the results of the child’s blood tests for lead poisoning administered in accordance with the guidelines of the Centers for Disease Control and Prevention in the screening of young children for lead poisoning: Guidance for State and Local Public Health Officials (November 1997) and any subsequent guidelines; and
2. By September 2003, require a program or school to report the information received under sub-subparagraph 1 of this subparagraph to the local health department in the jurisdiction where the child resides.
(3) Any requirement for the administration of pertussis vaccine shall be consistent with § 18-332 (b) of the Health-General Article.
(b) Exception.
(1) Unless the Secretary of Health and Mental Hygiene declares an emergency or an epidemic of disease, a child whose parent or guardian objects to immunization on the ground that it conflicts with the parent’s or guardian’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.
(2) The Secretary of Health and Mental Hygiene shall adopt rules and regulations for religious exemptions under this subsection.

SECOND OF TWO VERSIONS OF THIS SECTION
§ 7-403. Immunizations (Abrogation of amendment effective May 31, 2005.)

(a) Rules and regulations.
(1) In cooperation with the State Board and the Medical and Chirurgical Faculty of Maryland, the Department of Health and Mental Hygiene shall adopt rules and regulations regarding the immunizations and blood tests for lead poisoning required of children entering schools.
(2) These rules and regulations shall:
(i) Be adopted in compliance with the Administrative Procedure Act;
(ii) Provide that any child may have the immunization administered by his personal physician; and
(iii) 1. By September 2003, in areas designated as at risk for lead poisoning, as determined under § 18-106 of the Health-General Article, when a child enters a public pre-kindergarten program, kindergarten program, or first grade, require the parent or legal guardian of the child to provide evidence of the results of the child’s blood tests for lead poisoning administered in accordance with the guidelines of the Centers for Disease Control and Prevention in the screening of young children for lead poisoning: Guidance for State and Local Public Health Officials (November 1997) and any subsequent guidelines; and
2. By September 2003, require a program or school to report the information received under sub-subparagraph 1 of this subparagraph to the local health department in the jurisdiction where the child resides.
(3) Any requirement for the administration of pertussis vaccine shall be consistent with § 18-332 (b) of the Health-General Article.
(b) Exception.
(1) Unless the Secretary of Health and Mental Hygiene declares an emergency or an epidemic of disease, a child whose parent or guardian objects to immunization on the ground that it conflicts with the parent’s or guardian’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.
(2) The Secretary of Health and Mental Hygiene shall adopt rules and regulations for religious exemptions under this subsection.

HEALTH-GENERAL
TITLE 18. DISEASE PREVENTION
SUBTITLE 4. MISCELLANEOUS PROVISIONS
Md. HEALTH-GENERAL Code Ann. § 18-403 (2002)
§ 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.

Allows:

  • Medical exemptions
  • Religious exemptions

Contact:

Massachusetts Citizens for Vaccination Choice
Post Office Box 1033
East Arlington, Massachusetts 02174-0020
Phone 781-646-4797
Annual Membership $20
Email MCVCHQ@juno.com

PART I. ADMINISTRATION OF THE GOVERNMENT
TITLE XII. EDUCATION
CHAPTER 76. SCHOOL ATTENDANCE
ALM GL ch. 76, § 15 (2002)
§ 15. Vaccination and Immunization; Exceptions by Reason of Physical Condition or Religious Belief.
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.

PART I. ADMINISTRATION OF THE GOVERNMENT
TITLE XVI. PUBLIC HEALTH
CHAPTER 111. PUBLIC HEALTH
VACCINATION
ALM GL ch. 111, § 183 (2003)
§ 183. Exemptions.
Any person over eighteen presenting a certificate, signed by the register of a probate court, that he is under guardianship shall not be subject to section one hundred and eighty-one; and any child presenting a certificate, signed by a registered physician designated by the parent or guardian, that the physician has at the time of giving the certificate personally examined the child and that he is of the opinion that the physical condition of the child is such that his health will be endangered by vaccination, shall not, while such condition continues, be subject to the two preceding sections.

105 CMR 220.500
CODE OF MASSACHUSETTS REGULATIONS
TITLE 105: DEPARTMENT OF PUBLIC HEALTH
CHAPTER 220.000: IMMUNIZATION OF STUDENTS BEFORE ADMISSION TO SCHOOL
105 CMR 220.500 (2003)
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.

Allows:

  • Medical exemptions
  • Religious exemptions
  • Philosophical (conscientious objector, personal belief) exemptions

Contact:

Michigan Opposing Mandatory Vaccines (MOM)
Post Office Box 1121
Troy, Michigan 48099-1121
Founder Suzanne Waltman
Director of Vaccine Research and Education Mary Tocco
Voice Mail 586-447-2418
Annual Membership $15
Email info@momvaccines.org

Public Health Code:

CHAPTER 333 HEALTH
PUBLIC HEALTH CODE
ARTICLE 9. SUPPORTIVE PERSONAL HEALTH SERVICES
PART 92. IMMUNIZATION
MCL § 333.9205
§ 333.9205. Child immunization; duty of parent, guardian, person in loco parentis.
Sec. 9205. 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.
MCL § 333.9208
§ 333.9208. Certificate of immunization or statement of exemption; presentation to school officials; minimum doses of immunizing agent; updated certificate.
Sec. 9208. (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
§ 333.9211. Preschool child immunization certificate, exemption statement; requirement of program registration; limitation on participation; minimum immunization, updated certificate; immunization status.
Sec. 9211. (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.

MCL § 333.9215
§ 333.9215. Exemption of child; immunization detrimental to health or not appropriate, physician certificate; religious convictions or other objections, parent’s written statement.
Sec. 9215. (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.

DEPARTMENT OF COMMUNITY HEALTH
HEALTH LEGISLATION AND POLICY DEVELOPMENT
COMMUNICABLE AND RELATED DISEASES
MICH. ADMIN. CODE R. 325.176 (2001)
§ 325.176 Immunizations required of children attending group programs or entering school.
Rule 6.
(1) As used in this rule:
(a) “Certificate of immunization” means a medical, health department, school, or personal record which indicates the dates when each dose of a vaccine was given to an individual and which is certified by a health professional or local health department.
(b) “Exemption” means a temporary or permanent waiver of 1 or more of the specific immunization requirements for medical, religious, or other reasons.
(c) “Medical exemption” means a written statement from a physician that a vaccination is medically contraindicated for a particular child for a specified period of time.
(d) “Religious or other exemption” means a written statement which is signed by the parent, guardian, or person in loco parentis of a child, which certifies that immunization is in conflict with religious or other convictions of the signer, and which includes the name and date of birth of the child.
(e) “Vaccine” means an agent for immunization against an infection or disease caused by an infectious agent.
(2) A child who is 2 months through 3 months of age and who is registered in a program of group residence or care shall have received at least all of the following vaccines:
(a) One dose of any appropriate diphtheria vaccine.
(b) One dose of any appropriate tetanus vaccine.
(c) One dose of any appropriate pertussis vaccine.
(d) One dose of any appropriate poliovirus vaccine.
(e) One dose of any appropriate Haemophilus influenzae type b vaccine.
(f) One dose of any appropriate hepatitis B vaccine.
(3) A child who is 4 months through 5 months of age and who is registered in a program of group residence or care shall have received at least all of the following vaccines:
(a) Two doses of any appropriate diphtheria vaccine.
(b) Two doses of any appropriate tetanus vaccine.
(c) Two doses of any appropriate pertussis vaccine.
(d) Two doses of any appropriate poliovirus vaccine.
(e) Two doses of any appropriate Haemophilus influenzae type b vaccine.
(f) Two doses of any appropriate hepatitis B vaccine.
(4) A child who is 6 months through 14 months of age and who is registered in a program of group residence or care shall have received at least all of the following vaccines:
(a) Three doses of any appropriate diphtheria vaccine.
(b) Three doses of any appropriate tetanus vaccine.
(c) Three doses of any appropriate pertussis vaccine.
(d) Two doses of any appropriate poliovirus vaccine.
(e) Two doses of any appropriate Haemophilus influenzae type b vaccine.
(f) Two doses of any appropriate hepatitis B vaccine.
(5) A child who is 15 months through 4 years of age and who is registered in a program of group residence, care, or camping shall have received at least all of the following vaccines:
(a) Four doses of any appropriate diphtheria vaccine.
(b) Four doses of any appropriate tetanus vaccine.
(c) Four doses of any appropriate pertussis vaccine.
(d) Three doses of any appropriate poliovirus vaccine.
(e) Haemophilus influenzae type b vaccine as shown by either of the following:
(i)Receipt of 1 dose of any appropriate Haemophilus influenzae type b vaccine at or after 15 months of age or
(ii) Receipt of a complete series of any appropriate Haemophilus influenzae type b vaccine.
(f) One dose of any appropriate live measles vaccine at or after 12 months of age. A laboratory finding of measles immunity satisfies this requirement.
(g) One dose of any appropriate live mumps vaccine at or after 12 months of age. A laboratory finding of mumps immunity satisfies this requirement.
(h) One dose of any appropriate live rubella vaccine at or after 12 months of age. A laboratory finding of rubella immunity satisfies this requirement.
(i) Three doses of any appropriate hepatitis B vaccine.
(j) Effective January 1, 2000, have evidence of varicella immunity as shown by any of the following:
(i)One dose of any appropriate varicella vaccine at or after 12 months of age.
(ii) Laboratory evidence of varicella immunity. (iii) A parent, guardian, person in loco parentis, or physician statement that the child has had varicella disease.
(6) A child who is 4 years through 6 years of age and who is entering school shall be in compliance with all of the following immunization requirements:
(a) Have received 4 doses of any appropriate diphtheria vaccine and, if a dose was not received on or after the fourth birthday, a booster dose at school entry.
(b) Have received 4 doses of any appropriate tetanus vaccine and, if a dose was not received on or after the fourth birthday, a booster dose at school entry.
(c) Have received 4 doses of any appropriate pertussis vaccine and, if a dose was not received on or after the fourth birthday, a booster dose at school entry.
(d) Have received 3 doses of any appropriate polio vaccine and, if a dose was not received on or after the fourth birthday, a booster dose at school entry.
(e) Have evidence of measles immunity as shown by either of the following:
(i) Two doses of any appropriate live measles vaccine received after the first birthday, not less than 28 days apart.
(ii) Laboratory evidence of measles immunity.
(f) Have evidence of mumps immunity as shown by either of the following:
(i) Two doses of any appropriate live mumps vaccine received after the first birthday, not less than 28 days apart.
(ii) Laboratory evidence of mumps immunity.
(g) Have evidence of rubella immunity as shown by either of the following:
(i) Two doses of any appropriate live rubella vaccine received after the first birthday, at least 28 days apart.
(ii) Laboratory evidence of rubella immunity.
(h) Three doses of any appropriate hepatitis B vaccine, beginning with the 2000-2001 school year.
(i) Beginning with the 2002-2003 school year, have evidence of varicella immunity as shown by any of the following:
(i) One dose of any appropriate live varicella vaccine at or after 12 months of age.
(ii) Laboratory evidence of varicella immunity.
(iii) A parent, guardian, person in loco parentis, or physician statement that the child has had varicella disease.
(7) A child who is 7 through 18 years of age and who is entering school shall be in compliance with all of the following immunization requirements:
(a) Have received 4 doses of any appropriate diphtheria vaccine — 3 doses if the first dose was received on or after the seventh birthday-and, if a dose was not received within the last 10 years, a booster dose at school entry.
(b) Have received 4 doses of any appropriate tetanus vaccine — 3 doses if the first dose was received on or after the seventh birthday-and, if a dose was not received within the last 10 years, a booster dose at school entry.
(c) Have received 3 doses of any appropriate poliovirus vaccine.
(d) Have evidence of measles immunity as shown by either of the following:
(i) Two doses of any appropriate live measles vaccine received after the first birthday, not less than 28 days apart.
(ii) Laboratory evidence of measles immunity.
(e) Have evidence of mumps immunity as shown by either of the following:
(i) Two doses of any appropriate live mumps vaccine received after the first birthday, not less than 28 days apart.
(ii) Laboratory evidence of mumps immunity.
(f) Have evidence of rubella immunity as shown by either of the following:
(i) Two doses of any appropriate live rubella vaccine received after the first birthday, not less than 28 days apart.
(ii) Laboratory evidence of rubella immunity.
(g) Have received 3 doses of any appropriate hepatitis B vaccine, beginning with the 2000-2001 school year.
(h) Beginning with the 2002-2003 school year, have evidence of varicella immunity as shown by any of the following:
(i) One dose of any appropriate live varicella vaccine at or after 12 months of age if the child received the vaccine before his or her thirteenth birthday.
(ii) Two doses of any appropriate live varicella vaccine, administered not less than 28 days apart, if the child received the first dose of vaccine at or after his or her thirteenth birthday.
(iii) Laboratory evidence of varicella immunity.
(iv) A parent, guardian, person in loco parentis, or physician statement that the child has had varicella disease.
(8) To satisfy the requirements in subrules (2) to (7) of this rule, each vaccine shall have been administered in accordance with the manufacturer’s instructions.
(9) 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.
(10) 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.
(11) 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.
(12) All of the following information is needed to fulfill the requirements of section 9209(1) of the code:
(a) A listing, by child, of the number of doses of each vaccine received.
(b) The date of each immunization for each vaccine received in the series.
(c) A listing, by type of exemption granted, of the children who have exemptions.
(13) Not less than 95% of entering students in a school-less the entering students who have medical, religious, or other exemptions-shall have received vaccinations as outlined in subrules (6) and (7) of this rule.
(14) A principal of a school or operator of a group program shall make immunization records available for inspection by authorized representatives of the department or the appropriate local health department. The local health officer shall also make public clinic immunization records available to local schools or group programs for the purpose of verifying pupil immunizations.
AUTHORITY: By authority conferred on the department of community health by sections 5111 and 9227 of Act No. 368 of the Public Acts of 1978, as amended, and Executive Reorganization Order No. 1996–1, being §§ 333.5111, 333.9227, and 330.3101 of the Michigan Compiled Laws

Allows:

  • Medical exemptions
  • Religious exemptions
  • Philosophical (conscientious objector, personal belief) exemptions

MINNESOTA
Minn. Stat. § 121A.15 (2002)
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.
Subdivision. 3a. Disclosures required.
(a) This paragraph applies to any written information about immunization requirements for enrollment in a school or child care facility that:
(1) is provided to a person to be immunized or enrolling or enrolled in a school or child care facility, or to the person’s parent or guardian if the person is under 18 years of age and not emancipated; and
(2) is provided by the department of health; the department of children, families, and learning; the department of human services; an immunization provider; or a school or child care facility. Such written information must describe the exemptions from immunizations permitted under subdivision 3, paragraphs (c) and (d). The information on exemptions from immunizations provided according to this paragraph must be in a font size at least equal to the font size of the immunization requirements, in the same font style as the immunization requirements, and on the same page of the written document as the immunization requirements.
(b) Before immunizing a person, an immunization provider must provide the person, or the person’s parent or guardian if the person is under 18 years of age and not emancipated, with the following information in writing:
(1) a list of the immunizations required for enrollment in a school or child care facility;
(2) a description of the exemptions from immunizations permitted under subdivision 3, paragraphs (c) and (d);
(3) a list of additional immunizations currently recommended by the commissioner; and
(4) in accordance with federal law, a copy of the vaccine information sheet from the federal Department of Health and Human Services that lists possible adverse reactions to the immunization to be provided.
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.
Subdivision. 6. Repealed, 1Sp2001 c 9 art 1 s 62
Subdivision. 7. File on immunization records.
Each school or child care facility shall maintain on file immunization records for all persons in attendance that contain the information required by subdivisions 1, 2, and 3. The school shall maintain the records for at least five years after the person attains the age of majority. The department of health and the board of health, as defined in section 145A.02, subdivision 2, in whose jurisdiction the school or child care facility is located, shall have access to the files maintained pursuant to this subdivision. When a person transfers to another elementary or secondary school or child care facility, the administrator or other person having general control and supervision of the school or child care facility shall assist the person’s parent or guardian in the transfer of the immunization file to the person’s new school or child care facility within 30 days of the transfer. Upon the request of a public or private post-secondary educational institution, as defined in section 135A.14, the administrator or other person having general control or supervision of a school shall assist in the transfer of a student’s immunization file to the post-secondary institution.
Subdivision. 8. Report.
The administrator or other person having general control and supervision of the elementary or secondary school shall file a report with the commissioner on all persons enrolled in the school. The superintendent of each district shall file a report with the commissioner for all persons within the district receiving instruction in a home school in compliance with sections 120A.22 and 120A.24. The parent of persons receiving instruction in a home school shall submit the statements as required by subdivisions 1, 2, 3, and 4 to the superintendent of the district in which the person resides by October 1 of each school year. The school report must be prepared on forms developed jointly by the commissioner of health and the commissioner of children, families, and learning and be distributed to the local districts by the commissioner of health. The school report must state the number of persons attending the school, the number of persons who have not been immunized according to subdivision 1 or 2, and the number of persons who received an exemption under subdivision 3, clause (c) or (d). The school report must be filed with the commissioner of children, families, and learning within 60 days of the commencement of each new school term. Upon request, a district must be given a 60-day extension for filing the school report. The commissioner of children, families, and learning shall forward the report, or a copy thereof, to the commissioner of health who shall provide summary reports to boards of health as defined in section 145A.02, subdivision 2. The administrator or other person having general control and supervision of the child care facility shall file a report with the commissioner of human services on all persons enrolled in the child care facility. The child care facility report must be prepared on forms developed jointly by the commissioner of health and the commissioner of human services and be distributed to child care facilities by the commissioner of health. The child care facility report must state the number of persons enrolled in the facility, the number of persons with no immunizations, the number of persons who received an exemption under subdivision 3, clause (c) or (d), and the number of persons with partial or full immunization histories. The child care facility report must be filed with the commissioner of human services by November 1 of each year. The commissioner of human services shall forward the report, or a copy thereof, to the commissioner of health who shall provide summary reports to boards of health as defined in section 145A.02, subdivision 2. The report required by this subdivision is not required of a family child care or group family child care facility, for pre-kindergarten children enrolled in any elementary or secondary school provided services according to sections 125A.05 and 125A.06, nor for child care facilities 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.
Subdivision. 9. Definitions. As used in this section the following terms have the meanings given them.
(a) “Elementary or secondary school” includes any public school as defined in section 120A.05, subdivisions 9, 11, 13, and 17, or nonpublic school, church, or religious organization, or home school in which a child is provided instruction in compliance with sections 120A.22 and 120A.24.
(b) “Person enrolled in any elementary or secondary school” means a person born after 1956 and enrolled in grades kindergarten through 12, and a child with a disability receiving special instruction and services as required in sections 125A.03 to 125A.24 and 125A.65, excluding a child being provided services according to section 125A.05, paragraph (c), or 125A.06, paragraph (d).
(c) “Child care facility” includes those child care programs subject to licensure under chapter 245A, and Minnesota Rules, chapters 9502 and 9503.
(d) “Family child care” means child care for no more than ten children at one time of which no more than six are under school age. The licensed capacity must include all children of any caregiver when the children are present in the residence.
(e) “Group family child care” means child care for no more than 14 children at any one time. The total number of children includes all children of any caregiver when the children are present in the residence.
Subdivision. 10. Requirements for immunization statements.
A statement required to be submitted under subdivisions 1, 2, and 4 to document evidence of immunization shall include month, day, and year for immunizations administered after January 1, 1990.
(a) For persons enrolled in grades 7 and 12 during the 1996-1997 school term, the statement must indicate that the person has received a dose of tetanus and diphtheria toxoid no earlier than 11 years of age.
(b) Except as specified in paragraph (e), for persons enrolled in grades 7, 8, and 12 during the 1997-1998 school term, the statement must indicate that the person has received a dose of tetanus and diphtheria toxoid no earlier than 11 years of age.
(c) Except as specified in paragraph (e), for persons enrolled in grades 7 through 12 during the 1998-1999 school term and for each year thereafter, the statement must indicate that the person has received a dose of tetanus and diphtheria toxoid no earlier than 11 years of age.
(d) For persons enrolled in grades 7 through 12 during the 1996-1997 school year and for each year thereafter, the statement must indicate that the person has received at least two doses of vaccine against measles, mumps, and rubella, given alone or separately and given not less than one month apart.
(e) A person who has received at least three doses of tetanus and diphtheria toxoids, with the most recent dose given after age six and before age 11, is not required to have additional immunization against diphtheria and tetanus until ten years have elapsed from the person’s most recent dose of tetanus and diphtheria toxoid.
(f) The requirement for hepatitis B vaccination shall apply to persons enrolling in kindergarten beginning with the 2000-2001 school term.
(g) The requirement for hepatitis B vaccination shall apply to persons enrolling in grade 7 beginning with the 2001-2002 school term.
Subdivision. 11. Commissioner of human services; continued responsibilities.
Nothing in this section relieves the commissioner of human services of the responsibility, under chapter 245A, to inspect and assure that statements required by this section are on file at child care programs subject to licensure.
Subdivision. 12. Modifications to schedule. (a) The commissioner of health may adopt modifications to the immunization requirements of this section. A proposed modification made under this subdivision must be part of the current immunization recommendations of each of the following organizations: the United States Public Health Service’s Advisory Committee on Immunization Practices, the American Academy of Family Physicians, and the American Academy of Pediatrics. In proposing a modification to the immunization schedule, the commissioner must:
(1) consult with the commissioner of children, families, and learning; the commissioner of human services; the chancellor of the Minnesota state colleges and universities; and the president of the University of Minnesota; and
(2) consider the following criteria: the epidemiology of the disease, the morbidity and mortality rates for the disease, the safety and efficacy of the vaccine, the cost of a vaccination program, the cost of enforcing vaccination requirements, and a cost-benefit analysis of the vaccination.
(b) Before a proposed modification may be adopted, the commissioner must notify the chairs of the house and senate committees with jurisdiction over health policy issues. If the chairs of the relevant standing committees determine a public hearing regarding the proposed modifications is in order, the hearing must be scheduled within 60 days of receiving notice from the commissioner. If a hearing is scheduled, the commissioner may not adopt any proposed modifications until after the hearing is held.
(c) The commissioner shall comply with the requirements of chapter 14 regarding the adoption of any proposed modifications to the immunization schedule.
(d) In addition to the publication requirements of chapter 14, the commissioner of health must inform all immunization providers of any adopted modifications to the immunization schedule in a timely manner.

Allows:

  • Medical exemptions

MISSISSIPPI
Miss. Code Ann. § 41-23-37 (2002)
§ 41-23-37. Immunization practices for control of vaccine preventable diseases; attendance by unvaccinated children
Whenever indicated, the state health officer shall specify such immunization practices as may be considered best for the control of vaccine preventable diseases. A listing shall be promulgated annually or more often, if necessary.

Except as provided hereinafter, it shall be unlawful for any child to attend any school, kindergarten or similar type facility intended for the instruction of children (hereinafter called “schools”), either public or private, with the exception of any legitimate home instruction program as defined in Section 37-13-91, Mississippi Code of 1972, for ten (10) or less children who are related within the third degree computed according to the civil law to the operator, unless they shall first have been vaccinated against those diseases specified by the state health officer.

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.
Section 41-23-37 serves an overriding and compelling public interest which extends to the exclusion of a child until immunization has been effected; the provision of § 41-23-37 providing an exemption because of religious belief is in violation of the Fourteenth Amendment to the United States Constitution and is void. Brown v. Stone, 378 So. 2d 218 (Miss. 1979), cert. denied, 449 U.S. 887, 101 S. Ct. 242, 66 L. Ed. 2d 112 (1980)

Allows:

  • Medical exemptions
  • Religious exemptions

Contact:
Missouri Citizens’ Coalition for Freedom in Health Care (MCC – FHC)
Post Office Box 190318
St. Louis, Missouri 63119-0318
Phone 314-968-8755
Annual Membership $25

MISSOURI
TITLE 11. EDUCATION AND LIBRARIES
CHAPTER 167. PUPILS AND SPECIAL SERVICES
PUPILS
§ 167.181 R.S.Mo. (2001)
§ 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.

Allows:

  • Medical exemptions
  • Religious exemptions

TITLE 20 EDUCATION
CHAPTER 5 PUPILS
PART 4 HEALTH
Mont. Code Anno., § 20-5-403 (2002)
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 any person to commence attendance 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 any person to commence attendance 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 send the original immunization records for the pupil to the school district to which the pupil transfers.
Mont. Code Anno., § 20-5-405 (2002)
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.

Administrative Rules (found below)
ARM 16.28.707 Medical exemption.
ARM 16.28.708 Religious or personal exemption.
Attorney General’s Opinions
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).

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. 37.114.716 (2002)
37.114.716 RELIGIOUS EXEMPTION
(1) A person seeking to attend school is exempt from all or part of the immunization requirements if the parent or guardian of that person, an adult responsible for that person, or the person 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) A claim of exemption from immunization requirements on religious grounds must be maintained on a form provided by the department and provided to the school prior to each school year by the parent or guardian of the pupil for which a religious exemption is claimed, or adult responsible for him or her, unless the pupil is 18 years of age or older or emancipated, in which case the pupil may claim his or her own exemption.
(3) The original copy of the claim of religious exemption must be kept by the school as part of the person’s school record.
MONT. ADMIN. R. 37.114.715 (2002)
37.114.715 MEDICAL EXEMPTION
(1) A person seeking to attend school is not required to have any immunizations which are medically contraindicated. A written and signed statement from any physician that an immunization is medically contraindicated will exempt a person from whatever immunization requirements of 20-5-403, MCA, the statement indicates necessary.
(2) The statement must include:
(a) which specific immunization is contraindicated;
(b) the period of time immunization is contraindicated; and
(c) the reasons for the medical contraindication.
(3) A physician’s medical exemption may be recorded on the department’s Montana certificate of immunization form or a form obtained from the department for use as documentation.
(4) The physician’s written statement must be maintained by the school as part of the immunization record of the person qualifying for the exemption.

 

N

Allows:

  • Medical exemptions
  • Religious exemptions

CHAPTER 71. PUBLIC HEALTH AND WELFARE
ARTICLE 19. CARE OF CHILDREN
(b) CHILD CARE LICENSURE
R.R.S. Neb. § 71-1913.01 (2002)
§ 71-1913.01. Immunization requirements; record; report
(1) Each program shall require the parent or guardian of each child enrolled in such program to present within thirty days after enrollment and periodically thereafter (a) proof that the child is protected by age-appropriate immunization against measles, mumps, rubella, poliomyelitis, diphtheria, pertussis, tetanus, and haemophilus influenzae type B and such other diseases as the Department of Health and Human Services may from time to time specify based on then current medical and scientific knowledge, (b) certification by a physician, an advanced practice registered nurse, or a physician assistant that immunization is not appropriate for a stated medical reason, or (c) a written statement that the parent or guardian does not wish to have such child so immunized and the reasons therefore. The program shall exclude a child from attendance until such proof, certification, or written statement is provided. At the time the parent or guardian is notified that such information is required, he or she shall be notified in writing of his or her right to submit a certification or written statement pursuant to subdivision (b) or (c) of this subsection.
(2) Each program shall keep the written record of immunization, the certification, or the written statement of the parent or guardian. Such record, certification, or statement shall be kept by the program as part of the child’s file, shall be available onsite to the Department of Health and Human Services and the Department of Health and Human Services Regulation and Licensure, and shall be filed with the Department of Health and Human Services for review and inspection. Each program shall report to the Department of Health and Human Services by November 1 of each year the status of immunization for children enrolled as of September 30 of that year, and children who have reached kindergarten age and who are enrolled in public or private school need not be included in the report.

CHAPTER 79. SCHOOLS
ARTICLE 2. PROVISIONS RELATING TO STUDENTS
(c) ADMISSION REQUIREMENTS
R.R.S. Neb. § 79-217 (2002)
§ 79-217. Board of education and governing authority; student; immunization against certain contagious diseases; exception
Except as provided in sections 79-221 and 79-222, the school board or board of education of each school district and the governing authority of each private, denominational, or parochial school in this state shall require each student to be protected against measles, mumps, rubella, poliomyelitis, diphtheria, pertussis, and tetanus by immunization prior to enrollment. Any student who does not comply with this section shall not be permitted to continue in school until he or she so complies, except as provided by section 79-222. Each school district shall make diligent efforts to inform families prior to the date of school registration of the immunization requirements of this section.

Except as provided in the Childhood Vaccine Act, the cost of such immunization shall be borne by the parent or guardian of each student who is immunized or by the Department of Health and Human Services for those students whose parent or guardian is financially unable to meet such cost.
R.R.S. Neb. § 79-220 (2002)
§ 79-220. Child; physical examination; immunization; right of refusal
At the time the parent or guardian of any child is notified that such child must have a physical examination pursuant to section 79-214 or immunizations pursuant to section 79-217, he or she shall also be notified in writing of his or her right to submit a written statement refusing a physical examination or immunization for his or her child.
R.R.S. Neb. § 79-221 (2002)
§ 79-221. Immunization; when not required
Immunization shall not be 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:
(1) A statement signed by a physician, a physician assistant, or an advanced practice registered nurse stating that, in the health care provider’s opinion, the immunizations required would be injurious to the health and well-being of the student or any member of the student’s family or household; or
(2) An 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.

Allows:

  • Medical exemptions
  • Religious exemptions

CHAPTER 71. PUBLIC HEALTH AND WELFARE
ARTICLE 19. CARE OF CHILDREN
(b) CHILD CARE LICENSURE
R.R.S. Neb. § 71-1913.01 (2002)
§ 71-1913.01. Immunization requirements; record; report
(1) Each program shall require the parent or guardian of each child enrolled in such program to present within thirty days after enrollment and periodically thereafter (a) proof that the child is protected by age-appropriate immunization against measles, mumps, rubella, poliomyelitis, diphtheria, pertussis, tetanus, and haemophilus influenzae type B and such other diseases as the Department of Health and Human Services may from time to time specify based on then current medical and scientific knowledge, (b) certification by a physician, an advanced practice registered nurse, or a physician assistant that immunization is not appropriate for a stated medical reason, or (c) a written statement that the parent or guardian does not wish to have such child so immunized and the reasons therefore. The program shall exclude a child from attendance until such proof, certification, or written statement is provided. At the time the parent or guardian is notified that such information is required, he or she shall be notified in writing of his or her right to submit a certification or written statement pursuant to subdivision (b) or (c) of this subsection.
(2) Each program shall keep the written record of immunization, the certification, or the written statement of the parent or guardian. Such record, certification, or statement shall be kept by the program as part of the child’s file, shall be available onsite to the Department of Health and Human Services and the Department of Health and Human Services Regulation and Licensure, and shall be filed with the Department of Health and Human Services for review and inspection. Each program shall report to the Department of Health and Human Services by November 1 of each year the status of immunization for children enrolled as of September 30 of that year, and children who have reached kindergarten age and who are enrolled in public or private school need not be included in the report.

CHAPTER 79. SCHOOLS
ARTICLE 2. PROVISIONS RELATING TO STUDENTS
(c) ADMISSION REQUIREMENTS
R.R.S. Neb. § 79-217 (2002)
§ 79-217. Board of education and governing authority; student; immunization against certain contagious diseases; exception
Except as provided in sections 79-221 and 79-222, the school board or board of education of each school district and the governing authority of each private, denominational, or parochial school in this state shall require each student to be protected against measles, mumps, rubella, poliomyelitis, diphtheria, pertussis, and tetanus by immunization prior to enrollment. Any student who does not comply with this section shall not be permitted to continue in school until he or she so complies, except as provided by section 79-222. Each school district shall make diligent efforts to inform families prior to the date of school registration of the immunization requirements of this section.

Except as provided in the Childhood Vaccine Act, the cost of such immunization shall be borne by the parent or guardian of each student who is immunized or by the Department of Health and Human Services for those students whose parent or guardian is financially unable to meet such cost.
R.R.S. Neb. § 79-220 (2002)
§ 79-220. Child; physical examination; immunization; right of refusal
At the time the parent or guardian of any child is notified that such child must have a physical examination pursuant to section 79-214 or immunizations pursuant to section 79-217, he or she shall also be notified in writing of his or her right to submit a written statement refusing a physical examination or immunization for his or her child.
R.R.S. Neb. § 79-221 (2002)
§ 79-221. Immunization; when not required
Immunization shall not be 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:
(1) A statement signed by a physician, a physician assistant, or an advanced practice registered nurse stating that, in the health care provider’s opinion, the immunizations required would be injurious to the health and well-being of the student or any member of the student’s family or household; or
(2) An 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.

Allows:

  • Medical exemptions
  • Religious exemptions

TITLE X. PUBLIC HEALTH
CHAPTER 141-C. COMMUNICABLE DISEASE
RSA 141-C:20-a (2002)
§ 141-C:20-a. Immunization
I. All parents or legal guardians shall have their children who are residing in this state immunized against certain diseases. These diseases shall include, but not be limited to, diphtheria, mumps, pertussis, poliomyelitis, rubella, rubeola, and tetanus. The commissioner shall adopt rules under RSA 541-A relative to other diseases which require immunization.
II. No child shall be admitted or enrolled in any school or child care agency, public or private, unless the following is demonstrated:
(a) Immunization under paragraph I;
(b) Partial immunization relative to the age of the child as specified in rules adopted by the commissioner; or
(c) Exemption under RSA 141-C:20-c.
RSA 141-C:20-c (2002)
§ 141-C:20-c. Exemptions
A child shall be exempt from immunization if:
I. A physician licensed under RSA 329, or a physician exempted under RSA 329:21, III, 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.
II. 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.

Allows:

  • Medical exemptions
  • Religious exemptions

TITLE 18A. EDUCATION
SUBTITLE 8A. HIGHER EDUCATION; PUBLIC AND NONPUBLIC INSTITUTIONS
CHAPTER 61D. RULES AND REGULATIONS

N.J. Stat. § 18A:61D-3 (2002)

§ 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 (2002)

§ 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.

N.J. Stat. § 18A:61D-10 (2003)

§ 18A:61D-10. Exemption from vaccination

A student shall not be required to receive a vaccination pursuant to section 2 or 3 of this act [C. 18A:61D-9 and 18A:40-21.1] based upon one of the following:

a. a written statement submitted to the secondary school or institution of higher education, as applicable, by a licensed physician indicating that the vaccine is medically contraindicated for a specific period of time and the reasons for the medical contraindication, based upon valid medical reasons as determined by regulation of the Commissioner of Health and Senior Services, which shall exempt the student from the vaccination for the stated period of time; or

b. a written statement submitted to the secondary school or institution of higher education, as applicable, by the student, or the student’s parent or guardian if the student is a minor, explaining how the administration of the vaccine conflicts with the bona fide religious tenets or practices of the student, or the parent or guardian, as appropriate; except that a general philosophical or moral objection to the vaccination shall not be sufficient for an exemption on religious grounds.

N.J. Stat. § 18A:40-21.1 (2002)

§ 18A:40-21.1. Hepatitis B vaccination required for public and private school students in grades nine through twelve
The Commissioner of Health and Senior Services shall require the immunization of a child for hepatitis B as a condition of enrollment in grades nine through 12.

b. Beginning with the 2003-2004 school year, a principal, director or other person in charge of a public or private school in this State shall not knowingly admit or retain in grades nine through 12 a child whose parent or guardian has not submitted acceptable evidence of the child’s immunization for hepatitis B prior to or during enrollment in ninth grade, as provided by regulation of the Commissioner of Health and Senior Services.

c. The Commissioner of Health and Senior Services shall adopt rules and regulations pursuant to the “Administrative Procedure Act,” P.L. 1968, c. 410 (C. 52:14B-1 et seq.) to carry out the purposes of this section.

TITLE 26. HEALTH AND VITAL STATISTICS
CHAPTER 1A. STATE DEPARTMENT OF HEALTH — REORGANIZED

N.J. Stat. § 26:1A-9.1 (2003)

§ 26:1A-9.1. Exemption for pupils from mandatory immunization; interference with religious rights; suspension
Provisions in the State Sanitary Code in implementation of this act shall provide for exemption for pupils from mandatory immunization if the parent or guardian of the pupil objects thereto in a written statement signed by the parent or guardian upon the ground that the proposed immunization interferes with the free exercise of the pupil’s religious rights. This exemption may be suspended by the State Commissioner of Health during the existence of an emergency as determined by the State Commissioner of Health.

N.J. Stat. § 26:1A-9.1 (2002)

TITLE 26. HEALTH AND VITAL STATISTICS

CHAPTER 2N. PERTUSSIS VACCINATION

N.J. Stat. § 26:2N-4 (2002)

§ 26:2N-4. Contraindication exemption
A child shall not be required to receive a pertussis vaccine as a condition for admission to a public or private school if the child’s health care provider states in writing that the vaccine is medically contraindicated pursuant to subsection b. (1) of section 2 of this act and the reasons for the medical contradictions.

Allows:

  • Medical exemptions
  • Religious exemptions
  • Philosophical (conscientious objector, personal belief) exemptions

CHAPTER 24. HEALTH AND SAFETY
ARTICLE 5. IMMUNIZATION

N.M. Stat. Ann. § 24-5-1 (2002)

§ 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 (2002)

§ 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 (2002)

§ 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.

Allows:

  • Medical exemptions
  • Religious exemptions

EDUCATION LAW
TITLE 1. GENERAL PROVISIONS
ARTICLE 19. MEDICAL AND HEALTH SERVICE

NY CLS Educ § 914 (2002)

§ 914. Immunization of children

1. Each school shall require of every child entering or, after the thirtieth day of June, nineteen hundred eighty, every child attending such school proof of immunization against poliomyelitis, mumps, measles, diphtheria [fig 1] , rubella and varicella in accordance with the provisions of section twenty-one hundred sixty-four of the public health law. If a child entered school prior to the first day of March, nineteen hundred seventy-seven, no school shall be required to obtain proof of such child’s having received an immunization against mumps until the first day of July, nineteen hundred eighty-one.

2. Each school district shall assist and cooperate with the municipality in the development of a plan required by section [fig 1] six hundred thirteen of the public health law.

3. Each school district shall participate in the surveys directed by the state commissioner of health pursuant to section [fig 1] six hundred thirteen of the public health law of the immunization level of the children entering and attending school within such district [fig 2] and which shall be subject to audit by the state commissioner of health. Each school and school district shall provide the state commissioner of health with any records and reports he may require for the purpose of such audit. In no event shall the state commissioner of health disclose student identity.

PUBLIC HEALTH LAW
ARTICLE 21. CONTROL OF ACUTE COMMUNICABLE DISEASES
TITLE VI. POLIOMYELITIS AND OTHER DISEASES

NY CLS Pub Health § 2164 (2002)

§ 2164. Definitions; immunization against poliomyelitis, mumps, measles, diphtheria, rubella, varicella, Haemophilus influenzae type b (Hib) and hepatitis B

1. As used in this section, unless the context requires otherwise:
a. The term “school” means and includes any public, private or parochial child caring center, day nursery, day care agency, nursery school, kindergarten, elementary, intermediate or secondary school.

b. The term “child” shall mean and include any person between the ages of two months and eighteen years.

c. The term “person in parental relation to a child” shall mean and include his father or mother, by birth or adoption, his legally appointed guardian, or his custodian. A person shall be regarded as the custodian of a child if he has assumed the charge and care of the child because the parents or legally appointed guardian of the minor have died, are imprisoned, are mentally ill, or have been committed to an institution, or because they have abandoned or deserted such child or are living outside the state or their whereabouts are unknown.

d. (Added, L 1989) The term “health practitioner” shall mean any person authorized by law to administer an immunization.

2. Every person in parental relation to a child in this state shall have administered to such child an adequate dose or doses of an immunizing agent against poliomyelitis, mumps, measles, diphtheria, rubella, varicella, Haemophilus influenzae type b (Hib) and hepatitis B, which meets the standards approved by the United States public health service for such biological products, and which is approved by the [fig 1] department [fig 2] under such conditions as may be specified by the public health council.

3. The person in parental relation to any such child who has not previously received such immunization shall present the child to a health practitioner and request such health practitioner to administer the necessary immunization against poliomyelitis, mumps, measles, diphtheria, Haemophilus influenzae type b (Hib), rubella, varicella and hepatitis B as provided in subdivision two of this section.

4. If any person in parental relation to such child is unable to pay for the services of a private health practitioner, such person shall present such child to the health officer of the county in which the child resides, who shall then administer the immunizing agent without charge.

5. The health practitioner who administers such immunizing agent against poliomyelitis, mumps, measles, diphtheria, Haemophilus influenzae type b (Hib), rubella, varicella and hepatitis B to any such child shall give a certificate of such immunization to the person in parental relation to such child.

6. In the event that a person in parental relation to a child makes application for admission of such child to a school or has a child attending school and there exists no certificate or other acceptable evidence of the child’s immunization against poliomyelitis, mumps, measles, diphtheria, rubella, varicella, hepatitis B and, where applicable, Haemophilus influenzae type b (Hib), the principal, teacher, owner or person in charge of the school shall inform such person of the necessity to have the child immunized, that such immunization may be administered by any health practitioner, or that the child may be immunized without charge by the health officer in the county where the child resides, if such person executes a consent therefore. In the event that such person does not wish to select a health practitioner to administer the immunization, he shall be provided with a form which shall give notice that as a prerequisite to processing the application for admission to, or for continued attendance at, the school such person shall state a valid reason for withholding consent or consent shall be given for immunization to be administered by a health officer in the public employ, or by a school physician or nurse. The form shall provide for the execution of a consent by such person and it shall also state that such person need not execute such consent if subdivision eight or nine of this section apply to such child.

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, varicella, hepatitis B and, where applicable, Haemophilus influenzae 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 and 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 and, where applicable, Haemophilus influenzae type b (Hib), 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.

10. The commissioner may adopt and amend rules and regulations to effectuate the provisions and purposes of this section.

11. (Added, L 1994) Every school shall annually provide the commissioner, on forms provided by the commissioner, a summary regarding compliance with the provisions of this section.

Allows:

  • Medical exemptions
  • Religious exemptions

CHAPTER 130A. PUBLIC HEALTH
ARTICLE 6. COMMUNICABLE DISEASES
PART 2. IMMUNIZATION

N.C. Gen. Stat. § 130A-152 (2002)

§ 130A-152. Immunization required

(a) Every child present in this State shall be immunized against diphtheria, tetanus, whooping cough, poliomyelitis, red measles (rubeola) and rubella. In addition, every child present in this State shall be immunized against any other disease upon a determination by the Commission that the immunization is in the interest of the public health. Every parent, guardian, person in loco parentis and person or agency, whether governmental or private, with legal custody of a child shall have the responsibility to ensure that the child has received the required immunization at the age required by the Commission. If a child has not received the required immunizations by the specified age, the responsible person shall obtain the required immunization for the child as soon as possible after the lack of the required immunization is determined.

(b) Repealed by Session Laws 2002-179, s. 10, effective October 1, 2002.

(c) The Commission shall adopt and the Department shall enforce rules concerning the implementation of the immunization program. The rules shall provide for:

(1) The child’s age at administration of each vaccine;

(2) The number of doses of each vaccine;

(3) Exemptions from the immunization requirements where medical practice suggests that immunization would not be in the best health interests of a specific category of children;

(4) The procedures and practices for administering the vaccine; and

(5) Redistribution of vaccines provided to local health departments.

(c1) The Commission for Health Services shall, pursuant to G.S. 130A-152 and G.S. 130A-433, adopt rules establishing reasonable fees for the administration of vaccines and rules limiting the requirements that can be placed on children, their parents, guardians, or custodians as a condition for receiving vaccines provided by the State. These rules shall become effective January 1, 1994.

(d) Only vaccine preparations which meet the standards of the United States Food and Drug Administration or its successor in licensing vaccines and are approved for use by the Commission may be used.

(e) When the Commission requires immunization against a disease not listed in paragraph (a) of this section, or requires an additional dose of a vaccine, the Commission is authorized to exempt from the new requirement children who are or who have been enrolled in school (K-12) on or before the effective date of the new requirement.

N.C. Gen. Stat. § 130A-156 (2002)

§ 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.

N.C. Gen. Stat. § 130A-157 (2002)

§ 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 Chapter, 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.

TITLE 15A. DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
CHAPTER 19. HEALTH: EPIDEMIOLOGY
SUBCHAPTER 19A. COMMUNICABLE DISEASE CONTROL
SECTION .0400. IMMUNIZATION

15A N.C.A.C. 19A.0403 (2003)

.0403 NON-RELIGIOUS PERSONAL BELIEF NO EXEMPTION

Except as provided in G.S. 130A-156 and G.S. 130A-157, and 15A NCAC 19A .0404 and .0405, no child shall be exempt from the requirements of 15A NCAC 19A .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.

Allows:

  • Medical exemptions
  • Religious exemptions
  • Philosophical (conscientious objector, personal belief) exemptions

TITLE 23. HEALTH AND SAFETY
CHAPTER 23-07. REPORTABLE DISEASES

N.D. Cent. Code, § 23-07-17.1 (2002)

§ 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 immunization against diphtheria, pertussis, tetanus, measles, rubella (German measles), mumps, hepatitis B, haemophilus influenza type b (Hib), and poliomyelitis. 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 health.

 

O

Allows:

  • Medical exemptions
  • Religious exemptions
  • Philosophical (conscientious objector, personal belief) exemptions

Contact:
Ohio Parents for Vaccine Safety
251 West Ridgeway Drive
Post Office Box 1033
Dayton, Ohio 45459
Founder Kristine M. Severyn, R.Ph., Ph.D.
Quarterly Newsletter $15 annually
Phone and Fax 937-435-4750

TITLE XXXIII [33] EDUCATION
CHAPTER 3313: BOARDS OF EDUCATION
[SCHOOL YEAR]

ORC Ann. 3313.67 (Anderson 2002)

§ 3313.67 Immunization of pupils; records, reports.

(A) The board of education of each city, exempted village, or local school district may make and enforce such rules to secure the immunization of, and to prevent the spread of communicable diseases among the pupils attending or eligible to attend the schools of the district, as in its opinion the safety and interest of the public require. Boards of health, legislative authorities of municipal corporations, and boards of township trustees, on application of the board of education of the district, at the public expense, without delay, shall provide the means of immunization to pupils who are not so provided by their parents or guardians.

(B) The board 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 [3313.67.1] 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.

(C) 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 (Anderson 2002)

[§ 3313.67.1] § 3313.671 Required immunizations; exceptions.

(A) Except as otherwise provided in this division, 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 so immunized. Also, except as provided in this division, no pupil who begins kindergarten at an elementary school subject to the state board of education’s minimum standards during or after the school year beginning in 1999 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 against hepatitis B or is in the process of being so immunized. “In the process of being so immunized” means the pupil has been immunized against mumps, rubeola and rubella, 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 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 so 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 of progress on the director of health’s interval schedule.

(1) A pupil who has had natural rubeola, and presents a signed statement from the pupil’s parent or physician to that effect, is not required to be immunized against rubeola.

(2) A pupil was has had natural mumps, and presents a signed statement from the pupil’s parent or physician to that effect, is not required to be immunized against mumps.

(3) A pupil who presents a written statement of the pupil’s parent or guardian in which the parent or guardian objects to the immunization for good cause, including religious convictions, is not required to be immunized.

(4) 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. This section does not limit or impair the right of a board of education of a city, exempted village, or local school district to make and enforce rules to secure immunization against mumps, poliomyelitis, rubeola, rubella, diphtheria, pertussis, tetanus, and hepatitis B of the pupils under its jurisdiction.

(B) 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.

Allows:

  • Medical exemptions
  • Religious exemptions
  • Philosophical (conscientious objector, personal belief) exemptions

IMMUNIZATION OF CHILDREN

10 Okl. St. § 411 (2003)

§ 411. Certificate of immunization as condition for admission to day care facility–Alteration of list of required immunizations

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. § 412 (2003)

§ 412. Manner and frequency of immunizations–Enforcement of act

A. The immunizations required by this act, and the manner and frequency of their administration, as prescribed by the State Board of Health, shall conform to recognized standard medical practices in this state. The State Department of Health shall supervise and secure the enforcement of the required immunization program.

B. The Department of Human Services shall render reasonable assistance to the State Department of Health in the enforcement of the provisions of this act. This assistance shall be in the form of revocation or denial of the license of any facility not in compliance with this act.

10 Okl. St. § 413 (2003)

§ 1-502. Rules and regulations

(a) The State Board of Health shall have authority to adopt such rules and regulations, not inconsistent with law, as it deems necessary to aid in the prevention and control of communicable disease, which may be on the following matters: Recommended immunization procedures; quarantine measures; exclusion of children from school; regulation of public meetings and gatherings in epidemic situations; regulation of vectors; control of vehicles capable of transmitting a communicable disease; detection and diagnosis of communicable disease; carriers of disease; disposal of infected body wastes and other materials; fumigation, cleaning and sterilization, and disinfection; and other necessary measures to prevent and control communicable disease.

(b) The State Board of Health is authorized to establish preventive programs for noncommunicable diseases and to promulgate rules and regulations for the control of causative or toxic substances which can or may cause disease.

DIVISION III. OTHER SCHOOL LAWS
CHAPTER 15. HEALTH AND SAFETY
IMMUNIZATION

70 Okl. St. § 1210.191 (2003)

70 Okl. St. § 1210.192 (2003)

§ 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.

Allows:

  • Medical exemptions
  • Religious exemptions

TITLE 36. PUBLIC HEALTH AND SAFETY
CHAPTER 433. DISEASE AND CONDITION CONTROL; MASS GATHERINGS; INDOOR AIR
IMMUNIZATION REGISTRY AND TRACKING SYSTEM

ORS § 433.102 (2001)

433.102. Parental responsibility for immunization; medical or religious exemptions.

(1) Nothing in ORS 433.090 to 433.102 is intended to affect the responsibility of a parent or guardian to have a child of that parent or guardian properly immunized.

(2) Nothing in ORS 433.090 to 433.102 is intended to require immunization or tracking of any child otherwise exempt from immunization requirements under ORS 433.267 (1)(b) or (c).

ORS § 433.267 (2001)

433.267. Immunization of school children; 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 Health Division 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;

(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; or

(d) A statement signed by the parent of a child transferring to a school or facility from another school or facility that the parent will have records required by paragraphs (a) to (c) of this subsection for the child sent to the school or facility within 30 days of initial attendance of the child therein. The statement shall be accompanied by a presigned exclusion order from the local health department to be used as described in subsection (6) of this section.

(2) A child shall be required to submit the statement described in subsection (1) of this section prior to attending the school or facility.

(3) Persons who have been emancipated pursuant to ORS 419B.558 or who have reached the age of majority as provided in ORS 109.510 or 109.520 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 shall 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) If the records are not received within 30 days, as provided in subsection (1)(d) of this section, the administrator shall enforce the presigned exclusion order and exclude the child in accordance with a time schedule established by rule of the Health Division.

(7) At the time specified by the Health Division 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 department.

(8) The 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), (b) or (d) of this section. If the child is determined to be in noncompliance, the 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.

(9) 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.

(10) 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 Health Division pursuant to ORS 433.273.

(11) 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.

(12) All statements required by this section shall be on forms approved or provided by the Health Division.

(13) In lieu of signed statements from practitioners of the healing arts, the division may accept immunization record updates using practitioner documented immunization records generated by electronic means or on practitioner letterhead but unsigned, if the division determines such records are accurate.

 

P

Allows:

  • Medical exemptions
  • Religious exemptions

TITLE 24. EDUCATION
CHAPTER 1. PUBLIC SCHOOL CODE OF 1949
ARTICLE XIII. PUPILS AND ATTENDANCE
(A) ATTENDANCE

24 P.S. § 13-1303a (2002)

§ 13-1303a. Immunization required; penalty

(a) It shall be the duty of all school directors, superintendents, principals, or other persons in charge of any public, private, parochial, or other school including kindergarten, to ascertain that every child, prior to admission to school for the first time has been immunized, as the Secretary of Health may direct, against such diseases as shall appear on a list to be made and from time to time reviewed by the Advisory Health Board. All certificates of immunization shall be issued in accordance with the rules and regulations promulgated by the Secretary of Health with the sanction and advice of the Advisory Health Board.

(b) Any person who shall fail, neglect, or refuse to comply with, or who shall violate, any of the provisions or requirements of this section, except as hereinafter provided, shall, for every such offense, upon summary conviction thereof, be sentenced to pay a fine of not less than five dollars ($ 5) nor more than one hundred dollars ($ 100), and in default thereof, to undergo an imprisonment in the jail of the proper county for a period not exceeding sixty (60) days. All such fines shall be paid into the treasury of the school district.

(c) The provisions of this section shall not apply in the case of any child deemed to have a medical contraindication which may contraindicate immunization and so certified by a physician. Such certificates may be accepted in lieu of a certificate of immunization.

(d) The provisions of this section shall not apply in the case of any child whose parent or guardian objects in writing to such immunization on religious grounds.

 

R

Allows:

  • Medical exemptions
  • Religious exemptions

TITLE 23. HEALTH AND SAFETY
CHAPTER 1. DEPARTMENT OF HEALTH

R.I. Gen. Laws § 23-1-44 (2002)

§ 23-1-44. Routine childhood immunization vaccines

The department of health shall include in the department’s immunization program those vaccines for routine childhood immunization as recommended by the advisory committee for immunization practices (ACIP) and the academy of pediatrics (AAP) to the extent permitted by available funds.

TITLE 16. EDUCATION
CHAPTER 38. OFFENSES PERTAINING TO SCHOOLS

R.I. Gen. Laws § 16-38-2 (2002)

§ 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.

 

S

Allows:

  • Medical exemptions
  • Religious exemptions

TITLE 44. HEALTH
CHAPTER 29. CONTAGIOUS AND INFECTIOUS DISEASES

S.C. Code Ann. § 44-29-180 (2002)

§ 44-29-180. School pupils and day care center children to be vaccinated or immunized; department to monitor immunization records of children in day care; exemptions and exclusions.

(A) No superintendent of an institution of learning, no school board or principal of a school, and no owner or operator of a public or private child day care facility as defined in Section 20-7-2700 may admit as a pupil or enroll or retain a child or person who cannot produce satisfactory evidence of having been vaccinated or immunized so often as directed by the Department of Health and Environmental Control. Records of vaccinations or immunizations must be maintained by the institution, school, or day care facility to which the child or person has been admitted.

(B) The Department of Health and Environmental Control shall monitor the immunization status of each child who is enrolled or retained in a licensed child day care facility or a registered church or religious child day care facility. The monitoring of day care facilities shall consist of a review of the immunization or vaccination records to insure that required immunizations are complete as recommended and routinely provided by the Department of Health and Environmental Control for all infants and children.

(C) South Carolina Department of Health and Environmental Control Regulation 61-8, as amended, “Vaccination, Screening and Immunization Regarding Contagious Diseases”, and its exemptions apply to this section.

(D) A South Carolina Certificate of Special Exemption signed by the school principal, authorized representative, or day care director 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 is valid for only thirty calendar days from date of enrollment. At the expiration of this special exemption, the student must present a valid South Carolina Certificate of Immunization, a valid South Carolina Certificate of Medical Exemption, or a valid South Carolina Certificate of Religious Exemption.

(E) Registered family day care homes are exempt from requirements of this section.

Allows:

  • Medical exemptions
  • Religious exemptions

TITLE 13. EDUCATION
CHAPTER 13-28. SCHOOL ATTENDANCE PRIVILEGES AND TUITION

S.D. Codified Laws § 13-28-7.1 (2002)

§ 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 a test for tuberculosis and is free from a contagious form of tuberculosis and 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 a test or 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 test and immunization; or

(3) A written statement signed by one parent or guardian requesting that the local health department give the test and immunization because the parents or guardians lack the means to pay for such tests and immunization.

The Department of Health may adopt 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.

OPINIONS OF ATTORNEY GENERAL.
Children not immunized as required by this section may be excluded from public school attendance, Opinion No. 77-75.
Student who has physician’s certificate that immunizations are in progress may not initially be refused admission, but school board may, in absence of adoption of rules by department of health, establish a reasonable period for completion of immunizations, Opinion No. 80-25.

 

T

Allows:

  • Medical exemptions
  • Religious exemptions

TITLE 37 JUVENILES
CHAPTER 10. MISCELLANEOUS PROVISIONS
PART 4. CHILDHOOD IMMUNIATIONS

Tenn. Code Ann. § 37-10-401 (2002)

TITLE 37. JUVENILES
CHAPTER 10. MISCELLANEOUS PROVISIONS
PART 4. CHILDHOOD IMMUNIZATIONS

Tenn. Code Ann. § 37-10-402 (2002)

37-10-401. Responsibility of parents to have children immunized – Specific vaccines – Immunization registry

(a) It is the responsibility of each parent or legal guardian to ensure that such person’s child or children receive the vaccines as are recommended by guidelines of the Center for Disease Control and/or the American Academy of Pediatrics to be administered to a child. The parent or legal guardian is encouraged to obtain the recommended immunizations within the first two (2) years of the child’s life. Such vaccines include without limitation, the following specific vaccines:
(1) Diphtheria -tetanus-pertussis (DTP)
(2) Polio: oral polio vaccine (OPV) or inactivated polio vaccine (IPV)
(3) Measles-mumps-rubella (MMR)
(4) Haemophilus influenzae type B conjugate vaccines (Hib)
(5) Hepatitis B vaccine (Hep B)
(6) Pneumoccocal vaccine when medically indicated
(7) Influenza vaccine when medically indicated, and
(8) Varicella when available.
(b) Subject to availability of funding for such purpose, the department of health is authorized to provide fee vaccine, through the first twenty-four (24) months of life, for Tennessee children born after January 1, 1996. If an administration fee is charged by a health provider receiving this vaccine, such fee may not exceed the administration fee established by the health care financing administration under the Vaccines for Children Program established in the Omnibus Budget Reconciliation Act of 1993. No immunization may be withheld due to the family’s inability to pay the fee.
(c) The department shall establish and maintain an immunization registry for children. By January 1, 1996, the department shall incrementally require all local public health departments to report, in a designated format, the record of each immunization given. Other health care providers may likewise report such records. Information from the registry shall be available to parents and legal guardians, health care providers, and schools, child care facilities, and other institutions having care or custody of children.
(d) The commissioner of health shall report to the members of the house health and human resources committee, the senate general welfare committee, the select joint committee on children and youth and the TennCare oversight committee, by March 1 of each year, on the immunization rates in each county and improvements or changes made during the preceding year.

TITLE 37. JUVENILES
CHAPTER 10. MISCELLANEOUS PROVISIONS
PART 4. CHILDHOOD IMMUNIZATIONS

Tenn Code Ann § 37-10-402 (2002)

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 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.

Allows:

  • Medical exemptions
  • Religious exemptions
  • Philosophical (conscientious objector, personal belief) exemptions

Contact:

Parents Requesting Open Vaccine Education
(PROVE)
P.O. Box 91566
Austin, TX 78709-1566
http://www.vaccineinfo.net
email: prove@vaccineinfo.net

(Source: http://www.vaccineinfo.net/exemptions/index.shtml)

The state of Texas grants and acknowledges the right of parents to exempt their children from vaccination requirements for day care, school, and college.

In 2003, the Texas legislature passed changes to the statutes expanding the reasons a parent can claim an exemption but the Health Department has also increased the bureaucratic red tape necessary for claiming the exemption. There are specific procedures for requesting an official state form and submitting it to the school or for completing a medical exemption that all take some time. We recommend this be handled well in advance.

Everyone claiming an exemption for the first time after 9/1/03 must comply with the new law. If you’ve submitted an old religious exemption prior to 9/1/03 you are grandfathered under the old law and do not need a new form. The vaccine exemption forms for reasons of conscience including a religious belief are only for students claiming a vaccine exemption for the first time after 9/1/03 when the new law went into effect. If you need to request forms from the state health department, you can do it by fax, mail, or personal visit. If you send it by mail, we suggest sending it registered mail with a receipt so you can keep track of your request.

According to the Texas Dept. of Health:

Written requests must be submitted through the U.S. Postal Service, commercial carrier, fax at (512) 458-7544 , or by hand-delivery to:

1946
DSHS Immunization Branch
1100 West 49th Street
Austin, Texas 78756

Hand-delivered requests may be submitted to the DSHS, Immunization Branch, between 8 a.m. and 5 p.m. Mondays through Fridays. ALL affidavit forms will be mailed to you via U.S. Postal Service. No requests will be filled at the time of hand-delivery.

Affidavit form requests will be processed and mailed within one week from the receipt of the request. If additional information is needed in order to process the affidavit, you will be notified;

The letter must include the following information:

  • Full name of each child for whom a form is requested (first, middle, and last)
  • Date of birth of each child for whom a form is requested
  • Parent or legal guardian’s complete return mailing address, including zip code
  • Number of forms needed for each child (not to exceed five forms per child)

Electronic mail or telephone requests cannot be processed.

The official Texas Department of State Health Services affidavit form must be notarized and submitted to school officials. The form must be submitted within 90 days from the date it is notarized.

The school will accept only official affidavit forms developed and issued by the Texas Department of State Health Services (DSHS), Immunization Branch.. No other forms or reproductions will be allowed.

(SOURCE: http://www.tdh.state.tx.us/immunize/school_exclusion.htm)

IT IS OUR OPINION THAT PARENTS SHOULD OBTAIN A WRITTEN NOTE FROM THE SCHOOL ACKNOWLEDGING RECEIPT OF THE EXEMPTION FORM. IF THE SCHOOL LOOSES THE FORM THEY CAN KICK YOUR KIDS OUT OF SCHOOL. IF YOU HAVE A WRITTEN RECEIPT FROM THE SCHOOL THAT YOU SUBMITTED THE FORM, YOU CAN PUT THE RESPONSIBILITY BACK ON THE SCHOOL TO GO FIND IT AND KEEP YOUR CHILD IN SCHOOL.

It is also our opinion that the department is outside of the law requiring that parents submit their children’s names to get a form especially since the law requires the department to develop a blank form. They are also exceeding their authority in the statute by putting 2 year expirations on the new forms as the statute specifies no expiration. This bullying behavior is putting the department at risk for a legal challenge. However, for now, until this is legally challenged, these are the dictatorial procedures the DSHS has set up.

Ignorant school officials around the state are denying kids admission to school if they have an old religious exemption affidavit saying they need one of the new forms from the health department. THIS IS NOT TRUE! If you hear this is happening in your district, please call the superintendent’s office and give them this link to the state health department where it clearly says you don’t need a new form. Also, when you transfer schools, the old religious exemption letter is still part of your child’s record and you do not need a new one as long as it was part of your child’s record prior to 9/1/03.

On the bottom of page 2, it says:

Q. If a child currently has a religious exemption for vaccinations on file with the school, do they need to obtain a new vaccine exemption for reasons of conscience affidavit?

A. No. Students who are currently exempt from vaccination for religious beliefs and already have an affidavit on file at the school they attend do not need a new vaccine exemption affidavit form. The religious exemption on file remains valid.

Also on page 2 it says:

Q. What if my child changes schools?

A. The vaccine exemption affidavit is part of the child’s school records and should be sent to the new school with other school records.

Additionally, some schools, daycare facilities and colleges are saying they don’t have to accept the exemption. This is wrong – the law grants parents this right and the schools and daycares can’t take this right away. For your convenience, we’ve posted links to the state statutes directly below.

The other option for parents to exempt their child from state immunization requirements is with a medical exemption written by a doctor. This is intended for families with children with health concerns or a past history of reactions. While this option bypasses the bureaucratic red tape with the new conscientious/religious exemption, the pressures on doctors to not write these are great and it may be difficult to get a doctor who acknowledges a vaccine reaction to substantiate that in writing by issuing an exemption because of pressures being put on them to deny acknowledgement of vaccine reactions.

Regardless, most families and physicians are not aware the exemption statute was greatly expanded last session to make it much easier for a doctor to write to protect a child from future reactions. No longer do they have to say the vaccine would definitively harm the child but that it instead poses a risk to the child. Any M.D. or D.O. licensed to practice medicine in the United States can write the letter stating that “in the physician’s opinion, the vaccine required poses a significant risk to the health and well-being of the child or any member of the child’s household.” If the letter also says this is for a lifelong condition, (the condition does not need to be named) the exemption never has to be renewed. Otherwise it has to be renewed annually. The doctor just needs to write it out on a piece of paper and sign it. In this case, you can keep the original and give the school a copy.

Here is a sample medical exemption letter:

Medical Exemption to Immunization

In my opinion, the required immunizations pose a significant risk to the health and well-being of (name of child). This is a lifelong exemption for lifelong conditions.

Doctor’s name, signature, and date

Children and Education including Colleges:
Texas Administrative Code Title 25 Part 1 Section 97 – Immunization Requirements in Texas Elementary and Secondary Schools and Institutes of Higher Education
(this section contains vaccine requirements by rule, provisional enrollment, and exemptions)

TEXAS H.B. No. 2292

AN ACT relating to the provision of health and human services in this state, including the powers and duties of the Health and Human Services Commission and other state agencies; providing penalties.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 2.04. Subchapter B, Chapter 531, Government Code, is amended by adding Section 531.0335 to read as follows:

Sec. 531.0335. PROHIBITION ON PUNITIVE ACTION FOR FAILURE TO IMMUNIZE.

(a) In this section:
(1) “Person responsible for a child’s care, custody, or welfare” has the meaning assigned by Section 261.001, Family Code.
(2) “Punitive action” includes the initiation of an investigation of a person responsible for a child’s care, custody, or welfare for alleged or suspected abuse or neglect of a child.
(b) The commissioner by rule shall prohibit a health and human services agency from taking a punitive action against a person responsible for a child’s care, custody, or welfare for failure of the person to ensure that the child receives the immunization series prescribed by Section 161.004, Health and Safety Code.
(c) This section does not affect a law, including Chapter 31, Human Resources Code, that specifically provides a punitive action for failure to ensure that a child receives the immunization series prescribed by Section 161.004, Health and Safety Code.

SECTION 2.160. Section 38.001, Education Code, is amended by amending Subsection (c) and adding Subsections (c-1) and (f) to read as follows:

(c) Immunization is not required for a person’s admission to any elementary or secondary school if the person applying for admission:
(1) submits to the admitting official:
(A) an affidavit or a certificate signed by a physician who is duly registered and licensed to practice medicine in the United States, in which it is stated that, in the physician’s opinion, the immunization required poses a significant risk [would be injurious] to the health and well-being of the applicant or any member of the applicant’s family or household; or
(B) an affidavit signed by the applicant or, if a minor, by the applicant’s parent or guardian stating that the applicant declines immunization for reasons of conscience,
including a religious belief [conflicts with the tenets and practice of a recognized church or religious denomination of which the applicant is an adherent or member, except that this exemption does not apply in times of emergency or epidemic declared by the
commissioner of public health]; or
(2) is a member of the armed forces of the United
States and is on active duty.
(c-1) An affidavit submitted under Section (c)(1)(B) must be on a form described by Section 161.0041, Health and Safety Code, and must be submitted to the admitting official not later than the 90th day after the date the affidavit is notarized.
(f) A person who has not received the immunizations required by this section for reasons of conscience, including because of the person’s religious beliefs, may be excluded from school in times of emergency or epidemic declared by the commissioner of public health.

SECTION 2.161. Section 51.933, Education Code, is amended by amending Subsection (d) and adding Subsection (d-1) to read as follows:

(d) No form of immunization is required for a person’s admission to an institution of higher education if the person applying for admission:
(1) submits to the admitting official:
(A) an affidavit or a certificate signed by a physician who is duly registered and licensed to practice medicine within the United States in which it is stated that, in the physician’s opinion, the immunization required poses a significant risk [would be injurious] to the health and well-being of the applicant or any member of the applicant’s family or household; or
(B) an affidavit signed by the applicant or, if a minor, by the applicant’s parent or guardian stating that the applicant declines immunization for reasons of conscience, including a religious belief [conflicts with the tenets and practice of a recognized church or religious denomination of which the applicant is an adherent or member]; or
(2) is a member of the armed forces of the United States and is on active duty.
(d-1) An affidavit submitted under Section (d)(1)(B) must be on a form described by Section 161.0041, Health and Safety Code, and must be submitted to the admitting official not later than the 90th day after the date the affidavit is notarized.

SECTION 2.162. Section 161.004(d), Health and Safety Code, is amended to read as follows:

(d) A child is exempt from an immunization required by this section if (1) [immunization conflicts with the tenets of an organized religion to which] a parent, managing conservator, or guardian states that the immunization is being declined for reasons of conscience, including a religious belief [belongs]; or
(2) the immunization is medically contraindicated based on the opinion of [an examination of the child by] a physician licensed by any state in the United States who has examined the child.

SECTION 2.163. Subchapter A, Chapter 161, Health and Safety Code, is amended by adding Section 161.0041 to read as follows:

Sec. 161.0041. IMMUNIZATION EXEMPTION AFFIDAVIT FORM.

(a) A person claiming an exemption from a required immunization based on reasons of conscience, including a religious belief, under Section 161.004 of this code, Section 38.001 or 51.933, Education Code, or Section 42.043, Human Resources Code, must complete an affidavit on a form provided by the department stating the reason
for the exemption.
(b) The affidavit must be signed by the person claiming the exemption or, if the person is a minor, the person’s parent, managing conservator, or guardian, and the affidavit must be notarized.
(c) A person claiming an exemption from a required immunization under this section may only obtain the affidavit form by submitting a written request for the affidavit form to the department.
(d) The department shall develop a blank affidavit form that contains a seal or other security device to prevent reproduction of the form. The affidavit form shall contain a statement indicating that the person or, if a minor, the person’s parent, managing conservator, or guardian understands the benefits and risks of immunizations and the benefits and risks of not being immunized.
(e) The department shall maintain a record of the total number of affidavit forms sent out each year and shall report that information to the legislature each year. The department may not maintain a record of the names of individuals who request an affidavit under this section.

SECTION 2.164. Section 42.043, Human Resources Code, is amended by amending Subsection (d) and adding Subsection (d-1) to read as follows:

(d) No immunization may be required for admission to a facility regulated under this chapter if a person applying for a child’s admission submits one of the following affidavits:
(1) an affidavit signed by a licensed physician stating that the immunization poses a significant risk [would be injurious] to the health and well-being of the child or a member of the child’s family or household; or
(2) an affidavit signed by the child’s parent or guardian stating that the applicant declines immunization for reasons of conscience, including a religious belief [conflicts with the tenets and practices of a recognized religious organization of which the applicant is an adherent or a member].
(d-1) An affidavit submitted under Section (d)(2) must be on a form described by Section 161.0041, Health and Safety Code, and must be submitted not later than the 90th day after the date the affidavit is notarized.

 

U

Allows:

  • Medical exemptions
  • Religious exemptions
  • Philosophical (conscientious objector, personal belief) exemptions

Code Ann. § 53A-11-301 (2003)

§ 53A-11-301. Certificate of immunization required

(1) Unless exempted for personal, medical, or religious objections as provided in Section 53A-11-302, a student may not attend a public, private, or parochial kindergarten, elementary, or secondary school through grade 12, nursery school, licensed day care center, child care facility, family care home, or headstart program in this state unless there is presented to the appropriate official of the school a certificate of immunization from a licensed physician or authorized representative of the state or local health department stating that the student has received immunization against communicable diseases as required by rules adopted under Section 53A-11-303.

(2) School districts may not receive weighted pupil unit monies for a student unless the student has obtained a certificate of immunization under this section or qualifies for conditional enrollment or an exemption from immunization under Section 53A-11-302.

Utah Code Ann. § 53A-11-302 (2003)

§ 53A-11-302. Immunizations required — Exceptions — Grounds for exemption from required immunizations

(1) A student may not enter school without a certificate of immunization, except as provided in this section.

(2) A student who at the time of school enrollment has not been completely immunized against each specified disease may attend school under a conditional enrollment if the student has received one dose of each specified vaccine prior to enrollment.

(3) A student is exempt from receiving the required immunizations if there is presented to the appropriate official of the school one or more of the following:

(a) a certificate from a licensed physician stating that due to the physical condition of the student one or more specified immunizations would endanger the student’s life or health;

(b) A completed form obtained at the local health department where the student resides, providing:

(i) the information required under Subsection 53A-11-302.5(1); and

(ii) a statement that the person has a personal belief opposed to immunizations, which is signed by one of the individuals listed in Subsection 53A-11-302(3)(c) and witnessed by the local health officer or his designee; or

(c) a statement that the person is a bona fide member of a specified, recognized religious organization whose teachings are contrary to immunizations, signed by one of the following persons:

(i) one of the student’s parents;

(ii) the student’s guardian;

(iii) a legal age brother or sister of a student who has no parent or guardian; or

(iv) the student, if of legal age.

Utah Code Ann. § 53A-11-302.5 (2003)

§ 53A-11-302.5. Personal belief immunization exemption

(1) The Department of Health shall provide to all local health departments a form to be used by persons claiming an exemption from immunization requirements based on a personal belief opposed to immunization. The form shall include a statement printed on the form and drafted by the Department of Health stating the department’s position regarding the benefits of immunization. The form shall require, at a minimum:

(a) a statement claiming exemption from immunizations required under Section 53A-11-302, signed by a person listed under Subsection 53A-11-302(3)(c);

(b) the name and address of the person who signs the form;

(c) the name of the student exempted from immunizations; and

(d) the school at which the student is enrolling.

(2) (a) The Department of Health shall provide these forms to the local health departments.

(b) Local health departments shall make the forms available to the public upon request.

(3) (a) A student enrolling in a school and who claims exemption from immunizations based on a personal belief shall complete the form described in Subsection (1) and provide it to the school officials at the school in which the student is enrolling.

(b) Students who prior to July 1, 1992, claimed an exemption from immunizations based on personal beliefs shall prior to December 1, 1992, complete the form described in Subsection (1) and provide it to the appropriate official of the school the student attends.

 

V

Allows:

  • Medical exemptions
  • Religious exemptions
  • Philosophical (conscientious objector, personal belief) exemptions

TITLE EIGHTEEN. HEALTH
PART 2. PUBLIC HEALTH REGULATIONS
CHAPTER 21. COMMUNICABLE DISEASES
SUBCHAPTER 4. IMMUNIZATION

18 V.S.A. § 1121 (2002)

§ 1121. Immunizations required prior to attending school

Except as provided under section 114 of this title, no person may enroll as a student in a Vermont school, regardless of whether the student has been enrolled in the school during a previous school year, unless the appropriate school official has received a record or certificate of immunization issued by a licensed physician or a health clinic that the person has received required immunizations appropriate to age as specified by the Vermont department of health.

18 V.S.A. § 1122 (2002) § 1122. Exemptions

(a) A person may remain in school without a required immunization
(1) If the person, or in the case of a minor the person’s parent or guardian presents a written statement from a licensed physician, health clinic or nurse that the person is in the process of being immunized. The person may continue to attend school as long as the immunization process is being accomplished,
(2) If a physician, licensed to practice in Vermont, certifies in writing that a specific immunization is or may be detrimental to the person’s health or is not appropriate,
(3) If the person, or in the case of a minor the person’s parent or guardian states in writing that the person, parent or guardian has religious beliefs or moral convictions opposed to immunization.
(b) The health department may provide by rule for further exemptions to immunization based upon sound medical practice.

Allows:

  • Medical exemptions
  • Religious exemptions

Contact:
Virginia Families for Vaccine Information and Choice
P.O. Box 1468
Virginia Beach, VA 23451
757-301-9602
http://www.vafvic.org/
email: vafvic@cox.net

Va. Code Ann. § 22.1-271.2 (2002)

§ 22.1-271.2. Immunization requirements

A. No student shall be admitted by a school unless at the time of admission the student or his parent or guardian submits documentary proof of immunization to the admitting official of the school or unless the student is exempted from immunization pursuant to subsection C. If a student does not have documentary proof of immunization, the school shall notify the student or his parent or guardian (i) that it has no documentary proof of immunization for the student; (ii) that it may not admit the student without proof unless the student is exempted pursuant to subsection C; (iii) that the student may be immunized and receive certification by a licensed physician, registered nurse or an employee of a local health department; and (iv) how to contact the local health department to learn where and when it performs these services. Neither this Commonwealth nor any school or admitting official shall be liable in damages to any person for complying with this section.

Any physician, registered nurse or local health department employee performing immunizations shall provide to any person who has been immunized or to his parent or guardian, upon request, documentary proof of immunizations conforming with the requirements of this section.

B. Any student whose immunizations are incomplete may be admitted conditionally if that student provides documentary proof at the time of enrollment of having received at least one dose of the required immunizations accompanied by a schedule for completion of the required doses within ninety days.

The immunization record of each student admitted conditionally shall be reviewed periodically until the required immunizations have been received.

Any student admitted conditionally and who fails to comply with his schedule for completion of the required immunizations shall be excluded from school until his immunizations are resumed.

C. No certificate of immunization shall be required for the admission to school of any student if (i) the student or his parent or guardian submits an affidavit to the admitting official stating that the administration of immunizing agents conflicts with the student’s religious tenets or practices; or (ii) the school has written certification from a licensed physician or a local health department that one or more of the required immunizations may be detrimental to the student’s health, indicating the specific nature and probable duration of the medical condition or circumstance that contraindicates immunization.

D. The admitting official of a school shall exclude from the school any student for whom he does not have documentary proof of immunization or notice of exemption pursuant to subsection C.

E. Every school shall record each student’s immunizations on the school immunization record. The school immunization record shall be a standardized form provided by the State Department of Health, which shall be a part of the mandatory permanent student record. Such record shall be open to inspection by officials of the State Department of Health and the local health departments.

The school immunization record shall be transferred by the school whenever the school transfers any student’s permanent academic or scholastic records.

Within thirty calendar days after the beginning of each school year or entrance of a student, each admitting official shall file a report with the local health department. The report shall be filed on forms prepared by the State Department of Health and shall state the number of students admitted to school with documentary proof of immunization, the number of students who have been admitted with a medical or religious exemption and the number of students who have been conditionally admitted.

F. The requirement for mumps immunization as provided in § 32.1-46 shall not apply to any child admitted for the first time to any grade level, kindergarten through grade twelve, of a school prior to August 1, 1981.

The requirement for Haemophilus Influenzae Type b immunization as provided in § 32.1-46 shall not apply to any child admitted to any grade level, kindergarten through grade twelve.

G. The Board of Health shall promulgate rules and regulations for the implementation of this section in congruence with rules and regulations of the Board of Health promulgated under § 32.1-46 and in cooperation with the Board of Education.

HISTORY: 1982, c. 510; 1983, c. 433; 1988, c. 216; 1989, c. 382; 2000, c. 476.

TITLE 32.1. HEALTH
CHAPTER 2. DISEASE PREVENTION AND CONTROL
ARTICLE 3. DISEASE CONTROL MEASURES

Va. Code Ann. § 32.1-46 (2002)

§ 32.1-46. Immunization of children against certain diseases; authority to share immunization records
A. The parent, guardian or person standing in loco parentis of each child within this Commonwealth shall cause such child to be immunized by vaccine against diphtheria, tetanus, whooping cough and poliomyelitis before such child attains the age of one year, against Haemophilus influenzae type b before he attains the age of thirty months, and against measles (rubeola), German measles (rubella) and mumps before such child attains the age of two years. All children born on or after January 1, 1994, shall be required to receive immunization against hepatitis B before their first birthday. All children shall also be required to receive a second dose of measles (rubeola) vaccine in accordance with the regulations of the Board. The Board’s regulations shall require that all children receive a second dose of measles (rubeola) vaccine prior to first entering kindergarten or first grade and that all children who have not yet received a second dose of measles (rubeola) vaccine receive such second dose prior to entering the sixth grade. All children born on or after January 1, 1997, shall be required to receive immunization against varicella zoster (chicken pox), not earlier than the age of twelve months. Children who have evidence of immunity as demonstrated by laboratory confirmation of immunity or a reliable medical history of disease are exempt from such requirement. After July 1, 2001, all children who have not yet received immunization against hepatitis B shall receive such immunization prior to entering sixth grade.

The parent, guardian or person standing in loco parentis may have such child immunized by a physician or registered nurse or may present the child to the appropriate local health department, which shall administer the required vaccines without charge.

B. A physician, registered nurse or local health department administering a vaccine required by this section shall provide to the person who presents the child for immunizations a certificate which shall state the diseases for which the child has been immunized, the numbers of doses given, the dates when administered and any further immunizations indicated.

C. The vaccines required by this section shall meet the standards prescribed in, and be administered in accordance with, regulations of the Board.

D. The provisions of this section shall not apply if:

1. The parent or guardian of the child objects thereto on the grounds that the administration of immunizing agents conflicts with his religious tenets or practices, unless an emergency or epidemic of disease has been declared by the Board, or

2. The parent or guardian presents a statement from a physician licensed to practice medicine in Virginia which states that the physical condition of the child is such that the administration of one or more of the required immunizing agents would be detrimental to the health of the child.

E. For the purpose of protecting the public health by ensuring that each child receives age-appropriate immunizations, any physician, licensed institutional health care provider, local or district health department, and the Department of Health may share immunization and child locator information, including, but not limited to, the month, day, and year of each administered immunization; the child’s name, address, telephone number, birth date, and social security number; and the parents’ names. The immunization information; the child’s name, address, telephone number, birth date, and social security number; and the parents’ names shall be confidential and shall only be shared for the purposes set out in this subsection.

TITLE 23. EDUCATIONAL INSTITUTIONS
CHAPTER 1. GENERAL PROVISIONS

Va. Code Ann. § 23-7.5 (2003)

§ 23-7.5. Health histories required; immunizations

A. No full-time student shall be enrolled for the first time in any four-year, public institution of higher education in this Commonwealth unless he has furnished, before the beginning of the second semester or quarter of enrollment, a health history consistent with guidelines adopted by each institution’s board of visitors, pursuant to the requirements of this section. Any student who fails to furnish the history will not be eligible for registration for the second semester or quarter. Any student who objects on religious grounds shall be exempt from the health history requirement set forth in this section.

B. The health history shall include documented evidence, provided by a licensed health professional or health facility, of the diseases for which the student has been immunized, the numbers of doses given, the dates when administered and any further immunizations indicated. Prior to enrollment, all students shall be immunized by vaccine against diphtheria, tetanus, poliomyelitis, measles (rubeola), German measles (rubella), and mumps according to the guidelines of the American College Health Association.

C. In addition to the immunization requirements set forth in subsection B, all incoming full-time students, prior to enrollment in any public four-year institution of higher education, shall be vaccinated against meningococcal disease.

However, if the institution of higher education provides the student or, if the student is a minor, the student’s parent or other legal representative, detailed information on the risks associated with meningococcal disease and on the availability and effectiveness of any vaccine, the student or, if the student is a minor, the student’s parent or other legal representative may sign a written waiver stating that he has received and reviewed the information on meningococcal disease and the availability and effectiveness of any vaccine and has chosen not to be or not to have the student vaccinated.

D. Any student shall be exempt from the immunization requirements set forth in this section who (i) objects on the grounds that administration of immunizing agents conflicts with his religious tenets or practices, unless an emergency or epidemic of disease has been declared by the Board of Health, or (ii) presents a statement from a licensed physician which states that his physical condition is such that administration of one or more of the required immunizing agents would be detrimental to his health.

E. The Board and Commissioner of Health shall cooperate with any board of visitors seeking assistance in the implementation of this section.

F. Further, the State Council of Higher Education shall, in cooperation with the Board and Commissioner of Health, encourage private colleges and universities to develop a procedure for providing information about the risks associated with meningococcal disease and the availability and effectiveness of any vaccine against meningococcal disease.

TITLE 22. SOCIAL SERVICES
AGENCY NO. 15. CHILD DAY-CARE COUNCIL
CHAPTER 30. MINIMUM STANDARDS FOR LICENSED CHILD DAY CENTERS
PART II. ADMINISTRATION

22 VAC 15-30-150 (2003)

22 VAC 15-30-150 Immunizations for children.

A. The center shall obtain documentation that each child has received the immunizations required by the State Board of Health before the child can attend the center.

Exemptions (subsection C of § 22.1-271.2 of the Code of Virginia and 12 VAC 5-110-110 of the Regulations for the Immunizations of School Children): Documentation of immunizations is not required for any child whose (i) parent submits an affidavit to the center, on the form entitled “Certification of Religious Exemption,” stating that the administration of immunizing agents conflicts with the parent’s or child’s religious tenets or practices, or (ii) physician or a local health department states on a MCH 213B or MCH 213C Form that one or more of the required immunizations may be detrimental to the child’s health.

B. Updated information on additional immunizations shall be obtained once every six months for children under the age of two years.

C. Updated information on additional immunizations shall be obtained once between each child’s fourth and sixth birthdays.

TITLE 12. HEALTH
AGENCY NO. 5. DEPARTMENT OF HEALTH
DISEASE PREVENTION AND CONTROL
CHAPTER 110. REGULATIONS FOR THE IMMUNIZATION OF SCHOOL CHILDREN
PART III. IMMUNIZATION REQUIREMENTS

12 VAC 5-110-30 (2003)

12 VAC 5-110-30 Administration.

A. The Board of Health has the responsibility for promulgating regulations pertaining to the implementation of the school immunization law and standards of immunization by which a child attending a school or child care center may be judged to be adequately immunized.

B. The State Health Commissioner is the executive officer for the State Board of Health with the authority of the board when it is not in session, subject to the rules and regulations of the board.

C. The local health director is responsible for providing assistance in implementing this chapter to the school divisions in his jurisdiction and for providing immunizations to children determined not to be adequately immunized, who present themselves to the local health department for immunization.

D. The school principals of public schools and the principals, headmasters and directors of nonpublic schools and child care centers shall require each student attending their institutions to provide documentary proof of immunization against the diseases listed in 12 VAC 5-110-70.

12 VAC 5-110-70 (2003)

12 VAC 5-110-70 Immunization requirements.

Every new student and every child attending a licensed child care center shall provide documentary proof of adequate immunization with the prescribed number of doses of each of the vaccines and toxoids listed in the following subdivisions, as appropriate for his age. A copy of every student’s immunization record shall be on file in his school record.

1. Diphtheria and Tetanus Toxoids and Pertussis Vaccine (DTP). For students less than seven years of age, a minimum of three doses of DTP, with one dose administered after the student’s fourth birthday. If any of these three doses must be administered on or after the seventh birthday, Td (adult tetanus toxoid full dose and diphtheria toxoid reduced dose) should be used instead of DTP.

2. Poliomyelitis Vaccine. A minimum of three doses of trivalent oral poliomyelitis vaccine (OPV), with one dose administered after the fourth birthday or three doses of enhanced-potency inactivated poliomyelitis vaccine (IPV), with one dose administered after the fourth birthday when OPV is contraindicated.

3. Measles (Rubeola) Vaccine. For students enrolling in kindergarten or first grade on and after July 1, 1991, one dose of live measles vaccine administered at age 12 months or older, and a second dose administered prior to entering kindergarten or first grade, whichever occurs first. The two doses must be administered at least one month apart. Students entering sixth grade on and after July 1, 1992, shall also have received two doses of live measles vaccine, with the first dose administered at age 12 months or older and the second dose at least one month after the first dose. All other students shall have received at least one dose of live measles vaccine. Any measles immunization received after 1968 should be considered to have been administered using a live virus vaccine.

4. German Measles (Rubella) Vaccine. A minimum of one dose of rubella virus vaccine administered at age 12 months or older.

5. Mumps Vaccine. A minimum of one dose of mumps virus vaccine administered at age 12 months or older. The requirement for mumps vaccine shall not apply to any child admitted for the first time to any grade level, kindergarten through grade 12 of a school prior to August 1, 1981.

6. Haemophilus Influenzae Type b (Hib) Vaccine. A complete series of Hib vaccine i.e., up to a maximum of four doses of vaccine as appropriate for the age of the child and the age at which the immunization series was initiated. The number of doses administered shall be in accordance with current recommendations of either the American Academy of Pediatrics or those of the U.S. Public Health Service. Attestation by the physician or his designee on the temporary form documenting immunizations against Hib, that portion of Form MCH 213C pertaining to Hib vaccine, a computer generated facsimile of MCH 213C, or on the MCH 213C Supplement as defined in 12 VAC 5-110-10 under “documentary proof” shall mean that the child has satisfied the requirements of this section. This section shall not apply to children older than 30 months of age.

The dosage schedule for Hib vaccine varies with the manufacturer. The number of doses of vaccine required is also governed by the age at which immunization is initiated. Hence the reason why the requirements for Hib vaccine are prescribed in a manner different from those for the other vaccines.

7. Hepatitis B Vaccine. A minimum of three doses of hepatitis B vaccine for all children born on or after January 1, 1994

12 VAC 5-110-80 (2003)

12 VAC 5-110-80 Exemptions from immunization requirements.

A. Religious and medical exemptions. No certificate of immunization shall be required of any student for admission to school if:

1. The student or his parent or guardian submits a Certificate of Religious Exemption (Form CRE 1), to the admitting official of the school to which the student is seeking admission. Form CRE 1 is an affidavit stating that the administration of immunizing agents conflicts with the student’s religious tenets or practices. For a student enrolled before July 1, 1983, any document present in the student’s permanent school record claiming religious exemption shall be acceptable, or

2. The school has written certification on any of the documents specified under “documentary proof” in 12 VAC 5-110-10 from a physician or a local health department that one or more of the required immunizations may be detrimental to the student’s health. Such certification of medical exemption shall specify the nature and probable duration of the medical condition or circumstance that contraindicates immunization. For a student enrolled before July 1, 1983, any document attesting to the fact that one or more of the required immunizations may be detrimental to the student’s health shall be acceptable.

B. Demonstration of existing immunity. The demonstration in a student of antibodies against either rubeola or rubella in sufficient quantity to ensure protection of that student against that disease, shall render that student exempt from the immunization requirements contained in 12 VAC 5-110-70 for the disease in question. Such protection should be demonstrated by means of a serological testing method appropriate for measuring protective antibodies against rubeola or rubella respectively.

Statutory Authority: §§ 22.1-271.1, 22.1-271.2, 32.1-12, and 32.1-46 of the Code of Virginia.

12 VAC 5-90-110 (2003)

12 VAC 5-90-110 Dosage and age requirements for immunizations; obtaining immunizations.

A. Every child in Virginia shall be immunized against the following diseases by receiving the specified number of doses of vaccine by the specified ages:

1. Diphtheria, Tetanus, and Pertussis (Whooping cough) Vaccine–four doses by 18 months of age of toxoids of diphtheria and tetanus, combined with pertussis vaccine.

2. Poliomyelitis Vaccine, trivalent type–three doses by age 18 months of attenuated (live) trivalent oral polio virus vaccine or inactivated poliomyelitis vaccine or combination.

3. Measles (Rubeola) Vaccine–one dose at 12-15 months of age of further attenuated (live) measles virus vaccine. A second dose shall also be required at the time of initial entry to school. For those children who did not receive a second dose at initial school entry, a second dose shall be required at the time of entry to grade six.

4. Rubella (German measles) Vaccine–one dose at 12-15 months of age of attenuated (live) rubella virus vaccine.

5. Mumps Vaccine–one dose at 12-15 months of age or by age two years of mumps virus vaccine (live).

6. Haemophilus influenzae type b (Hib) Vaccine–a maximum of four doses of Hib vaccine for children up to 30 months of age as appropriate for the child’s age and in accordance with current recommendations of either the American Academy of Pediatrics or the U.S. Public Health Service.

7. Hepatitis B Vaccine–three doses by 18 months of age.

B. The required immunizations may be obtained from a physician licensed to practice medicine or from the local health department.

 

W

Allows:

  • Medical exemptions
  • Religious exemptions
  • Philosophical (conscientious objector, personal belief) exemptions

TITLE 28A. COMMON SCHOOL PROVISIONS
CHAPTER 28A.210. HEALTH — SCREENING AND REQUIREMENTS

Rev. Code Wash. (ARCW) § 28A.210.080 (2002)

§ 28A.210.080. Immunization program — Attendance of child conditioned upon presentation of alternative proofs

The attendance of every child at every public and private school in the state and licensed day care center shall be conditioned upon the presentation before or on each child’s first day of attendance at a particular school or center, of proof of either (1) full immunization, (2) the initiation of and compliance with a schedule of immunization, as required by rules of the state board of health, or (3) a certificate of exemption as provided for in RCW 28A.210.090. The attendance at the school or the day care center during any subsequent school year of a child who has initiated a schedule of immunization shall be conditioned upon the presentation of proof of compliance with the schedule on the child’s first day of attendance during the subsequent school year. Once proof of full immunization or proof of completion of an approved schedule has been presented, no further proof shall be required as a condition to attendance at the particular school or center.

Rev. Code Wash. (ARCW) § 28A.210.090 (2002)

§ 28A.210.090. Immunization program — Exemptions from on presentation of alternative certifications

Any child shall be exempt in whole or in part from the immunization measures required by RCW 28A.210.060 through 28A.210.170 upon the presentation of any one or more of the following, on a form prescribed by the department of health:

(1) A written certification signed by any physician licensed to practice medicine pursuant to chapter 18.71 or 18.57 RCW that a particular vaccine required by rule of the state board of health is, in his or her judgment, not advisable for the child: PROVIDED, That when it is determined that this particular vaccine is no longer contraindicated, the child will be required to have the vaccine;

(2) A written certification signed by any parent or legal guardian of the child or any adult in loco parentis to the child that the religious beliefs of the signator are contrary to the required immunization measures; and
(3) A written certification signed by any parent or legal guardian of the child or any adult in loco parentis to the child that the signator has either a philosophical or personal objection to the immunization of the child.

Allows:

  • Medical exemptions

CHAPTER 16. PUBLIC HEALTH
ARTICLE 3. PREVENTION AND CONTROL OF COMMUNICABLE AND OTHER INFECTIOUS DISEASES

W. Va. Code § 16-3-4 (2002)

§ 16-3-4. Compulsory immunization of school children; information disseminated; offenses; penalties

Whenever a resident birth occurs, the state director of health shall promptly provide parents of the newborn child with information on immunizations mandated by this state or required for admission to a public school in this state.

All children entering school for the first time in this state shall have been immunized against diphtheria, polio, rubeola, rubella, tetanus and whooping cough. Any person who cannot give satisfactory proof of having been immunized previously or a certificate from a reputable physician showing that an immunization for any or all diphtheria, polio, rubeola, rubella, tetanus and whooping cough is impossible or improper or sufficient reason why any or all immunizations should not be done, shall be immunized for diphtheria, polio, rubeola, rubella, tetanus and whooping cough prior to being admitted in any of the schools of the state. No child or person shall be admitted or received in any of the schools of the state until he or she has been immunized as hereinafter provided or produces a certificate from a reputable physician showing that an immunization for diphtheria, polio, rubeola, rubella, tetanus and whooping cough has been done or is impossible or improper or other sufficient reason why such immunizations have not been done. Any teacher having information concerning any person who attempts to enter school for the first time without having been immunized against diphtheria, polio, rubeola, rubella, tetanus and whooping cough shall report the names of all such persons to the county health officer. It shall be the duty of the health officer in counties having a full-time health officer to see that such persons are immunized before entering school: Provided, That persons enrolling from schools outside of the state may be provisionally enrolled under minimum criteria established by the director of the department of health so that the person’s immunization may be completed while missing a minimum amount of school: Provided, however, That no person shall be allowed to enter school without at least one dose of each required vaccine.

In counties where there is no full-time health officer or district health officer, the county commission or municipal council shall appoint competent physicians to do the immunizations and fix their compensation. County health departments shall furnish the biologicals for this immunization free of charge.

Health officers and physicians who shall do this immunization work shall give to all persons and children a certificate free of charge showing that they have been immunized against diphtheria, polio, rubeola, rubella, tetanus and whooping cough, or he or she may give the certificate to any person or child whom he or she knows to have been immunized against diphtheria, polio, rubeola, rubella, tetanus and whooping cough. If any physician shall give any person a false certificate of immunization against diphtheria, polio, rubeola, rubella, tetanus and whooping cough, he or she shall be guilty of a misdemeanor, and, upon conviction, shall be fined not less than twenty-five nor more than one hundred dollars.

Any parent or guardian who refuses to permit his or her child to be immunized against diphtheria, polio, rubeola, rubella, tetanus and whooping cough, who cannot give satisfactory proof that the child or person has been immunized against diphtheria, polio, rubeola, rubella, tetanus and whooping cough previously, or a certificate from a reputable physician showing that immunization for any or all is impossible or improper, or sufficient reason why any or all immunizations should not be done, shall be guilty of a misdemeanor, and except as herein otherwise provided, shall, upon conviction, be punished by a fine of not less than ten nor more than fifty dollars for each offense.

§ 16-3-5. Distribution of free vaccine preventives of disease

(a) Declaration of legislative findings and purpose. — The Legislature finds and declares that early immunization for preventable diseases represents one of the most cost-effective means of disease prevention. The savings which can be realized from immunization, compared to the cost of health care necessary to treat the illness and lost productivity, are substantial. Immunization of children at an early age serves as a preventative measure both in time and money and is essential to maintain our children’s health and well-being. The costs of childhood immunizations should not be allowed to preclude the benefits available from a comprehensive, medically supervised child immunization service. Furthermore, the federal government has established goals that require ninety percent of all children to be immunized by age two and provided funding to allow uninsured children to meet this goal.

(b) The state director of health shall acquire vaccine for the prevention of polio, measles, mumps, rubella, diphtheria, pertussis, tetanus, hepatitis-b, haemophilus influenzae-b and other vaccine preventives of disease as may be deemed necessary or required by law, and shall distribute the same, free of charge, in such quantities as he or she may deem necessary, to county and municipal health officers, to be used by them for the benefit of, and without expense to the citizens within their respective jurisdictions, to check contagions and control epidemics.

(c) The county and municipal health officers shall have the responsibility to properly store and distribute, free of charge, vaccines to private medical or osteopathic physicians within their jurisdictions to be utilized to check contagions and control epidemics: Provided, That the private medical or osteopathic physicians shall not make a charge for the vaccine itself when administering it to a patient. The county and municipal health officers shall provide a receipt to the state director of health for any vaccine delivered as herein provided.

(d) The director of the division of health is charged with establishing a childhood immunization advisory committee to plan for universal access, make recommendations on the distribution of vaccines acquired pursuant to this section and tracking of immunization compliance in accordance with federal and state laws. The childhood immunization advisory committee shall be appointed by the secretary of the department of health and human resources no later than the first day of July, one thousand nine hundred ninety-four, and shall be comprised of representatives from the following groups: Public health nursing, public health officers, primary health care providers, pediatricians, family practice physicians, health care administrators, state medicaid program, the health insurance industry, the public employees insurance agency, the self-insured industry and consumers. The state epidemiologist shall serve as an advisor to the committee. Members of the advisory committee shall serve two-year terms.

(e) All health insurance policies and prepaid care policies issued in this state which provide coverage for the children of the insured shall provide coverage for child immunization services to include the cost of the vaccine, if incurred by the health care provider, and all costs of administration from birth through age sixteen years. These services shall be exempt from any deductible, per-visit charge and/or co-payment provisions which may be in force in these policies or contracts. This section does not exempt other health care services provided at the time of immunization from any deductible and/or co-payment provisions.

(f) Attending physicians, midwives, nurse practitioners, hospitals, birthing centers, clinics and other appropriate health care providers shall provide parents of newborns and preschool age children with information on the following immunizations: Diphtheria, polio, mumps, measles, rubella, tetanus, hepatitis-b, haemophilus influenzae-b and whooping cough. This information should include the availability of free immunization services for children.

Allows:

  • Medical exemptions
  • Religious exemptions
  • Philosophical (conscientious objector, personal belief) exemptions

HEALTH CHAPTER 252. COMMUNICABLE DISEASES

Wis. Stat. § 252.04 (2002)

252.04. Immunization program.

(1) The department shall carry out a statewide immunization program to eliminate mumps, measles, rubella (German measles), diphtheria, pertussis (whooping cough), poliomyelitis and other diseases that the department specifies by rule, and to protect against tetanus. Any person who immunizes an individual under this section shall maintain records identifying the manufacturer and lot number of the vaccine used, the date of immunization and the name and title of the person who immunized the individual. These records shall be available to the individual or, if the individual is a minor, to his or her parent, guardian or legal custodian upon request.

(2) Any student admitted to any elementary, middle, junior or senior high school or into any day care center or nursery school shall, within 30 school days, present written evidence to the school, day care center or nursery school of having completed the first immunization for each vaccine required for the students grade and being on schedule for the remainder of the basic and recall (booster) immunization series for mumps, measles, rubella (German measles), diphtheria, pertussis (whooping cough), poliomyelitis, tetanus and other diseases that the department specifies by rule or shall present a written waiver under sub. (3)

(3) The immunization requirement is waived if the student, if an adult, or the students parent, guardian or legal custodian submits a written statement to the school, day care center or nursery school objecting to the immunization for reasons of health, religion or personal conviction. At the time any school, day care center or nursery school notifies a student, parent, guardian or legal custodian of the immunization requirements, it shall inform the person in writing of the persons right to a waiver under this subsection.

(4) The student, if an adult, or the students parent, guardian or legal custodian shall keep the school, day care center or nursery school informed of the students compliance with the immunization schedule.

(a) By the 15th and the 25th school day after the student is admitted to a school, day care center or nursery school, the school, day care center or nursery school shall notify in writing any adult student or the parent, guardian or legal custodian of any minor student who has not met the immunization or waiver requirements of this section. The notices shall cite the terms of those requirements and shall state that court action and forfeiture penalty could result due to noncompliance. The notices shall also explain the reasons for the immunization requirements and include information on how and where to obtain the required immunizations.
1. A school, day care center or nursery school may exclude from the school, day care center or nursery school any student who fails to satisfy the requirements of sub. (2)

2. Beginning on July 1, 1993, if the department determines that fewer than 98% of the students in a day care center, nursery school or school district who are subject to the requirements of sub. (2) have complied with sub. (2), the day care center or nursery school shall exclude any child who fails to satisfy the requirements of sub. (2) and the school district shall exclude any student enrolled in grades kindergarten to 6 who fails to satisfy the requirements of sub. (2)

3. Beginning on July 1, 1995, if the department determines that fewer than 99% of the students in a day care center, nursery school or school district who are subject to the requirements of sub. (2) have complied with sub. (2), the day care center or nursery school shall exclude any child who fails to satisfy the requirements of sub. (2) and the school district shall exclude any student enrolled in grades kindergarten to 6 who fails to satisfy the requirements of sub. (2)

4. No student may be excluded from public school under this paragraph for more than 10 consecutive school days unless, prior to the 11th consecutive school day of exclusion, the school board provides the student and the students parent, guardian or legal custodian with an additional notice, a hearing and the opportunity to appeal the exclusion, as provided under s. 120.13 (1) (c) 3.

(6) The school, day care center or nursery school shall notify the district attorney of the county in which the student resides of any minor student who fails to present written evidence of completed immunizations or a written waiver under sub. (3) within 60 school days after being admitted to the school, day care center or nursery school. The district attorney shall petition the court exercising jurisdiction under chs. 48 and 938 for an order directing that the student be in compliance with the requirements of this section. If the court grants the petition, the court may specify the date by which a written waiver shall be submitted under sub. (3) or may specify the terms of the immunization schedule. The court may require an adult student or the parent, guardian or legal custodian of a minor student who refuses to submit a written waiver by the specified date or meet the terms of the immunization schedule to forfeit not more than $ 25 per day of violation.

(7) If an emergency arises, consisting of a substantial outbreak as determined by the department by rule of one of the diseases specified in sub. (2) at a school or in the municipality in which the school is located, the department may order the school to exclude students who are not immunized until the outbreak subsides.

(8) The department shall provide the vaccines without charge, if federal or state funds are available for the vaccines, upon request of a school district or a local health department. The department shall provide the necessary professional consultant services to carry out an immunization program, under the requirements of sub. (9), in the jurisdiction of the requesting local health department. Persons immunized may not be charged for vaccines furnished by the department.

(9)

(a) An immunization program under sub. (8) shall be supervised by a physician, selected by the school district or local health department, who shall issue written orders for the administration of immunizations that are in accordance with written protocols issued by the department.

(b) If the physician under par. (a) is not an employee of the county, city, village or school district, receives no compensation for his or her services under par. (a) and acts under par. (a) in accordance with written protocols issued by the department, he or she is a state agent of the department for the purposes of ss. 165.25 (6), 893.82 (3) and 895.46

(c) The department may disapprove the selection made under par. (a) or may require the removal of a physician selected.

(10) The department shall, by rule, prescribe the mechanisms for implementing and monitoring compliance with this section. The department shall prescribe, by rule, the form that any person immunizing a student shall provide to the student under sub. (1)
(11) Annually, by July 1, the department shall submit a report to the legislature under s. 13.172 (3) on the success of the statewide immunization program under this section.

Allows:

  • Medical exemptions
  • Religious exemptions

TITLE 21. EDUCATION
CHAPTER 4. PUPILS
ARTICLE 3. RIGHT TO ATTEND SCHOOL

Wyo. Stat. § 21-4-309 (2002)

§ 21-4-309. Mandatory immunizations for children attending schools; exceptions

(a) Any person attending, full or part time, any public or private school, kindergarten through twelfth grade, shall within thirty (30) days after the date of school entry, provide to the appropriate school official written documentary proof of immunization. For purposes of this section, documentary proof of immunization is written certification by a private licensed physician or his representative or by any public health authority, that the person is fully immunized. Documentation shall include month, day and year of each required immunization received against vaccine preventable disease as designated by the state health authority. No school administrator shall permit a student to attend school for more than thirty (30) calendar days without documentary proof of immunization. If immunization requires a series of immunizations over a period of more than thirty (30) calendar days, the child shall be permitted to attend school while receiving continuing immunization if the school administrator receives written notification by a private licensed physician or his representative or by a public health official, specifying a written schedule for necessary immunization completion within the medically accepted time period. Waivers shall be authorized by the state or county health officer upon submission of written evidence of religious objection or medical contraindication to the administration of any vaccine. In the presence of an outbreak of vaccine preventable disease as determined by the state or county health authority, school children for whom a waiver has been issued and who are not immunized against the occurring vaccine preventable disease shall be excluded from school attendance for a period of time determined by the state or county health authority, but not suspended from school as provided in W.S. 21-4-305. Children excluded from school attendance under this section shall not be counted in the aggregate number of pupils absent as defined in W.S. 21-13-101(a)(i).

(b) The school administrator shall be responsible for an audit of the immunization status of any child enrolled in the school in accordance with rules and regulations prescribed by the department of health.

(c) The written documented proof of immunization on a form provided by the state health officer shall be an integral part of the child’s school record.

(d) For purposes of this section:

(i) “State health officer” means the person appointed by the director of the department of health pursuant to W.S. 9-2-101(f) [9-2-103];

(ii) “County health officer” means the licensed medical officer designated by the county commissioners to serve as health officer for his county;

(iii) “Immunized” or “immunization” means initial immunization and any boosters or reimmunizations required to maintain immunization pursuant to the immunization standards and recommendations issued by the state health officer.