Vaccinations part4

MISSISSIPPI

Mississippi Immunization Requirements

Authority: Public Health, Contagious Diseases,- Quarantine, Miss. Code Ann. Sec. 41-23-37

General Rule: It is unlawful for any child to attend school, kindergarten or similar type facility

intended for the instruction of children, either public or private, unless they have been

vaccinated against those diseases specified by the state health officer. MCA Sec. 41-23-37 (2).

The local health officer may grant up to 90 days to complete required vaccinations, if such

delay will not cause undue risk to the child, the school or the community. MCA Sec.

41-23-37(5). 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. MCA Sec. 41-23-37(9).

Exceptions: There are two exceptions:

1. Any children attending a legitimate home instruction program as defined in Sec. 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 are exempted. MCA Sec. 41-23-37(2).

2. A certificate of exemption for medical reasons may be offered on behalf of a child by a duly

licensed physician and may be accepted when, in his opinion, such exemption will not cause

undue risk to the community.' MCA Sec. 41-23-37(3).

Note: Mississippi's religious exemption under MCA Sec. 41-23-37, which was written much less

inclusive than most states, was ruled in violation of the Fourteenth Amendment to the US

Constitution and voided. Brown v. Stone, 378 So. 2d. 218 (1979 Miss.), cert. denied 449 US 887.

Certificate: Certificates of vaccination are 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.' MCA Sec. 41-23-37(4).

Designated Diseases: Diphtheria, tetanus, pertussis, polio, measles, rubella, and mumps. Draft,

Grades K-12 Immunization Requirements, in letter from Liane Hostler, Director of

Immunization Program to Kimberly Wray, September 21, 1993.

MISSOURI

Missouri Immunization Requirements

(Updated December 1993)

Authority: Education and Libraries, Pupils, Title 11, Mo.Rev. Stat. 167.181. Rules of

Department of Social Services, Mo.Code Regs. lit. 13, 50-1 10.0 10.

General Rule: It is unlawful for any student to attend school for longer than fifteen school days

unless he has been immunized as required under the rules and regulation of the department of

health, and can provide satisfactory evidence of such immunization. MRS 167.181.2.

Exceptions: 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. If for medical reasons, a statement from a duly licensed physician

must also be provided. MRS 167.181.3.

Epidemic: Where there is threat of epidemic or any actual epidemic, school district board of

education is authorized to make reasonable rules and regulations respecting compulsory

vaccination or immunization of school children, but board does not have such power except

where there is a threat of epidemic or an actual epidemic.' Op. Atty. Gen. No. 22, Anderson,

3-27-62.

Definitions: This rule is designed to govern any child - regardless of age - who is attending

public, private, parochial or parish school.' MCR tit. 13, 50-110.010(l)(A).

Designated Diseases: Poliomyelitis, rubella, rubeola, mumps, diphtheria, tetanus and pertussis.

MRS 167.181.1.

Responsibility of Parents: 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.' MRS

167.181.2. For each student in noncompliance, appropriate legal action should be taken. School

administrators should exercise their power of compulsory education under section MRS

167.031 and penalty under MRS 167.061. MCR tit. 13, 50-110.010(l)(A).

Further Research: Investigate how broad the religious exemption is along with whether or not

home schools are covered in the definition of schools.

MONTANA

Montana Immunization Requirements

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.

NEBRASKA

Nebraska Immunization Requirements

79-221 Immunization; when not required.

Immunization shall not be required for a student's enrollment in any school in this state if he/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.

NEVADA

Nevada Immunization Requirements

Authority: Private Education, Nev. Rev. Stat. Ann. 394.192 to 199, 439.550 to 580.

Immunization Against Disease, Nev. Admin. Code ch. 392 105.

General Rule: A child may not be enrolled in a private school within this state unless his parent

or guardian submit a certificate stating that the child has been immunized and has received

proper boosters for the designated diseases. NRS 394.192(l). A child may enter school

conditionally if the child is in the, process of receiving the required immunizations. A certificate

showing the child is fully immunized must be received in 90 days after the conditional

admittance. NRS 394.192(4). A child who is excluded from school pursuant to this section is a

neglected child for the purposes of NRS 432.100 to 432.130, inclusive, and chapter 432B of

NRS. 394.192(4).

Exceptions: There are two exceptions:

1) A private school shall not refuse enrollment if the parents or guardian 'have submitted to the

governing body a written statement indicating that their religious belief prohibits immunization.

NRS 394.193.

2) If the medical condition of a child will not permit him to be immunized," a written statement

of this fact signed by a doctor shall exempt the child from immunization requirements. NRS

394.194.

Epidemic: Whenever the state board of health or a local board of health determines that there is

a dangerous contagious disease in a private school attended by a child exempted under NRS

394.193 or 394.194, the governing body of such private school shall require either. 1) That the

child be immunized or 2) That he remain outside the school environment and the local health

officer be notified. NRS 394.198.

Certificate: The certificate must show that the required vaccines and boosters were given, and

must bear the signature of the licensed physician or registered nurse who administered them.

NRS 394.192(2).

Designated Diseases: Diphtheria, tetanus, pertussis (if under 6 years old), poliomyelitis, rubella

and rubeola. AM 394.192(l). Mumps. NAC 392.105.

Enforcement: Each local health officer is charged with the strict and thorough enforcement of

the provisions of this chapter in his jurisdiction, under the supervision and direction of the health

division. NRS 439.550. Actions for injunction under this section may be prosecuted by the

attorney general, any district attorney in this state or any retained counsel of any local board of

health in the name and upon the complaint of the state board of health or any local board of

health, or upon the complaint of the state health officer or of any local health officer or his

deputy.' NRS 439.565(2). Each person who violates any of the provisions of this chapter or

refuses or neglects to obey any lawful order, rule or regulation of the state board of health or

violates any rule or regulation approved by the state board of health," "is guilty of a

Misdemeanor. NRS 439.580."

NEW HAMPSHIRE

New Hampshire Exemptions

Authority: Public Health, Communicable Disease, NH Rev. Stat. Ann. 141-C:2, C:20-a to e,

C:21, 200:38, 39. N.H. Code A& nin. R. Ed. 311-01.

General Rule: All parents or legal guardians shall have their children who are residing in this

state immunized against the designated diseases. RSA 141-C:20-a.I. 'No child shall be admitted

or enrolled in any school or child care agency, public or private, unless immunized, partially

immunized relative to the age of the child as specified in rules adopted by the director, or

exempted. RSA 141-C-.20-a.H. All children shall be immunized prior to school entrance in

accordance with RSA 141-C:20-a. RSA 200:38. If a child is not immunized, does not have a

religious or medical exemption, or is unable to provide evidence of immunization being in

process of completion before October 15 or 30 days from admission, he/she shall be excluded

from school.' CAR 311.01(c).

Exceptions: There are two exemptions: RSA 141-C:20-c.

NEW JERSEY

New Jersey Immunization Requirements

Authority: Education, N.J. Star. Ann. 99 18A:61 D-l et seq., Health and Vital Statistics, N.J Stat.

Ann § 26:1A-7, 26:1A-9, 9.1, 26:2N-1 et seq. Chapter 14, New Jersey Stare Sanitary Code,

Immunization of Pupils in Schools, N.J. Admin Code tit. 8 §57-4.1 to 4.17.

General Rule: The Public Health Council shall have power to establish such reasonable sanitary

regulations as may be necessary and proper to preserve and improve the public health in this

State. The State Sanitary Code may cover any subject affecting public health, including the

immunization against disease of all school children in the State of New Jersey. NJ §26:1A-7.

"No principal or other person in charge of a school shall knowingly admit or retain any pupil

who has not submitted acceptable evidence of immunization," "except when there are

exemptions." NJAC §8:57-4.2. "These regulations shall apply to all pupils attending any public

or private school in New Jersey, including child we centers, nursery schools and kindergartens,

except that the regulations shall not apply to pupils under one year of age." NJAC §§8:57-4. 1. A

pupil may be admitted on a provisional basis if a doctor indicates that immunization has already

been initiated and the pupil is in the process of complying with all requirements. NJAC

§8:57-4.5(a).

Exceptions: There are three exceptions:

1) A written statement from any doctor that an immunization is medically contraindicated, will

exempt a pupil from the specific immunization requirements for the period of time specified in

the statement. NJAC §8:57-4.3.

2) A pupil shall be exempted from mandatory immunization if the parent or guardian objects

thereto in a signed, written statement upon the ground that the proposed immunization interferes

with the free exercise of the pupil's religious rights. "General philosophical or moral objection to

immunization shall not be sufficient for an exemption or religious grounds." NJAC §8:57-4.4(a).

This exemption may be suspended during the existence of an emergency as determined by the

State Commissioner of Health. NJAC §8 :57-4. 4(c).

3) The Commissioner of Health shall prepare and make available to all health care providers in

the State and parents and guardians, upon request, a pamphlet which explains the benefits and

possible adverse reactions to immunizations for pertussis. Specific information should include,

among others. NJS §26:2N-2. "The circumstances under which pertussis vaccine should not be

administered or should be delayed, including the categories of persons who are significantly

more vulnerable to major adverse reactions." NJS §26:2N-2.b(l). A child shall not be required to

receive a pertussis vaccine as a condition for admission to 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 hllS §26:2N, and the reasons for the medical contraindications. NJS §26:2N-4.

Epidemic: In the event of an outbreak or threatened outbreak of any designated disease, the

Commissioner may issue either additional immunization requirements or modify the

requirements to meet the emergency. NJAC §8:57-4.16(a). All pupils failing to meet these

additional requirement shall be excluded from school until outbreak is over. NJAC

§8:57-4.16(b).

Designated Diseases: Diphtheria, tetanus, pertussis, poliomyelitis, measles, rubella, and mumps.

NJACS

Higher Learning: Every public and independent institution of higher learning in this State shall,

as a condition of admission, require every graduate and undergraduate student who is 30 years of

age of less and is enrolled full-time or part-time, to submit a valid immunization record. MIS 9

18A:61 D-l. Student who attended an elementary or secondary school located in the State may be

exempted. IWS g 18A:61 D-2. Religious and medical exemptions also apply. NIS 9 18A:61 D-3

and D-4.

1. A doctor certifies that immunization against a particular disease may be detrimental to the

child's health.

2. 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.

Epidemic: Whenever any student exhibits symptoms of contagion or is a hazard to himself or

others, he shall be excluded from the classroom and his parents or guardians shall be notified as

soon as possible. RSA 200:39. During an outbreak of a communicable disease for which

immunization is required,' children exempted, 'shall not attend' school. RSA 141-C:20-d.

Definitions:

School--means any facility which provides primary or secondary education. NBRS 141-C:2.=-a.

Director--means the director, division of public health services, department of health and human

services, or his designee. RSA 141-C:2.DC.

Certificate: Any person who immunizes a child shall complete a form to be supplied by the

director and shall give the completed form to the parent.' RSA 141-C:20-b.I.

Designated Diseases: Diphtheria, mumps, pertussis, poliomyelitis, rubella, rubeola, and tetanus.

RSA 141-C:20-a.

Responsibility of Parents: Any person who shall violate, disobey, refuse, omit or neglect to

comply with any of the provisions of RSA 141-C, or of the rules adopted pursuant to it, shall be

guilty of a misdemeanor.' RSA 141-C:21.

NEW MEXICO

New Mexico Immunization Requirements

Authority: Health and Safety, N.M. Star. Ann. § 24-5-1 to 6.

General Rule: 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 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 process is accomplished in the prescribed manner. Exception section

is controlling as to children attending public, private or parochial schools. 1961-62 Op. Atty

Gen.No. 62-5.

Exceptions: There are two general categories of exemptions, which are good for nine months:

Medical. The parent or guardian may file a certificate from a doctor 'stating that the physical

condition of the child is such that immunization would seriously endanger the life or health of

the child.' NMS § 24-5-3.A(l).

Religious. ARMS § 24-5-3.A(2) and (3)

1) The parent or guardian may file an affidavit from an officer of a recognized religious

denomination that such parents are bona fide members whose religious teaching requires

reliance upon prayer or spiritual means alone for healing; or

2) File affidavits that his religious beliefs, held either individually or jointly with others, do not

permit the administration of vaccine or other immunizing agents.

Responsibility of Parents: 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. NMS § 24-5-1.

The name of any parent or guardian who neglects or refuses to permit his child to be immunized

against diseases as required by rules and regulations promulgated hereunder shall be reported by

the school superintendent to the director of the health services division of the department of

health. NMS § 24-5-4. Violation of any provisions relating to the immunization of school

children is a misdemeanor. NMS § 24-5-6.

NEW YORK

New York Immunization Requirements

NY PUB HEALTH S 2164

MCKINNEY'S CONSOLIDATED LAWS OF NEW YORK ANNOTATED

PUBLIC HEALTH LAW

CHAPTER 45 OF THE CONSOLIDATED LAWS

ARTICLE 21--CONTROL OF ACUTE COMMUNICABLE DISEASES

TITLE VI--POLIOMYELITIS AND OTHER DISEASES

2164. Definitions; immunization against polio, 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. 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 department 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 therefor. In the event that

such person does not wish to select a linehealth 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. Every school shall annually provide the commissioner, on forms provided by the

commissioner, a summary regarding compliance with the provisions of this section.

NORTH CAROLINA

North Carolina Immunization Requirements

Authority: Public Health, N. C. Gen. Slat. 13OA- 152 to 157. Health: Epidemiology, N. C.

Admin. Code tit. 15A, r. 19A.0400 to .0404.

General Rule: Every child present in this State shall be immunized against the designated

diseases. NCGS 13OA-152. 'No child shall attend a school (K-12), whether public, private or

religious, or a day care facility,' unless a certificate indicating that the child has received

immunization against the designated disease 'is presented to the school or facility.' NCGS

13OA-155(a).

Exceptions: There are two statutory exceptions:

1) If a doctor certifies that a required immunization is or may be detrimental to a person's health,

the person is not required to receive the specified immunization as long as the contraindication

persists. NCGS 13OA-156.

2) Upon submission of a written statement of the bona fide religious beliefs and opposition to

the immunization requirements, the person may attend school without presenting a certificate of

immunization. NCGS 13OA-157.

No child shall be exempt from immunization requirements for the case of a personal belief or

philosophy of a parent or guardian not founded upon a religious belief.' NCAC T15A:19A.0403.

Certificate: A physician or local health department administering a required vaccine shall give a

certificate of immunization to the person who presented the child.' NCGS 13OA-154.

Procedure: If a certificate is not presented on the first day, the principal or operator shall present

a notice of deficiency to the parent or guardian. The parent or guardian will then have 30 days to

comply. If more than 30 days is required to administer a series of vaccines, additional time will

be granted. 'Upon termination of 30 calendar days or the extended period, the principal or

operator shall not permit the child to attend school, unless the required immunization has been

obtained.' NCGS 13OA-155(a).

Designated Diseases: Diphtheria, tetanus, whooping cough, poliomyelitis, red measles (rubeola),

rubella and any other disease upon a determination of the Commission. NCGS 13OA-152(a).

Responsibility of Parents: '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 dated. " NCOS f 13OA-152(a),

Graduate School: Except for medical and religious exemptions, 'no person shall attend a College

or university, whether public, private, or religious, unless a certificate of immunization or a

record of immunization from a high school located in North Carolina indicating that the person

has received the immunizations required is presented to the college or university. NCGS 13OA-

155. 1 (a).