Current through Register Vol. 49, No. 18, September 16, 2024
PURPOSE: This rule amendment revises the requirements for
school children to include meningococcal vaccine for students in eighth grade
and a booster dose for students in twelfth grade. Also, the amendment clarifies
requirements and incorporates by reference required forms and supporting
documents.
PUBLISHER'S NOTE: The secretary of state has determined that
the publication of the entire text of the material which is incorporated by
reference as a portion of this rule would be unduly cumbersome or expensive.
This material as incorporated by reference in this rule shall be maintained by
the agency at its headquarters and shall be made available to the public for
inspection and copying at no more than the actual cost of reproduction. This
note applies only to the reference material. The entire text of the rule is
printed here.
(1) The superintendent
of each public, private, parochial, or parish school shall make a summary
report to the Department of Health and Senior Services no later than October 15
of each school year. This date is necessitated by the law which prohibits the
enrollment and attendance of students who are in noncompliance. This report
shall include aggregate immunization information by grade by vaccine antigen,
number of students enrolled, number of students in compliance with state
immunization requirements, number of students in progress, number of students
with signed medical exemption, number of students with signed religious
exemption, number of students noncompliant with immunization record, and number
of students with no immunization record. Each school superintendent or designee
shall submit a summary report for all schools under the administrator's
jurisdiction. Separate reports for each school should not be submitted,
although separate lists shall be maintained in each school for auditing
purposes.
(A) Exclusion of students in
noncompliance, section
167.181,
RSMo. Students cannot attend school unless they are properly immunized and can
provide satisfactory evidence of the immunization or unless they are exempted.
The school administration shall exercise its power of pupil suspension or
expulsion under section
167.161,
RSMo, and possible summary suspension under section
167.171,
RSMo, until the violation is removed. Transfer students in noncom-pliance shall
not be permitted to enroll or attend school. Students enrolled during the
previous school year shall be denied attendance for the current school year if
not in compliance. Under section
160.2000, RSMo,
children of military families shall be given thirty (30) days from the date of
enrollment to obtain any required immunization, or initial vaccination for a
required series of immunizations. A student determined to be homeless by school
officials may be enrolled in school for no more than thirty (30) days prior to
providing satisfactory evidence of immunization. If the homeless student's
immunization record is not obtained within the thirty (30) days and the student
is still eligible for services under the homeless education program, the
student shall begin the immunization series and demonstrate that satisfactory
progress has been accomplished within ninety (90) days. If the homeless student
is exempted from receiving immunizations, then after the initial thirty- (30-)
day enrollment, the student shall provide documentation in accordance with the
exemption requirements included herein. For the purpose of this paragraph, a
homeless student shall be defined as a student who lacks a fixed, regular, and
adequate nighttime residence; or who has a primary nighttime residence in a
supervised publicly or privately operated shelter or in an institution
providing temporary residence or in a public or private place not designated
for or ordinarily used as a regular sleeping accommodation for human
beings.
(B) This rule is designed
to govern any student, regardless of age, who is attending a public, private,
parochial, or parish school. If the specific age or grade recommendations are
not mentioned within this rule, the Missouri Department of Health and Senior
Services should be consulted.
(C)
It is unlawful for any student to attend school unless the student has been
immunized according to this rule or unless a signed statement of medical or
religious exemption is on file with the school administrator. In the event of
an outbreak or suspected outbreak of a vaccine-preventable disease within a
particular facility, the administrator of the facility shall follow the control
measures instituted by the local health authority or the Department of Health
and Senior Services pursuant to
19
CSR 20-20.040.
1.
Medical exemption. A student shall be exempted from the immunization
requirements of this rule as provided in section
167.181,
RSMo, upon signed certification by a licensed doctor of medicine (MD), doctor
of osteopathy (DO), or his or her designee indicating that either the
immunization would seriously endanger the student's health or life or the
student has documentation of disease or laboratory evidence of immunity to the
disease. The exemption shall be provided on an original Department of Health
and Senior Services' form Imm.P.12 and shall be placed on file with the school
immunization health record for each student with a medical exemption. The
Imm.P.12 form is incorporated by reference in this rule as published June 2012
by the Department of Health and Senior Services and may be obtained by
contacting a medical provider, local public health agency, or the department's
Bureau of Immunization Assessment and Assurance at PO Box
570, Jefferson City, MO 65102-0570, or by calling 800-219-3224. This rule does
not incorporate any subsequent amendments or additions. This need not be
renewed annually.
2.
Religious exemption. A student shall be exempted from the immunization
requirements of this rule as provided in section
167.181,
RSMo, if one (1) parent or guardian objects in writing to the school
administrator that immunization of that student violates his/her religious
beliefs. This exemption must be provided on an original Department of Health
and Senior Services' form Imm.P.11A, and shall be signed by the parent or
guardian and placed on file with the school immunization health record. The
Imm.P.11A form is incorporated by reference in this rule as published April
2012 by the Department of Health and Senior Services and may be obtained by
contacting a medical provider, local public health agency, or the department's
Bureau of Immunization Assessment and Assurance at PO Box 570, Jefferson City,
MO 65102-0570, or by calling 800-219-3224. This rule does not incorporate any
subsequent amendments or additions. This need not be renewed
annually.
3. Immunization in
progress. Section
167.181,
RSMo, provides that students may continue to attend school as long as they have
started an immunization series and provide satisfactory evidence indicating
progress is being accomplished. An original Department of Health and Senior
Services' form Imm.P.14 shall be completed and placed on file with the school
immunization health record of each student with immunizations in progress. The
Imm.P.14 form is incorporated by reference in this rule as published June 2012
by the Department of Health and Senior Services and may be obtained by
contacting a medical provider, local public health agency, or the department's
Bureau of Immunization Assessment and Assurance at PO Box 570, Jefferson City,
MO 65102-0570, or by calling 800-219-3224. This rule does not incorporate any
subsequent amendments or additions. Failure to meet the next scheduled
appointment constitutes noncompliance with the school immunization law and
exclusion shall be initiated immediately. Refer to subsection (1)(A) of this
rule regarding exclusion of students in noncompliance.
(2) Review of immunization
requirements for school entry shall be conducted annually by each school
superintendent or designee. Age- or grade-appropriate vaccine requirements
shall be according to the Missouri School Immunization Requirements Vaccines
Received 0- 18 Years of Age, published on April 2014 or the Centers for Disease
Control and Prevention's Catch-up Immunization Schedule for Persons Aged 4
Months through 18 Years Who Start Late or Who Are More Than 1 Month Behind,
published January 2014. These schedules are incorporated by reference in this
rule and are available on the Department of Health and Senior Services' website
at http://health.mo.gov/immunizations/schoolre-quirements.php
or by contacting the department's Bureau of Immunization Assessment and
Assurance at PO Box 570, Jefferson City, MO 65102-0570, or by calling
800-219-3224. This rule does not incorporate any subsequent amendments or
additions. Revisions to school immunization requirements shall be required for
school attendance one (1) full year after publication in the Code of State
Regulations, beginning with the first day of school of that school
year.
(3) The parent or guardian
shall furnish the superintendent or designee satisfactory evidence of
immunization or exemption from immunization.
(A) Satisfactory evidence of immunization
means a statement, certificate, or record from a physician or his or her
designee, other recognized health facility, immunization registry, school
record, or child care record stating that the required immunizations have been
given to the person and verifying the type of vaccine. This statement,
certificate, or record shall provide documentation of the specific antigen and
the month, day, and year of vaccine administration.
*Original authority: 167.181, RSMo 1963, amended 1972,
1973, 1992, 1993, 1995, 1996, 2001; 192.006, RSMo 1993, amended 1995; and
192.020, RSMo 1939, amended 1945, 1951,
2004.
