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SOAHR 2005-094 DEPARTMENT OF COMMUNITY HEALTH
BUREAU OF EPIDEMIOLOGY COMMUNICABLE AND RELATED DISEASES
Filed with the Secretary of State on May 26, 2006
These rules take effect immediately after filing with the Secretary of State unless adopted under sections 33, 44, 45a(6), or 48 of 1969 PA 306. Rules adopted under these sections become effective 7 days after filing with the Secretary of State.
(By authority conferred on the department of community health by sections 5111 and 9227 of 1978 PA 368 and Executive Reorganization Order Nos. 1996-1 and 1997-4, MCL 333.5111, 333.9227, 330.3101,
and 333.26324)
R 325.176 of the Michigan Administrative Code is amended as follows:
R 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 or a laboratory finding of hepatitis B immunity or disease satisfies this requirement.
(g) Effective January 1, 2007, 1 dose of any appropriate pneumococcal conjugate 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 or a laboratory finding of hepatitis B immunity or disease satisfies this requirement.
(g) Effective January 1, 2007, 2 doses of any appropriate pneumococcal conjugate 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 or a laboratory finding of hepatitis B immunity or disease satisfies this requirement.
(g) Effective January 1, 2007, pneumococcal conjugate vaccine as shown by either of the following:
(i) Three doses of any appropriate pneumococcal conjugate vaccine.
(ii) Receipt of an age appropriate complete series of any appropriate pneumococcal conjugate vaccine.
(5) A child who is 15 months through 23 months 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 age 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.
(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) Have evidence of hepatitis B immunity as shown by either 3 doses of any appropriate hepatitis B vaccine or a laboratory finding of hepatitis B immunity or disease satisfies this requirement.
(j) 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.
(k) Effective January 1, 2007, pneumococcal conjugate vaccine as shown by either of the following:
(i) Four doses of any appropriate pneumococcal conjugate vaccine.
(ii) Receipt of an age appropriate complete series of any appropriate pneumococcal conjugate vaccine.
(6) A child who is 24 months through
4years 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.
(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 or a laboratory finding of hepatitis B immunity or disease satisfies this requirement.
(j) 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.
(k) Effective January 1, 2007, pneumococcal conjugate vaccine as shown by either of the following:
(i) Receipt of an age appropriate complete series of any appropriate pneumococcal conjugate vaccine.
(ii) Receipt of 1 dose of any appropriate pneumococcal conjugate vaccine at or after 24 months of age.
(7) A child who is 5 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) One dose of any appropriate live measles vaccine at or after 12 months of age. A laboratory finding of measles immunity satisfies this requirement.
(f) One dose of any appropriate live mumps vaccine at or after 12 months of age. A laboratory finding of mumps immunity satisfies this requirement.
(g) One dose of any appropriate live rubella vaccine at or after 12 months of age. A laboratory finding of rubella immunity satisfies this requirement.
(h) Three doses of any appropriate hepatitis B vaccine or a laboratory finding of hepatitis B immunity or disease satisfies this requirement.
(i) 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.
(8) 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 4 doses of any appropriate polio vaccine. If dose 3 was administered after the fourth birthday only 3 doses are required.
(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 or a laboratory finding of hepatitis B immunity or disease satisfies this requirement.
(I) 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.
(9) A child who is 7 through 18 years of age and who is entering school or enrolled in grade 6, 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.
(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.
(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) Receipt of a complete series of any appropriate hepatitis B vaccine or a laboratory finding of hepatitis b immunity or disease satisfies this requirement.
(h) 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.
(10) To satisfy the requirements in subrules (2) to (9) of this rule, each vaccine shall have been administered in accordance with the manufacturer's instructions. A 4-day grace leniency is allowed on the minimum ages and intervals for each vaccine.
(11) If the requirements for immunization cannot be completed due to medical reasons within 4 months of admittance, a child shall be permitted to remain enrolled in a school or group program for a reasonable length of time that is consistent with good medical practice. A statement requesting the enrollment of the child beyond the exclusion date shall be signed by a physician or local health officer and shall certify that the child is in the process of complying with all immunization requirements. This medical exemption shall be filed with the child's school or group program immunization records until it can be replaced with proof that the vaccines for which an exemption was granted have been received. Upon completion of the required immunizations, a parent shall present the school or group program with a certificate of immunization.
(12) When presented with a medical exemption, religious or other exemption, the administrator of a child's school or operator of a child's group program shall recognize the exemption status of the child.
(13) A standard record of the immunizations required by this rule and exemptions shall be maintained by every school for every pupil on forms supplied by the department. When a pupil transfers to another school or school district, the record of immunization, or a true copy of the record, shall be sent to the new school by the original school.
(14) 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.
(15) 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 (8) and (9) of this rule.
(16) 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.
(17) A requirement for immunization with a specific vaccine may be suspended temporarily at the request of the department director for reasons of inadequate vaccine supply.
