Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 20 - Division of Community and Public Health › Chapter 28 - Immunization › Section 19 CSR 20-28.040 - Day Care Immunization Rule

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This 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) As mandated by
				section
				210.003,
				RSMo, the administrator of each public, private, or parochial day care center,
				preschool, or nursery school caring for ten (10) or more children shall have a
				record prepared showing the immunization status of every child enrolled in or
				attending a facility under the administrator's jurisdiction. Each administrator
				caring for or licensed for ten (10) or more children shall complete an annual
				summary report showing the immunization status of each child enrolled and
				submit to the Department of Health and Senior Services no later than January 15
				of each year. The summary report shall be submitted electronically through the
				department's online system at
http://health.mo.gov/immunizations/daycarerequirements.php
or by completing and mailing the Imm.P-32 form to the Bureau of Immunization
				Assessment and Assurance, PO Box 570, Jefferson City, MO 65102-0570. The
				Imm.P-32 form is incorporated by reference in this rule as published October
				2013 by the Department of Health and Senior Services and may be obtained 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.
(2) No child shall enroll in or attend a
				public, private, or parochial day care center, preschool, or nursery school
				caring for ten (10) or more children unless the child has been adequately
				immunized according to this rule. Children attending elementary school who
				receive before or after school care, or both, shall meet the immunization
				requirements established in the School Immunization Rule,
				19 CSR
				20-28.010. Age-appropriate vaccine requirements will
				be according to the Missouri Day Care Immunization Requirements Vaccines
				Received 0-18 Years of Age or the Center 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. These schedules are incorporated by
				  reference in this rule as published February 2014 by the Department of Health
				  and Senior Services and are available on the web at
http://health.mo.gov/immunizations/daycarerequirements.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.
(3) Section
				210.003,
				RSMo, provides that a child who has not completed all appropriate immunizations
				may enroll if-
(A) Satisfactory evidence is
				produced that the child has begun the process of immunization. The child may
				continue to attend as long as they have started an immunization series and
				provide satisfactory evidence indicating progress is being accomplished. The
				Department of Health and Senior Services' form Imm.P.14 shall be completed and
				placed on file with the child's immunization health record for each child with
				immunizations in progress. Failure to meet the next scheduled appointment
				constitutes noncompliance with the day care immunization law, and action shall
				be initiated immediately by the administrator to have the child excluded from
				the facility. The Imm.P.14 form is incorporated by reference in this rule as
				published June 2012 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.
(B) The parent or
				guardian has signed and placed on file with the day care administrator a
				statement of exemption which may be either of the following:
1. A medical exemption, by which a child
				shall be exempted from the requirements of this rule 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
				child's health or life, or the child has documentation of disease or laboratory
				evidence of immunity to the disease. The Department of Health and Senior
				Services' form Imm.P.12 shall be placed on file with the immunization record of
				each child 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. The medical exemption need not be renewed annually; or
2. A parent or guardian exemption, by which a
				child shall be exempted from the requirements of this rule if one (1) parent or
				guardian files a written objection to immunization with the day care
				administrator. The Department of Health and Senior Services' form Imm.P.11
				shall be signed by the parent or guardian and placed on file with the
				immunization record of each child with a parental exemption. The parental
				exemption must be renewed annually. The Imm.P.11 form is incorporated by
				reference in this rule as published July 2010 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.