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 20-28.010 - Immunization Requirements for School Children

Current through Register Vol. 49, No. 14, July 15, 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.