Texas Administrative Code › Title 25 - HEALTH SERVICES › Part 1 - DEPARTMENT OF STATE HEALTH SERVICES › Chapter 97 - COMMUNICABLE DISEASES › Subchapter B - IMMUNIZATION REQUIREMENTS IN TEXAS ELEMENTARY AND SECONDARY SCHOOLS AND INSTITUTIONS OF HIGHER EDUCATION › Section 97.63 - Immunization Requirements in Child-Care Facilities, Pre-Kindergarten, Early Childhood Programs, and Texas Elementary and Secondary Schools

Current through Reg. 49, No. 28; July 12, 2024
Every child in the state shall be vaccinated against
					 vaccine-preventable diseases caused by infectious agents, in accordance with
					 the following immunization schedule. While the department recommends that
					 providers immunize children according to the recommendations found on the
					 department's website at www.ImmunizeTexas.com, this section sets out minimum
					 immunization requirements for school entry for the child. The child must have
					 the indicated vaccinations by the grade level indicated. The vaccination
					 schedule also indicates the grade before which the child should not obtain the
					 specific vaccination. A copy of the current recommended schedule is available
					 at www.ImmunizeTexas.com, or by mail by writing the Department of State Health
					 Services, Mail Code 1946, P.O. Box 149347, Austin, Texas 78714-9347.
(1) For those vaccines where it is stated in
				  this section that a certain dose must be received on or after a certain
				  birthday, a vaccine administered up to four days prior to the birthday is
				  considered compliant.
(2) For
				  diseases listed below, a child or student shall show acceptable evidence of
				  vaccination prior to entry, attendance, or transfer to a child-care facility or
				  public or private elementary or secondary school.
(A) Children enrolled in child-care
				  facilities, pre-kindergarten, or early childhood programs shall be immunized
				  against: diphtheria, pertussis, tetanus, poliomyelitis,
Haemophilus
				  influenzae
type b (Hib), measles, mumps, rubella, hepatitis B,
				  hepatitis A, invasive pneumococcal, and varicella diseases. In recognition of
				  the fact that immunization needs vary depending on the age of the child, the
				  minimum number of doses required for each vaccine is indicated in the schedule
				  below:
Attached
					 Graphic
(B)
				  Students in kindergarten through twelfth grade shall have the following
				  vaccines, according to the schedule listed.
(i) Poliomyelitis.
(I) Kindergarten through twelfth grade.
				  Students are required to have four doses of polio vaccine--one of which must
				  have been received on or after the fourth birthday. Or, if the third dose was
				  administered on or after the fourth birthday, only three doses are required.
				  Four doses of oral polio vaccine (OPV) or inactivated poliovirus vaccine (IPV)
				  in any combination by age four to six years old is considered a complete
				  series, regardless of age at the time of the third dose.
(II) Polio vaccine is not required for
				  persons eighteen years of age or older.
(ii) Diphtheria/Tetanus/Pertussis.
(I) Kindergarten through sixth grade.
				  Students are required to have five doses of a
				  diphtheria/tetanus/pertussis-containing vaccine -- one of which must have been
				  received on or after the fourth birthday. Or, if the fourth dose was
				  administered on or after the fourth birthday, only four doses are
				  required.
(II) Students seven years
				  of age or older. Students seven years of age or older are required to have at
				  least three doses of a tetanus/diphtheria-containing vaccine, provided at least
				  one dose was administered on or after the fourth birthday. Any combination of
				  three doses of a tetanus/diphtheria-containing vaccine will meet this
				  requirement.
(III) Tdap.
(-a-) Seventh grade. Students are required to
				  have one booster dose of a tetanus/diphtheria/pertussis-containing vaccine for
				  entry into the 7th grade, if at least five years have passed since the last
				  dose of a tetanus-containing vaccine. If five years have not elapsed since the
				  last dose of a tetanus-containing vaccine at entry into the 7th grade, then
				  this dose will become due as soon as the five-year interval has passed. Td
				  vaccine is an acceptable substitute, if Tdap vaccine is medically
				  contraindicated.
(-b-) Grades 8 -
				  12. Students who have not already received Tdap vaccine are required to receive
				  one booster dose of Tdap when ten years have passed since the last dose of a
				  tetanus-diphtheria-containing vaccine.
(IV) Children who were enrolled in school,
				  grades K - 12, prior to August 1, 2004, and who received a booster dose of DTaP
				  or polio vaccine in the calendar month of (or prior to) their fourth birthday,
				  shall be considered in compliance with clause (i)(I) (polio) and clause (ii)(I)
				  (DTaP) of this subparagraph.
(iii) MMR. Beginning SY 2016 - 2017, students
				  enrolling in kindergarten through 12th grade are required to have two doses of
				  MMR vaccine with the first dose received on or after the first birthday.
				  Students vaccinated prior to 2009 with two doses of measles and one dose each
				  of rubella and mumps satisfy this requirement.
(iv) Hepatitis B.
(I) Students enrolling in kindergarten
				  through 12th grade are required to have three doses of hepatitis B
				  vaccine.
(II) In some
				  circumstances, the United States Food and Drug Administration may officially
				  approve in writing the use of an alternative dosage schedule for this vaccine.
				  Such an alternative regimen may be used to meet the requirements under this
				  section only when alternative regimens are fully documented. Such documentation
				  must include vaccine manufacturer and dosage received for each dose of that
				  vaccine.
(v) Varicella.
				  Beginning SY 2016 - 2017, students enrolling in kindergarten through 12th grade
				  are required to have two doses of varicella vaccine received on or after the
				  first birthday.
(vi) Hepatitis A.
				  For SY 2016 - 2017, students are required to have two doses of hepatitis A
				  vaccine with the first dose received on or after the first birthday for the
				  following grades and school years:
(I) SY
				  2016 - 2017: K - 7;
(II) SY 2017 -
				  2018: K - 8;
(III) SY 2018 - 2019:
				  K - 9;
(IV) SY 2019 - 2020: K -
				  10;
(V) SY 2020 - 2021: K - 11;
				  and
(VI) SY 2021 - 2022: K -
				  12.
(VII) Effective SY 2022-2023,
				  students enrolling in kindergarten through 12th grade are required to have two
				  doses of hepatitis A vaccine with the first dose received on or after the first
				  birthday.
(vii)
				  Meningococcal. Effective SY 2016 - 2017, students enrolling in 7th - 12th
				  grades are required to have one dose of quadrivalent meningococcal conjugate
				  vaccine (MCV4) on or after the student's 11th birthday.