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FFAB (TSBVI) Wellness and Health Services: Immunizations

IMMUNIZATION REQUIREMENTS

Each student shall be fully immunized against diphtheria, pertussis, rubeola (measles), rubella, mumps, tetanus, and poliomyelitis.  The Texas Department of State Health Services (TDSHS) may modify or delete any of these immunizations or may require immunizations against additional diseases as a requirement for admission to any elementary or secondary school. Education Code 38.001(a), (b), 19 TAC 97.63(2)(B)

Students in kindergarten through twelfth grade shall have the following additional vaccines, according to the immunization schedules set forth in department regulations: pertussis, Diptheria, tetanus, MMR (measles, mumps, rubella), hepatitis B, hepatitis A (as applicable to the grade levels specified in state rule), and varicella (chickenpox).TDSHS requires students in seventh through twelfth grade to have the meningococcal vaccine (MCV4), on or after the student’s 11th birthday.

TDSHS requires students 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.

TDSHS requires students in Grades 8 – 12 who have not already received the Tdap vaccine to receive one booster dose of Tdap when ten years have passed since the last dose of a tetanus-diphtheria-containing vaccine.

25 TAC 97.6


Note:  The immunization requirements can be found on the TDSHS’s Web site [http://www.dshs.texas.gov/immunize/school/default.shtm#requirements]. See TDSHS’s recommended immunization schedule [http://www.dshs.state.tx.us/immunize/Schedule/schedule_child.shtm ].

Under Health and Safety Code Chapter 81, Subchapter E, additional vaccinations may be required by TDSHS and/or the local health authority in specific situations under the mechanism of a control order containing control measures.  25 TAC 97.72

IMMUNIZATION AWARENESS PROGRAM

The School shall post prominently on the website:

  1. A list, in English and Spanish, of:
    1. The immunizations required by TDSHS for admission to public school;
    2. Any immunizations or vaccines recommended for public school students by TDSHS. The list must include the influenza vaccine, unless TDSHS requires the influenza vaccine for admission to public school; and
    3. A statement advising viewers to check the website of their local school district to obtain names of health clinics in the district that offer the influenza vaccine and the fact that the TSBVI Health Center offers the free vaccine to enrolled students.
  2. A link to the TDSHS Internet website where a person may obtain information relating to the procedures for claiming an exemption from the immunization requirements.  The link must be presented in the same manner as the information provided under paragraph 1. Education Code 38.19 http://www.dshs.texas.gov/immunize/school/default.shtm#requirements

APPLICABILITY

The vaccine requirements apply to all students entering, attending, enrolling in, and/or transferring to a district or TSBVI.  25 TAC 97.61(a)

Exceptions

Immunization is not required for admission to the School:

  1. If the student submits to the admitting official:

Medical reasons

  1. An affidavit or a certificate signed by the student’s physician (M.D. or D.O.) who is duly registered and licensed to practice medicine in the United States and who has examined the student.
  2. The affidavit or certificate must state that, in the physician’s opinion, the immunization required is medically contraindicated or poses a significant risk to the health and well-being of the student or any member of the student’s household.  Unless it is written in the statement that a lifelong condition exists, the exemption statement is valid for only one year from the date signed by the physician.
    or
  3. The affidavit must be on a form obtained from the TDSHS and must be submitted to the admitting official not later than the 90th day after the date the affidavit is notarized.
  4. A student who has not received the required immunizations for reasons of conscience may be excluded from school in times of emergency or epidemic declared by the commissioner of state health services.

Education Code 38.001(c), (c-1), (f); Health and Safety Code 161.004(a), d(2), .0041; 25 TAC 97.62

PROVISIONAL ADMISSION

A student may be provisionally admitted or enrolled if the student has begun the required immunizations.  The student must have an immunization record that indicates the student has received at least one dose of each age-appropriate vaccine specified in the regulations.

Completion of Vaccinations

To remain enrolled, the student must continue to receive the necessary immunizations as rapidly as medically feasible.  The student must complete the required subsequent doses in each vaccination series on schedule and provide acceptable evidence of vaccination to TSBVI.

Review of Status

A school nurse or school administrator shall review the immunization status of a provisionally enrolled student every 30 days to ensure continued compliance in completing the required doses of vaccination. If, at the end of the 30-day period, a student has not received a subsequent dose of vaccine, the student is not in compliance and the School will exclude the student from school attendance until the required dose is administered.

Education Code 38.001(e), 25 TAC 97.66(a); Atty. Gen. Op. GA-178 (2004)

Homeless Student

A student who is homeless, as defined in the McKinney-Vento Homeless Education Act, shall be admitted temporarily for 30 days if acceptable evidence of vaccination is not available.  The school shall promptly refer the student to appropriate public health programs to obtain the required vaccinations.  [See FD25 TAC 97.66(b); 42 U.S.C .11302

Transfer of Referred Students

A student can be enrolled provisionally for no more than 30 days after transferring from the student’s local district of residence to TSBVI and while awaiting the transfer of the immunization record.

Military Dependents

A military dependent can be enrolled provisionally for no more than 30 days after transferring from the student’s local district of residence to TSBVI and while awaiting the transfer of the immunization record.

CONFIDENTIALITY

The collection and exchange of information pertaining to immunizations shall be subject to confidentiality provisions prescribed by federal law.  Health and Safety Code 162.002 art. IV, C; 25 TAC  97.69(b);

EVIDENCE OF IMMUNIZATION

A student shall show acceptable evidence of vaccination before entry, attendance, or transfer to a district or to TSBVI.   25 TAC 97.63(2)

Vaccines administered after September 1, 1991, shall include the month, day, and year each vaccine was administered.  The following documentation is acceptable:

  1. Documentation of vaccines administered that includes the signature or stamp of the physician or his or her designee, or public health personnel; immunization records generated from electronic health record systems must include clinic contact information and the provider’s signature/stamp;
  2. An official immunization record generated from a state or local health authority, such as a registry; or
  3. A record received from a student’s local school officials including a record from another state.

25 TAC 97.68

Serologic confirmations of immunity to measles, rubella, mumps, hepatitis A, hepatitis B, or varicella are acceptable.  Evidence of measles, rubella, mumps, hepatitis A, hepatitis B, or varicella illnesses must consist of a valid laboratory report that indicates either confirmation of immunity or infection.

A written statement from a parent, legal guardian, managing conservator, school nurse, or physician attesting to a child’s positive history of varicella disease (chickenpox) or varicella immunity is acceptable in lieu of a vaccine record for that disease.  [Find the form on the TDSHS’s website  [http://www.dshs.state.tx.us/immunize/docs/c-9.pdf] 25 TAC 97.65

IMMUNIZATION RECORDS

If a parent or other person with legal control of a student under a court order enrolls the student at TSBVI, the parent or other person, or the district in which the student most recently attended school, shall furnish to the School a record showing that the student has:

  1. The immunizations as required by law;
  2. Proof as required by law that the student is not required to be immunized; or
  3. Proof that the student is entitled to provisional admission under law.

Education Code 25.002(a)(3), 38.001; 25 TAC Chapter 97, Subchapter B

Each student’s resident district and the School shall keep an individual immunization record during the period of attendance for each student admitted.  The records shall be sufficient for a valid audit to be completed.  The records shall be open for inspection at all reasonable times by TEA, local health departments, or the TDSHS.  Immunization records may be maintained in paper and\or electronic form.  Education Code 38.002(a); 25 TAC 97.67

Transfer of Records

Each student’s resident district and TSBVI shall cooperate in transferring students’ immunization records to other schools.  Specific approval from students, parents, or guardians is not required before transferring those records.  Education Code 38.002(b)

Annual Report

TSBVI shall submit annual reports of the immunization status of students, in a format prescribed by TDSHS, to monitor compliance with immunization requirements.  The School shall submit the report at the time and in the manner indicated in the instructions printed on the form. Education Code 38.002(c); 25 TAC 97.71

CONSENT TO IMMUNIZATION

In addition to persons authorized to consent to immunization under Family Code Chapters 151 (parents) and 153 (conservators), the following persons may consent to the immunization of a child:

  1. A guardian of the child or adult with Medical Power of Attorney; or
  2. A person authorized under the law of another state or a court order to consent for the child.

Family Code 32.101(a);

The School may consent to the immunization of an enrolled student if:

  1. The persons listed above are not available; and
  2. TSBVI or the resident district has written authorization to consent from a person listed above.

Family Code 32.101(b)(5)

TSBVI may not consent for the child if it has actual knowledge that a person listed above has:

  1. Expressly refused to give consent to the immunization;
  2. Been told not to consent for the child; or
  3. Withdrawn a prior written authorization for the district or TSBVI to consent.

Family Code 32.101(c)

Consent By Child

A student may consent to the child’s own immunization for a disease if the child is pregnant or is the parent of a child and has actual custody of that child, and the Centers for Disease Control and Prevention recommend or authorize the initial dose of an immunization for that disease to be administered before seven years of age.

Consent by a student to immunization is not subject to disaffirmance because of minority.  A health-care provider or facility may rely on the written statement of the child containing the grounds on which the child has capacity to consent to the child’s immunization.

Family Code 32.1011

Duty to Provide Information

If TSBVI consents to immunization of a child, the School shall provide the health-care provider with sufficient and accurate health history and other information as set forth in Family Code 32.101(e).

Form of Consent

Consent to immunization must meet the requirements of Family Code 32.002(a).  TSBVI has the responsibility to ensure that the consent, if given, is an informed consent.  TSBVI is not required to be present when the immunization is requested if a consent form has been given to the health-care provider.  Family Code 32.101(f), 32.102

Liability

If TSBVI consents to immunization of a child, the School is not liable for damages arising from an immunization administered to a child authorized under Family Code Subchapter B except for injuries resulting from TSBVI’s own acts of negligence, subject to the provisions of Texas sovereign immunity.  Family Code 32.103

Adopted:         11/13/81

Amended:       9/10/82, 3/10/88, 7/17/92, 3/26/96, 9/26/97, 5/28/03, 1/22/10, 6/3/16, 8/9/18

Reviewed: