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MICHIGAN
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CHAPTER 333 HEALTH
PUBLIC HEALTH CODE
ARTICLE 9. SUPPORTIVE PERSONAL HEALTH SERVICES
PART 92. IMMUNIZATION
MCL § 333.9205 (2007)
§ 333.9205. Child immunization; duty of parent, guardian, person in loco parentis.
Sec. 9205. A parent, guardian, or person in loco parentis of a child shall provide for the child's immunization by an authorized health professional, physician, local health department, clinic, or other agency offering immunizations for diseases and within an age period prescribed by thedepartment.
MCL § 333.9205a (2007)
333.9205a. Risks associated with meningococcal disease; materials; notice; availability; "institution of higher education" defined.
(1) The department shall identify materials that contain information regarding the risks associated with meningococcal disease and the availability, effectiveness, and potential risks of immunization for meningococcal disease, and other diseases about which the department may recommend immunization or immunization information.
(2) The department shall notify each institution of higher education and high school in this state of the availability of the materials described in subsection (1) and post the materials on its website.
(3) The department shall encourage each institution of higher education in this state to provide or make available to students enrolled in the institution of higher education, and each high school in this state to provide or make available to parents of students attending the high school, information regarding the risks associated with meningococcal disease and the availability, effectiveness, and potential risks of immunization for meningococcal disease and other diseases about which the department may recommend immunization or immunization information.
(4) As used in this section, "institution of higher education" means a degree or certificate granting public or private college or university, junior college, or community college.
MCL § 333.9208 (2007)
§ 333.9208. Certificate of immunization or statement of exemption; presentation to school officials; minimum doses of immunizing agent; updated certificate.
Sec. 9208.
(1) A parent, guardian, or person in loco parentis applying to have a child registered for the first time in a school in this state and, beginning in 2002-2003, a parent, guardian, or person in loco parentis of a child entering the sixth grade, shall present to school officials, at the time of registration or not later than the first day of school, a certificate of immunization or statement of exemption under section 9215.
(2) A teacher or principal shall not permit a child to enter or attend school unless a certificate indicating that a minimum of 1 dose of an immunizing agent against each of the diseases specified by the department has been received and certified to by a health professional or local health department. A parent, guardian, or person in loco parentis having a child registered with only these minimum doses of immunizing agents shall present an updated certificate of immunization within 4 months after initial attendance showing that the immunizations have been completed as prescribed by the department.
MCL § 333.9211 (2007)
§ 333.9211. Preschool child immunization certificate, exemption statement; requirement of program registration; limitation on participation; minimum immunization, updated certificate; immunization status.
Sec. 9211.
(1) A parent, guardian, or person in loco parentis applying to have a preschool aged child registered in a program of group residence, care, or camping shall present to the operator of the program at the time of registration or not later than the first day of the program a certificate of immunization or a statement of exemption under section 9215. The operator of the group program shall not permit a child to attend the group activity unless a minimum of 1 dose of an immunizing agent against each of the diseases specified by the department has been received and certified to by a health professional or local health department. A parent, guardian, or person in loco parentis of a child registered with only these minimum doses of an immunizing agent and continuing enrollment in the group program shall present an updated certificate of immunization within 4 months after initial attendance showing that the immunizations have been completed as prescribed by the department, if the child remains in the program.
(2) Upon request by the department or local health department, a program operator shall report to the state and local health departments the immunization status of each child accepted.
MCL § 333.9215 (2007)
§ 333.9215. Exemption of child; immunization detrimental to health or not appropriate, physician certificate; religious convictions or other objections, parent's written statement.
Sec. 9215.
(1) A child is exempt from the requirements of this part as to a specific immunization for any period of time as to which a physician certifies that a specific immunization is or may be detrimental to the child's health or is not appropriate.
(2) A child is exempt from this part if a parent, guardian, or person in loco parentis of the child presents a written statement to the administrator of the child's school or operator of the group program to the effect that the requirements of this part cannot be met because of religious convictions or other objection to immunization.
DEPARTMENT OF COMMUNITY HEALTH
HEALTH LEGISLATION AND POLICY DEVELOPMENT
COMMUNICABLE AND RELATED DISEASES
MICH. ADMIN. CODE R. 325.176 (2007)
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 4 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) 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.
History: 1993 MR 4, Eff. Apr. 29, 1993; 1994 MR 7, Eff. July
21, 1994; 1995 MR 8, Eff. Aug. 17, 1995; 1999 MR 1, Eff. Feb.
5, 1999; 2006 MR 10, Eff. May 26, 2006.