2280.09 - PRESCHOOL IMMUNIZATION
Immunizations Which Are Medically Contraindicated
A written statement from a health care practitioner (i.e., a physician, physician’s assistant, advanced practice registered nurse, or a certified nurse practitioner) that a particular immunization is medically contraindicated or not medically appropriate for the child’s age.
The physician's statement shall be maintained by the program as part of the immunization record of the student.
Immunization Requirements
Chicken Pox | Varicella vaccine (varivax) in accordance with the Department of Health and Human Services' immunization schedule or as prescribed by a physician. |
| One (1) or two (2) doses – depending on the child’s age – of varicella vaccine must be administered prior to entry. The first (1st) dose must be administered on or after the first (1st) birthday. The second (2nd) dose should be administered at least three (3) months after the first (1st) dose; if the second dose is administered at least twenty-eight (28) days after first (1st) dose, it is considered valid. | |
| Similar to other immunizations, the Ohio Department of Health has determined that the requirements for immunization against chicken pox will be progressive. | |
Diphtheria, | Four (4) or more doses of DTaP, DTP or DT (pediatric) vaccine, or any combination. If all four (4) doses were administered prior to the fourth (4th) birthday, a fifth (5th) dose of DTaP or DT is required. If the fourth (4th) dose was administered at least six (6) months after the third (3rd) dose, and on or after the fourth (4th) birthday, a fifth (5th) dose is not required. |
Measles, | One (1) or two (2) doses – depending on the child’s age – of MMR. Dose one (1) administered on or after the first (1st) birthday. The second dose must be administered at least twenty-eight (28) days after dose one (1). |
| Hepatitis B | Three (3) doses. The second dose must be at least twenty-eight (28) days after the first. The third dose must be given at least sixteen (16) weeks after the first dose and at least eight (8) weeks after the second dose. The last dose in the series (third or fourth dose) must not be administered before age twenty-four (24) weeks. |
| Similar to other immunizations, the Ohio Department of Health has determined that the requirements for immunization against Hepatitis B will be progressive. | |
| Polio | Three (3) or more doses of IPV. The final dose must have been administered on or after the 4th birthday regardless of the number of previous doses. If a combination of OPV and IPV was received, four (4) doses of either vaccine are required. Only trivalent OPV (tOPV) counts. |
| Rotavirus | Two (2) or three (3) doses – administering a third dose at age six (6) months depends on the brand of rotavirus vaccine used for previous dose. |
| Haemophilus influenzae type b | Three (3) or four (4) doses – administering a third dose at age six (6) months depends on the brand of Hib vaccine used for previous dose. |
| Pneumococcal disease | Four (4) doses. |
| Influenza | One (1) or two (2) doses annually – two (2) doses given at least four (4) weeks apart are recommended for children aged six (6) months through eight (8) years of age who are getting an influenza (flu) vaccine for the first time and for some other children in this age group. |
| Hepatitis A | Two (2) doses – two (2) doses of Hep A vaccine are needed for lasting protection. The two (2) doses should be given between ages twelve (12) and twenty-three (23) months. Both doses should be separated by at least six (6) months. Children two (2) years and older who have not received two (2) doses should complete the series. |
Vaccine doses are only considered valid if administered according to the most recent version of the Recommended Immunization Schedules for Persons Aged 0 Through 18 Years or the Catch-up Immunization Schedule for Persons Aged 4 Months Through 18 Years Who Start Late or Who Are More Than 1 Month Behind, as published by the Advisory Committee on Immunization Practices. Vaccine doses administered four (4) or fewer days before the minimum interval or age are valid (grace period). Doses administered more than five (5) days earlier than the minimum interval or age are not valid doses and should be repeated as age appropriate. If MMR and Varicella are not given on the same day, the doses must be separated by at least twenty-eight (28) days with no grace period.
No child shall be permitted to remain in the program unless not later than thirty (30) days after enrollment in the program, and every thirteen (13) months thereafter, the child’s caretaker parent provides the program with a medical statement indicating that the child has been immunized against or is in the process of being immunized against all the above-listed diseases. “In the process of being immunized” means the child has received at least the first dose of the immunization sequence and is complying with the immunization intervals or catch-up schedule prescribed by the Director of Health.
Any child previously admitted under the "in process of being immunized" provision who has not complied with the immunization intervals prescribed by the Director of Health shall be excluded from the program if the child fails to submit the required follow-up medical statement(s) in a timely manner. Any student so excluded may be readmitted upon furnishing a new medical statement indicating the child is again making progress on the Director of Health's interval schedule.
A child does not have to be immunized against a disease listed in the preceding paragraph if any of the following apply:
- A healthcare practitioner certifies in writing that immunization against the disease is medically contraindicated or not medically appropriate for the child’s age.
- The child presents a written statement signed by a parent or guardian in which the parent or guardian declines to have the student immunized against the disease for reasons of conscience, including religious convictions.
A “health care practitioner” means a physician, physician’s assistant, advanced practice registered nurse, or certified nurse practitioner.
In the case of influenza, a child is not required to be immunized against the disease if the seasonal vaccine is not available.
A child who has not completed immunization may not be admitted to the program, except as is consistent with the law.
The Board will consult with the Ohio Department of Health and/or refer to its website (www.odh.gov) regarding the progressive nature of the above immunization requirements on a yearly basis.
Exemptions: Parent Objections
A student shall be exempted from mandatory immunization if the parent objects in a written signed statement upon the grounds that the parent declines to have the student immunized for reasons of conscience, including religious convictions.
This statement will be kept by the school as part of the student's immunization record.
Requisite Medical Statement
The above-referenced medical statement shall include all the following information: (1) the dates that the child received immunizations against each of the diseases specified above; and (2) whether a child is subject to any of the above-listed exceptions. The medical statement shall also include a component where a parent or guardian may indicate that the parent or guardian has declined to have the child immunized.
Required Records
The program shall keep an immunization record for each child, available in writing to the child’s parent or guardian upon request. Each child’s record of immunization will include the date of each individual immunization or the reason why the child did not receive that vaccine (e.g., a health care practitioner determined the immunization against the disease was medically contraindicated for the child or was not medically appropriated for the child’s age, or the parent declined to have the child immunized against the disease for reasons of conscience, including religious convictions).
Records Available for Inspection
The Program Director shall make immunization records available for inspection by authorized representatives of the State Department of Health or the Trumbull County Health Department.
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