GUIDE TO THE REQUIREMENTS OF THE CALIFORNIA SCHOOL IMMUNIZATION LAW FOR

Grades K-12


REFERENCE Health and Safety Code Sections 120325-120380 (formerly Sections 3380-3390); California Administrative Code, Title 17, Sections 6000-6075

INSTRUCTIONS Post this guide on a wall or desktop as a quick reference to help you determine whether children seeking admission to your school meet California's school immunization requirements. If you have any questions, call the Immunization Coordinator at your local health department.

IMMUNIZATION REQUIREMENTS To enter or transfer into public and private elementary and secondary schools (grades kindergarten through 12), children under age 18 years must have immunizations as outlined below. New 7th grade entry requirements went into effect 7/1/99. A varicella requirement for kindergarten entry will go into effect 7/1/01.

VACCINE REQUIRED DOSES

Polio

4 doses at any age, but... 3 doses meet requirement for ages 4-6 if at least one was given on or after the 4th birthday; 3 doses meet requirement for ages 7-17 years if at least one was given on or after the 2nd birthday.

Diphtheria, Tetanus, and Pertussis

Age 6 years and under (Pertussis is required) DTP, DTaP or any combination of DTP or DTaP with DT (tetanus and diphtheria)

Age 7 years and older (Pertussis is not required) Td, DT, or DTP, DTaP or any combination of these

5 doses at any age, but...
4 doses meet requirements for ages 4-6 if at least one was on or after the 4th birthday.


4 doses at any age, but ...
3 doses meet requirement for ages 7-17 years if at least one was on or after the 2nd birthday. If last dose was given before the 2nd birthday, one more (Td) dose is required.

7th grade
Td booster

1 dose not required but recommended if more than 5 years have passed since last DTP, DTaP, DT, or Td dose.

Measles, Mumps, Rubella (MMR)

Kindergarten
7th grade
Grades 1-6 and 8-12


2 doses* both on or after 1st birthday.
2 doses* both on or after 1st birthday.
1 dose must be on or after the 1st birthday.

Hepatitis B
Kindergarten
7th grade


3 doses
3 doses**

Varicella***
Kindergarten


1 dose or health care provider-documented varicella disease or immunity.

* Two doses of measles-containing vaccine required. One dose of mumps and rubella-containing vaccine required; mumps vaccine is not required for children 7 years of age and older.

** Two doses of the 2-dose formulation given at age 11-15 years along with provider documentation that the 2-dose formulation was used for both doses will also fulfill this requirement.

***Effective Date 7/1/01

EXEMPTIONS The law allows (a) parents/guardians to choose exemptions from immunization requirements based on their personal beliefs, and (b) physicians of children to elect medical exemptions. The law does not allow parents/guardians to elect an exemption simply because of inconvenience (a record is lost or incomplete and it is too much trouble to go to a physician or clinic to correct the problem.) See the back of the blue California School Immunization Record (PM 286) for instructions and the affidavit to be signed by parents/guardians electing the personal beliefs exemption. For children with medical exemptions, the physician's written statement should be stapled to the CSIR. Schools should maintain an up-to-date list of pupils with exemptions, so they can be excluded quickly if an outbreak occurs.

PUPILS NOT
MEETING REQUIREMENTS
Refer pupils who do not meet these State requirements to their physician or local health department. Give families a written notice indicating which doses are lacking.

DOCUMENTATION

All children must present an immunization record.

What is it? It is a written immunization record, either a personal record with entries made by a physician or clinic, or a school immunization record-the blue California School Immunization Record (PM 286) from a former school or another state's school record. It must include at least the month and year each dose was received; for measles, rubella and/or mumps vaccine and for varicella vaccine given in the month of the first birthday, month, day and year are required. A record with check marks instead of dates or saying only "upto-date," "all requirements met," or "series complete" is inadequate. Also, parents cannot simply fill out a California School Immunization Record from memory but must present a written immunization record. Further, the record must show that all due vaccine doses have been received.

Who must present it? All children under age 18 years entering school or transferring between school campuses. Kindergarten entrants and entrants from outside the U.S. must present a personal immunization record. (Kindergarten entrants can present a California School Immunization Record from a child care center they previously attended, but this record usually will not include the final "booster" polio and DTP or DTaP vaccine doses or the second measles-containing vaccine dose.) Children transferring from other schools in California or other states must present either a personal immunization record or a state school immunization record. As of July 1, 1999, students entering 7th grade must present a personal immunization record so that the 7th grade requirement immunization dates can be added to the student's school immunization record.

When must it be presented? Kindergarten entrants, 7th grade entrants, and entrants from outside the U.S. must present the record at or before entry; no "grace period" of attendance is allowed for these pupils if they do not have a record. Children transferring from other schools in California or other states, or entering at other grade levels may be given up to 30 school days of attendance while waiting for their records to arrive from the previous school; some schools elect to require transferring children to present their immunization record at entry and do not allow the 30 days of attendance while waiting for records.

What do schools do with it? School staff must transcribe the immunization dates onto the California School Immunization Record (CSIR or blue card; PM 286), which is available from local health departments. School staff should then review the blue card to determine whether all immunization requirements have been met. The blue card is part of the child's Mandatory Permanent Pupil Record and must be transferred to the child's new school when he/she leaves your school. Although some vaccine doses are not required, please record dates of all doses from the child's personal immunization records on to PM 286. This information will be valuable should outbreaks of these diseases occur in your school.


CONDITIONAL
ADMISSIONS
Children lacking one or more required vaccine doses but not currently due for a dose may be admitted on condition that they receive the remaining doses when due, according to the schedule below. If the maximum time interval between doses has passed, the child must be excluded until the next immunization is obtained.

VACCINE TIME INTERVALS BETWEEN DOSES
Polio 2nd dose: 6-10 weeks after 1st dose
3rd dose: 6 weeks to 12 months after 2nd dose

DTP, DTaP, DT, Td
Under 7 years (DTP, DTaP, DT)

2nd dose: 4-8 weeks after 1st dose
3rd dose: 4-8 weeks after 2nd dose
4th dose: 6-12 months after 3rd dose

Age 7 years and older (Td)*

2nd dose: 4-8 weeks after 1st dose
3rd dose: 6-12 months after 2nd dose

MMR

2nd dose: 1-3 months after 1st dose

Hepatitis B
for 3-dose formulation

2nd dose: 1-2 months after 1st dose
3rd dose: 2-6 months after 2nd dose and at least 4 months after 1st dose

for 2-dose formulation
(7th grade entry for child 11 through 15 years old)

2nd dose: 4-8 months after 1st dose

* Note: DTP, DTaP, DT doses received previously are counted toward meeting the 3-dose tetanus-diphtheria immunization requirement for this age group.


State of California - Department of Health Services - Immunization Branch - 2151 Berkeley Way • Berkeley, CA 94704 • 510/540-2065 - IMM-231 (11/00)