Immunization Requirements

 

The following are the immunization requirements set by the State of Missouri.

• All students must present documentation of up-to-date immunization status, including month, day, and year of each immunization before they can attend school
• The Advisory Committee on Immunization Practices (ACIP) allows a 4-day grace period (meaning 4 or fewer days prior to the recommended interval or age), so students in all grade levels may receive immunizations up to 4 days before they are due.
• For children beginning kindergarten during or after the 2003-04 school year, required immunizations should be administered according to the current ACIP Schedule, including all spacing, (http://www.cdc.gov/vaccines/recs/schedules/child-schedule.htm).
• To remain in school, students "in progress" must have an Imm.P.14 form (which includes appointment date for needed immunization(s)) on file and must receive immunizations as soon as they become due. In progress means that a child has begun the vaccine series and has an appointment for the next dose. This appointment must be kept and an updated record provided to the school. If the appointment is not kept, the child is no longer in progress and is noncompliant. (For example, hep B vaccine series was begun but the child is not yet eligible to receive the next dose in the series.)

             In progress does not apply to the Tdap or Td booster.

• Religious (Imm.P.11A) and Medical (Imm.P.12) exemptions are allowed. The appropriate exemption card must be on file. Unimmunized children are subject to exclusion from school when outbreaks of vaccine-preventable diseases occur.

Kindergarten:

DTap:

• Minimum of 4 doses needed.
• The fourth dose may be administered as early as age 12 months, provided at least 6 months have elapsed since the 3rd dose.
• Administer the final dose in the series at age 4 through 6 years.

Polio:

• Minimum of 3 doses needed.
• the final dose in the series should be administered on or after the 4th birthday and at least 6 months following the previous dose.
• If 4 doses are administered prior to age 4 years a fifth dose should be administered at age 4 through 6 years.

MMR:

• Minimum of 2 doses needed.
• Administer the 2nd dose routinely at age 4 through 6 years. However, the 2nd dose may be administered before age 4, provided at least 28 days have elapsed since the 1st dose.

Hepatitis B:

• Minimum of 3 doses needed.
• Administer the 2nd dose a minimum of 4 weeks after the 1st dose and a maximum of 8 weeks.
• Administer the 3rd dose a minimum of 8 weeks after the 2nd dose and a minimum age of 24 weeks (168 days).
• If a 4th dose is needed, the final dose should be administered no earlier than age 24 weeks.

Varicella:

• Minimum of 2 doses needed.
• Administer the 2nd dose routinely at age 4 through 6 years. However, the 2nd dose may be administered before age 4, provided at least 3 months have lapsed since the first dose.
• For children age 12 months through 12 years the minimum interval between doses is 3 months. However, if the 2nd dose was administered at least 28 days after the 1st dose, it can be accepted as valid.
• As satisfactory evidence of disease, an MD or DO may sign and place on file with the school a written statement documenting the month and year of previous varicella disease.

In 1st Grade:

DTaP:

• 4 doses needed
• Last dose must be on or after the 4th birthday, and last dose of pediatric pertussis before the 7th birthday.

Polio:

• 3 doses needed
• Last dose must be administered on or after the 4th birthday. The interval between the next-to-last and last dose should be at least 6 months.

MMR:

• 2 doses needed

Hepatitis B:

• 3 doses needed

Varicella:

• 2 doses needed
• As satisfactory evidence of disease, an MD or DO may sign and place on file with the school a written statement documenting the month and year of previous varicella (chickenpox) disease.

In grades 2nd through 6th:

DTaP:

• 4 doses needed
• Last dose on or after 4th birthday and last dose of pediatric pertussis before 7th birthday.

Polio:

• 3 doses needed
• Last dose on or after 4th birthday. If all 4 doses are administered appropriately and received prior to the 4th birthday, an additional dose is not needed. Any combination of 4 doses of IPV and OPV by 4-6 years of age constitutes a complete series. 

MMR:

• 2 doses needed

Hepatitis B:

• 3 doses needed.

Varicella:

• 1 dose needed

In 7th Grade-

DTaP:

• 4 doses needed
• Last dose on or after 4th birthday

Polio:

• 3 doses needed

MMR:

• 2 doses needed

 Hepatitis B:

• 3 doses needed

Varicella:

• No doses required, however, vaccination is highly recommended 

In 8th grade

DTaP:

• 4 doses required
• Last dose on or after 4th birthday

Tdap:

• 1 dose required
• Tdap, which contains pertussis vaccine, is required for students enrolled in the 8th & 9th grade who have completed the recommended childhood DTaP/DTP vaccination series and have not received a Td booster dose within the past 2 years. If a student received a Tdap the student is up-to-date. Tdap is currently licensed for one dose only; an additional dose is not needed.

Polio:

• 3 doses needed

MMR:

• 2 doses needed

Hepatitis B:

• 3 doses needed

Varicella:

• No doses required however, vaccination is highly recommended.

In 9-12th Grade

DTaP/DTP/DT:

• 4 doses required
• Last dose on or after the 4th birthday.

Tdap:

• 1 dose required in 9th grade, if not received in 8th grade.
• For 10-12 grades, a Tdap or Td booster is required 10 years after the last dose of DTaP, DTP or DT. In the event of a pertussis outbreak situation, Tdap may be given at intervals less than 10 years.

 

Polio:

• 3 doses required.

MMR:

• 2 measles, 1 mumps, 1 rubella required. However, 2 MMRs are highly recommended.

Hepatitis B:

• 3 doses required.

Varicella:

• No doses required, however, vaccination is highly recommended.