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Back to Index | Relevant Policy - 10.49 Immunizations of Students
10.49.P.1 Immunizations of Students
PROCEDURE PROCEDURE
Subject to the exemptions in A.R.S. 15-873, immunization against each of the following diseases is required for attendance of a child in any school:
  • Diphtheria;
  • Tetanus;
  • Hepatitis B;
  • Pertussis;
  • Poliomyelitis;
  • Measles (rubeola);
  • Mumps;
  • Rubella (German measles);
  • Haemophilus influenzae type b (Hib);
  • Varicella; and
  • Meningococcal.
  • Hepatitis A, for a child one (1) through five (5) years of age in a day care program in Maricopa County.

The preceding schedules will remain in effect unless the school is notified by the Arizona Department of Health Services of a modification to the schedule. Refer to Arizona Department of Health Services School Immunization Toolkit.

A child is in compliance with the requirements if the child has met the criteria of the appropriate immunization schedule as recommended by the Department of Health Services or is actively in the process of meeting such criteria as evidenced by having received one (1) dose of each of the required immunizations and has established a schedule for completion of the required immunizations.

A child shall not be allowed to attend school without submitting documentary proof to the school administrator unless the child is exempted from immunization pursuant to section 15-873.  Upon enrollment, schools shall forbid attendance or (suspend) a student not meeting the requirements for immunization or exemption from immunization.  Homeless students shall be referred to the liaison for homeless students and shall not be required to comply with the immunization requirements until the fifth (5th) calendar day after enrollment.

The admitting official shall deem the student to be in compliance with the requirements of this procedure if:
  • The student's immunization record complies with the documentary proof required pursuant to A.A.C. R9-6-704, and the student has received or is in the process of receiving all required age-specific vaccine doses according to Policy Procedure 10.49 – Immunization of Students; or
  • An exemption from immunization is submitted in accordance with the procedures set forth in R9-6-706.

When the student's immunization record is not available at the time of enrollment, the school shall provide the responsible person with the following:
  • Notification of the lack of compliance with the immunization requirements;
  • A written notice that specifies when the required doses shall be completed, notes the availability of exemptions to immunization, and refers the student to a physician or local health department for review of the student's immunization history and provision of immunizations as needed; and
  • Notification that the student is suspended in accordance with 15-872 until an acceptable immunization record that meets the standards of documentary proof is presented to the school.

When immunization records are presented that do not comply with the standards for documentary proof, the school shall:
  • Notify the responsible person of the lack of compliance with the immunization requirements; and
  • Obtain a review and verification of the student's immunization record by or in consultation with a certificated school nurse, a public health nurse, a licensed physician, or an authorized representative of a local health department.

If the admitting official is unable to verify the accuracy of the student's immunization record pursuant to the preceding paragraph, the school shall provide to the responsible person:
  • A written referral to a physician or local health department for further review of the student's immunization history and provision of immunizations as needed; and
  • Notification that the student is suspended until an immunization record that meets the standards of documentary proof is presented to the school. 

Each school shall maintain a current list of students without evidence of immunization or immunity to the diseases listed in R9-6-702, which shall include the names of all students with incomplete immunization histories or exemptions for personal, religious or medical reasons where evidence of immunity has not been provided.

Schools shall forbid attendance by a student lacking proof of immunization or immunity against any of the immunization-preventable diseases as determined by the State Department of Health Services or local health department during periods of outbreaks of the diseases for which immunity is lacking.  The announcement of an outbreak of disease and the length of the period of communicability shall be as declared by the state or local health department.

Standards  for  Documentary  Proof
Proof of immunity to the diseases listed in R9-6-702 shall be documented in accordance with R9-6-704.

Immunization records or statements of immunity shall be signed by a physician or authorized representative of a health agency.

Exemptions  to  Immunizations
Students who have reached their fifth (5th) birthday shall be exempt from the Hib immunization requirement.

Students who have reached their seventh (7th) birthday shall be exempt from the pertussis immunization requirement.

Any student with laboratory evidence of immunity shall not be subject to immunization against that disease as a condition for attending school, provided that such evidence is submitted to the school.

In accordance with A.R.S. 15-873, documentary proof is not required for a student to be admitted to school if one (1) of the following occurs:
  • The parent or guardian of the student submits the appropriate exemption form to the school administrator stating the parent or guardian has received information about immunizations provided by the Department of Health Services, understands the risks and benefits of immunizations and the potential risks of non-immunization, and that, due to personal or religious beliefs, the parent or guardian does not consent to the immunization of the student.
  • The school administrator receives the appropriate exemption form, signed by the parent or guardian and by a physician, that states one (1) or more of the required immunizations may be detrimental to the student's health and indicates the specific nature and probable duration of the medical condition or circumstance that precludes immunization.

Parents whose personal or religious beliefs do not allow immunization must sign a personal beliefs or religious beliefs exemption form.  A medical exemption form must be signed by the child’s doctor if there is lab evidence of immunity or a medical reason why the child cannot receive shots.  A copy of the lab results must be kept on file to prove the child’s immunity.

An exemption pursuant to the preceding subparagraph is valid only during the duration of the circumstance or condition that precludes immunization.

If a medical exemption is granted in accordance with A.R.S. 15-873, it shall be defined by the grantor as either permanent or temporary.
  • A permanent medical exemption may be provided for one (1) or more vaccines.
  • A temporary medical exemption shall specify the date of its termination.  A student with a temporary medical exemption shall be allowed to attend school on the condition that the required immunizations are obtained at the termination of the exemption.  The responsible person shall be notified of the date by which the student shall complete all required immunizations.

Any exemption granted in accordance with A.R.S. 15-873 shall be recorded on the school immunization record in the student's permanent file.

Students who lack documentary proof of immunization shall not attend school during outbreak periods of communicable immunization-preventable diseases as determined by the Department of Health Services or local health department.  The Department of Health Services or local health department shall transmit notice of this determination to the school administrator responsible for the exclusion of the students.

Reporting  Communicable  Diseases
The administrator of a school shall submit by telephone a report to the local health department any case, suspected case, or outbreak of a communicable disease as follows:
Within twenty-four (24) hours after detecting a case or suspected case of:
  • Cryptosporidiosis
  • Enterohemorrhagic Escherichia coli
  • Haemophilus influenzae: invasive disease
  • Hepatitis A
  • Measles
  • Meningococcal invasive disease
  • Mumps
  • Pertussis (whooping cough)
  • Rubella (German measles)
  • Salmonellosis
  • Shigellosis
  • Within twenty-four (24) hours after detecting an outbreak of:
  • Conjunctivitis: acute
  • Diarrhea, nausea, or vomiting
  • Scabies
  • Streptococcal Group A infection
  • Within five (5) working days after detecting a case or a suspected case of:
  • Campylobacteriosis
  • Varicella (chicken pox)

The report shall include:
  • The name and address of the school
  • The number of individuals having the disease, infestation, or symptoms
  • The date and time the disease or infestation was detected or the symptoms began
  • The number of rooms, grades, or classes affected and the name of each
  • Information about each affected individual to include:
    • Name,
    • Date of birth or age,
    • Residential address and telephone number,
    • Whether the individual is a staff member, student, child in care, or a resident,
  • The number of individuals attending or residing in the school, and
  • The name, address, and telephone number of the person making the report.

Other  Required  Reports
By November 15 of each year, the Superintendent shall submit a report on the immunization status of students to the state or local health department on a form provided by the Department.

Each Superintendent of a school whose nurses are authorized to administer vaccines or immunizing agents shall submit monthly reports to the county health department in accordance with the procedures set forth in R9-6-707.  Reports are due by the fifth (5th) day of the following month.

An immunization record shall be maintained for each student in the school.  Each immunization record shall include the following information:
Name of the student;
  • Date of birth; 
  • The date of the student's admission to the school;
  • The month and year in which each vaccine was received, except for measles, mumps, and rubella, for which the day, month, and year are required.
  • The type of immunizing agents administered to the student;
  • The date each dose of immunizing agent is administered to the student; and
  • The established schedule for completion of immunizations if the student is admitted to or allowed to continue to attend a school pursuant to section 15-872, subsection E.

By November 15 of each year, each administrator of a public-school-based day care program or preschool shall submit a report to the state or local health department on a form provided by the Department.

A school shall transfer an immunization record and signed requests for provision of immunizations, including any revocations thereof, with the mandatory permanent student record and provide at no charge, on request, a copy of the immunization record to the parent or guardian of the pupil.