Agency # 005.15
ADE 302-1
ARKANSAS DEPARTMENT OF EDUCATION RULES GOVERNING
KINDERGARTEN THROUGH 12
TH
GRADE IMMUNIZATION REQUIREMENTS IN
ARKANSAS PUBLIC SCHOOLS
August 2015
1.0 PURPOSE
1.01 The purpose of these rules is to establish the requirements and procedures for
governing Kindergarten through 12
th
grade immunization requirements in
Arkansas Public Schools.
1.02 Immunizations against poliomyelitis, diphtheria, tetanus, pertussis, red (rubeola)
measles, mumps, rubella, varicella (chickenpox), haemophilus imfluenza type b,
hepatitis B, hepatitis A, meningococcal, and pneumococcal, and other
communicable diseases have resulted in a dramatic decrease in the incidence of
these diseases in Arkansas. However, these diseases continue to occur in
childcare facilities, schools, and colleges and universities. A requirement that
children and students furnish proof that they have immunity against certain
communicable diseases will reduce the potential for an outbreak of these diseases.
2.0 REGULATORY AUTHORITY
2.01 The following Rules governing Kindergarten through 12
th
grade immunization
requirements in Arkansas Public Schools are duly adopted and promulgated by
the Arkansas State Board of Education pursuant to the authority expressly
conferred by the laws of the State of Arkansas including, without limitation, Ark.
Code Ann. § 20-7-109, Ark. Code Ann. § 6-18-702, Ark. Code Ann. §§ 6-60-501
– 504, and Ark. Code Ann. § 20-78-206.
3.0 REQUIREMENTS
3.01 Except as otherwise provided in these rules, no child shall be admitted to a public
school of this state who has not been immunized against poliomyelitis, diphtheria,
tetanus, pertussis, red (rubeola) measles, rubella, mumps, hepatitis B, hepatitis A,
meningococcal disease and varicella (chickenpox) (See Table I.), as evidenced by
an immunization record from a licensed physician or a public health department
acknowledging the immunization.
3.02 The requirements for entry into school are:
3.02.1 Kindergarten: At least four doses of Diphtheria/Tetanus/Acellular
Pertussis (DTaP), Diphtheria/Tetanus/Pertussis (DTP), or
Diphtheria/Tetanus (DT pediatric) vaccine; at least three doses of Polio
vaccine; two doses of MMR (measles, mumps, and rubella) vaccine; three
doses of Hepatitis B vaccine; one dose of Hepatitis A; and two doses of
Varicella (chickenpox) vaccine. A medical professional’s [medical doctor
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(MD), advanced practice nurse (APN), doctor of osteopathy (DO), or
physician assistant (PA)] history of disease may be accepted in lieu of
receiving Varicella vaccine. No self of parental history of varicella
disease will be accepted (See Table I). Exception: If a student has
previously received two doses of measles, one dose of mumps and one
dose of rubella before January 1, 2010, the doses will be accepted as
compliant to immunization requirements and 2 MMRs are not required.
3.02.2 1
st
through 12
th
grade: At least three or four doses of
Diphtheria/Tetanus/Acellular Pertussis (DTaP),
Diphtheria/Tetanus/Pertussis (DTP), Diphtheria/Tetanus (DT-pediatric),
Tetanus/Diphtheria (Td-adult) or Tetanus/Diphtheria/Acellular Pertussis
(Tdap) and one dose of Tdap for ages 11 years (as of September 1
st
each
year) and older or 3 doses for unvaccinated persons 7 years of age or older
(including persons who cannot document prior vaccination); at least three
doses of Polio vaccine; two doses of MMR (measles, mumps, and rubella)
vaccine, two or three doses of Hepatitis B vaccine; one dose of Hepatitis A
for First Grade; two doses of varicella vaccine; and one or two doses of
Meningococcal vaccine with one dose for 7
th
grade and a second dose of
Meningococcal vaccine at age 16 years (as of September 1
st
each year).
However, if the first dose of Meningococcal vaccine is administered at age
16 years or older, no second dose is required; or if not vaccinated prior to
age 16 years, one dose is required. A medical professional’s [medical
doctor (MD), advanced practice nurse (APN), doctor of osteopathy (DO),
or physician assistant (PA)] history of disease may be accepted in lieu of
receiving Varicella vaccine. No self or parental history of varicella
disease will be accepted. (See Table I). Exception: If a student has
previously received two doses of measles, one dose of mumps and one
dose of rubella before January 1, 2010, the doses will be accepted as
compliant to immunization requirements and 2 MMRs are not required.
3.02.3 7
th
grade: In addition to the vaccines requirements listed under 1
st
through
12th grade, one dose of Meningococal vaccine (See Table I.)
3.03 Every child must have received all of the vaccines, be in-process of receiving
needed doses listed in Table 1, show proof that they have a letter from the
Arkansas Department of Health approving serology as proof of immunity, or
applied for an exemption for those vaccines he or she has not received in order to
continue attendance in a public school. If the child does not meet the
immunization requirements for entering a public school, refer the child to a
medical authority (private doctor or health department) for immunization or
consultation.
3.04 A facility may temporarily admit a child provided that the child becomes
appropriately immunized, is in-process of receiving the needed doses of vaccine,
or shows proof that they have applied for an exemption for those vaccines he/she
has not received within thirty (30) calendar days after the child’s original
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admission or by October 1
st
for Tdap and Meningococcal at age 11 and 16 years
respectively. "In process" means the student has received at least one dose of the
required immunizations and is waiting the minimum time interval to receive the
additional doses. When a student is admitted who is in the process of completing
the required minimum immunizations, the facility shall require each student to
complete the required doses on schedule. A written statement from a public health
nurse or private physician stating that the student is in process and containing a
date when he/she must return for the next immunization shall be in the student's
file. If a student does not produce documentation of additional immunizations per
the schedule or show proof that they have applied for an exemption from the
immunization requirements, they must be excluded from the facility until
documentation is provided. The immunization series does not need to be restarted
as each dose of vaccine counts toward the minimum requirements.
3.05 School officials should evaluate the immunization status of all children in their
facilities. Table I is used to determine if the child meets the immunization
requirements to enter school.
3.06 School boards, superintendents, and principals shall be responsible for enforcing
immunization requirements with respect to kindergarten through grade 12 (K-12)
within public schools.
4.0 DOCUMENTATION FOR IMMUNIZATION OR PROOF OF IMMUNITY
4.01 The following documentation of immunizations is required:
4.01.1 Immunization records may be stored on a computer database, such as the
Arkansas Public School Computer Network (APSCN). A copy of the
original source document or a copy from the immunization provider’s
medical record shall be placed in a permanent file. The immunization
record printed off the statewide immunization registry with the Official
Seal of the State of Arkansas is considered an official immunization
record and is approved for placement in a permanent file as source
documentation. It shall be the responsibility of the entity to maintain a list
of individuals not appropriately immunized and a list of individuals with
medical, religious or philosophical exemptions.
4.01.2 The only proof of immunizations to be accepted shall be an immunization
record provided by a licensed physician, health department, military
service, or an official record from another educational institution in
Arkansas, acknowledging the same, stating the vaccine type and dates of
vaccine administration must be provided and entered on the school record.
Terms such as “up-to-date”, “complete”, “adequate”, etc. are not to be
accepted as proof of immunization.
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4.02 The following documentation for proof of immunity is required:
4.02.1 Serologic testing is only applicable to Hepatitis B virus, Measles, Mumps,
Rubella and Varicella. Any individual who has immunity to Hepatitis B,
Measles, Mumps, Rubella and/or Varicella as documented by appropriate
serological testing shall not be required to have the vaccine for that
disease.
4.02.2 A copy of the serological test should be submitted to the Arkansas
Department of Health, Immunization Section, along with a letter
requesting that the serological test be accepted as proof of immunity in
lieu of receiving vaccine for the disease indicated on the serological test.
After review by the Medical Director, Immunization Section, a letter
indicating approval or denial will be sent to the individual, parent, or
guardian and it will be that person’s responsibility for informing the
school. For approvals, annual approval is not required and a copy of the
letter should be placed in the student’s permanent file. For denials, the
student must receive the required immunization or request an exemption.
4.03 An individual who has lost his/her immunization records or whose serology test
results are unavailable shall be properly immunized for those diseases or will be
required to show proof that they have applied for an exemption for those vaccines
he/she has not received.
5.0 EXEMPTIONS
5.01 General Requirements
5.01.1 Exemptions shall be granted only by the Department of Health.
5.01.2 Individuals shall complete an annual application for medical, religious,
and philosophical exemptions.
5.01.3 A notarized statement by the individual requesting the exemption must
accompany the application.
5.01.4 All individuals requesting an exemption must complete an educational
component developed by the Department of Health that includes
information on the risks and benefits of vaccinations.
5.01.5 All individuals must sign an “informed consent” form provided by the
Department of Health that includes:
5.01.5.1 A statement of refusal to vaccinate;
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ADE 302-5
5.01.5.2 A statement of understanding that at the discretion of the
Department of Health the non-immunized child or
individual may be removed from the applicable facility (for
21 days or longer) during an outbreak if the child or
individual is not fully vaccinated; and
5.01.5.3 A statement of understanding that the child or individual
shall not return to the applicable facility until the outbreak
has been resolved and the Department of Health approves
the return.
5.02 Medical Exemptions
5.02.1 Only a letter issued by the Medical Director, Immunization Section of the
Arkansas Department of Health, stating the vaccine or vaccines for which
a child/student is exempt is to be accepted as a valid medical exemption
by the school. Statements from private physicians are not to be accepted
by the school without this letter. In addition to the general requirements
found in section 5.01, the Immunization Section’s standard form for
medical exemptions must be submitted to the Immunization Section. This
form is available from the Immunization Section of the Department of
Health upon request.
5.03 Religious Exemptions
5.03.4 In addition to the general requirements found in section 5.01, the
Department of Health, Immunization Section’s standard form for religious
exemptions must be submitted to the Immunization Section. This form is
available from the Immunization Section upon request.
5.04 Philosophical Exemptions
5.04.1 In addition to the general requirements found in section 5.01, the
Department of Health Immunization Section’s standard form for
philosophical exemptions must be submitted to the Immunization Section.
This form is available from the Immunization Section upon request.
6.0 EXCLUSION FROM FACILITIES
6.01 Public Schools
6.01.1 Each facility must maintain an accurate and current list of all exempt and
deficient individuals. Individuals who are exempt or deficient (except
those who have had the disease as verified by appropriate serological
testing) will be excluded from the facility if the Department of Health
determines that a possibility of disease transmission exists. The exempt or
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ADE 302-6
deficient child or individual shall not return to the facility (for 21 days or
longer) until the possibility of disease transmission has been controlled
and the Department of Health approves the return.
6.01.2 If a child is excluded from a facility pursuant to Section 6.01.1 of these
rules, he or she shall not be dismissed or dropped from the attendance records of
the school, school district, or open-enrollment charter school in accordance with
Ark. Code Ann. § 6-18-213(f).
6.01.2.1 Absences accrued due to exclusion from a facility pursuant to
Section 6.01.1 of these rules shall be counted as excused or
unexcused in accordance with the attendance policy of the school,
school district, or open-enrollment charter school.
7.0 REPORTING REQUIREMENTS
7.01 In order to identify areas where additional emphasis is needed and to measure
levels of immunization compliance, the Arkansas Department of Health will conduct
annual assessments in schools. The entity’s cooperation in completing these surveys and
audits is required.
Agency # 005.15
ADE 302-7
TABLE I
KINDERGARTEN THROUGH GRADE TWELVE IMMUNIZATION
REQUIREMENTS*
Vaccine
►
----------
----
Grade
▼
Diphtheria,
Tetanus,
Pertussis
(DTP/DT/Td/DTa
P/Tdap)
Polio
(OPV – Oral
or
IPV –
Inactivated)
MMR*****
(Measles,
Mumps,
and
Rubella)
Meningococca
l(MCV4)
Varicella
Hepatitis A
Kinderga
rten
4 doses
(with 1 dose on
or after 4
th
birthday)
3 doses
(with 1 dose
on or after 4
th
birthday)
with a
minimum
interval of 6
months
between the
2
nd
and 3
rd
dose
OR
4 doses with
1 dose on or
after 4
th
birthday and
a minimum
interval of 6
months
between the
3
rd
and 4
th
dose.
.
2 doses
(with dose
1 on or
after 1
st
birthday
and dose 2
at least 28
days after
dose 1)
None
2 doses
(with dose 1
on or after
1
st
birthday
and dose 2
at least 28
days after
dose 1)
******A
medical
professional
history of
disease will
be accepted
in lieu of
vaccine.
1 dose on
or after 1
st
birthday
Grades 1
– 12
4 doses
(with 1 dose on
or after 4
th
birthday)
AND
1 dose of Tdap
for ages 10 11
years (as of
September 1
st
each year) and
older
OR
3 doses
(with 1 dose
on or after 4
th
birthday with
a minimum
interval of 6
months
between the
2
nd
and 3
rd
dose )
OR
4 doses with
1 dose on or
2 doses
(with dose
1 on or
after 1
st
birthday
and dose 2
at least 28
days after
dose 1)
Second dose
at age 16
years (as of
September 1
st
each year)
with a
minimum
interval of 8
weeks since
1
st
dose
OR
1 dose if not
vaccinated
2 doses
(with dose 1
on or after
1
st
birthday
and dose 2
at least 28
days after
dose 1)
OR
******A
medical
professional
history of
Grade 1
only:
1 dose on
or after 1
st
birthday
Agency # 005.15
ADE 302-8
3 doses
******* for
persons 7 years
of age or older
who are not
fully
vaccinated
(including
persons who
cannot
document prior
vaccination)
after 4
th
birthday and
a minimum
interval of 6
months
between the
3
rd
and 4
th
dose.
prior to age
16 years (If
first dose is
administered
at age 16
years or
older, no
second dose
is required.)
disease may
be accepted
in lieu of
receiving
vaccine.
Grade 7
4 doses
(with 1 dose on
or after 4
th
birthday)
and
1 dose of
Tdap****
OR
3
doses*******
for persons 7
years of age or
older who are
not fully
immunized
(including
persons who
cannot
document prior
vaccination)
3 doses
(with 1 dose
on or after 4
th
birthday with
a minimum
interval of 6
months
between the
2
nd
and 3
rd
dose)
OR
4 doses with
1 dose on or
after 4
th
birthday and
a minimum
interval of 6
months
between the
3
rd
and 4
th
dose.
2 doses
(with dose
1 on or
after 1
st
birthday
and dose 2
at least 28
days after
dose 1)
1 dose
2 doses
(with dose
1 on or after
1
st
birthday
and dose 2
at least 28
days after
dose 1)
OR
******A
medical
professional
history of
disease may
be accepted
in lieu of
receiving
vaccine.
NONE
*Doses of vaccine required for school entry may be less than the number of doses required for
age-appropriate immunization.
**An alternative two-dose hepatitis B schedule for 11-15 year-old children may be substituted
for the three-dose schedule. Only a FDA-approved alternative regimen vaccine for the two-dose
series may be used to meet this requirement. If you are unsure if a particular child’s two-dose
schedule is acceptable, please contact the Immunization Section for assistance at 501-661-2169.
*** 3
rd
dose of hepatitis B should be given at least 8 weeks after the 2
nd
dose, at least 16 weeks
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ADE 302-9
after the 1
st
dose, and it should not be administered before the child is 24 weeks (168 days) of
age. (All 3
rd
doses of hepatitis B vaccine given earlier than 6 months of age before 6/21/96 are
valid doses and should be counted as valid until 6/21/2014.)
**** Tdap vaccine can be administered regardless of the interval since the last tetanus and
diphtheria toxoid-containing vaccine.
***** Exception: If a student has previously received two doses of measles, one dose of mumps
and one dose of rubella before January 1, 2010, the doses will be accepted as compliant to
immunization requirements and 2 MMRs are not required.
****** A medical professional is a medical doctor (MD), advanced practice nurse (APN), doctor
of osteopathy (DO), or physician assistant (PA). No self or parental history of disease will be
accepted.
******* For unvaccinated persons 7 years of age and older (including persons who cannot
document prior vaccination), the primary series is 3 doses. The first two doses should be
separated by at least 4 weeks, and the third dose at least 6 months after the second. One of these
doses (preferably the first) should be administered as Tdap and the remaining two doses
administered as Td.
Vaccine doses administered up to 4 days before the minimum interval for age can be counted as
valid for doses already administered. Exception: the minimum interval between doses of live
vaccines (such as MMR and Varicella) must be 28 days.
If the child does not meet the immunization requirements for entering school, the school shall
refer the child to a medical authority (private doctor or health department) for immunization or
consultation for when the immunization is due.