PLEASE RETAIN THIS
MANUAL
UPDATED MATERIAL
WILL BE ISSUED AS
NECESSARY
Information and directions contained in this manual shall be
utilized when completing Form IP-101 for all
preschools/childcares in Macomb County. Conflicting
directions are clarified in this manual (IP-101 vs. Macomb
County Health Department Immunization Manual) and will
be resolved per requirements of the Macomb County Health
Department.
3
Contents
PURPOSE ................................................................................................................................................. 4
MCIR REVISIONS ...................................................................................................................................... 5
SECTION I – PROGRAM INFORMATION ........................................................................................... 6
E.
LEGAL REQUIREMENTS ..................................................................................................... 6
F.
DEFINITIONS .................................................................................................................... 7
G.
MINIMUM REQUIREMENTS FOR FIRST DAY OF SCHOOL ..................................................... 8
H.
REQUIREMENTS FOR CONTINUED ATTENDANCE ............................................................... 9
I.
ACCEPTABLE PROOF OF IMMUNIZATION ......................................................................... 10
J.
FIRST DAY EXCLUSIONS .................................................................................................. 11
K.
REQUIRED IMMUNIZATION NOTICES ............................................................................... 11
L.
RECORDING IMMUNIZATION DATES................................................................................ 11
M.
NON-COMPLIANT, INCOMPLETE CHILDREN ..................................................................... 11
N.
IMMUNIZATION WAIVERS .............................................................................................. 12
O.
EXCLUSIONS .................................................................................................................. 14
P.
REPORTING PROCEDURE ................................................................................................ 14
Q.
AUDITS .......................................................................................................................... 14
R.
SCHOOL IMMUNIZATION PROGRAM CONTACT INFORMATION .............................................. 15
SECTION II - LEGAL REFERENCES ................................................................................................... 16
MACOMB COUNTY IMMUNIZATION REGULATIONS ..................................................................... 16
SECTION 1 - GENERAL PROVISIONS ............................................................................................. 16
SECTION 2 - ENFORCEMENT....................................................................................................... 16
SECTION 3 - REGULATION .......................................................................................................... 16
SECTION 4 - CERTIFICATION ....................................................................................................... 16
SECTION 5 - IMMUNIZATION ................................................................................................... 17
SECTION 6 - EXEMPTIONS .......................................................................................................... 17
SECTION 7 - EXEMPT STUDENT/MINOR CHILDREN DURING DISEASE OUTBREAKS ......................... 17
SECTION 8 - RECORDS ................................................................................................................ 17
SECTION 9 - PROMULGATION OF ADMINISTRATIVE GUIDELINES .................................................. 17
SECTION 10 - SANCTIONS ........................................................................................................... 17
SECTION 11 - INTERPRETATION CLAUSES .................................................................................... 18
STATE OF MICHIGAN ACT 368, P.A. 1978 PART 92 IMMUNIZATION .............................................. 19
REQUIREMENTS FOR ENTERING AND REMAINING IN SCHOOL ..................................................... 19
MEDICAL, RELIGIOUS AND OTHER EXEMPTIONS .......................................................................... 19
ENFORCEMENT ......................................................................................................................... 20
EXPANDING THE IMMUNIZATION REQUIREMENT TO UPPER GRADE CHILDREN ........................... 20
4
PURPOSE
The purpose of the Macomb County Health Department (MCHD) School
Immunization Program (SIP) is to
work in collaboration with the Michigan Department
of Health and Human Services (MDHHS), in upholding
the mandates of the MDHHS CHILD CARES and PRESCHOOLS Vaccines Required for Child Care and Preschool
in Michigan chart and the Protocol for the IP-101 Childcare Immunization Reporting Process. This collaborative
effort is required by law in the Michigan Public Health Code, Act 368, 1978, and the
Macomb County
Immunization Regulation enacted by the Macomb County Board of
Commissioners on September 27,
1979. These efforts are undertaken to keep
immunization levels high, in order to protect children from
vaccine-preventable
disease, possible serious complications of these diseases and prevent the loss of
valuable classroom learning time.
It is the responsibility of parents, legal guardians or person in loco parentis to have their child receive the
required childhood
immunizations before childcare center or preschool entry. They must maintain a record
of all their immunizations on
an ongoing basis and provide the childcare center/preschool with written
documentation of a valid/certified immunization record.
In order to ensure a high level of immunity against these vaccine-preventable
diseases, it is the
responsibility of t h e childcare center/preschool program to maintain a record of
required immunizations
on each entering child, and exclude children from the program
that do not meet the minimum immunization
entrance requirements.
A
childcare center/preschool program must also monitor that children have,
or eventually
receive all of the required immunizations according to the acceptable timetable of vaccine
series administration. CHILDREN THAT DO NOT RECEIVE THE REQUIRED VACCINES, A CERTIFIED
NONMEDICAL WAIVER OR AN APPROVED MEDICAL WAIVER,
MUST BE EXCLUDED FROM THE CHILDCARE
CENTER/PRESCHOOL PROGRAM.
5
MCIR REVISIONS
Effective March, 2022, the Michigan Department of Health and Human Services (MDHHS) has made
available to all childcares the following rosters:
1. An outbreak roster: in the case of an outbreak, the childcare can check the children’s status of the COVID
vaccination. This roster is found on the MCIR home page in the “person box”.
2. An employee roster: The childcare as an Employer use of the MCIR to verify Employee COVID vaccination
status.
The childcare has to fill out “Employer Site Usage MCIR Agreement – Form” in order to activate the
employee roster. Also, the childcare must have a consent from the employee in order to check their COVID
vaccination status in MCIR.
To know more and to access the Employee Roster User Guide for Schools – How to use the Employee
Roster in MCIR follow the link below:
https://mcir.org/wp-content/uploads/2022/02/Employee-Roster-User-Guide_schools-02022022.pdf
6
SECTION I – PROGRAM INFORMATION
LEGAL REQUIREMENTS
1. STATE LAW & MACOMB COUNTY IMMUNIZATION REGULATIONS
All children who attend childcare center and preschool programs in Michigan
are required by law
to be fully vaccinated in accordance with Michigan
Public Health Code Act 368 of 1978 Part 92
Immunization. All programs licensed by the Michigan Department of Health and Human Services (MDHHS)
are required to report the immunizations status of specific childhood populations annually, and exclude
children from attendance that do not meet immunization(s) or waiver requirements. Sec. 9211 of this act
states, “The operator of the group program shall not permit a child to attend the group activity unless a
minimum of 1 dose of an immunizing agent against each of the diseases specified by the department has
been received and certified to by a health professional or local health department.” Sec. 9229 of this act
states, “A person who violates this part or a rule promulgated under this part is guilty of a misdemeanor.”
The specific childhood populations include those newly enrolled in the childcare center/preschool.
Parents, legal guardians or person in loco parentis of the child, must present a written record indicating
that their child has received all required vaccines. For children without the required vaccines, the parent
is required to submit an approved medical waiver or certified nonmedical waiver using the current version
of the appropriate State of Michigan waiver form.
The Macomb
County Health Department (MCHD) has established immunization
requirements that may
exceed the minimum established by the MDHHS. These requirements are for children enrolled in childcare
centers, preschool and Head Start programs. Failure to meet these requirements, as set by the
MDHHS,
requires the
program director to EXCLUDE a child from attendance. Also, all childcare centers, preschool
or Head Start programs must have a completed, waived or provisional record (compliancy) for at least
90% of these children for the October IP-101 report. Failure to do so can result in the program being
referred to the MDHHS and Childcare Center Licensing for follow up by the Michigan Attorney General
Office which may result in a misdemeanor charge/fine.
2. NEW ENTRANTS INCLUDE THE FOLLOWING:
All children entering a childcare center, preschool or Head Start program.
3. RECORDS TO BE ASSESSED AND REPORTED
Each year, assess and report immunization records of all preschool-
children 4 and younger. Children
age five and older who are in
developmental kindergarten or kindergarten will be assessed through
the school reporting program. Children attending before and after school
programs are not reported on
the IP-101 reporting system.
7
DEFINITIONS
a. REPORT YEAR: January 1st, through December 31st is the time frame
for reporting entering children as
described above.
b. OCTOBER REPORT: Includes children entered from January 1
st
through September 30
th
. The IP-101,
waiver, incomplete and
provisional reports are due before October 2
nd
. If the October IP-101
report
submission is delayed until the final deadline date, children that
enter between October 1
st
and
December 31
st
, should be included on the report.
c. COMPLIANCE RATE: The compliance rate is the percentage of
children that are complete, provisional,
or waivered. Formula =
(Total children – Incomplete children) ÷ Total children x 100.
d. IMMUNIZATION RATE: The immunization rate is the percentage of
enrollment that is completely
or provisionally immunized.
Immunization rates drop when there are waivered children. ALL
enrolled children without certified waivers must meet immunization
requirements. Formula = (Total
children – Incomplete Children − Waivers) ÷ Total children x 100.
MINIMUM REQUIREMENTS FOR FIRST DAY OF SCHOOL
Each Required Vaccine Must Be Addressed
1 Dose of Each
Vaccine
A written record of immunization showing month-day-year for at
least 1 dose of each required vaccine. Statements such as complete, up-
to-date, or similar statements are NOT accepted.
Provisional Status
(Waiting period
between doses)
Current medical practice requires a waiting period between doses of
vaccines and it may not possible to complete all vaccines in a series
before entering preschool/childcare center, especially if the series was
started late. Children in this provisional status must have ongoing
monitoring of additional vaccine administration until the child’s vaccine
status becomes complete. The younger the child, the more frequently
they may be due for the next vaccine in the series.
Medical Exemption
A MDHHS Medical Contraindication Form must be signed by a M.D.,
D.O. PA or NP, specify which vaccines cannot be administered, state the
valid medical contraindication, and the time period required before the
vaccines may be given. A child’s admittance is provisional until the
waiver is reviewed and approved by the Macomb County Health
Department Medical Director. An approved medical waiver form must
be filed in the child’s record.
Nonmedical
Exemption
Parents/guardians who object to some or all vaccines must receive
waiver education by a Local Health Department (LHD) and sign a
MDHHS Immunization Waiver Form (nonmedical waiver) claiming
immunization is against their religious beliefs, or other objection
(philosophical) to immunization. The waiver form must be signed and
certified at a LHD. Certified waivers are taken to the childcare
center/preschool office. A certified nonmedical waiver form must be
filed in the child’s record.
Laboratory Finding
of Immunity
Laboratory finding of immunity is acceptable for measles, mumps,
rubella, hepatitis B and varicella (chickenpox). Laboratory test results
are best read and entered into MCIR by a health care provider. A
childcare may forward the laboratory results to the MCHD for review
and approval of immunity. Approved laboratory result reports must be
filed in the child’s record.
REQUIREMENTS FOR CONTINUED ATTENDANCE
Complete dates (month, day and year) are required to confirm necessary minimum
ages and
intervals between doses of vaccines. MCHD has vaccine requirements as set by MDHHS.
ACCEPTABLE PROOF OF IMMUNIZATION
a. Health Appraisal Form (BRS-3305). The immunization section must
have validating signature
of a health care provider.
b. Complete record dates (month, day & year) are required to confirm necessary minimum ages
and intervals between doses of vaccines.
c. Macomb County Health Department Immunization History Record.
d. Records on physician letterhead or prescription pad. These must state
vaccines given, dates,
and have the provider’s validating signature.
e. The Official Michigan Care Improvement Registry (MCIR) immunization record with
medically validated data
only, i.e., the data was entered by a health care provider rather
than a
school or childcare.
f. Laboratory finding of immunity for hepatitis B, measles, mumps, rubella,
and/or varicella
(chickenpox). Each disease has a separate test. The
child must have a laboratory evidence
of immunity for measles, mumps,
and rubella for the child to be exempt from MMR
vaccine
Laboratory test results are best read and entered into MCIR by a health care provider
A childcare may forward the laboratory results to the MCHD for review and approval
of immunity.
Please call with any questions about laboratory findings.
g. Signed physician or parent/legal guardian statement of Varicella
Disease Form. Chickenpox
is the only illness for which disease history is
currently accepted instead of immunization
dates.
h. AN ORAL STATEMENT FROM PARENTS IS NOT ACCEPTABLE
PROOF OF IMMUNIZATION
i. State law requires every entrant have written proof of immunization in
the child’s preschool
or child care record.
PRESCHOOL AND CHILD CARE PROGRAM STAFF MUST:
1. Copy all records presented by parents and place
the copy in the child’s program record.
The original must be
returned to the parent except Health Appraisal Forms.
2. Check records for completeness, i.e., all dates must indicate
Day, Month, and Year.
Statements such as complete or up-to-
date are NOT acceptable.
FIRST DAY EXCLUSIONS
All children may be registered, but not admitted, if they DO NOT have one
dose of each
required vaccine on the first day of attendance. The child may
attend the program only after
immunization documentation or valid waiver is provided.
REQUIRED IMMUNIZATION NOTICES
Provide the parent a copy of the immunization requirements at
the time of the child’s
registration. Use copies of the Michigan Department of
Health and Human Services (MDHHS)
Child Cares and Preschools Vaccines Required for Child Care and Preschool in Michigan
requirements chart.
RECORDING IMMUNIZATION DATES
Refer all undocumented vaccinations to the child’s doctor. If the child doesn’t have one, the
parent can call the MCHD immunization clinic to schedule an appointment to enter shots into
the MCIR.
If the childcare must enter vaccination please follow the procedure below to enter
immunization dates.
Month & Year Dates. Use the last day of the month to enter dates, e.g., 3/2022 =
3/31/2022.
Duplicate Dates. DO NOT enter duplicate dates into MCIR if it appears
on more than one
document. When reviewing the child’s records,
always check with parents to determine
questionable immunization
dates.
Date Primary Series Ended/Completed. When entering incomplete data
(i.e. State
Immunization Certificate or date when primary series ended
was 3/5/2022) record the
available dates noted on the record.
For children having a history of Chickenpox disease, parents/guardians can complete the
Statement of
Varicella Disease form at the program. Maintain copies of these forms
in the child’s record and program’s master waiver file.
It is the responsibility of the parent to supply
documentation of immunization(s). Advise the
parent of the
need for ALL dates of immunizations.
NON-COMPLIANT, INCOMPLETE CHILDREN
1. If a child returns to the program before complying with the requirements
of the exclusion,
THE CHILD IS NOT TO BE ADMITTED TO THE
PROGRAM.
2. Contact is to be made with the parent by the program
director to require compliance
with the exclusion. Verbal contact by
phone or in-person is to be followed-up with a
written notification that
specifies the requirements for entry into the program.
3. Excluded children who have not returned to preschool or childcare for
an extended
period of time can be removed from the roster at your
discretion. You may follow-
up with the family to determine if the child will be returning to the program
IMMUNIZATION WAIVERS
Keep a copy in the child’s file and in the master waiver file
An immunization waiver is required when a child enters a childcare center/preschool if the
parent objects to any of the required immunizations.
Waivers are for specific vaccines and specific time periods. A waiver for a specific vaccine does
not constitute a waiver for all vaccines.
Waivers should not be encouraged or used as administrative relief from the burden of
exclusion.
A child with a nonmedical waiver appointment may provisionally attend a childcare program
during the waiver education appointment date waiting period.
A child may also provisionally attend childcare while the medical waiver is in the review process.
A master file of all waivers, along with a list of children with waivers indicating specific vaccine
and time limits, must be maintained at each program. Please keep an up-to-date list of
children with waivers in the master file.
It is recommended an electronic list of children with waivers is also created and maintained.
Any child in the building with a waiver on file, regardless of the year the waiver was signed,
is to be on the list and a copy of the waiver kept in the master file.
There are two types of waivers: medical and certified nonmedical. Only the current versions of
the MDHHS Medical Contraindication Form or certified Immunization Waiver Form can be
accepted.
1. NONMEDICAL IMMUNIZATION WAIVERS
The MDHHS Immunization Waiver Form is used when a parent objects to immunizations for
religious convictions or other objection to immunizations (philosophical reasons).
Certified immunization waiver forms are completed and signed at the LHD following a waiver
education session.
The parent is responsible to provide a copy of the certified MDHHS Immunization Waiver
Form, obtained at the LHD, to the childcare center/preschool.
For children having a history of chickenpox disease, parents/guardians can complete the
Statement of Varicella Disease form at the program. Maintain copies of these forms in the
child’s record and program’s master file.
Inspect the waiver form for following information:
1. MDHHS waiver form is utilized
2.
Child’s name, date of birth & address
3.
Vaccine(s) being waived box checked off
4. Reason for the waiver
5.
Parent/legal guardian/in loco parentis signature & date
6. LHD staff signature and date signed
7. LHD address stamp
8. Name of Childcare Center/Preschool
MEDICAL CONTRAINDICATION WAIVERS
Only a M.D., D.O., NP or PA can complete and sign a MDHHS Medical
Contraindication Form.
The parent is responsible to provide the childcare with a MDHHS Medical Contraindication Form
that is completed, signed with the expiration date addressed by a health care provider. This form
can be found on the MDHHS Immunization Waiver Information web page and on the MCHD
School Immunization Program website.
The program is responsible for forwarding a copy of the medical waiver to the SIP for review by
the MCHD Medical Director. A maximum thirty (30) day provisional admittance is permitted
pending the receipt and review of the waiver.
i. ACCEPTED MEDICAL WAIVERS
The School Immunization Program will return the approved waiver to the
program for
placement in the child’s permanent record and program master file.
ii. DENIED MEDICAL WAIVERS
The School Immunization Program will return the denied waiver to the program with the
reason indicated for the denial. An instruction sheet will accompany the denied waiver
providing guidance of the next steps needed to be taken by the school and parents.
The parent has 30 days to respond to a denied medical waiver.
Children still in need of
immunizations after 30 days must be
EXCLUDED until:
the required vaccine(s) are received OR
a new medical waiver with a valid medical contraindication is signed and
submitted to the SIP for review OR
The parent receives and submits to the program a certified nonmedical waiver from
the LHD.
EXCLUSIONS
Each childcare center/preschool program is to send exclusion letters to parents of
incompletely immunized children. Programs are required to set exclusion
dates to keep the
immunization level above 90%.
Before mailing the exclusion letters, check for:
a. Additional updated immunization information f r o m t h e p a r e n t .
b. Accuracy in the recording of dates on the IP-101 report and exclusion
letter.
When
sending exclusion letters, please give parents at least two (2) weeks’ notice of the
exclusion date AND
Enclose a copy of the Macomb County Health
Department School Immunization Program “Parents
Resources and Requirements of Childcare Children” found on the MCHD SIP website.
The un- or under immunized child must be EXCLUDED until:
1. The parent presents acceptable evidence of the required immunization,
2. The parent indicates a possible medical contraindication and presents the
Childcare/Preschool with a MDHHS Medical Contraindication Form completed by their
doctor and/or
3. The parent receives a certified MDHHS nonmedical Immunization Waiver Form from the
LHD and submits a copy to the program.
It is the legal responsibility of the director/program administrator to
enforce the exclusion of
children from the program not meeting immunization or waiver requirements.
REPORTING PROCEDURE
IP-101 reports are based on the calendar year, not the school year. The
October 1
st
report
includes children who entered from January 1
st
to September
30
th
of the reporting year. The first
date of IP-101 report acceptance is September
15
th
Mail, email or fax printed IP-101 reports, copies of waivers, Statement of Varicella
Disease
forms by the due date of Oct, 1
st
regardless of compliance rate to the address, email address or
fax number
supplied at the end of this section.
AUDITS
The Macomb County Health Department may conduct random audits during
the year. The
School Immunization Program staff will notify program
administrators in advance of the audit
date.
SECTION II - LEGAL REFERENCES
MACOMB COUNTY IMMUNIZATION REGULATIONS
This regulation shall be known as the Macomb County Immunization
Regulation, enacted
by the Macomb County Board of Commissioners
September 27, 1979:
SECTION 1 - GENERAL PROVISIONS
ENACTING CLAUSE: The Macomb County Board of Commissioners, under
the authority to adopt
regulations vested in it by Sections 2433, 2441 and 2442
of Act 368 of the Public Acts of 1978,
State of Michigan; hereby adopts the
Macomb County Immunization Regulation.
POLICY STATEMENTS: This Regulation is designed to assist the Macomb
County Health
Department in its enforcement of State and local immunization
and communicable disease laws
and its general responsibility for protecting the
health and safety of the citizens of Macomb
County. Nothing contained in this
regulation shall be construed to abrogate or supersede any
other statutory or
common law rights any person may have.
SECTION 2 - ENFORCEMENT
The Macomb County Health Officer or the Health Officer's authorized
representative is
charged with the authority and duty to apply and enforce the
provisions of this regulation and
any guidelines promulgated under this
regulation in any township, village or city within the
jurisdiction of the Macomb
County Health Department.
SECTION 3 - REGULATION
No student or minor child shall be admitted to any public, private or parochial
elementary or
secondary school, day care center, camp or any other organized
care or educational facility for
preschool, elementary or secondary level
operating in Macomb County unless such student or
minor child can present to
the appropriate school, program or day care authorities written
certification
from a licensed physician or authorized representative of a state or local health
department that such student or minor child has received immunizations, is in
the process of
receiving immunizations or has otherwise demonstrated
immunity against vaccine preventable
diseases through serological testing
using standards and practices specified by or acceptable
to the Michigan
Department of Public Health and the Macomb County Health Department.
SECTION 4 - CERTIFICATION
What constitutes acceptable written certification of immunization shall be
subject to the
approval of the Macomb County Health Department. Acceptable
written certification of
immunization shall include, but not be limited to, the date
of month and year of each dose of
every antigen required by the Macomb
County Health Department.
SECTION 5 - IMMUNIZATION
The diseases to be immunized against, the antigens to be used, and manner
and frequency of
their administration shall be specified by the Macomb County
Health Department but shall not
be less than minimum standards promulgated
by the Michigan Department of Public Health to
enforce Part 92, Sections 9201
through 9229 of Act 368 of the Public Acts of 1978 and shall
conform to
accepted standard medical practices.
SECTION 6 - EXEMPTIONS
MEDICAL: Any student or minor child with a physical condition such that
immunization
would endanger the life or health of such student or minor child,
shall submit a statement to
the enforcing authorities from a licensed physician
or designee, specifying which immunizations
are contraindicated and the
period of time the contraindication is in effect. Certification of
medical
exemption shall be subject to approval by the Macomb County Health
Department.
Children with temporary medical contraindications shall receive
the appropriate immunizations
after the contraindication is no longer in effect.
RELIGION & OTHER: A student or a guardian of a minor child with a religious
or other objection
to immunizations shall submit to the enforcing authorities a
statement or objection in a form
approved by the Macomb County Health
Department.
SECTION 7 - EXEMPT STUDENT/MINOR CHILDREN
DURING DISEASE OUTBREAKS
Children and minor children with temporary and permanent exemptions to
immunizations
are susceptible to the diseases which they are not immunized
against. Such children and minor
children may be excluded from the school,
day care centers, preschool program, camp or
other facility by order of the
Macomb County Health Department during periods of disease
outbreaks until
such time as the disease outbreak has ended.
SECTION 8 - RECORDS
A student's or minor child's written immunization history shall be incorporated
into his or her
permanent school, day care, preschool program and/or camp
record in a form subject to the
approval by the Macomb County Health
Department, and shall be subject to inspection and
audit by local health and
education officials. Summaries of such records shall be sent to the
Macomb
County Health Department on dates and in a manner specified by the
Department.
SECTION 9 - PROMULGATION OF ADMINISTRATIVE GUIDELINES
The Macomb County Health Department shall promulgate administrative
guidelines under this
regulation and shall supply or approve forms for recording
the immunization history of children
or minor children affected by this
regulation.
SECTION 10 - SANCTIONS
PENALTIES: Any person who shall fail to comply with any provisions of this
regulation or any
order of the Macomb County Health Officer promulgated
there under, shall be deemed guilty
of a misdemeanor.
INJUNCTION: When injunctive relief would be the most effective remedy or
whenever any
person has repeatedly violated the provisions of this regulation
and the orders of the Macomb
County Health Officer, the Health Officer may
commence appropriate civil legal action in a
court of competent jurisdiction in
the name of the Macomb County Health Department to
enjoin and restrain
further continuance of such violation.
SECTION 11 - INTERPRETATION CLAUSES
OTHER LAWS AND REGULATIONS: This regulation and guidelines
promulgated under this
regulation are minimum standards, supplemental to the
statutes of the State of Michigan, the
administration rules duly promulgated
there under, and any local regulations or ordinances.
Where any provision of
this regulation and a provision of any Federal, State or local statute,
ordinance
or regulation both apply, the more restrictive of any or all codes, statutes,
ordinances or regulations shall prevail.
INTERPRETATION: Provisions of this Regulation shall be construed liberally
so as to best
preserve the public health and safety. The word "shall" is
mandatory, not merely directory.
STATE OF MICHIGAN ACT 368, P.A. 1978 PART 92 IMMUNIZATION
EXCERPTS from the Public Health Code
REQUIREMENTS FOR ENTERING AND REMAINING IN SCHOOL
Sec. 9208. (1) A parent, guardian or person in loco parentis applying to have
a child registered
for the first time in a school in this state and, beginning January 1,
2014, a parent, guardian,
or person in loco parentis of a child entering the
seventh grade, shall present to school officials,
at the time of registration or not
later than the first day of school, a certificate of immunization
or statement of
exemption under Section 9215.
(2) A teacher or principal shall not permit a child to enter or attend
school unless a
certificate indicating that a minimum of 1 dose of an
immunizing agent against each of the
diseases specified by the department
has been received and certified to by a health
professional or local health
department. A parent, guardian or person in loco parentis having a
child registered with only
these minimum doses of immunizing agents shall present an
updated
certificate of immunization within 4 months after initial attendance showing that
the
immunizations have been completed as prescribed by the department.
Sec. 9211. (1) A parent, guardian, or person in loco parentis applying to have a preschool aged
child registered in a program of group residence, care, or camping shall present to the operator
of the program at the time of registration or not later than the first day of the program a
certificate of immunization or a statement of exemption under section 9215. The operator of the
group program shall not permit a child to attend the group activity unless a minimum of 1 dose
of an immunizing agent against each of the diseases specified by the department has been
received and certified to by a heath professional or local health department. A parent, guardian,
or person in loco parentis of a child registered with only these minimum doses of an immunizing
agent and continuing enrollment in the group program shall present an updated certificate of
immunization within 4 months after initial attendance showing that the immunizations have
been completed as prescribed by the department, if the child remains in the program.
(2) Upon request by the department or local health department, a program operator shall
report to the state and local health departments the immunization status of each child accepted.
MEDICAL, RELIGIOUS AND OTHER EXEMPTIONS
Sec. 9215. (1) A child is exempt from the requirements of this part as to a
specific
immunization for any period of time as to which a physician certifies
that a specific
immunization is or may be detrimental to the child's health or is
not appropriate
(2) A child is exempt from this part if a parent, guardian or person in
loco parentis of the child
presents a written statement to the administrator of
the child's school or operator of the group
program to the effect that the requirements of this part cannot be met
because of religious
convictions or other objection to immunization.
ENFORCEMENT
Sec. 9229. A person who violates this part or a rule promulgated under this
part is guilty of a
misdemeanor.
EXPANDING THE IMMUNIZATION REQUIREMENT
TO UPPER GRADE CHILDREN
The people of the State of Michigan enact:
Sec. 1. Act No. 368 of the Public Acts of 1978, as amended, being sections
333.1101 to
333.25211 of the Compiled Laws of 1970, is amended by adding
section 9212 to read as follows:
Sec. 9212. If the immunization level in any grade in a public or nonpublic
school in this state
falls below the level necessary to guard against the spread
of disease within the grade or school
as determined by the director or the local
health department, the board of the local school
district in which the public
school is located or the governing body of the nonpublic school may
designate
the immunization requirements set forth in section 9208 as a condition for
admission to the grade in which the immunization is low.
