Procedure No. 3413P
Section: 3000 - Students

Student Immunization and Life-Threatening Health Conditions

Immediately upon enrollment in the district, the student’s parent or legal guardian must provide proof of the required immunizations as specified by the Washington Department of Health with a completed Certificate of Immunization Status (CIS) form approved by the Department of Health, and/or an exemption with a completed Certificate of Exemption (COE) form approved by the Washington Department of Health. The student cannot start attending school until the completed CIS and/or COE is on file at the school or the Conditional Immunization Status conditions have been met. Students experiencing homelessness, including migratory and refugee children and children in out-of-home (foster) care, who have not provided the required documentation will be allowed to enroll, attend classes, and participate fully, despite being out of compliance with immunization requirements.

The CIS and/or COE will be a part of the student's permanent record. The district will provide access to immunization records of each student enrolled to agents of the state or local health department. The district will return the CIS and/or COE or a legible copy to the parent or legal guardian if the child is withdrawn or transferred from the district. The district may not withhold the CIS and/or COE for any reasons, including nonpayment of school fees.

Certificate of Immunization

Language if the district is actively using the IIS School Module:

School staff may verify that the student’s immunizations are complete in the WA Immunization Information System (IIS), in this situation a CIS is not required to be on file. School staff will document this verification in the student’s cumulative school record. If the immunizations are not complete in the IIS the immunization status of students must be documented on a completed CIS form.

Language if the district is not actively using the IIS School Module:

The immunization status of all students must be documented on a completed CIS form.

All immunization information documented on a CIS by new enrollees starting school on or after August 1, 2020 must be medically verified. A CIS printed from the Washington Immunization Information System (IIS) with immunization information prepopulated is considered medically verified by the IIS. A hardcopy CIS completed by the parent or legal guardian must be verified as accurate by either a health care provider signature or by a school administrator, school nurse or designee’s signature after verifying that the information on the CIS is accurate when compared to medical immunization records attached to the CIS.

For currently enrolled students all new immunization documentation submitted on or after August 1, 2020 must be on a medical immunization record. School staff may use the information on the medical immunization record to update the student’s existing CIS on file.  A district school nurse or their delegate, with parent or legal guardian permission, may use the information on the medical immunization record to update the student’s immunization information in the WAIIS.

Conditional Immunization Status Attendance

If by a student’s first day of attendance the student does not have documentation of all of the required immunizations the student may be permitted to start school in a temporary “conditional immunization status” provided that the student has received all of the immunizations that he/she is eligible to receive and is waiting for the recommended date of the next vaccine dose according to the national immunization catch-up schedule. The parent or legal guardian must sign the CIS acknowledging the conditional status rules and times lines that follow. Once the next dose comes due the student can remain in conditional status for thirty (30) calendar days to have time to turn in the required documentation. If additional vaccines are needed conditional status continues in a similar manner until all of the vaccine series are complete. If the thirty (30) calendar day period expires and documentation has not been given to the school the student will be excluded from further attendance. Valid documentation includes medical records showing vaccination, evidence of immunity to the disease in question, or a completed Certificate of Exemption (COE) form.

Exemptions from Immunization

Any and all exemptions will be processed and recorded on a Certificate of Exemption (COE) form approved by the Washington Department of Health (DOH). All exemptions requested on a COE must be signed by the parent or legal guardian. Additionally, with the exception of a religious membership exemption, all COE forms presented on or after July 22, 2011, must also have the signature of a health care practitioner (HCP) saying they have given the parent or guardian information about the benefits and risks of immunizations. The form may be signed by a HCP at any time prior to the enrollment of the child in a school. Photocopies of the signed form or a letter from the HCP referencing the child's name shall be accepted in lieu of the original form. Such a letter should be attached to the COE signed by the parent or legal guardian. Only a health care practitioner who is a physician (MD), physician assistant (PA), osteopath (DO), naturopath (ND), or advanced registered nurse practitioner (ARNP) licensed in Washington State may sign the COE.

The district will grant medical exemptions from one or more of the required immunizations if the HCP indicates on the COE that in their opinion the vaccine is not advisable for the student. If the HCP indicates the medical exemption is temporary an expiration date must be documented on the COE. When a temporary medical exemption expires the student can attend school in “conditional immunization status” for thirty (30) calendar days to get the missing immunization or another exemption. If the thirty (30) calendar day period expires and documentation has not been given to the school, the student will be excluded from further attendance. Valid documentation includes medical records showing vaccination, evidence of immunity to the disease in question, or a completed Certificate of Exemption (COE) form.

The district will grant religious exemptions from one or more of the required immunizations if the parent or legal guardian completes the religious exemption section of the COE. Along with the COE form, the parent or legal guardian must submit a letter statement from a health care practitioner that includes the practitioner's printed name, signature, and date of signature stating that they have provided the parent information about the benefits and risks of immunization to the child as a condition of obtaining a medical, religious, personal, or philosophical exemption. The letter must reference the student’s name. 

The district will grant religious membership exemptions from one or more of the required immunizations if the parent or legal guardian completes the religious membership section of the COE and signs affirming they are a member in a religious body or church with beliefs or teachings that preclude a child from receiving medical treatment from a HCP. The HCP signature is not required for a religious membership exemption.

The district will grant personal/philosophical exemptions from one or more of the required immunizations, except measles, mumps or rubella, if the parent completes the personal/philosophical exemption section on the COE. The district will not grant an exemption for philosophical or personal reasons from the measles, mumps, or rubella immunization requirements. Along with the COE form, the parent or legal guardian must submit a letter statement from a health care practitioner that includes the practitioner's printed name, signature, and date of signature stating that they have provided the parent information about the benefits and risks of immunization to the child as a condition of obtaining a medical, religious, personal, or philosophical exemption. The letter must reference the student’s name. 

If an outbreak of vaccine-preventable disease for which the child is exempted occurs, the child may be excluded from the school for the duration of the outbreak. 

Exclusion from School

The school principal will exclude students from further attendance who are out of compliance with the immunization requirements as required in RCW 28A.210.120.

When excluding students, the school will provide written notification as required in WAC 392-380-050. Written notification will:

• Order that the student is excluded immediately, and
• Be delivered in person or by certified mail, and
• Be in the parent’s native language if possible, and
• Include a copy of the applicable laws and rules (RCW 28A.210.010-160, 246-105 WAC, and 392-182 WAC sections 005, 020, 045, 050, 080), and
• Provide information regarding immunization services available through local health or other public agencies, and
• Include notice that the parent/legal guardian and student has a right to a hearing provided they notify the school within three (3) days after receiving the exclusion order from the school principal, and
• Describe the hearing process, and
• Explain that the exclusion continues until either the required immunization documentation, or a completed Certificate of Exemption form is turned in to the school, or a hearing officer determines that the student is no longer excluded from school.

If the parent requests a hearing, the district will notify in writing the parent or guardian and school principal of the time and place for the hearing and will present the case to a hearing officer appointed by the superintendent.

List of Students Not Fully Immunized

The district will keep or be able to produce within twenty-four hours a current list of children who are not fully immunized. This list will be transmitted to the local health department upon request. The local health officer may use this list for easy identification of students to be excluded from school temporarily during a disease outbreak.

Meningococcal Disease, Human Papilloma Virus Disease and Vaccine Information Distribution

At the beginning of every school year, the district will provide parents/guardians of sixth through twelfth grade students, information provided by the Washington State Department of Health about meningococcal disease, human papilloma virus (HPV) disease and their vaccines.

The information will include the causes and symptoms of meningococcal disease, human papilloma virus, how the diseases are spread, the places where parents/guardians may obtain additional information and vaccinations for their children, and current recommendations from the United States Centers for Disease Control Prevention regarding the vaccines.

 

Cross References:	2162 - Education of Students With Disabilities Under Section 504 of the Rehabilitation Act of 1973
	3115 - Students Experiencing Homelessness - Enrollment Rights and Services   28A.210.120 - Immunization program — Prohibiting child's presence, Notice to parent, guardian, or adult in loco parentis

 

Legal References:		Chapter 246-105 WAC Immunization of child care and school children against certain vaccine-preventable diseases
		Chapter 28A.210 RCW Health — Screening and requirements
		WAC 392-182 Student — Health records
		WAC 392-380 Public school pupils — Immunization requirement and life-threatening health condition
		Chapter 28A.210.080 RCW - Immunization program —Information regarding meningococcal disease—Information regarding human papillomavirus disease.
Management Resources:	Department of Health - DOH 348-186 March 2021 2020 - May WA Issue 2018 - August 2018 - August Policy Issue
	2012 - August Issue
	2011 - August Issue
	2011 - June Issue
	Policy News, August 2007 Human Papilloma Virus Disease Notification
	Policy News, April 2006 Chickenpox Immunization Required
	Policy News, June 2005 Distribution of Information on Meningococcal Disease
	Policy News, October 2002 Legislature Addresses “Life-Threatening Conditions”

 

Initially Adopted: October 16, 1980

Adopted: February 22, 2010

Amended: October 14, 2019

Amended:  March 27, 2023