Regulation
R 5320 IMMUNIZATION
A. Immunizations
on Admission
1. No
Principal shall knowingly admit or retain any pupil who has not submitted
acceptable evidence of immunization according to the schedule set forth at ¶E,
unless the pupil is provisionally admitted as provided at ¶A2 or exempted as
provided at ¶B. N.J.A.C. 6:29-2.1 and N.J.A.C. 8:57-4.3 and 8:57-4.4.
2. A
pupil may be admitted to preschool or school on a provisional basis if a
physician, a certified nurse practitioner or health department can document
that at least one dose of each of the required vaccine(s) or antigen(s) which
are age appropriate have been administered and that the pupil is in the process
of receiving the remaining immunizations.
a. No
child will be enrolled provisionally in a school or child care center without
documentation of at least one dose of polio, diphtheria, tetanus, pertussis, measles, mumps, rubella, and HIB vaccine (for
child care centers only) which are age-appropriate for the child, and hepatitis
B as described below. The child must
also have an appointment for, and be in process of, receiving the remaining
antigens.
b. A
child under five years of age lacking all required vaccines shall have no more
then seventeen months to meet all immunization requirements.
c. A
child five years of age or older lacking all required vaccines shall have no
more than one year to complete all immunization requirements.
d. Beginning
in September 2001, a child born after
e. Provisional
status shall be granted only one time to pupils entering or transferring into
this district. If a pupil on provisional status transfers
from this district information on his/her status will be sent to the new
school. Provisional status may be
extended by a physician for medical reasons as indicated in N.J.A.C. 8:57-4.3.
f. Pupils
transferring into this district from another state or country shall be allowed
a thirty-day grace period in order to obtain past immunization documentation
before provisional status shall begin.
The thirty-day grace period does not apply to pupils transferring from
within the State of
g. The
Principal shall ensure that the provisionally admitted pupil is receiving
required immunizations on schedule. If
the pupil has not completed the immunizations at the end of the provisional
period, the Principal shall exclude the pupil from school until appropriate
documentation of completion has been presented.
h. Pupils
on provisional status may be temporarily excluded from school during a
vaccine-preventable disease outbreak or threatened outbreak, as determined by
the State Commissioner of Health and Senior Services.
B. Exemptions
from Immunization
1. A
pupil shall not be required to have any specific immunization(s) that are
medically contraindicated.
a. A
written statement from any physician licensed to practice medicine or
osteopathy in any jurisdiction in the
the
medical contraindication, will exempt a pupil from the specific immunization
requirements of law for the period of time specified in the physician's
statement.
b. The
physician's or a certified nurse practitioner’s statement shall be maintained
by the school as part of the immunization record of the pupil and shall be
reviewed annually.
c. When
the pupil's medical condition permits immunization, this exemption shall
thereupon terminate, and the pupil will be required to obtain the immunizations
from which he/she has been exempted.
2. A
pupil shall be exempted from mandatory immunization if the parent(s) or legal
guardian(s) submits a signed statement that explains how the administration of
immunizing agents conflicts with the pupil's exercise of bona fide religious
tenets or practices. General
philosophical or moral objection to immunization shall not be sufficient for an
exemption on religious grounds.
a. The
written statement signed by the parent(s) or legal guardian(s) will be kept by
the school as part of the pupil's immunization record.
b. This
exemption may be suspended by the State Commissioner of Health during the
existence of an emergency as determined by the State Commissioner of Health.
c. Pupils
enrolled in school before September 1991 and granted a religious exemption to
immunization before May 1990 shall not be required to reapply for a new religious
exemption under N.J.A.C. 8:57-4.4(a).
3. Pupils
exempted on medical or religious grounds may be temporarily excluded from
school during a vaccine-preventable disease outbreak or threatened outbreak, as
determined by the State Commissioner of Health.
C. Documentation
of Immunization
1. Any
of the following documents will be accepted as evidence of a pupil's
immunization history, provided that the document lists the type of immunization
and the specific date (month, day and year) when each immunization was
administered.
a. An
official school record from any school or preschool indicating compliance with
immunization requirements,
b. A
record from any public health department indicating compliance with
immunization requirements, or
c. A
certificate signed by a physician licensed to practice medicine or osteopathy
in any jurisdiction in the
2. All
immunization records submitted by a parent(s) or legal guardian(s) in a
language other than English shall be accompanied by a translation provided by
the parent(s) or legal guardian(s) sufficient to determine compliance with the
immunization requirements of this regulation.
3. Parental
verbal history or recollection or previous immunization is unacceptable
documentation or evidence of immunization.
D. Immunization
Records
1. Each
school shall maintain an official State of
a. The
New Jersey Department of Health and Senior Services’ “School/Child Care
Immunization Record” IMM-8 form or the New Jersey Education Department’s
“Health History and Appraisal” A-45 form for schools continue to be the only
two acceptable immunization documentation records under these regulations.
b. When
a child is transferring to a different school, and at the request of a parent
or the receiving school, a copy of the school immunization form or the original
form must be sent or communicated to the receiving school within twenty-four hours
of such a request so that the child may be quickly enrolled at the new
school. If the pupil leaves the school
or child care center for any reason, and if the parent requests the State
“School Immunization Record”, a certified copy shall be provided to the parent
within twenty-four hours (one working day) of such a request.
c. The
immunization record shall be kept separate and apart from the pupil's other
medical records for the purpose of immunization record audit.
d. If
a pupil withdraws, is promoted, or transfers to another school, the record,
including statements pertaining to medical or religious exemptions, or
certified copies thereof, shall be sent to the new school or be given to the
parent(s) or legal guardian(s) on request, within twenty-four hours of the
request.
e. Child
care centers and elementary schools are to retain immunization records, or a
copy thereof, for at least one year after the pupil has transferred or
withdrawn from the facility. For
children who are promoted from elementary to middle school or from middle
school to high school within the same school system, this record retention
requirement is not applicable in accordance with Department of Education rules
and policies on transfer of pupil records.
f. Each
pupil's immunization record or a copy thereof shall be retained by the high
school for a minimum of four years after the pupil has left the school and
shall be retained by the elementary school for a minimum of one year after the
pupil has left the school.
g. When
a pupil graduates from high school, the record or a certified copy thereof
shall be sent to an institution of higher education or may be given to the
parent(s) or legal guardian(s) on request.
h. Any
computer-generated document or list developed to record immunization
information will be considered a supplement to, not a replacement of, the
official New Jersey Immunization Record.
2. A
report of the immunization status of the pupils in each school shall be sent
each year to the State Department of Health and Senior Services by the
Principal or other person in charge of a school. The form for the report will be provided by
the State Department of Health and Senior Services. The report shall include all pupils and shall
be submitted by December 1 of the respective academic year. A copy of this report shall be sent to the
local Board of Health in whose jurisdiction the school is located.
3. The
Principal in charge of a school shall make immunization records available for
inspection by authorized representatives of the State Department of Health and
Senior Services or the local Board of Health in whose jurisdiction the school
is located, within twenty-four hours of notification.
E. Immunization
Requirements (Effective September 2001)
1. Diphtheria
and Tetanus Toxoids and Pertussis
Vaccine
a. For
those children less than seven years of age, entering Kindergarten or first
grade, a minimum of four doses of DTP are still required. One dose must have been administered on or
after the fourth birthday. Children receiving
any five doses of DTP, DTaP, DTP/Hib,
DTaP/Hib, or DT (with a valid medical
contraindication) shall also be in compliance with this regulation.
b. DTaP vaccine doses are valid toward meeting the DTP
requirement. DTP vaccine is no longer
available in the
c. Children
under age one in childcare centers are still covered by the DTP immunization
regulations. Children too young to have
four doses of DTP/DTaP, with at least one dose being
administered after the fourth birthday, shall be appropriately immunized for
their age to meet the DTP requirement.
d. For
children over seven years of age, three doses of TD or a combination of DTP,
DT, DTaP/Hib, DTP/Hib, DTaP, and Td to total three doses shall meet the DTP
requirements.
e. For
child care centers, what is routinely considered as the fifth dose of DTP or DTaP, is not required for a child to remain in a preschool
class since it is routinely given as a school entry booster at 4, 5, or 6 years
of age depending on when the child enters school (Kindergarten or Grade 1) and
the physician’s timing preference for this booster dose.
f. The
regulation formally recognizes that the more recently licensed DTP/Hib, DTaP/Hib, and DTaP vaccines, as specified in licensure and these rules,
constitute a valid DTP dose.
g. Pediatric
Diphtheria-Tetanus (DT) toxoid is acceptable in lieu
of DTP or DTaP, only if a valid medical
contraindication is submitted by a physician or a certified registered nurse
practitioner.
2. Polio
Vaccine
a. For
those children less than seven years of age, a minimum of three doses of oral
polio vaccine (OPV) and/or enhanced inactivated poliovirus vaccine (IPV), is
required, provided at least one dose is given on or after the fourth
birthday. Alternatively, children
receiving four doses of polio vaccine, separated by a minimum of one month,
shall also be in compliance with this requirement.
b. Children
under one year of age enrolled in childcare centers
are still covered by the immunization regulations. Those children too young to have three doses
of polio vaccine, with at least one dose after their fourth birthday, shall be
appropriately immunized for their age.
c. For
children seven to eighteen years of age, three doses of oral polio vaccine or
IPV will satisfy the polio vaccine requirement.
d. Pupils
eighteen years of age or older are not required to receive poliovirus vaccine
in order to enter or remain in school.
Physicians should continue to recommend that person eighteen years of
age or older who have begun, yet not completed the primary series, finish the
series.
e. For
child care centers, what is routinely considered as the fourth dose of
poliovirus vaccine is not required to remain in a preschool class since it is
routinely given as a school entry booster at 4, 5, or 6 years of age depending
on when the child enters school (Kindergarten or Grade 1) and the physician’s
timing preference for this booster dose.
3. Measles
Vaccine
a. Two
doses of a measles-containing vaccine given after the first birthday,
preferably
b. The
two doses of measles-containing vaccine must be separated by an interval of at
least one month (twenty-eight days).
c. Children
presenting at Kindergarten or Grade 1, or higher grades as noted above, with no
documented doses of measles-containing vaccine will be given provisional status
after receiving 1 dose. These children
shall be required to receive the second dose of measles vaccine, preferably as
d. One
dose of measles vaccine administered on or after the first birthday continues
to be acceptable for school enrollment and for continued attendance for
children born before
e. Child
care pupils younger than fifteen months of age who lack measles vaccine are in
compliance with this regulation until they become fifteen months of age, which
is the recommended age for routine measles vaccination.
f. Documented
laboratory evidence of measles immunity continues to be acceptable.
4. Rubella
Vaccine
a. All
school or childcare pupils must still have rubella vaccine administered on or
after the first birthday. Those children
immunized before one year of age are to be re-immunized, preferably with
b. Children
lacking rubella vaccine who are younger than fifteen months of age are still
considered to be in compliance with this regulation until they become fifteen
months of age, which is the recommended age for rubella vaccination.
c. Documented
laboratory evidence of rubella immunity continues to be acceptable.
5. Mumps
Vaccine
a. All
school or childcare pupils must still have mumps vaccine administered on or
after the first birthday. Those children
immunized before one year of age are to be re-immunized, preferably with
b. Children
lacking mumps vaccine who are younger than fifteen months of age are in
compliance with this regulation until they become fifteen months of age, which
is the recommended age for mumps vaccination.
c. A
history of mumps disease from a parent or physician will not be acceptable
proof of immunity for children entering school or a childcare center after
d. Documented
laboratory evidence of mumps immunity continues to be acceptable under this
regulation.
6. Haemophilus Influenza Type B (HIB) Vaccine
a. All
infants, two to eleven months of age, enrolling or attending child care
centers, shall have received at least two doses of age-appropriate Hib conjugate vaccine as a primary series, or fewer as
age—appropriate. This rule recognizes
that the various licensed Hib vaccines have different
numbers of doses and intervals, that the number of Hib
doses administered is also dependent upon the child’s age at the time they
begin the series, and the child’s actual age.
b. At
least one booster dose of any licensed Hib conjugate
vaccine is required of day care/child care enrollees after twelve months of age
and before sixteen months of age. This
rule recognizes that for all licensed Hib vaccine
products, the booster dose can be given at twelve to fifteen months of
age.
For
most Hib vaccine products, it is recommended that the
booster be routinely given at fifteen months, while for one vaccine product the
booster dose is recommended at twelve months of age. A child shall not be considered delinquent nor subject to exclusion unless the booster dose has not
been given by the sixteenth month of age.
c. All
unvaccinated children fifteen to fifty-nine months of age attending a childcare
center or preschool, not previously vaccinated with any Hib
vaccine must document receipt of at least one dose of any Hib
conjugate vaccine.
d. A
dose of any licensed combination DTP/Hib vaccine is
considered a valid Hib dose. The DTaP/Hib
combination vaccine is only valid as a Hib dose when
given as the fourth Hib dose.
7. Hepatitis
B Vaccine
a. Children
born on or after
b. All
children born on or after
c. For
children granted provisional admittance status by having received one
documented dose of a hepatitis B vaccine, the second dose shall be received no
later than three months following the first initial dose. Children in provisional status must receive
the third and final dose of the hepatitis B vaccine series no later than twelve
months following the first dose which established the provisional status.
d. Beginning
e. All
children born on or after
f. The
recently licensed two dose hepatitis B vaccine and its unique regimen is also
recognized as an acceptable alternative to the three dose hepatitis B
requirement provided that the medical provider appropriately documents it as HepB Adult.
Formulation
1.0 ml Merck or RecombivaxHB 1.0 ml to differentiate
it from the three dose regimen and that both doses of that specific vaccine be
administered to a pupil eleven to fifteen years of age.
g. Children
presenting documented laboratory evidence of hepatitis B immunity or a physician’s
written certification of past hepatitis B disease constitutes a medical
exemption and shall not be required to receive hepatitis B vaccine.
F. Emergency
Powers
If
a threatened outbreak or outbreak exists at a school, as determined by the
State Commissioner of Health, all pupils with provisional, religious, or
medical exemptions (which relate to the specific disease threatening or
occurring) shall be excluded for a specific period of time or until the
outbreak is declared over as determined by the New Jersey Department of
Health. If these pupils become immunized
or produce serologic evidence of immunity to the specific disease the pupil may
immediately be readmitted to school.
G. Required
Immunizations by Age for New Jersey Child Care Centers.
By
This Age Child shall have Intervals
between Immunizations
received a total of:
2-3
months 1 dose of DTP/DTaP
(Diphtheria-Tetanus-Pertussis)
1 dose Hib
1 dose Polio Vaccine
4-5
months 2 doses DTP/DTaP 2 months
2 doses Hib
2 doses Polio
6-7
months 3 doses DTP/DTaP 2 months
2-3 doses Hib*
2 doses Polio
8-14
months 3 doses DTP/DTaP
2-3 doses Hib*
2 doses Polio
15-17
months 3 doses DTP/DTaP 9
months
1 dose Hib
2 doses Polio
1 dose
18-19
months 4 doses DTP/DTaP 3
months
1 dose Hib
3 doses Polio
1 dose
19 months- 4 doses DTP/DTaP 16-17
months to complete
4
years 1 dose Hib the required series
3 doses Polio
dose
*Haemophilus influenzae b (Hib) vaccine has different schedules depending on the type
of vaccine used and when the child started the series.
H. Recommended
Booster Vaccine Doses for Children Between 4-6 Years
Before Entering School (Kindergarten/Grade 1)
By Age
4-6 Vaccines Interval
School Child should have Variable:
Entry received school Dependent
Boosters entry boosters; upon when
these
consist of 1 the child
dose
of DTP/DTaP and
will be
1 dose of poliovirus entering a
vaccine
given on or school
after
the fourth setting and
birthday;
and 1 dose the
of measles/
not
given before. preference.
I. Required
Immunizations for New Jersey Child Care Centers and Schools for Children
Entering Kindergarten or Grade 1 Not Previously Immunized
Visit Child shall receive Intervals
Number at each physician between
visit Immunizations
1 1 dose
DTP/DTaP
Provisional
(Diphtheria-Tetanus- status
Pertussis) granted
1 dose Polio Vaccine
1 dose
Mumps, Rubella)
1 dose Hep
B
(Hepatitis B)*
2 1 dose Hep
B* 2 months
1 dose DTP/DTaP
1 dose Polio Vaccine
1 dose
3 1 dose DTP/DTaP 2 months
4 1 dose Hep
B* 6-8 months
1 dose DTP/DTaP
1 dose Polio vaccine
Totals 3 doses Hep
B* 10-12 months
4 doses DTP/DTaP to complete
3 doses Polio vaccine required
2 doses
*Beginning
**Second
dose of a measles-containing vaccine, preferably
J. Required
Immunizations for New Jersey Schools for Children Age 7 or Older Not Previously
Immunized
Visit Child shall receive Intervals between
Number at each physician visit Immunizations
1 1 dose
Td (Tetanus- Provisional
Diphtheria) status
1 dose Polio Vaccine granted
1 dose
Mumps, Rubella)*
1 dose Hepatitis B (Hep B)**
2 1 dose
1 dose Td
1 dose Polio Vaccine
1 dose Hep
B -
dependent
on regimen
and
pupil age**
3 1 dose Td 6-10 months
1 dose Polio Vaccine
1 dose Hep
B**
Totals 3 doses Td 8-12 months
3 doses Polio Vaccine to complete
1 or 2 doses
2 or 3 doses Hep B** vaccines
*If
born on or after
**NOTE: Beginning
K. Hib and Hep B Vaccine Information
Preschools
and child care enters are advised that physicians are likely to document Hib conjugate and hepatitis B vaccine administration in
various ways. There are currently eleven
basic separate or combination Hib or hepatitis B
vaccines available in the
Separate
Hib Vaccines
Routine Infant Schedule
HbOC (HibTiter) by 2,4,6,12-15
months
Wyeth-Ayerst routinely 4
doses given
PRP-T
(ActHib or 2,4,6,12-15
months
OmniHib) by Aventis
routinely 4 doses given
PRP-OMP
(PedvaxHib) by
2,4,12 months
Merck
routinely 3 doses
given
PRP-D
(ProHIBit) by 15 months
Aventis routinely 1 dose
after 15 months of age
(Can
also be used as a
booster dose 12-15
months)
Combination
Hib Vaccines
DTP/HbOC (Tetramune) by 2,4,6,12-15
months
Wyeth-Ayerst
DTP/PRP-T
(ActHib,
2,4,6,12-15 months
OmniHIB) reconstituted
with special DTP vaccine
by
Aventis
DTaP/Hib (TriHIBit) by 4th dose of Hib
Wyeth-Ayerst
only (12-15
months)
Hib/Hepatitis
B (Comvax)
2,4,12-15 months
(6
weeks-4 years) by
Merck
Hepatitis
B Vaccine 2,4,6-18
months
Recombivax HB 0.5 mL
(for pediatrics 0-18)
by
Merck 3 dose
Recombivax HB 1.0 mL 11 years, 11 years
(for adolescents 11-15)
6 months
by
Merck 2 dose
Engerix B 0.5 mL 2,4,6-18
months
(pediatrics 0-18) by
SmithKline
3 dose
Comvax Hib/hepatitis B 2,4,12-15
months
(6
weeks-4 years) by
Merck
Issued: 25 November 2002