SECTION 310:535-1-2. Criteria for immunizations required

(a)   Each child shall present certification that he or she has received or is receiving the immunizations as specified below before he or she is admitted to any public, private, or parochial school.

(b)   Certification shall include the following:

(1)   Diphtheria, Tetanus and Pertussis (DTP/DTaP) vaccine in five doses unless the fourth dose is received on or after the fourth birthday in which case only four doses are required. If the doses are not completed by the seventh birthday, the series must be completed with Adult Td vaccine and/or Tdap vaccine based on the individual's age at the time the first dose was received and age at the time the series is completed and beginning with the fall 2011-12 school year one dose of Tdap vaccine for students entering the seventh grade. Each year following the 2011-12 school year, the Tdap requirement shall be extended one grade level so that in the 2016-17 school year and all subsequent school years, students in grades seven through twelve shall be required to have received one dose of Tdap vaccine.

(2)   Poliomyelitis vaccine in four doses unless the last dose is on or after the fourth birthday in which case only three doses are required. If the doses are not started or completed by the eighteenth birthday, no additional doses are required.

(3)   Measles, Mumps and Rubella (MMR) vaccine with the first dose on or after the first birthday and the second dose at least twenty-eight days thereafter for children in grades kindergarten through eighth grade in the school year beginning in 1998. In the school year beginning in 1999, this requirement shall apply to the children through the ninth grade. Each year thereafter the requirement shall be extended one grade level so that in the school year beginning in 2002, children in all grades shall be required to have the second dose of vaccine.

(4)   Hepatitis B vaccine in three doses for students of any age or two doses for students eleven through fifteen years of age who complete the alternative dosage schedule providing that the alternative schedule is fully documented. Such documentation must include the name of the vaccine and the dosage received for each dose of that vaccine:

(A)   before entering seventh and eighth grades in 1998. In the school year beginning in 1999, this requirement shall apply to the children entering the seventh through ninth grades. Each year thereafter the requirement shall be extended one grade level so that in the school year beginning in 2002, children in grades seven through twelve shall be required to have the three doses of the vaccine.

(B)   before entering kindergarten in 1998. In the school year beginning in 1999, this requirement shall apply to the children entering kindergarten and first grade. Each year thereafter the requirement shall be extended one grade level so that in the school year beginning in 2004, all children entering school shall be required to have the three doses of the vaccine.

(5)   Hepatitis A vaccine in two doses with the first dose on or after the first birthday and the second dose six to eighteen calendar months later:

(A)   before entering kindergarten in 1998. In the school year beginning in 1999, this requirement shall apply to the children entering kindergarten and first grade. Each year thereafter the requirement shall be extended one grade level so that in the school year beginning in 2004, all children entering school shall be required to have the two doses of the vaccine.

(B)   before entering grade seven in 1998. In the school year beginning in 1999, this requirement shall apply to the children entering the seventh and eighth grade. Each year thereafter the requirement shall be extended one grade level so that in the school year beginning in 2003, children in grades seven through twelve shall be required to have the two doses of the vaccine.

(6)   Varicella (chickenpox) vaccine in one dose on or after the first birthday: before entering kindergarten in 1998. In lieu of vaccination, a parent's statement of a history of the disease chickenpox will be accepted. In the school year beginning in 1999, this requirement shall apply to the children entering kindergarten and first grade. Each year thereafter the requirement shall be extended one grade level so that in the school year beginning in 2010, all children entering school shall be required to have the vaccine or a parent's statement of a history of the disease chickenpox.

(c)   The minimum intervals between doses and minimum ages for doses shall be as follows:

(1)   DTP/DTaP:

(A)   First and second dose - 4 weeks

(B)   Second and third dose - 4 weeks

(C)   Third and fourth dose - 4 months

(D)   Fourth and fifth dose - 6 months

(E)   For all fifth doses given after January 1, 2003 the minimum age for the fifth dose is 4 years of age

(2)   Polio:

(A)   First and second dose - 4 weeks

(B)   Second and third dose - 4 weeks

(C)   Third and fourth dose - 4 weeks

(3)   MMR: First and second dose - 4 weeks

(4)   Hepatitis B 3-dose series:

(A)   First and second dose - 1 month (4 weeks)

(B)   Second and third dose - 2 months (8 weeks), and the third dose at least 4 months (16 weeks) after first dose, and the third dose not before 24 weeks of age

(5)   Hepatitis B 2-dose series: First and second dose - 4 months

(6)   Hepatitis A: First and second dose -- 6 months and for all doses given on or after January 1, 2003, 6 months will be defined as 6 calendar months

(7)   Four day grace period: Vaccine doses administered 4 days or less before the minimum intervals or ages listed in the preceding sections will be counted as valid.

(d)   A child, through his parent or guardian, may apply for an exemption from this requirement by submitting a form to the Department. The school shall maintain a copy of the approved application in the child's records. All exemptions submitted prior to a student entering 7^th grade shall expire at the end of the student's 6^th grade year. A new exemption is required to be completed and submitted to the Oklahoma State Department of Health by the parent or guardian prior to enrolling the child in 7^th grade.

(1)   A request for exemption for medical reasons shall contain a certificate signed by a physician stating that the physical condition of the child is such that the immunization would endanger the life or health of the child and that the child should be exempt for immunization.

(2)   Religious and personal exemptions may be obtained after receiving an approved brief instructional presentation provided by any local county health department regarding the risks associated with not being vaccinated and the benefits vaccinations provide to the individual and the community. To be approved, the completed exemption form along with evidence of completed instruction is required.

(e)   A child participating in a pre-kindergarten school program shall have received or be in the process of receiving the appropriate immunization for the listed diseases based on the child's age.

(f)   The Department may grant exemptions or substitutions in the immunization schedule based on a medical history of a physical condition such that the immunization would endanger the life or health of the child or a medical history stating the child is likely to be immune as a result of having had a vaccine-preventable disease if the following are met:

(1)   A history of having had diphtheria and/or tetanus is not acceptable as proof of immunity since infection with diphtheria or tetanus may not render an individual immune to either of these diseases,

(2)   A history of having had polio, pertussis, rubella, mumps, hepatitis B, or hepatitis A must be supported by laboratory evidence to be acceptable as proof of immunity to these diseases,

(3)   A history of having had measles must be accompanied by a statement from a physician, public health authority, or laboratory evidence to be acceptable as proof of immunity to measles,

(4)   A parental history of having had varicella is acceptable evidence of immunity to varicella.

(g)   Haemophilus influenzae type B (Hib) vaccine is not a requirement for children attending pre-kindergarten, kindergarten, or school.

(h)   In some circumstances, the United States Food and Drug Administration may approve the use of an alternative dosage schedule for an existing vaccine. These alternative schedules may be used to meet the requirements only when the alternative schedule is fully documented. Such documentation must include the name of the vaccine and dosage received for each dose of that vaccine.

[Source: Amended at 13 Ok Reg 1795, eff 4-18-96 (emergency); Amended at 14 Ok Reg 1749, eff 5-27-97; Amended at 15 Ok Reg 4163, eff 7-29-98 (emergency); Amended at 16 Ok Reg 1400, eff 5-27-99; Amended at 17 Ok Reg 3448, eff 8-29-00 (emergency); Amended at 18 Ok Reg 1717, eff 5-25-01; Amended at 19 Ok Reg 2919, eff 7-26-02 (emergency); Amended at 20 Ok Reg 1661, eff 6-12-03; Amended at 22 Ok Reg 1132, eff 5-26-05; Amended at 23 Ok Reg 1344, eff 5-25-06; Amended at 24 Ok Reg 1987, eff 6-25-07; Amended at 27 Ok Reg 2531, eff 7-25-10; Amended at 37 Ok Reg 1413, eff 9-11-20]