NorthNorthNorth Dakota Dakota
School School
Immunization Immunization
GuideGuide
Updated 02/2014
TABLE OF CONTENTS
Cover Letter.……………………………………………………...……………..………………...1
Information
Vaccine Abbreviation List………………………………………………………………...………2
The North Dakota Immunization Information System……………………………………………4
School Immunization Survey
Timeline for survey……………………………………………………………………………..…5
School Immunization Survey…………………………………………………………………..….6
Letters and Materials to Determine Compliance
FAQ Letter for Tdap and Meningococcal Vaccines………………………..……………………..7
Letter about Tdap and Meningococcal Vaccines……………………………………………….....9
Algorithm for Exclusion…………………………………………………………………………10
Non-Compliance Letter………………………………………………………………………….11
Notice of Exclusion Letter…………………………………………………………………….…12
Certificate of Immunization………..………………………………………………………….…13
Additional Information
Directory of Local Public Health Units………………………………………………………….14
Laws Requiring Immunization of Students….…………………………………………………..16
Rules Requiring Immunization of Students.…………………………………………………….17
Disease Control Medical Examiner 701.328.2378 701.328.6138 701.328.2499 (fax) 701.328.6145 (fax)
DIVISION OF DISEASE CONTROL 2635 East Main Avenue
P.O. Box 5520 Bismarck, ND 58506-5520
www.ndhealth.gov
School Administrators and Nurses:
The following packet contains information and materials regarding the North Dakota school
immunization requirements. This document is intended to make the immunization compliance
process easier by providing templates and detailed information concerning immunization
requirements, school immunization laws, and criteria for exclusion.
Additionally, information regarding the yearly school immunization survey is included.
The school immunization survey is required by North Dakota state law and allows the health
department to assess the vaccination and exemption rates of school-aged children. The school
immunization survey is due mid-November every year.
This packet also includes information about the North Dakota Immunization Information
System (NDIIS), a list of vaccine abbreviations, and Meningococcal and Tdap vaccination FAQs
for parents. Please take a moment to review the packet and evaluate its contents and let us know
if you have any questions.
Thank you,
Amy Schwartz
Immunization Surveillance Coordinator
1
Relevant Vaccines Abbreviation List
DPT
Replaced by use of DTP. See DTP for description.
DT
Diphtheria and tetanus toxoids, pediatric formulation
DTaP
Diphtheria and tetanus toxoids and acellular pertussis vaccine, pediatric formulation
DTP
Diphtheria and tetanus toxoids and whole-cell pertussis vaccine, pediatric formulation
HAV
Hepatitis A Virus
HBV
Hepatitis B Virus
HepA
Hepatitis A Vaccine
HepB
Hepatitis B Vaccine
Hib
Haemophilus influenzae type b
HPV
Human Papillomavirus
HPV2
Human Papillomavirus vaccine, bivalent (Cervarix®)
HPV4
Human Papillomavirus vaccine, quadrivalent (Gardasil®)
IIV3
Trivalent Inactivated Influenza Vaccine
IIV4
Quadrivalent Inactivated Influenza Vaccine
IPV
Inactivated Poliovirus Vaccine
LAIV4
Quadrivalent Live, Attenuated Influenza Vaccine (Nasal Spray)
MCV4 Meningococcal Conjugate Vaccine (Quadravalent)
MMR
Measles, Mumps & Rubella Vaccine
MMRV
Measles, Mumps, Rubella & Varicella Vaccine
MPSV4
Meningococcal Polysaccharide Vaccine (Quadravalent)
OPV
Oral Polio Vaccine
2
Td
Tetanus & diphtheria Vaccine, adult/adolescent formulation
Tdap
Tetanus, diphtheria & acellular pertussis vaccine, adult/adolescent formulation
TIV
Trivalent (Inactivated) Influenza Vaccine
TT
Tetanus Toxoid
VAR
Chickenpox Vaccine
VZV
Varicella Zoster Virus (causes chickenpox and shingles)
3
Introduction to NDIIS
Brief Overview
The North Dakota Immunization Information System (NDIIS) is a confidential, population-based,
computerized information system that attempts to collect vaccination data about all North Dakotans.
The NDIIS is an important tool to increase and sustain high vaccination coverage by consolidating
vaccination records of children from multiple providers and providing official vaccination forms.
Children are entered into the NDIIS at birth through a linkage with electronic birth records. An
NDIIS vaccination record also can be initiated by a health-care provider at the time of the child's first
immunization. The NDIIS has the capability of collecting vaccination data on adults as well as
children. Schools have the option of having read-only access to NDIIS. This means that schools can
access the immunization records of their students, but they cannot enter information into the system.
If your institution would like to gain access to NDIIS, contact a member of the Immunization
Program at 701.328.3386 or toll-free at 800.472.2180. For more information about NDIIS, please
visit our website at www.ndhealth.gov/Immunize.
NDIIS Forecaster
NDIIS contains a tool that allows users to determine whether or not a child is up to date on
immunizations. Schools can use this tool to determine if the child meets the school immunization
requirements. The vaccine forecaster will generate a list of vaccines the child is due for or will be
due for in the future.
4
School Immunization Survey Timeline and Due Dates
Event Date Useful Materials
Schools notify parents of the school immunization
requirements for the next school year.
Spring of previous
school Year and
Summer
School
Immunization
Requirements
School Year Begins August
Students not up to date with school immunization
requirements should be given a letter detailing required
vaccinations.
First day of School
Non-compliance
letter
Students who have not received required immunizations
or are not in the process of receiving them must be given
an exclusion letter and be excluded from school.
30 days after the
start of school
Algorithm for
Exclusion
Notice of
Exclusion
School Immunization Survey is distributed to all schools
in North Dakota. If you do not receive any information
about the survey, contact your administrator or the
Immunization Program.
First week of
October School Survey
Materials
The School Immunization Survey is due to the North
Dakota Department of Health. Survey should have been
submitted online.
Mid-November Instructions for
school survey
The Centers for Disease Control and Prevention (CDC)
will choose a sample of schools who must participate in
the validation study. Because the annual School
Immunization Survey is self-reported by schools,
NDDoH is required to validate the immunization rates
by reviewing a sample of records from select schools. If
the self-reported results do not fall within confidence
intervals for the validation results, NDDoH must report
the validated results as our statewide immunization
rates. NDDoH will be contacting the chosen schools for
copies of their kindergarten immunization records.
January
Results of the study will be reported to CDC April
Schools will be able to see results of survey on the
school survey website. May
www.ndhealth.gov/i
mmunize/rates/
5
6
Dear Parent or Guardian,
Tdap and Meningococcal vaccines are required upon entry into the seventh grade. Tdap is a
vaccine that protects against tetanus, diphtheria and pertussis or whooping cough.
Meningococcal vaccine (MCV4) protects against four common strains of meningococcal disease.
Adolescents are recommended and required to receive both of these vaccines. To ensure
compliance with school vaccination requirements, it is essential that your child receives these
vaccinations before entering the seventh grade. You must provide proof of immunization or
claim an exemption.
1. What grades are affected and what vaccines are required?
Both Tdap and the meningococcal vaccine are required for entry into the seventh grade.
2. How many vaccinations are required?
Only one dose of Tdap vaccine and one dose of meningococcal vaccine are required;
however, a second dose of meningococcal vaccine is recommended at age 16-18 years. In
addition, your child may need additional vaccines to meet school requirements, such as
the chickenpox (varicella) vaccine if he/she has not yet been vaccinated or had
chickenpox.
3. Are there any exceptions?
If your child has already been vaccinated with one dose of Tdap and Meningococcal
vaccine, they do not need to receive another dose in order to be compliant. Proof of
vaccination should be submitted to your child’s school. Vaccination with Td will not
satisfy the Tdap requirement.
4. Is prior illness with pertussis/whooping cough an exception to the Tdap
requirement?
No, anyone who has had pertussis should still be vaccinated. The length of immunity is
unknown following illness. Additionally, it is sometimes difficult to confirm a pertussis
diagnosis.
5. Are Tdap and meningococal vaccines readily available?
Yes, most doctor’s offices, pharmacies and local public health units have a supply of
Tdap and meningococcal vaccines.
6. Why are these vaccines required?
7
Pertussis and meningococcal disease are both very serious illnesses that can be prevented
by vaccination. Pertussis is still very common in North Dakota and the United States.
Although most children have been vaccinated with DTaP before entering kindergarten;
immunity lessens after a few years. Tdap vaccination provides renewed protection against
the disease. Meningococcal disease, although significantly less common than pertussis,
has a high fatality rate. Incidence is higher among adolescents and teenagers,
necessitating the vaccination requirement.
8
Algorithm for Students not Fully Immunized with Required Vaccines
*** Exclude child from school
Record on File
Yes
Meets School Requirements for
Immunizations
Yes
Up to date with valid doses, no further action
required.
No
Philosophical, Moral, Religious, Medical, or Historical Exemption
claimed by submitting a signed form.
Yes
No further action required.
No
Student has received required vaccines, has
started receiving needed doses or has
claimed an exemption by 30th school day.
Yes
Student has fulfilled all needed vaccine requirements
Yes
No further action required.
No
Required subsequent doses received by 90th
school day
Yes
Continue to follow student until all
required vaccines have been received.
No
Behind Schdule***
No
Behind Schedule***
No
Check NDIIS
No Record on file or in NDIIS***
Immunization record in NDIIS
9
To the Parent, Guardian or Legal Custodian of __________________ in Grade___:
Section 23-07-17.1 section of North Dakota State Law entitled Inoculation Required before
Admission to School mandates that all students through grade 12 meet a minimum number of
required immunizations prior to school entrance. These requirements can be waived only for
medical, philosophical, moral or religious reasons. Our records show that your child is not
compliant with the requirements. Non-compliance may be due to absence of immunization
record or because your child is in need of an immunization. The reason for your child’s non-
compliance is noted below. In order to meet the requirements, please complete the form attached
or submit an official certificate of immunization. If vaccinations are added or if you are claiming
a medical exemption, the form must be signed by a medical professional. If you are claiming a
moral, philosophical or religious exemption, the form must be signed by a parent or guardian.
Failure to comply with requirements may result in exclusion of your child from school.
Reason for noncompliance:
The school does not have a copy of your child’s immunization record.
Your child needs the following checked vaccines:
1 If your child has had chickenpox disease, please enter the date of illness on the attached
form in the history of disease section.
Thank you so much for your cooperation.
___________________________ __________________
Date
DTaP Polio MMR Hepatitis B Varicella1 Tdap Meningococcal
1st dose 1
st dose 1
st dose 1
st dose 1
st dose 1
st dose 1
st dose
2nd
dose 2nd
dose 2nd
dose 2nd
dose 2nd
dose
3rd
dose 3rd
dose 3rd
dose
4th
dose 4th
dose
5th
dose
10
NOTICE OF EXCLUSION
Dear Parent or Guardian:
Your child has failed to meet the school immunization requirements as mandated by state law.
As a result, your child will be excluded from school starting on _________. To re-enter school
your child must meet one of the following requirements:
1) Provide proof of required immunizations by completing the attached form and providing
the signature of a medical professional. If you are claiming history of disease of
chickenpox, date of illness must be indicated in the history of disease portion of the
attached form.
2) Claim an exemption and complete the attached form indicating the exemption.
Exemptions that may be claimed include philosophical, moral, religious or medical. If
claiming a medical exemption, the form must be signed by a medical professional.
Your cooperation is much appreciated.
___________________________________ ___________________
Date
11
North Dakota law requires this form be completed* and provided to the childcare facility or school. Child’s Name (Last, First, Middle Initial):
Date of Birth:
Parent’s Name:
Telephone Number:
Vaccine Type Exemption
Check type below€
Enter Month/Day/Year for Each Immunization Given
Hepatitis B Hepatitis B
Rotavirus Rotavirus
Hib Haemophilus influenzae type B
PCV Pneumococcal conjugate
DTP/DTaP/DT Diphtheria-Tetanus-Pertussis
OPV/IPV Polio
MMR Measles-Mumps-Rubella
Varicella Chickenpox History of Disease Date:
Hepatitis A Hepatitis A
Td/Tdap Tetanus-Diphtheria (and Pertussis)
MCV4 Meningococcal
HPV Human Papillomavirus
Other
To the best of my knowledge, this person has received the above-indicated immunizations on the above dates. Physician, Nurse, Local/State Health Title Date
If additional doses are added after initial signature, please initial dose and sign below. Update signature #1: Physician, Nurse, Local/State Health: Title: Date:
Update signature #2: Physician, Nurse, Local/State Health: Title: Date:
My child has not met the minimum requirements for his/her age. I agree to resume immunizations within 30 days from the date I was notified (today’s date noted below) that my child’s immunizations are incomplete and to submit a signed Certificate of Immunization.
Parent/Guardian Signature: Date:
Statement of Exemption to Immunization Law
In the event of an outbreak, exempted persons may be subject to exclusion from school or childcare facility.
Medical Exemption: The physical condition of the above-named person is such that immunization would endanger life or health or is medically contraindicated due to other medical conditions.
Physician Signature: Date:
€Exemption: (Indicate vaccine above)
(Please check one) □ Religious □ Philosophical □ Moral □ History of Disease
Parent/Guardian Signature Date
CERTIFICATE OF IMMUNIZATION NORTH DAKOTA DEPARTMENT OF HEALTH SFN 16038 (Revised 05-2012)
Division of Disease Control 2635 East Main Ave. PO Box 5520
Bismarck, ND 58506-5520 800.472.2180 or 701.328.3386
12
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Up
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