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Minnesota Legislature

Office of the Revisor of Statutes

121A.15 HEALTH STANDARDS; IMMUNIZATIONS; SCHOOL CHILDREN.
    Subdivision 1. School and child care facility immunization requirements. Except as
provided in subdivisions 3, 4, and 10, no person over two months old may be allowed to enroll or
remain enrolled in any elementary or secondary school or child care facility in this state until the
person has submitted to the administrator or other person having general control and supervision
of the school or child care facility, one of the following statements:
(1) a statement from a physician or a public clinic which provides immunizations stating that
the person has received immunization, consistent with medically acceptable standards, against
measles after having attained the age of 12 months, rubella, diphtheria, tetanus, pertussis, polio,
mumps, haemophilus influenza type b, and hepatitis B; or
(2) a statement from a physician or a public clinic which provides immunizations stating that
the person has received immunizations, consistent with medically acceptable standards, against
measles after having attained the age of 12 months, rubella, mumps, and haemophilus influenza
type b and that the person has commenced a schedule of immunizations for diphtheria, tetanus,
pertussis, polio, and hepatitis B and which indicates the month and year of each immunization
received.
    Subd. 2. Schedule of immunizations. No person who has commenced a treatment schedule
of immunization pursuant to subdivision 1, clause (2), may remain enrolled in any child care
facility, elementary, or secondary school in this state after 18 months of enrollment unless there
is submitted to the administrator, or other person having general control and supervision of the
school or child care facility, a statement from a physician or a public clinic which provides
immunizations that the person has completed the primary schedule of immunizations for
diphtheria, tetanus, pertussis, polio, and hepatitis B. The statement must include the month and
year of each additional immunization received. For a child less than seven years of age, a primary
schedule of immunizations shall consist of four doses of vaccine for diphtheria, tetanus, and
pertussis and three doses of vaccine for poliomyelitis and hepatitis B. For a child seven years
of age or older, a primary schedule of immunizations shall consist of three doses of vaccine
for diphtheria, tetanus, polio, and hepatitis B.
    Subd. 3. Exemptions from immunizations. (a) If a person is at least seven years old and
has not been immunized against pertussis, the person must not be required to be immunized
against pertussis.
(b) If a person is at least 18 years old and has not completed a series of immunizations
against poliomyelitis, the person must not be required to be immunized against poliomyelitis.
(c) If a statement, signed by a physician, is submitted to the administrator or other person
having general control and supervision of the school or child care facility stating that an
immunization is contraindicated for medical reasons or that laboratory confirmation of the
presence of adequate immunity exists, the immunization specified in the statement need not be
required.
(d) If a notarized statement signed by the minor child's parent or guardian or by the
emancipated person is submitted to the administrator or other person having general control and
supervision of the school or child care facility stating that the person has not been immunized as
prescribed in subdivision 1 because of the conscientiously held beliefs of the parent or guardian of
the minor child or of the emancipated person, the immunizations specified in the statement shall
not be required. This statement must also be forwarded to the commissioner of the Department
of Health.
(e) If the person is under 15 months, the person is not required to be immunized against
measles, rubella, or mumps.
(f) If a person is at least five years old and has not been immunized against haemophilus
influenza type b, the person is not required to be immunized against haemophilus influenza type b.
(g) If a person who is not a Minnesota resident enrolls in a Minnesota school online learning
course or program that delivers instruction to the person only by computer and does not provide
any teacher or instructor contact time or require classroom attendance, the person is not subject to
the immunization, statement, and other requirements of this section.
    Subd. 3a. Disclosures required. (a) This paragraph applies to any written information about
immunization requirements for enrollment in a school or child care facility that:
(1) is provided to a person to be immunized or enrolling or enrolled in a school or child
care facility, or to the person's parent or guardian if the person is under 18 years of age and
not emancipated; and
(2) is provided by the Department of Health; the Department of Education; the Department
of Human Services; an immunization provider; or a school or child care facility.
Such written information must describe the exemptions from immunizations permitted under
subdivision 3, paragraphs (c) and (d). The information on exemptions from immunizations
provided according to this paragraph must be in a font size at least equal to the font size of the
immunization requirements, in the same font style as the immunization requirements, and on the
same page of the written document as the immunization requirements.
(b) Before immunizing a person, an immunization provider must provide the person, or the
person's parent or guardian if the person is under 18 years of age and not emancipated, with the
following information in writing:
(1) a list of the immunizations required for enrollment in a school or child care facility;
(2) a description of the exemptions from immunizations permitted under subdivision 3,
paragraphs (c) and (d);
(3) a list of additional immunizations currently recommended by the commissioner; and
(4) in accordance with federal law, a copy of the vaccine information sheet from the
federal Department of Health and Human Services that lists possible adverse reactions to the
immunization to be provided.
(c) The commissioner will continue the educational campaign to providers and hospitals on
vaccine safety including, but not limited to, information on the vaccine adverse events reporting
system (VAERS), the federal vaccine information statements (VIS), and medical precautions and
contraindications to immunizations.
(d) The commissioner will encourage providers to provide the vaccine information
statements at multiple visits and in anticipation of subsequent immunizations.
(e) The commissioner will encourage providers to use existing screening for immunization
precautions and contraindication materials and make proper use of the vaccine adverse events
reporting system (VAERS).
(f) In consultation with groups and people identified in subdivision 12, paragraph (a), clause
(1), the commissioner will continue to develop and make available patient education materials on
immunizations including, but not limited to, contraindications and precautions regarding vaccines.
(g) The commissioner will encourage health care providers to use thimerosal-free vaccines
when available.
    Subd. 4. Substitute immunization statement. (a) A person who is enrolling or enrolled
in an elementary or secondary school or child care facility may substitute a statement from the
emancipated person or a parent or guardian if the person is a minor child in lieu of the statement
from a physician or public clinic which provides immunizations. If the statement is from a parent
or guardian or emancipated person, the statement must indicate the month and year of each
immunization given.
(b) In order for the statement to be acceptable for a person who is enrolling in an elementary
school and who is six years of age or younger, it must indicate that the following was given:
no less than one dose of vaccine each for measles, mumps, and rubella given separately or in
combination; no less than four doses of vaccine for poliomyelitis, unless the third dose was given
after the fourth birthday, then three doses are minimum; no less than five doses of vaccine for
diphtheria, tetanus, and pertussis, unless the fourth dose was given after the fourth birthday, then
four doses are minimum; and no less than three doses of vaccine for hepatitis B.
(c) In order for the statement to be consistent with subdivision 10 and acceptable for a person
who is enrolling in an elementary or secondary school and is age seven through age 19, the
statement must indicate that the person has received no less than one dose of vaccine each for
measles, mumps, and rubella given separately or in combination, and no less than three doses of
vaccine for poliomyelitis, diphtheria, tetanus, and hepatitis B.
(d) In order for the statement to be acceptable for a person who is enrolling in a secondary
school, and who was born after 1956 and is 20 years of age or older, the statement must indicate
that the person has received no less than one dose of vaccine each for measles, mumps, and
rubella given separately or in combination, and no less than one dose of vaccine for diphtheria
and tetanus within the preceding ten years.
(e) In order for the statement to be acceptable for a person who is enrolling in a child care
facility and who is at least 15 months old but who has not reached five years of age, it must
indicate that the following were given: no less than one dose of vaccine each for measles, mumps,
and rubella given separately or in combination; no less than one dose of vaccine for haemophilus
influenza type b; no less than four doses of vaccine for diphtheria, tetanus, and pertussis; and no
less than three doses of vaccine for poliomyelitis.
(f) In order for the statement to be acceptable for a person who is enrolling in a child care
facility and who is five or six years of age, it must indicate that the following was given: no
less than one dose of vaccine each for measles, mumps, and rubella given separately or in
combination; no less than four doses of vaccine for diphtheria, tetanus, and pertussis; and no less
than three doses of vaccine for poliomyelitis.
(g) In order for the statement to be acceptable for a person who is enrolling in a child care
facility and who is seven years of age or older, the statement must indicate that the person has
received no less than one dose of vaccine each for measles, mumps, and rubella given separately
or in combination and consistent with subdivision 10, and no less than three doses of vaccine for
poliomyelitis, diphtheria, and tetanus.
(h) The commissioner of health, on finding that any of the above requirements are not
necessary to protect the public's health, may suspend for one year that requirement.
    Subd. 5. Transfer of immunization statements. If a person transfers from one elementary
or secondary school to another, the school board of a public school district or the administrator of
a nonpublic school may allow the person up to a maximum of 30 days to submit one or more
of the statements as specified in subdivision 1 or 3, during which time the person may enroll in
and attend the school. If a person enrolls in a child care facility in which at least 75 percent
of children in the facility participate on a onetime only or occasional basis to a maximum of
45 hours per child, per month, or is placed in a facility by a crisis nursery, the person shall be
exempt from all requirements of this section for up to five consecutive days, starting from the
first day of attendance.
    Subd. 6.[Repealed, 1Sp2001 c 9 art 1 s 62]
    Subd. 7. File on immunization records. Each school or child care facility shall maintain
on file immunization records for all persons in attendance that contain the information required
by subdivisions 1, 2, and 3. The school shall maintain the records for at least five years after the
person attains the age of majority. The Department of Health and the board of health, as defined in
section 145A.02, subdivision 2, in whose jurisdiction the school or child care facility is located,
shall have access to the files maintained pursuant to this subdivision. When a person transfers to
another elementary or secondary school or child care facility, the administrator or other person
having general control and supervision of the school or child care facility shall assist the person's
parent or guardian in the transfer of the immunization file to the person's new school or child care
facility within 30 days of the transfer. Upon the request of a public or private postsecondary
educational institution, as defined in section 135A.14, the administrator or other person having
general control or supervision of a school shall assist in the transfer of a student's immunization
file to the postsecondary institution.
    Subd. 8. Report. The administrator or other person having general control and supervision
of the elementary or secondary school shall file a report with the commissioner on all persons
enrolled in the school. The superintendent of each district shall file a report with the commissioner
for all persons within the district receiving instruction in a home school in compliance with
sections 120A.22 and 120A.24. The parent of persons receiving instruction in a home school shall
submit the statements as required by subdivisions 1, 2, 3, and 4 to the superintendent of the district
in which the person resides by October 1 of each school year. The school report must be prepared
on forms developed jointly by the commissioner of health and the commissioner of education and
be distributed to the local districts by the commissioner of health. The school report must state the
number of persons attending the school, the number of persons who have not been immunized
according to subdivision 1 or 2, and the number of persons who received an exemption under
subdivision 3, clause (c) or (d). The school report must be filed with the commissioner of
education within 60 days of the commencement of each new school term. Upon request, a district
must be given a 60-day extension for filing the school report. The commissioner of education shall
forward the report, or a copy thereof, to the commissioner of health who shall provide summary
reports to boards of health as defined in section 145A.02, subdivision 2. The administrator or other
person having general control and supervision of the child care facility shall file a report with the
commissioner of human services on all persons enrolled in the child care facility. The child care
facility report must be prepared on forms developed jointly by the commissioner of health and the
commissioner of human services and be distributed to child care facilities by the commissioner of
health. The child care facility report must state the number of persons enrolled in the facility, the
number of persons with no immunizations, the number of persons who received an exemption
under subdivision 3, clause (c) or (d), and the number of persons with partial or full immunization
histories. The child care facility report must be filed with the commissioner of human services
by November 1 of each year. The commissioner of human services shall forward the report, or
a copy thereof, to the commissioner of health who shall provide summary reports to boards of
health as defined in section 145A.02, subdivision 2. The report required by this subdivision is not
required of a family child care or group family child care facility, for prekindergarten children
enrolled in any elementary or secondary school provided services according to sections 125A.05
and 125A.06, nor for child care facilities in which at least 75 percent of children in the facility
participate on a onetime only or occasional basis to a maximum of 45 hours per child, per month.
    Subd. 9. Definitions. As used in this section the following terms have the meanings given
them.
(a) "Elementary or secondary school" includes any public school as defined in section
120A.05, subdivisions 9, 11, 13, and 17, or nonpublic school, church, or religious organization, or
home school in which a child is provided instruction in compliance with sections 120A.22 and
120A.24.
(b) "Person enrolled in any elementary or secondary school" means a person born after 1956
and enrolled in grades kindergarten through 12, and a child with a disability receiving special
instruction and services as required in sections 125A.03 to 125A.24 and 125A.65, excluding a
child being provided services according to section 125A.05, paragraph (c), or 125A.06, paragraph
(d)
.
(c) "Child care facility" includes those child care programs subject to licensure under chapter
245A, and Minnesota Rules, chapters 9502 and 9503.
(d) "Family child care" means child care for no more than ten children at one time of which
no more than six are under school age. The licensed capacity must include all children of any
caregiver when the children are present in the residence.
(e) "Group family child care" means child care for no more than 14 children at any one
time. The total number of children includes all children of any caregiver when the children
are present in the residence.
    Subd. 10. Requirements for immunization statements. (a) A statement required to be
submitted under subdivisions 1, 2, and 4 to document evidence of immunization shall include
month, day, and year for immunizations administered after January 1, 1990.
(b) A person who has received at least three doses of tetanus and diphtheria toxoids, with
the most recent dose given after age six and before age 11, is not required to have additional
immunization against diphtheria and tetanus until ten years have elapsed from the person's most
recent dose of tetanus and diphtheria toxoid.
(c) The requirement for hepatitis B vaccination shall apply to persons enrolling in
kindergarten beginning with the 2000-2001 school term.
(d) The requirement for hepatitis B vaccination shall apply to persons enrolling in grade 7
beginning with the 2001-2002 school term.
    Subd. 11. Commissioner of human services; continued responsibilities. Nothing in this
section relieves the commissioner of human services of the responsibility, under chapter 245A,
to inspect and assure that statements required by this section are on file at child care programs
subject to licensure.
    Subd. 12. Modifications to schedule. (a) The commissioner of health may adopt
modifications to the immunization requirements of this section. A proposed modification
made under this subdivision must be part of the current immunization recommendations
of each of the following organizations: the United States Public Health Service's Advisory
Committee on Immunization Practices, the American Academy of Family Physicians, and the
American Academy of Pediatrics. In proposing a modification to the immunization schedule, the
commissioner must:
(1) consult with (i) the commissioner of education; the commissioner of human services;
the chancellor of the Minnesota State Colleges and Universities; and the president of the
University of Minnesota; and (ii) the Minnesota Natural Health Coalition, Vaccine Awareness
Minnesota, Biological Education for Autism Treatment (BEAT), the Minnesota Academy of
Family Physicians, the American Academy of Pediatrics-Minnesota Chapter, and the Minnesota
Nurses Association; and
(2) consider the following criteria: the epidemiology of the disease, the morbidity and
mortality rates for the disease, the safety and efficacy of the vaccine, the cost of a vaccination
program, the cost of enforcing vaccination requirements, and a cost-benefit analysis of the
vaccination.
(b) Before a proposed modification may be adopted, the commissioner must notify the
chairs of the house and senate committees with jurisdiction over health policy issues. If the
chairs of the relevant standing committees determine a public hearing regarding the proposed
modifications is in order, the hearing must be scheduled within 60 days of receiving notice from
the commissioner. If a hearing is scheduled, the commissioner may not adopt any proposed
modifications until after the hearing is held.
(c) The commissioner shall comply with the requirements of chapter 14 regarding the
adoption of any proposed modifications to the immunization schedule.
(d) In addition to the publication requirements of chapter 14, the commissioner of health
must inform all immunization providers of any adopted modifications to the immunization
schedule in a timely manner.
History: 1967 c 858 s 1,2; 1973 c 137 s 1-3; 1977 c 305 s 45; 1978 c 758 s 1; 1980 c 504 s
1; 1986 c 444; 1987 c 309 s 24; 1988 c 430 s 1-8; 1989 c 215 s 1-7; 1991 c 30 s 1-10; 1991 c 265
art 3 s 38; 1Sp1995 c 3 art 9 s 26; art 16 s 13; 1996 c 398 s 25; 1Sp1997 c 3 s 20-22; 1Sp1997 c
4 art 6 s 8-10; 1998 c 305 s 1-4; 1998 c 397 art 3 s 54-56,103; art 11 s 3; 1998 c 407 art 2 s
24; 1Sp2001 c 9 art 1 s 24,25; 2002 c 379 art 1 s 113; 2003 c 130 s 12; 2004 c 279 art 10 s 1,2;
1Sp2005 c 5 art 2 s 29; 2006 c 263 art 7 s 2