Missouri Revised Statutes













Chapter 210

Child Protection and Reformation

←210.002

Section 210.003.1

210.004→

August 28, 2015

Immunizations of children required, when, exceptions--duties of administrator, report--notification of parents, when.

210.003. 1. No child shall be permitted to enroll in or attend any

public, private or parochial day care center, preschool or nursery school

caring for ten or more children unless such child has been adequately

immunized against vaccine-preventable childhood illnesses specified by the

department of health and senior services in accordance with recommendations

of the Centers for Disease Control and Prevention Advisory Committee on

Immunization Practices (ACIP). The parent or guardian of such child shall

provide satisfactory evidence of the required immunizations.



2. A child who has not completed all immunizations appropriate for

his age may enroll, if:



(1) Satisfactory evidence is produced that such child has begun the

process of immunization. The child may continue to attend as long as the

immunization process is being accomplished according to the ACIP/Missouri

department of health and senior services recommended schedule; or



(2) The parent or guardian has signed and placed on file with the day

care administrator a statement of exemption which may be either of the

following:



(a) A medical exemption, by which a child shall be exempted from the

requirements of this section upon certification by a licensed physician

that such immunization would seriously endanger the child's health or life;

or



(b) A parent or guardian exemption, by which a child shall be

exempted from the requirements of this section if one parent or guardian

files a written objection to immunization with the day care administrator.





Exemptions shall be accepted by the day care administrator when the

necessary information as determined by the department of health and senior

services is filed with the day care administrator by the parent or

guardian. Exemption forms shall be provided by the department of health

and senior services.



3. In the event of an outbreak or suspected outbreak of a

vaccine-preventable disease within a particular facility, the administrator

of the facility shall follow the control measures instituted by the local

health authority or the department of health and senior services or both

the local health authority and the department of health and senior

services, as established in Rule 19 CSR 20-20.040, "Measures for the

Control of Communicable Diseases".



4. The administrator of each public, private or parochial day care

center, preschool or nursery school shall cause to be prepared a record of

immunization of every child enrolled in or attending a facility under his

jurisdiction. An annual summary report shall be made by January fifteenth

showing the immunization status of each child enrolled, using forms

provided for this purpose by the department of health and senior services.

The immunization records shall be available for review by department of

health and senior services personnel upon request.



5. For purposes of this section, satisfactory evidence of

immunization means a statement, certificate or record from a physician or

other recognized health facility or personnel, stating that the required

immunizations have been given to the child and verifying the type of

vaccine and the month, day and year of administration.



6. Nothing in this section shall preclude any political subdivision

from adopting more stringent rules regarding the immunization of preschool

children.



7. All public, private, and parochial day care centers, preschools,

and nursery schools shall notify the parent or guardian of each child at

the time of initial enrollment in or attendance at the facility that the

parent or guardian may request notice of whether there are children

currently enrolled in or attending the facility for whom an immunization

exemption has been filed. Beginning December 1, 2015, all public, private,

and parochial day care centers, preschools, and nursery schools shall

notify the parent or guardian of each child currently enrolled in or

attending the facility that the parent or guardian may request notice of

whether there are children currently enrolled in or attending the facility

for whom an immunization exemption has been filed. Any public, private, or

parochial day care center, preschool, or nursery school shall notify the

parent or guardian of a child enrolled in or attending the facility, upon

request, of whether there are children currently enrolled in or attending

the facility for whom an immunization exemption has been filed.



(L. 1988 S.B. 797 § 1, A.L. 2015 S.B. 341)



CROSS REFERENCES:



Consent to immunization may be delegated to other persons, when,

431.058



Mandatory insurance coverage of immunizations, exceptions, 376.1215





1991



1991



210.003. 1. No child shall be permitted to enroll in or attend any

public, private or parochial day care center, preschool or nursery school

caring for ten or more children unless such child has been adequately

immunized against vaccine-preventable childhood illnesses specified by the

department of health and senior services in accordance with recommendations

of the Immunization Practices Advisory Committee (ACIP). The parent or

guardian of such child shall provide satisfactory evidence of the required

immunizations.



2. A child who has not completed all immunizations appropriate for his

age may enroll, if:



(1) Satisfactory evidence is produced that such child has begun the

process of immunization. The child may continue to attend as long as the

immunization process is being accomplished according to the ACIP/Missouri

department of health and senior services recommended schedule; or



(2) The parent or guardian has signed and placed on file with the day

care administrator a statement of exemption which may be either of the

following:



(a) A medical exemption, by which a child shall be exempted from the

requirements of this section upon certification by a licensed physician that

such immunization would seriously endanger the child's health or life; or



(b) A parent or guardian exemption, by which a child shall be exempted

from the requirements of this section if one parent or guardian files a

written objection to immunization with the day care administrator.

Exemptions shall be accepted by the day care administrator when the necessary

information as determined by the department of health and senior services is

filed with the day care administrator by the parent or guardian. Exemption

forms shall be provided by the department of health and senior services.



3. In the event of an outbreak or suspected outbreak of a

vaccine-preventable disease within a particular facility, the administrator

of the facility shall follow the control measures instituted by the local

health authority or the department of health and senior services or both the

local health authority and the department of health and senior services, as

established in Rule 19 CSR 20-20.040, "Measures for the Control of

Communicable Diseases".



4. The administrator of each public, private or parochial day care

center, preschool or nursery school shall cause to be prepared a record of

immunization of every child enrolled in or attending a facility under his

jurisdiction. An annual summary report shall be made by January fifteenth

showing the immunization status of each child enrolled, using forms provided

for this purpose by the department of health and senior services. The

immunization records shall be available for review by department of health

and senior services personnel upon request.



5. For purposes of this section, satisfactory evidence of immunization

means a statement, certificate or record from a physician or other recognized

health facility or personnel, stating that the required immunizations have

been given to the child and verifying the type of vaccine and the month, day

and year of administration.



6. Nothing in this section shall preclude any political subdivision from

adopting more stringent rules regarding the immunization of preschool

children.



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