Immediately upon enrollment in the district, the student’s parent or legal guardian must provide proof of the required immunizations as specified by the Washington Department of Health with a completed Certificate of Immunization Status (CIS) form approved by the Department of Health, and/or an exemption with a completed Certificate of Exemption (COE) form approved by the Washington Department of Health. The student cannot start attending school until the completed CIS and/or COE is on file at the school or the Conditional Immunization Status conditions have been met. Students experiencing homelessness, including migratory and refugee children and children in out-of-home (foster) care, who have not provided the required documentation will be allowed to enroll, attend classes, and participate fully, despite being out of compliance with immunization requirements.

The CIS and/or COE will be a part of the student's permanent record. The district will provide access to immunization records of each student enrolled to agents of the state or local health department. The district will return the CIS and/or COE or a legible copy to the parent or legal guardian if the child is withdrawn or transferred from the district. The district may not withhold the CIS and/or COE for any reasons, including nonpayment of school fees.

Certificate of Immunization (CIS Form)

School staff may verify that the student’s immunizations are complete in the WA Immunization Information System (IIS), in this situation a CIS is not required to be on file. School staff will document this verification in the student’s cumulative school record. If the immunizations are not complete in the IIS, the immunization status of students must be documented on a completed CIS form.

All immunization information documented on a CIS by new enrollees starting school on or after August 1, 2020 must be medically verified. A CIS printed from the Washington Immunization Information System (IIS) with immunization information prepopulated is considered medically verified by the IIS. A hardcopy CIS completed by the parent or legal guardian must be verified as accurate by either a health care provider signature or by a school administrator, school nurse or designee’s signature after verifying that the information on the CIS is accurate when compared to medical immunization records attached to the CIS.

For currently enrolled students all new immunization documentation submitted on or after August 1, 2020 must be on a medical immunization record. School staff may use the information on the medical immunization record to update the student’s existing CIS on file. A district school nurse or their delegate, with parent or legal guardian permission, may use the information on the medical immunization record to update the student’s immunization information in the IIS.

Conditional Immunization Status Attendance:

If by a student’s first day of attendance the student does not have documentation of all of the required immunizations, the student may be permitted to start school in a temporary “conditional immunization status” provided that the student has received all of the immunizations that they are eligible to receive and is waiting for the recommended date of the next vaccine dose according to the national immunization catch-up schedule. The parent or legal guardian must sign the CIS acknowledging the conditional status rules and times lines that follow.

1. Once the next dose comes due the student can remain in conditional status for thirty (30) calendar days to have time to turn in the required documentation. If additional vaccines are needed conditional status continues in a similar manner until all of the vaccine series are complete.
2. If the thirty (30) calendar day period expires and documentation has not been given to the school, the student will be excluded from further attendance. Valid documentation includes medical records showing vaccination, evidence of immunity to the disease in question, or a completed Certificate of Exemption (COE) form.

Exemptions from Immunization

Exemptions will be processed and recorded on a Certificate of Exemption (COE) form as provided by the Washington Department of Health (DOH).

The district will grant exemptions from one or more vaccines for medical reason upon certification by a Licensed Healthcare Provider (LHP) that there is a medical reason for not administering the vaccine.

The district will grant exemptions for religious reasons upon the parent/legal guardian’s submission of a COE, as follows. If a COE states that the parent/legal guardian is a member in a religious body or church with beliefs or teachings that preclude a child from receiving medical treatment from a LHP, the LHP signature on the COE is not required. If the COE claims a religious reason, but does not state that the parent/legal guardian is a member in a religious body or church with beliefs or teachings that preclude a child from receiving medical treatment from a LHP, the LHP signature on the COE is required.

With the exception of the measles, mumps, and rubella vaccine, the district will grant exemptions for philosophical or personal reasons upon the parent/legal guardian’s submission of a COE, signed by an LHP, stating that the parent/legal guardian has a philosophical or personal objection to the immunization of the child and the LHP has provided the parent/legal guardian with information about the benefits and risks of immunization. The district will not grant an exemption for philosophical or personal reasons from the measles, mumps, and rubella vaccine. The LHP may sign the form any time prior to the district’s enrollment of the child. The district will accept a photocopy of the signed form or a letter from LHP in lieu of the original form. The district will mark the permanent file of students who have exemptions for easy identification in the event that the local department of health order exempted students a temporary exclusion from school during an outbreak or an epidemic.

If the district does not receive a COE upon the student’s enrollment in school, the principal or designee will provide written notice to the parent/guardian informing them of the immunization requirements. They will also inform the parent/guardian the potential of denied attendance if proper documentation meeting requirements is not provided prior to the first day of attendance.

Exclusion Process for Lack of Compliance with Immunizations at School

The school principal or designee will exclude students from further attendance who are out of compliance with the immunization requirements as required in RCW 28A.210.120.

When excluding students, the school will provide written notification as required in WAC 392-380-050. Written notification will:

• Order that the student is excluded immediately, and
• Be delivered in person or by mail, or by email, and
• Be in the parent’s/guardian’s native language if possible, and
• Include a copy of the applicable laws and rules (RCW 28A.210.010-160, 246-105 WAC, and 392-182 WAC sections 005, 020, 045, 050, 080), and
• Provide information regarding immunization services available through local health or other public agencies, and
• Include notice that the parent/legal guardian and student has a right to a hearing provided they notify the school within three (3) days after receiving the exclusion order from the school principal, and
• Describe the hearing process, and
• Explain that the exclusion continues until either the required immunization documentation, or a completed Certificate of Exemption form is turned in to the school, or a hearing officer determines that the student is no longer excluded from school.

If the parent requests a hearing, the district will notify in writing the parent or guardian and school principal of the time and place for the hearing and will present the case to a hearing officer appointed by the superintendent.

Exceptions for the Immunization laws include:

Students who qualify as McKinney Vento (Policy 3115) or Foster Care (Policy 3116) may NOT be excluded from school for lack of compliance for immunization requirements. They still must fill out the CIS (Certificate of Immunization) form and the district Health History Form as much as possible and have it signed by the parent/guardian. The Registrar must notify the McKinney-Vento Liaison, Foster Care Liaison and School Nurse and enroll the student.

List of Students Not Fully Immunized

The district will keep or be able to produce within twenty-four hours a current list of children who are not fully immunized. This list must be transmitted to the local health department upon request. The local health officer may use this list for easy identification of students to be excluded from school temporarily during a disease outbreak.

Procedure Process Roles and Responsibility for Student Immunizations

1. The district will provide training for staff who are responsible for registering students to ensure completeness of records and following of district procedure.
2. The person(s) assigned the responsibility of student registration (the registrar or other designated enrollment staff) must enter the provided immunizations into the electronic data system and determine if the student is in compliance at the time of registration. If not in compliance at this time, families should be notified that the student will not be able to attend without appropriate documentation. The registering parent/guardian will be provided with written information including:
   1. The list of non-compliant immunizations
   2. Written notification, informing the parent/guardian that the student must have updated immunizations or show that they are in process towards meeting compliance, or they may be excluded from school.
   3. The notification will also include information related to temporary “conditional immunization status” provided that the student has received all of the immunizations that they are eligible to receive and is waiting for the recommended date of the next vaccine dose according to the national immunization catch-up schedule. The parent or legal guardian must sign the CIS acknowledging the conditional status rules and timelines.
3. Designated enrollment staff will work with the school nurse to ensure newly enrolled students, withdrawals, and transfers are in compliance with immunization state requirements.
4. The school nurse will review all student immunization records for accuracy, compliance, and completion of required state immunizations.
5. If an enrolled student is not in compliance and has not been informed of their conditional status, in writing, the registrar or school nurse or their designee will inform the parent/guardian of their conditional status at that time, giving them thirty (30) calendar days to update their immunizations.
   1. The student’s conditional status will be tracked every thirty days for continued updating towards compliance.
   2. If the student fails to progress towards compliance after thirty days, the student may be excluded from school.
6. If an enrolled student is not in compliance and has previously been informed of their conditional status, in writing, but has not shown progress towards compliance after thirty (30) calendar days, the registrar or school nurse will move forward toward exclusion of the student for non-compliance of immunizations.
   1. The staff person moving forward with the exclusion will provide proper written notification of the exclusion to the parent/guardian via certified mail per the exclusion process.

Enrollment Types

An original or copy of a completed Washington Certificate of Immunization Status (CIS) form must be presented at the time of enrollment following the compliance requirements. Students under conditional status will still require a parent to complete the CIS form with as much information as possible at time of enrollment. Parents/Guardians should sign both lines of the CIS if they agree to immunizations being entered into the Washington State Immunization Information System (WA IIS).

1. A request for records from previous school will not suffice.
2. A faxed copy of the student’s CIS form, if complete and a new signature by parent/guardian, is acceptable.

Special Programs

1. Special Education Students
Special education students must comply with immunization law requirements like all other students with no exceptions.

2. Alternative Program Students
If a student is dually enrolled, the immunizations shall be maintained at the home school (e.g., kindergarten students enrolled at an elementary school and attending school on another campus or students taking classes at a high school within HPS and at PSSC).

Transfers/Graduation
Upon student transfer, graduation, or withdrawal, the student should be given their original CIS form and instructed to take the form with them when they enroll in another institution. If a student withdraws, a copy may be placed in the student folder.

Age Based Immunization Requirements

Students can go from a compliant status to a non-compliant status when there are new age/grade based immunization requirements. (e.g., Tdap when  6^th graders go into 7^th grade). These students become non-compliant at that time and are required to follow the requirements for school attendance in the following school year.

1. The nurses working in conjunction with the office staff should provide notification to the parent/guardian of the new requirements.
   1. In the spring, prior to the new requirement, school nurses will provide letters to be sent home with the spring report cards.
   2. At the end of that school year, those students continuing to need immunizations will receive an additional notification prior to the beginning of the next school year.
   3. School nurses will provide a list of students who are not in compliance for the coming school year to the office staff and principal.
      i.      Principals should develop a system for the fall of the coming school year to track immunization compliance with their school registrars and exclude those students who are not in compliance.
      ii.     Upon the start of the next school year, students who are non-compliant, have previously received notification of the new requirements and not yet been excluded, may be excluded from school per the exclusion process.

Forms:
Certificate of Immunization Status (CIS)
Certificate of Exemption (COE)

Cross reference:
Student Health - Policy 3410
Medication in Schools - Policy 3416
Homeless Students Enrollment Rights and Services - Policy 3115
Students in Foster Care - Policy 3116

Documents:
Health – Screening Requirements - RCW 28A.210
Immunization of child care and school children against certain vaccine-preventable diseases - WAC 246-105
Student – Health records - WAC 392-182    
Public School Pupils – Immunization Requirement and life –threatening health condition - WAC 329-380  

Highline School District 401
Adopted by the Superintendent: August 1985
Revised by the Superintendent: 5.90, 5.11, 6.14, 4.17, 6.18, 8.19, 5.23, 1.24