MCHD/MDHHS/MCIR/SIRS IP-100 Educational Materials Retain as a Desk Reference

Transcription

1 MCHD/MDHHS/MCIR/SIRS IP-100 Educational Materials Retain as a Desk Reference Macomb County Health Department School Immunization Program Elizabeth Road Mount Clemens, MI Telephone: (586) Fax: (586) MCIR Helpdesk:

2 School Immunization Program FALL 2017 LIST OF MATERIALS* SCHOOL MCIR/SIRS** IP-100 REPORTING 1. Macomb County Health Department (MCHD) Materials November 2016 & February 2017 Compliancy Waiver Percentage Chart School Bulletin #26 Fall 2017 Q & A for Schools/Preschools/Childcare Centers 06/30/2017 Q & A for Parents/Guardians or 18 Year Old Students 01/30/2017 NEW for 8/1/17 Immunization Clinic Hours or Nonmedical Waiver Education Services 08/01/ Master Forms MCHD Statement of Varicella Disease (Chickenpox) MCHD/SIP 6/99, Revised 3/2017 MDHHS Medical Contraindication Form Rev. January 1, Michigan Department of Health and Human Services Department (MDHHS) Materials MCIR/SIRS Rev. March 31, 2017 Letter To Superintendents, Principals and Directors of Public School Academies April 24, 2017 Teen Vaccines Information For Parents Updated January 31, 2017 Influenza: Information for Schools on Influenza and Vaccines Updated February 28, 2017 MEMORANDUM Vision Screening and Reporting for Kindergarten February 10, 2017 SCHOOLS: Vaccines Required For School Entry In Michigan Updated March 1, 2017 PARENTS: Vaccines Required For School Entry In Michigan Updated March 1, 2017 Dear Parent/Guardian: Key Points Related to Claiming a Nonmedical Immunization Waiver for Children Attending Michigan Schools and Licensed Child-Care Centers April 12, 2017 Nonmedical Waiver Rule for Childhood Immunizations in School and Licensed Childcare: Information for Parents/Guardians April 12, 2017 Vaccine Terminology Rev. April 24, 2017 *Please use the materials provided in this packet and dispose all outdated versions in your files. **Michigan Care Improvement Registry/School Immunization Reporting System

3 SCHOOL IMMUNIZATION PROGRAM SCHOOL BULLETIN NUMBER 26 FALL 2017 RESPONSIBILITIES for SCHOOL IMMUNIZATION REQUIREMENTS* 1. The Macomb County Health Department (MCHD) School Immunization Program (SIP) works with the Michigan Department of Health and Human Services (MDHHS) in upholding the immunization requirements in The Michigan Public Health Code Act 368 of 1978 Part 92 Immunization, and the Macomb County Immunization Regulation enacted by the Macomb County Board of Commissioners on September 27, Current versions of the MDHHS SCHOOLS Vaccines Required for School Entry in Michigan (Updated March 1, 2017) and Protocol for the IP-100 School Immunization Reporting Process (Rev. June 7, 2017) are used in the collaborative process. 2. Per the Michigan Public Health Code, it is the responsibility of parents, legal guardians, or person in loco parentis to have their child receive the immunizations listed on the MDHHS PARENTS Vaccines Required for School Entry in Michigan (Updated March 1, 2017) chart before school entry. An 18 year old student must adhere to the immunization requirements. Parents must maintain a record of their child s immunizations on an ongoing basis and provide the school written documentation of a valid/certified immunization record. For a child without the required vaccines, parents must submit a certified MDHHS Immunization Waiver Form, an approved MDHHS Medical Contraindication Form, MCHD Statement of Varicella Disease History form and/or approved laboratory evidence of immunity. 3. Per the Michigan Public Health Code, it is the responsibility of schools to adhere to the MDHHS SCHOOLS Vaccines Required for School Entry in Michigan (Updated March 1, 2017) chart. The specific student populations include: all kindergarten (including developmental kindergarten), all 7 th grade students and all new-to-district entrants through 18 years of age. A teacher or principal shall not permit a child to enter or attend school unless a certificate indicating that a minimum of 1 dose of an immunizing agent against each of the diseases specified by the department has been received. For a child that is registered with only these minimum doses of immunizing agents, parents must present an updated certificate of immunization within 4 months after initial attendance showing that the immunizations have been completed as prescribed by the department. Schools must maintain a record of required immunizations for each student and a principal of a school or operator of a group program shall make immunization records available for inspection by authorized representatives of the department or the appropriate local health department. When presented with a medical exemption, religious or other exemption, the administrator of a child s school or operator of a child s group program shall recognize the exemption status of the child. A child that does not have the required vaccines must have a certified nonmedical waiver, an approved medical waiver, statement of varicella disease history form and/or approved laboratory evidence of immunity form on file. If these requirements are not met, the student must be excluded from school. All public schools, charter schools, private, parochial, special education, alternative education, adult education, homeschool partnerships and virtual schools must have a completed, waived or provisional immunization record (compliancy) for at least 90% of these students for the November IP-100 report and 95% compliancy for the February IP-100 report. Failure to do so can result in the public school district or charter academy being referred to the Michigan Attorney General Office and the loss of 5% of the Michigan Department of Education (MDE) financial funding, withheld from their June or July payment. According to Sec of the Michigan Public Health Code, a person who violates this part or a rule promulgated under this part is guilty of a misdemeanor. *This is not an all-inclusive list.

4 NONMEDICAL WAIVER EDUCATION IS BY APPOINTMENT ONLY Instruct parents to Call the SIP for a waiver education appointment. Avoid saying, You have to go to the health department for a waiver. o The second statement may lead parents to believe that walk-in waiver education is available like walk-in immunization services. o The difference in the use of call vs. go can decrease frustration for parents and staff. For individuals seeking nonmedical waiver information, please copy and provide the SIP Q & A for Parents/Guardians or 18 Year Old Students for information to make a waiver education appointment at the Mount Clemens Health Center. For individuals asking for MCHD Immunization Clinic services, please copy and provide the Immunization Clinic Hours flyer for information to receive immunization services at 3 MCHD centers IMMUNIZATION REQUIREMENTS REMAIN THE SAME Please see the MDHHS SCHOOLS Vaccines Required for School Entry in Michigan (Updated March 1, 2017) for vaccines required for school entrance and attendance. November 2017 and February 2018 IP-100 REPORTING PROCEDURE All certified nonmedical and approved medical waiver forms received for children on the current roster, must be faxed or mailed with the following four reports: 1. IP 100 Summary 2. Waivers only if you have waivered students 3. Provisionals 4. Incompletes The SIP will review all waiver forms for authenticity. Do not fax nonmedical waivers intermittently. REPORT DUE DATES Report Period November 2017 February 2018 Earliest date to submit Monday October 2, 2017 Tuesday January 2, 2018 Report due date No later than Wednesday November 1, 5:00 p.m. Thursday February 1, 5:00 p.m. Minimum compliance rate 90% 95%

5 STATE OF MICHIGAN IMMUNIZATION ADMINISTRATIVE RULES CHANGE Effective January 1, 2015, the Michigan Public Health Code Rule (R ) for nonmedical waivers is: Rule 6 (12) When presented with a medical, religious or other exemption, the administrator of a child s school or operator of a child s group program shall recognize the exemption status of the child. Each nonmedical exemption filed at the child s school or group program of a child entering a program after December 31, 2014 shall be certified by the local health department (LHD) that the individual received education on the risks of not receiving the vaccines being waived and the benefits of vaccination to the individual and the community. All waivers shall be submitted using the waiver form prescribed by the department. NOTE: Parents/Guardians/18 year old students should present a certified nonmedical Immunization Waiver Form or Medical Contraindication Form at the time of registration to a school, preschool or childcare center. For the purpose of reporting to Macomb County Health Department, a child without a waiver can be admitted and attend, but must submit a waiver within 30 days of the first date of attendance. A school, preschool or childcare center may have more stringent program admittance and waiver submission rules. Waiver education appointments may not be immediately available in such cases. NONMEDICAL WAIVERS A nonmedical waiver is a parent s/guardian s written statement indicating the religious or philosophical (other) objections to a particular vaccination(s). (MI FAQ) The State of Michigan nonmedical Immunization Waiver Form (Rev. January 1, 2017) must be used. All LHDs across the state must provide nonmedical waiver education services and provide a certified nonmedical waiver following a waiver education appointment. Nonmedical waivers are no longer approved or denied. Physicians cannot provide nonmedical waiver education or certify nonmedical waivers. Nonmedical waiver education sessions are by appointment only at the Mount Clemens Health Center. Individuals can call (586) to schedule an appointment. Public Health Nurses provide the 1-on-1 waiver education session. Not a Class - Not a Video - Not a Lecture Not a Power Point Presentation minutes needed. Reason for waiver can be stated as religious or other objection to immunization. The LHD will waive the vaccines appropriate for the child s age and program requirements. Upon completion of the waiver education session, the Immunization Waiver Form is completed and signed by the parent/guardian/18 year old student and signed and stamped (certified) by a Public Health Nurse. Parents/guardians/18 year old students are required to take the certified waiver to their school or program. MEDICAL WAIVERS A medical waiver is a signed statement from the physician that the child cannot receive a certain vaccine due to a true contraindication or precaution to the vaccine or a vaccine component. (MI FAQ) The State of Michigan Medical Contraindication Form (Rev. January 1, 2017) must be used. English and Spanish versions are available online at Health Departments>Immunization Waiver Information>Health Care Providers Section. Physicians should only check boxes for vaccines that are medically contraindicated. Reason, physician name, address, signature and date is required. Parents/guardians/18 year old students are required to take the completed form to the school or program. Schools or programs must record the non-administered vaccines into MCIR indicating medical as the reason. Fax or mail a copy of the medical waiver form to the SIP. The MCHD Medical Director reviews medical waivers for valid medical contraindications. The SIP will fax or mail the approved or denied medical waiver back to the program with a follow up letter and instructions. Denied medical waiver disposition forms are no longer used.

6 WEEKLY COMMUNICABLE DISEASE ONLINE REPORTING IS REQUIRED The CD Program is responsible for public health efforts in communicable disease and influenza prevention, surveillance and control. In 2010, the Communicable Disease (CD) Program implemented an online system at Paper reports are no longer used. Visit OR call the Call the CD Program for questions or problems at: Macomb County Health Department Telephone: (586) Communicable Disease Program Fax: (586) Elizabeth Road Mount Clemens, MI SCHOOL IMMUNIZATION PROGRAM WEBSITE TOPICS Immunization Waiver Update Kindergarten Entry Booklet Childcare/School August Mailing Packets Forms Childcare/School Compliancy Rates County Quarterly Immunization Report Card Visit: CALL THE SIP FOR MCIR/SIRS IP-100 Reporting QUESTIONS or PROBLEMS Macomb County Health Department Telephone: (586) School Immunization Program Secure Fax: (586) Elizabeth Road Mount Clemens, MI CALL THE MCIR/SIRS for questions or technical assistance. Do not send Protected Health Information, e.g. vaccine or MCIR records, via . If contacting mcir.org or the SIP via , please do not submit Protected Health Information such as name, date of birth or immunization dates. You may submit requests by using the MCIR ID, only. The SIP prefers receiving information by fax for review. Both mcir.org and the SIP addresses are not secure. Follow the Macomb County Health Department on Facebook

7 Macomb County Health Department (MCHD) School Immunization Program (SIP) Elizabeth Road Mount Clemens, MI Q & A for Schools/Preschools/Childcare Centers What current information is available for medical and nonmedical waivers? For all children through age 18 years, Michigan Public Health Code requires waivers be signed in the year in which a child s immunization status is assessed and reported for school and childcare purposes: this includes children entering a licensed childcare center, preschool, Head Start, and school-aged children who are new entrants to a school district, in kindergarten, or in 7 th grade.* Parents/Guardians/18 year old students should present a certified nonmedical Immunization Waiver Form or Medical Contraindication Form at the time of registration to a school, preschool or childcare center. For the purpose of reporting to Macomb County Health Dept., a child without a waiver can be admitted and attend, but must submit a waiver within 30 days of the first date of attendance. A school, preschool or childcare center may have more stringent program admittance and waiver submission rules. Waiver education appointments may not be immediately available in such cases. Schools, preschools and childcare centers remain responsible for entering all waivered vaccines into a child s MCIR/SIRS record. Place a waiver copy in the child s record and one copy in the master file of all children with waivers. Previously approved MCHD medical or parental waivers remain valid until the child reaches a new immunization assessment, e.g., preschool to kindergarten, students entering 7 th grade or new to district or childcare program. A certified nonmedical or medical waiver is now needed. If the child has a certified nonmedical waiver for all age appropriate and required vaccines, a new waiver is not needed when: o A child was reported on an IP-100 for developmental kindergarten, and remains in the same school district for kindergarten entry. The child does not need a new waiver or be reported again on the IP-100 for kindergarten entry. o A child remains enrolled at the same school, preschool or childcare center for consecutive years. Waivers do not need to be signed on a yearly basis. According to the Michigan Department of Health and Human Services (MDHHS) Division of Immunizations: * Students in Special Education that are not identified with a grade would be reported either as SE=Special Education or at the age appropriate for the average student in kindergarten (5 y/o) and 7 th grade (12 y/o). ECDD or PPI students 5 y/o or older should be assessed as school age students. ECDD students < 5 y/o should be assessed as though they are childcare and reported through the IP-101. McKinney Vento is a child who is homeless and would not be required upon entry to receive the waiver education. The child would be marked as McKinney Vento for the November and February reporting period. Schools are responsible to ensure the McKinney Vento Act rules are followed. Exchange students need to comply with the rule change and receive waiver education just as any other student attending school in Michigan. Alterations of the Immunization Waiver Form constitutes an invalid waiver. A school, preschool or childcare center cannot accept forms that have information crossed out or words, statements or objections added to the Instructions to Parents or Guardians section on the form. 06/30/2017 SIP Page 1 of 2

8 All certified nonmedical and approved medical waiver forms received for children on the current roster, must be faxed or mailed with the following four reports: 1. IP-100/101 Summary 2. Waivers only if you have waivered students 3. Provisionals 4. Incompletes The SIP will review all waiver forms for authenticity. Nonmedical waivers should no longer be faxed intermittently. NONMEDICAL WAIVERS: The State of Michigan Immunization Waiver Form (Rev. January 1, 2017) will be used, signed and stamped (certified) by a LHD. Nonmedical waivers are no longer approved or denied, but are issued upon completion of the waiver education session at a LHD. It is preferred that all Macomb County residents receive waivers from the Macomb SIP, but waivers certified by any LHD in the state are acceptable. MEDICAL WAIVERS: The procedures to process a medical waiver remain the same, except the State of Michigan Medical Contraindication Form (Rev. January 1, 2017) is now required. When a parent/guardian or 18 year old student submits a medical waiver to the office, please check all areas of the form, especially that it has been signed by a physician with the reason for exemption section completed. Enter the vaccines to be waived in the child s MCIR/SIRS record and fax the medical waiver to the SIP. The Macomb County Health Department Medical Director reviews all medical waivers for valid medical contraindications to the vaccines checked and will approve or deny the medical waiver. The SIP will fax the medical waiver form reviewed and signed by the medical director (disposition forms will no longer be used) back to the school, preschool or childcare center. If the waiver was approved, keep a copy in the child s record and one in the school s or program s master file of children with waivers. If the waiver was disapproved, remove the waivered vaccines from the child s MCIR/SIRS record and contact the parent/guardian or 18 year old student that the waiver was not approved for the reason the medical director provided on the form. A letter and instruction sheet will be faxed with each disapproved medical waiver to be used in guiding the parent/guardian or 18 year old student on the next steps they must take. STATEMENT of VARICELLA DISEASE: The form should be placed in the child s record and a copy in school s or program s master file of children with waivers. FINDING WAIVER FORMS ONLINE: Health Departments > Immunization Waiver Information A BLANK Immunization Waiver Form is not available. Previously dated versions of this form are not acceptable for use. A BLANK Medical Contraindication Form (Rev. January 1, 2017) is in the Health Care Providers section. A BLANK Statement of Varicella Disease form (MCHD/SIP 6/99, Revised 03/2017) is available from the SIP. o These two forms were provided in the 2017 August Mailing Packet. Call the SIP at (586) for questions or assistance. Fax reports and waiver forms to (586) Visit the SIP website at: Follow the Macomb County Health Department on Facebook 06/30/2017 SIP Page 2 of 2

9 Macomb County Health Department (MCHD) School Immunization Program (SIP) Elizabeth Road Mount Clemens, MI health.macombgov.org/health-home Call (586) TO SCHEDULE A WAIVER EDUCATION APPOINTMENT Q & A for Parents/Guardians or 18 Year Old Students What steps are needed to obtain a certified nonmedical Immunization Waiver Form? Michigan Public Health Code requires waivers be signed in the year in which a child s immunization status is assessed and reported for school and childcare purposes which includes attendance in: o A licensed childcare center o Preschool or Head Start o Kindergarten or developmental kindergarten o 7 th grade o School-aged children who are new entrants to a school district Parents/guardians/18 y/o students must receive waiver education at a local health department on the: o benefits of vaccination o risks of vaccine-preventable diseases to the individual and community Waiver education appointments are available for Macomb County residents and those attending Macomb County schools, preschools or childcare centers by calling the School Immunization Program at (586) Walk-in requests for waiver education are not available. Appointments are one-on-one with a public health nurse. A nonmedical immunization waiver cannot be issued through a school, preschool, or childcare center. Upon completion of the required waiver education, parents/guardians/18 y/o students will: o Receive a certified waiver (MCHD employee signature, address stamp, and date) on the State of Michigan Immunization Waiver Form (Rev. January 1, 2017). o Be required to take the certified nonmedical waiver form to the school, preschool or childcare center. Copies of the waiver will be made and placed in the child s record and one in the school s or program s master file of children with waivers. o Be responsible to retain the original waiver form and keep it safe. Written alteration of the Instructions to Parents or Guardians section on the Immunization Waiver Form, constitutes an invalid waiver and cannot be accepted by a school, preschool or childcare center. Additional notes Children that do not have the required doses of vaccines (unless they have provisional status) and do not have a waiver on file, must be excluded from the school, preschool or childcare center. Medical waivers, for valid health contraindications, require the State of Michigan Medical Contraindication Form (Rev. January 1, 2017). The form is available at a school, preschool, childcare center or online. Parents/guardians/18 y/o students are responsible to have their physician (M.D., D.O., P.A. or N.P.) complete and sign the required sections and take the form to the school, preschool or childcare center. The form will then be faxed to the SIP for review by the MCHD Medical Director. 01/30/2017 Schools, Preschools, Childcare Centers and Clinics: PLEASE COPY AND DISTRIBUTE THIS FLYER TO PARENTS/GUARDIANS/STUDENTS

10 Macomb County Health Department 1. Immunization OR 2. Nonmedical Waiver Education Services THESE SERVICES ARE CONDUCTED BY TWO SEPARATE COUNTY PROGRAMS. PLEASE READ EACH SECTION CAREFULLY TO CONTACT THE PROGRAM YOU NEED. 1. Information for IMMUNIZATION CLINIC SERVICES ONLY NOTE: NEW CLINIC HOURS Effective August 1, 2017 Mt. Clemens Health Center Elizabeth Road Mt. Clemens, MI (586) MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY Open TB testing Closed Open 8:30-6:30 TB testing Open No TB testing Closed* *Except 3 rd Fridays, Open 11:30-4:30 2. Information for NONMEDICAL WAIVER EDUCATION SERVICES ONLY For parents, guardians or 18 year old students seeking a nonmedical immunization waiver, a waiver education session is available by appointment only through the School Immunization Program. Please call (586) to schedule an appointment. The waiver education session is with a public health nurse. Southwest Health Center Van Dyke, Ste. B Warren, MI (586) Southeast Health Center Harper Avenue St. Clair Shores, MI (586) /01/2017 Closed Open 8:30-6:30 TB testing Open TB testing Open TB testing Open TB testing Closed Open 8:30-6:30 No TB testing Closed Open* TB testing *Except 3 rd Fridays, Open 11:30-4:30 Open* TB testing *Except 3 rd Fridays (Closed) PARENT OR GUARDIAN MUST be available to complete & sign immunization consent forms for each child. FORMS ARE AVAILABLE AT: PLEASE BRING WITH YOU TO THE HEALTH CENTER: IMMUNIZATION RECORD(S) for all persons being immunized. INSURANCE CARD(S) for all persons being immunized. There may be monetary charges for vaccine administration, payable by CASH or CHECK ONLY. Medicaid/Medicare will be billed for approved vaccines. Macomb County Health Department can bill some commercial insurances for immunization services. Please contact one of our health centers above to check if the Macomb Health Department accepts your insurance. The Immunization Waiver Form (nonmedical waiver form) is not available online or at your school or childcare center office. Schools, Preschools, Childcare Centers and Clinics: PLEASE COPY AND DISTRIBUTE THIS FLYER TO PARENTS/GUARDIANS/STUDENTS The public health code requires waivers be signed in the year in which a child s immunization status is assessed and reported for school and childcare purposes:, which includes: all children in a licensed childcare center, preschool, Head Start; and school-aged children who are new entrants to a school district, in kindergarten or developmental kindergarten, or in the 7 th grade, including children in special education programs. Per the requirements of the Michigan Public Health Code, R (12), all nonmedical Immunization waivers shall be certified by the local health department (LHD) that the individual received education on the risks of not receiving vaccines being waived and the benefits of vaccination to the individual and the community. The Medical Contraindication Form (medical waiver form for valid medical contraindications to vaccines), is available online or at your school or childcare center office. Contact the office for information about obtaining and submitting a medical waiver for review by the Macomb County Health Department Medical Director.

11 Statement of Varicella Disease CHICKENPOX The Michigan Public Health Code Act 368 of 1978 Part 92 Immunization and Macomb County Immunization Regulations require all children admitted to any public, private, parochial, special education, alternative education, adult education, career/technical education, homeschool cooperative, virtual school or charter academy, childcare center, nursery school, preschool, camp, or any other organized care or educational facility operating in Macomb County to present a certificate indicating dates of all required immunizations. Complete the portion below only if your child has had varicella (chickenpox) disease. This form must be signed and witnessed at your child s school/childcare program. I certify my child: Last Name First Name M.I. Birth Date Grade Date of School Enrollment has had varicella disease (When did varicella occur: Age or Date) Signature: (Parent or Legal Guardian) Date: Witnessed by: Date: (School/Program Staff) School District: School/Childcare Program: PLACE THIS FORM IN THE CHILD S PERMANENT RECORD MCHD/SIP 6/99, Revised 3/2017

12 RICK SNYDER GOVERNOR STATE OF MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES LANSING NICK LYON DIRECTOR Medical Contraindication Form Michigan immunization law requires that a child enrolled in a school or childcare center be immunized against the diseases specified unless a valid exemption applies. A child is exempt from these requirements for any specific immunization for any period of time for which a physician certifies that a specific immunization is or may be detrimental to the child's health. Any child with a medical contraindication to a particular vaccination is considered susceptible to that vaccine-preventable disease, and is subject to exclusion from school or childcare center if an outbreak of the disease occurs in the school or center. PLEASE PRINT: NAME OF CHILD (Last, First, Middle Initial) BIRTH DATE (Mo/Day/Yr) Preschool Program Or Childcare Center or School Name: The following immunization(s) are medically contraindicated: DTaP, DT, Td, Tdap (Diphtheria, Tetanus, Pertussis) Haemophilus influenzae type b Polio Pneumococcal Conjugate Hepatitis B Varicella (chickenpox) MMR (Measles, Mumps, Rubella) Meningococcal Conjugate Reason for exemption The exemption shall continue until (Mo/Day/Yr): PRINT NAME & ADDRESS OF PHYSICIAN TELEPHONE ( ) PHYSICIAN S SIGNATURE (REQUIRED) DATE School and Childcare Staff: File in the child s permanent record and send a copy to your local health department. *Condition of acceptance is based on local health department policies. DCH-0713 AUTHORITY: P. A. 368, PART 92, 1978, as amended Rev. January 1, SOUTH GRAND AVENUE PO BOX LANSING, MICHIGAN

13 RICK SNYDER GOVERNOR STATE OF MICHIGAN DEPARTMENT OF HEAL TH AND HUMAN SERVICES LANSING NICK LYON DIRECTOR April 24, 2017 RE: 2017 Calendar Year Immunization Requirements for Children Entering Kindergarten, 7th Grade or Children Entering a New School District in Grades 1-12 Dear Superintendents of Local and Intermediate School Districts; Principals of all Public, Private and Parochial Schools; and Public School Academy Directors: Immunizations are one of the most effective measures in protecting children from harmful diseases and death. The Michigan Public Health Code requires all children who attend school in Michigan to have an up-to-date immunization history or a valid waiver on file per Administrative Rules and report their immunization status to their jurisdictional local health department. A child who fails to meet these immunization requirements shall not be admitted into the school. It is the responsibility of the parent(s)/guardian(s) to ensure that their child has received all required vaccine doses upon school entry. Since 1978, Michigan law requires that each student possess a certificate of immunization at the time of registration (or no later than the first day of school) for entry into kindergarten, 7th grade, or into a new school district involving grades There are three circumstances in which a required vaccine may be waived or delayed: 1. The child has received at least one dose of required vaccine(s) and the next dose(s) are not yet due. These children are considered to be in a "provisional" status. Schools are required to follow-up with these students to ensure subsequent doses of vaccine are received and are complete for all required vaccines; 2. The child has a medical contraindication to a vaccine, in this case a Medical Contraindication Form is required to be completed and signed by the child's primary care physician. The form shall state the medical contraindication(s), the vaccine(s) involved, and the time period during which the child is precluded from receiving the vaccine(s); 3. A parent or guardian holds a religious or philosophical ("other") belief which preclude receipt of vaccination(s). These are nonmedical exemptions and require certification at the local health department. To meet admission requirements, it is the parent(s)/legal guardian(s) responsibility to bring the original signed current 2017 Nonmedical Waiver Form to your school for entry into the Michigan Care Improvement Registry (MCIR)/School Immunization Reporting System (SIRS). A student who fails to meet school immunization requirements shall not be admitted to school: Students excused, on "Pupil Membership Count Day" may still be counted for purposes of the State School Aid, if they physically return to school within 30 calendar days from the date of "Pupil Membership Count Day." 333 SOUTH GRAND AVENUE PO BOX LANSING. MICHIGAN

14 Superintendents, Principals and Directors April 24, 2017 Page 2 Students excluded from school entry due to an incomplete immunization record may be granted an excused absence by the Michigan Department of Education if permitted by the local school district Board of Education. The MCIR/SIRS system must be utilized to meet immunization compliancy with school immunization reporting. This system pulls immunization records contained within the MCIR for students entered into the MCIR/SIRS school roster. All students in both kindergarten and 7th grade need to be placed on the roster as well as any newly enrolled student to the district. The November 1, 2017 report should include all newly enrolled students from January 1, 2017 through September 30, The February 1, 2018 report should include the November roster, plus any students starting from October 1, 2017 through December 31, The local health department will monitor the progress, timeliness and accuracy of your school(s) immunization compliance reporting. For those individual programs without internet access, please contact your local health department for approval and guidance to report, using the handwritten IP Immunization Reporting Form. Proper maintenance of up-to-date immunization records are critical in the event of an outbreak of vaccine preventable disease, or if an audit is conducted by your local health department or the Michigan Department of Health and Human Services. Copies of the Nonmedical Waiver and Medical Contraindication Forms must be submitted no later than November 1, 2017 and February 1, 2018 to the jurisdictional local health department. Parent(s)/guardian(s) are required to receive education on the benefits of vaccination and the risks of disease before obtaining the signed certified Nonmedical Waiver Form from their local health department. Health professionals shall address concerns and/or questions, and then sign the current State of Michigan 2017 Nonmedical Waiver Form. Parents seeking a nonmedical exemption must contact the local health department to arrange for the educational session. The State School Aid Act (PA 94 of 1979) Section , requires that school districts shall submit an immunization report of the completed, appropriately waived and provisional immunization by November 1, 2017, and meet a 90% compliancy of the entering students, as listed above. School districts which are not in compliance will be subject to 5% of their state school aid funds being withheld. By February 1, 2018, a minimum of 95% of entering students, as listed above, shall submit a completed, appropriately waived and provisional immunization record to avoid the implementation of another 5% withholding. Submission of immunization records prior to the November and February deadlines will allow your local health department to review the submitted information and assist with data entry corrections. The Revised School Code, Section a* also requires the Michigan Department of Education, in cooperation with the Michigan Department of Health and Human Services, to develop information for Michigan schools to address notification of families with children enrolled in grades 6, 9, and 12, about the risk and prevention of Meningococcal Meningitis and Human Papillomavirus Diseases. Information regarding the symptoms of vaccine-preventable diseases, how they spread, risk factors, risk associated with vaccination against these diseases, and where to obtain the vaccines are available in this packet. These materials should be distributed to all parent(s)/guardian(s) about the importance of getting their children and adolescents vaccinated with all recommended vaccines. Feel free to print

15 Superintendents, Principals and Directors April 24, 2017 Page 3 copies of these materials and include them in any new parent or orientation packets. Please disseminate this information in school newsletters, and any other social media source utilized in your school districts. Parent handouts can be found at: Information about influenza vaccine is included in this packet and should be shared within the school community. Online access to these notification materials is available at or A summary of requirements and supporting information is included in this packet and is also posted online at under the School/Childcare section. Please review this important information to assist you with the completion of the immunization reporting of your students. A request for additional informational materials should be directed to your local health department. To assist in completion of immunization reports, a summary of the immunization requirements for new school entrants, along with supporting information, are available online at under the School/Childcare link. To obtain technical assistance or to enroll as a MCIR/SIRS user, please contact the MCIR Help Desk at Thank you for your continued support and cooperation in ensuring that Michigan's children are properly immunized to avoid the ongoing threat of communicability and illness associated with vaccine preventable diseases. Sincerely, ~ar Nick Lyon Director Department of Health and Human Services Brian. iston State Superintendent Department of Education NL:jj Enclosures c: Local Health Departments * legislature. mi.gov/documents/mcl/pdf/mcl a. pdf

16 Toll-free MCIR helpdesk number is The following materials can be found on and should be reviewed. Childcare packet: School packet: MCIR/SIRS Information Sheet MCIR/SIRS Information Sheet Childcare Cover Letter School Cover Letter Vaccines Required for Childcare and Preschools in Michigan Information for Parents Teen Vaccines Papillomavirus, Parents Handout - Vaccines Required for Childcare and Preschools in Michigan Meningococcal & Vaccines for Pre- Teens and Teens Influenza Information for Childcare Centers Influenza Information for Schools Waiver Key Point Flyer Vision Screening Information Waiver FAQ for Parents Vaccines Required for School Entry in Vaccine Terminology Michigan Parents Handout - Vaccines Required for School Entry in Michigan Waiver Key Point Flyer Waiver FAQ for Parents Vaccine Terminology January December: October 1st: November 1 st : February 1 st : Build your roster, making sure that appropriate reporting period and grade is marked for each student. Use current grade, or roundup for kindergarten in the Spring and Summer of 2017 all students will be advanced automatically on August 1 st. Childcare closes the report period by going into IP Status and clicking on the close period button on October 2 nd. (The button will not be highlighted and you will not be able to close the period if you are not at 90% compliancy.) Continue to update immunization records until you reach at least 90% compliancy. School closes the report period by going into IP Status and clicking on the close period button. (The button will not be highlighted and you will not be able to close the period if you have not obtained at least 90% compliancy). Complete vision report for all kindergarten students. Continue to update immunization records until you reach at least 100% compliancy. School closes the report period by going into IP Status and clicking on the close period" button. (The button will not be highlighted and you will not be able to close the period if you are not at 95% compliancy). Continue to update immunization records until you reach at least 100% compliancy. Contact your local health department or the help desk if you have any questions about reporting. Rev. March 31, 2017

17 Teen Vaccines Information For parents Meningococcal Vaccines (MenACWY, MenB) Adolescent Catch-Up Tetanus, Diphtheria, Pertussis (Tdap) Human Papillomavirus (HPV) Meningococcal vaccines protect against meningitis, which affects the brain and spinal cord. If your child contracts meningitis, it can cause brain damage, severe disabilities or death. Common symptoms include a fever, rash, headache, or stiff neck. It is spread through close contact with an infected person, such as coughing, kissing, and sharing food or drinks. This disease is easily spread. MenACWY is given at years of age with a second dose at 16. MenB is given at years of age in a series of doses. If your child has not received these vaccines, talk to their health care provider today. Many vaccines are given during childhood to give life-long protection against diseases. If your child has not received all of the below vaccines, it is not too late! 3 doses of hepatitis B vaccine (Hep B) 2 doses of hepatitis A vaccine (Hep A) 2 doses of measles, mumps, rubella vaccine (MMR) 2 doses of varicella (chickenpox) vaccine At least 3 doses of polio vaccine (IPV or OPV) Flu vaccine every year These vaccines are important, especially if your child plans to travel. All doses are needed for full protection. Tdap vaccine protects your child against pertussis (whooping cough), diphtheria, and tetanus. Tetanus causes painful tightening of the muscles and is very serious. It is found in soil and enters the body through a cut or wound. Diphtheria can make it hard to breath or move body parts. It is spread by coughing or sneezing. Pertussis can cause severe coughing and choking, making it difficult for your child to breathe or eat. It is spread by coughing, sneezing or close contact with an infected person. Tdap vaccine is usually given at the years of age. However, anyone who has not had Tdap vaccine needs a dose. HPV vaccine protects against cervical cancer in women and genital warts in men and women. It also protects against anal, penile, vaginal and vulvar cancers. HPV is a common infection transmitted by skin-to-skin contact. Even if your child does not have sexual intercourse, they can still get HPV. HPV infection often has no symptoms so a person could have it and not know. The best time to get HPV vaccine is at years of age, well before sexual activity starts. If the series is started before age 15 years, only 2 doses are needed. Individuals can be vaccinated through 26 years of age. This vaccine is safe, effective, and prevents several types of cancers. MDE and MDHHS are required by law (MCL a) to develop and make available to schools information on meningococcal and HPV vaccines. MDHHS is also required (MCL b) to notify schools of the availability of HPV educational materials, and encourage schools to make them available to parents. Updated January 31, 2017

18 INFLUENZA: Information for Schools on Influenza and Vaccines Is flu vaccine recommended for children in schools? Yes. The Centers for Disease Control and Prevention (CDC) and the Michigan Department of Health and Human Services (MDHHS) recommend that all children 6 months of age and older receive flu vaccine every year to help them stay healthy. DID YOU KNOW? The flu vaccine is the best defense against the flu and the best way to protect children and adults from getting the flu. How can students and staff be protected from the flu? You can protect students and staff by getting a flu vaccine and encouraging others in contact with children to get vaccinated parents, teachers, secretaries, and other support staff. The flu vaccine protects against the flu by creating antibodies that fight against the flu virus. DID YOU KNOW? Every year there are Michigan schools that close because too many students are absent with the flu. Stop the spread by getting a flu vaccine! What is influenza or the flu? What are the symptoms of the flu? The flu is an infection of the nose, throat, and lungs that is caused by flu viruses. There are many different flu viruses that can make people sick. The flu spreads easily through coughing and sneezing. Many people get the flu every year. Some people can get very sick, and some even die. People who have the flu often get sick very fast with a high fever, headache, muscle aches, dry cough, and sore throat. Some people who have the flu have NO symptoms at all, but they can still spread the flu to others. What kinds of flu vaccine can students get? How often should a flu vaccine be given? School-aged children can get the flu shot. The nasal spray flu vaccine was not recommended for the flu season because it did not do a good job of protecting against the flu in previous seasons, in comparison to the flu shot. DID YOU KNOW? The decision to no longer use FluMist is an example of using science to help improve the public s health. Flu vaccines change from year to year, so children and adults need to get a flu vaccine every year. Some children may need two doses, which a healthcare provider can help determine. The vaccine can be given as soon as it becomes available (as early as August). DID YOU KNOW? It is safer to get the flu vaccine than it is to get the flu. Don t underestimate the health risks from flu. The Advisory Committee on Immunization Practices makes the recommendations for who should receive the flu vaccine each year. Visit for more information. Updated February 28, 2017.

19 DATE: February 10, 2017 M E M O R A N D U M Michigan Department of Health and Human Services TO: Principals and Superintendents of all Michigan Public, Private and Parochial Schools SUBJECT: VISION SCREENING and REPORTING FOR KINDERGARTEN The screening of children s vision prior to the start of Kindergarten is required in Michigan. Several laws mandate the screening, confirmation of screening, and the reporting of these screenings. Public Health Code Act 368 of 1978, Section 9307 states that a parent, guardian, or person in loco parentis applying to have a child registered for the first time in a kindergarten or first grade in a school in this state shall present to school officials, at the time of registration or not later than the first day of school, a certificate of hearing and vision testing or screening or statements of exception under Section The Revised School Code (Act 451 of 1976, section ) requires that parents of children entering kindergarten present a statement to school officials confirming that they have received the Michigan Department of Health and Human Services Vision Screening OR a statement, signed by a licensed eye care practitioner (optometrist or ophthalmologist) or medical/osteopathic physician, indicating that a child s eyes have been examined at least once after age three and before initial school entry may also be presented. School officials are required to enter vision screening data into the MCIR/SIRS system for all kindergarten or developmental kindergarten new entrants by November 1 of each year.

20 Please note the following points regarding Kindergarten Vision Screening in Michigan: Parents are responsible for getting their child s vision screened prior to the first day of Kindergarten Schools facilitate the screenings by communicating the requirement to parents Local public health departments offer free screenings for all children in their service area Schools can facilitate the screenings by including the local health department screening staff during Round-Ups or registration days, if available Screening statements from the local health department, a licensed eye care practitioner (optometrist or ophthalmologist) or medical/osteopathic physician are acceptable Screenings are available at no charge to families through your local health department Screenings should take place no more than 6 months prior to the start of school Students should not be denied access to school because the parent did not have the screening completed. Parents should have the screening completed within the first week of school School officials enter the screenings onto the immunization data entry screen in the MCIR no later than November 1 of each school year November 1 is the deadline to report that the screenings have been completed prior to the first day of school A separate report to MDHHS is no longer required Schools and screening sites should ensure the following when scheduling their screening day: o Have available a quiet room with table and appropriate chairs for either preschool or school-age screening o Have available a room with adequate space, outlets, air flow, etc. o Screenings should never be conducted in bathrooms or rooms where other events are taking place or where unsafe conditions exist o Observers (including parents) must not communicate with children during the screening to prevent leading responses which can result in false negatives o Failure to ensure the above necessities will result in being asked to reschedule the screening date If you, or your support personnel responsible for entering vision screening data, have questions regarding this requirement, please contact your local health department s Vision Screening Program or Dr. Rachel Schumann, Vision Program Consultant for the Michigan Department of Health and Human Services, at On behalf of the children of Michigan, many thanks for helping ensure that all Michigan children have good vision as they begin their journey to success in learning and life. MDHHS/Vision Program Revised: February 10, 2017

21 Schools Vaccines Required for School Entry in Michigan Whenever children are brought into group settings, there is a chance for diseases to spread. Students must follow state vaccine laws in order to attend school. These laws are the minimum standard to help prevent disease outbreaks in school settings. The best way to protect students in your care from other serious diseases is to promote the recommended vaccination schedule at Encourage parents to follow CDC s recommended schedule; by doing so, school requirements will be met. Diphtheria, Tetanus, Pertussis (DTP, DTaP, Tdap) All Kindergarteners and 4-6 year old transfer students 4 doses DTP or DTaP 1 dose must be at or after 4 years of age All 7th Graders and 7-18 year old transfer students 4 doses D and T or 3 doses Td if 1st dose given at or after 1 year of age 1 dose Tdap at 11 years of age or older upon entry into 7th grade or higher Polio Measles, Mumps, Rubella (MMR)* Hepatitis B* 4 doses 3 doses if dose 3 was given at or after 4 years of age 2 doses at or after 12 months of age 3 doses Meningococcal Conjugate (MenACWY) None 1 dose at 11 years of age or older upon entry into 7th grade or higher Varicella (Chickenpox)* 2 doses at or after 12 months of age or Current lab immunity or History of varicella disease During disease outbreaks, incompletely vaccinated students may be excluded from school. Parents and guardians choosing to decline vaccines must obtain a certified non-medical waiver from a local health department. Read more about waivers at *If the student has not received these vaccines, documented immunity is required. All doses of vaccines must be valid (correct spacing and ages) for school entry purposes. Updated March 1, 2017