Utah Immunization Rule for Students

R396-100-1. Purpose and Authority.

(1) This rule implements the immunization requirements of Title 53G, Chapter 9, Part 3 Immunization Requirements. It establishes minimum immunization requirements for attendance at a public, private, elementary, or secondary school through grade 12, nursery school or kindergarten, licensed day care center, child care facility, family home care, or Head Start program in this state. It establishes:

(a) required doses and frequency of vaccine administration;

(b) reporting of statistical data; and

(c) time periods for conditional enrollment.

(2) Section 53G-9-305 authorizes this rule.

R396-100-2. Definitions.

The definitions in Section 53G-9-301 apply to this rule. In addition, as used in this rule:

“Department” means the Utah Department of Health and Human Services created in Section 36B-1-201.

“Early Childhood Program” means a nursery or preschool, licensed day care center, child care facility, family care home, or Head Start program.

“Exemption” means a relief from the statutory immunization requirements by reason by qualifying under Section 53G-9-303.

R396-100-3. Required Immunizations.

(1) A student enrolling in kindergaten through sixth grade shall be immunized in accordance with the Advisory Committee on Immunization Practices (ACIP) Recommendations, as listed in Subsection R396-100-3(4), before school entry for the following vaccines and doses:

(a) Measles, Mumps, Rubella (MMR) - 2 Doses;

(b) Varicella - 2 doses;

(d) Polio - 4 doses, dose number 4 not necessary if dose 3 was administered at age 4 years or older and at least 6 months after the previous dose;

(e) Hepatitis A - 2 doses; and

(f) Diphtheria, Tetanus, and Pertussis (DTaP) - 5 doses, dose 5 is not necessary if dose 4 was administered at age 4 years or older and at least 6 months after dose 3.

(2)(a) A student enrolling in seventh through twelfth grade:

(b) Must be immunized in accordance with ACIP Recommendations, as listed in Subsection R396-100-3(4), before school entry for the following vaccines and doses:

(i) Tetanus, Diphtheria, and acellular Pertussis (Tdap) - One dose;

(ii) Measles, Mumps, Rubella (MMR) - 2 doses;

(iii) Varicella - 2 doses;

(iv) Hepatitis B - 3 doses;

(v) Polio - 4 doses, dose 4 is not necessary if dose 3 was administered at age 4 years or older and at least 6 months after the previous dose;

(vi) Hepatitis A - 2 doses; and

(vii) Meningococcal Conjugate Vaccine - One dose.

(c) Must provide proof of previously receiving five doses of DTaP vaccine or 4 doses if dose 4 was administered at age 4 years or older and at least 6 months after dose 3. A student who has never been vaccinated with DTaP vaccine or who was not fully vaccinated with DTaP vaccine as provided by Subsection R396-100-3(1)(f) must be immunized with the appropriate number of doses of Tetanus, Diphtheria (Td) or Tdap vaccine in accordance with the catch-up Immunization schedule for children and adolescents who start late or who are more than one month behind.

(3) To attend a Utah early childhood program, a student must meet the minimum immunization requirements of the ACIP listed in Subsection R396-100-3(4) for the following antigens:

(a) Diphtheria;

(b) Tetanus;

(d) Polio;

(e) Measles;

(f) Mumps;

(g) Rubella;

(h) Haemophilus Influenza Type b;

(i) Hepatitis A;

(j) Hepatitis B;

(k) Pneumococcal; and

(l) Varicella vaccines before school entry.

(4) The vaccinations must be administered according to the recommendations of the United States Public Health Service's Advisory Committee on Immunization Practices (ACIP) which are incorporated by reference into this rule:

(a) General Recommendations on Immunization: MMWR, Decembet 1, 2006/Vol. 55/No. RR-15;

(b) General Recommendations on Immunization: MMWR, January 28, 2011; 60(RR02):1-60;

(d) Combination Vaccines for Childhood Immunization: MMWR, May 14, 1999/Vol. 48/No. RR-5;

(e) Use of Diphtheria Toxoid-Tetanus Toxoid-Acellular Pertussis Vaccine as a Five-Dose Series: Supplemental Recommendations of the Advisory Committee on Immunization Practices: MMWR, November 17, 2000/Vol. 49/No. RR-13;

(f) Licensure of a Diphtheria and Tetanus Toxoids and Acellular Pertussis, Inactivated Poliovirus, Haemophilus influenzae Type b Conjugate, and Hepatitis B Vaccine, and Guidance for Use in Infants: MMWR, February 7, 2020, 69 (5); 136-139;

(g) Prevention of Pertussis, Tetanus, and Diphtheria with Vaccines in the United States: Recommendations of the Advisory Committee on Immunization Practices (ACIP): MMWR, April 27, 2018; 67 (2):1-44;

(h) Updated Recommendations for Use of Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis (Tdap) Vaccine from the Advisory Committee on Immunization Practices, 2010: MMWR, January 14, 2011; 60(01):13-15;

(i) Use of Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis Vaccines Among Adolescents: MMWR, March 24, 2006, Vol. 55(RR03):1-49;

(j) Use of Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis Vaccines: Updated Recommendations of the Advisory Committee on Immunization Practices: MMWR, January 24, 2020, vol. 69 (3);77-83;

(k) A Comprehensive Immunization Strategy to Eliminate Transmission of Hepatitus B Virus Infection in the United States. Part I: Immunization of Infants, Children and Adolescents: MMWR, December 23, 2005, Vol. 54(RR-16): 1-39;

(l) Prevention of Hepatitis B Virus Infection in the Unnited States: Recommendations of the Advisory Committee on Immunization Practices: MMWR, January 12, 2018; 67 (1); 1-31;

(m) Haemophilus b Conjugate Vaccines for Prevention of Haemophilus influenza Type b Disease Among Infants and Children Two Months of Age and Older: MMWR, January 11, 1991'Vol. 40/No. RR-1;

(n) Recommendations for Use of of Haemophilus b Conjugate Vaccines and a Combined Diphtheria, Tetanus, and Pertussis, and Haemophilus b Vaccine: MMWR, September 17, 1993/Vol. 42/No. RR-13;

(o) Prevention and Control of Haemophilus influenzae Type b Disease: Recommendations of the Advisory Committee on Immunization Practices (ACIP) Recommendations and Reports: MMWR, February 28, 2014; 63(RR01):1-14;

(p) Updated Recommendations of the Advisory Committee on Immunization Practices (ACIP) for the Control and Elimination of Mumps: MMWR, June 9, 2006/Vol. 55/No. RR-22;

(q) Measles, Mumps, Rubella Vaccine (PRIORIX): Recommendations of the Advisory Committee on Immunization Practices --- United States, 2022: MMWR, November 18, 2022, 71 (46); 1465-1470;

(r) Prevention of Measles, Rubella, Congenital Rubella Syndrome, and Mumps, 2013 -- Summary Recommendations of the Advisory Committee on Immunization Practices (ACIP): MMWR, June 14, 2013; 62(RR04):1-34;

(s) Use of Combination Measles, Mumps, Rubella, and Varicella Vaccine--Recommendations of the Advisory Committee on Immunization Practices: MMWR, May 7, 2010; 59(RR--3):1 -- 16;

(t) Updated Recommendations of the Advisory Committee on Immunization Practices (ACIP) Regarding Routine Poliovirus Vaccination: MMWR, August 7, 2009/Vol. 58/No. 30;

(u) Poliomyelitis Prevention in the United States: MMWR May 19, 2000 / Vol. 49 / No. RR-05;

(v) Prevention of Varicella: MMWR, June 22, 2007/Vol. 56/No. RR-4;

(w) Prevention of Hepatitis A Through Active or Passive Immunization: MMWR, May 29, 2006/Vol. 55/No. RR-7;

(x) Prevention of Hepatitis A Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices: MMWR, July 3, 2020, Vol. 69 (5);1-38;

(y) Licensure of a 13-Valent Pneumococcal Conjugate Vaccine (PCV13) and Recommendations for Use Among Children-Advisory Committee on Immunization Practices, (ACIP), 2010: MMWR March 12, 2010/Vol. 59/No. 09;

(z) Use of 15-Valent Pneumococcal Conjugate Vaccine Among U.S. Children: Updated Recommendations of the Advisory Committee on Immunization Practices-US, 2022: MMWR, September 16, 2022, 71(37);1174--1181;

(aa) Preventing Pneumococcal Disease Among Infants and Young Children: MMWR October 6, 2000 /Vol. 49 / No.RR-09;

(bb) Prevention and Control of Meningococcal Disease: Recommendations of the Advisory Committee on Immunization Practices (ACIP): March 22, 2013/62(RR02);1-22;

(cc) Meningococcal Vaccination: Recommendations of the Advisory Committee on Immunization Practices: MMWR, September 25, 2020, Volume 69(9); 1--41;

(dd) Licensure of a Meningococcal Conjugate Vaccine (Menveo) and Guidance for Use--Advisory Committee on Immunization Practices (ACIP), 2010: MMWR, March 12, 2010; 59(09):273; and

(ee) Updated Recommendations for Use of Meningococcal Conjugate Vaccines--Advisory Committee on
Immunization Practices (ACIP), 2010: MMWR, January 28, 2011; 60(03):72-76.

R396-100-4. Official Utah School Immunization Record (USIR).

(1) Schools and early childhood programs shall use the official Utah School Immunization Record (USIR) form as the record of each student’s immunizations. The department shall provide copies or electronic copies of the USIR to schools, early childhood programs, physicians, and local health departments upon each of their requests.

(2) Each school or early childhood program shall accept an immunization as a certificate of immunization if:

(a) it is received from a statewide registry, the student's former school, or the student's legally responsible individual;

(b) it relates to a student regarding required vaccinations that the student has received; and

(c) it includes the date each vaccine was administered, as verified by a licensed health care provider, an authorized representative of a local health department, an authorized representative of the department, a registered nurse, or a pharmacist.

(3)(a) Each school and early childhood program must maintain the following information in the file of each enrolled student:

(i) the completed USIR for each student;

(ii) an exemption form for each student claiming an exemption; and

(iii) immunity documents for each student claiming previously infection with measles, mumps, rubella (MMR), varicella, or hepatitis A disease. The immunity documents must include the results of serologic testing for immunity, titer testing, and a written statement signed by a health care provider confirming that, based on positive laboratory test results, the student does not need to receive the MMR, varicella, or hepatitis A vaccines. Immunity through serologic testing is only acceptable and allowed for those students who were previously infected with measles, mumps, rubella, varicella, or hepatitis A.

(b) The school and early childhood programs shall maintain up-to-date records of the immunization status for all students in all grades such that it can quickly exclude all non-immunized students if an outbreak occurs.

(c) If a student withdraws, transfers, is promoted, or otherwise leaves school, the school or early childhood program shall either:

(i) return the USIR, any immunity documents, and any exemption form to the legally responsible individual of a student; or

(ii) transfer the USIR, any immunity documents, and any exemption form with the student's official school record to the new school or early childhood program upon the request of the student's legally responsible individual.

(4) A representative of the department or the local health department may examine, audit, and verify immunization records maintained by any school or early childhood program.

(5) Schools and early childhood programs may meet the record keeping requirements of this section by keeping its official school immunization records in the Utah Statewide Immunization Information System (USIIS).

R396-100-5. Exemptions.

(1) A legally responsible individual of a student claiming an exemption to immunization for medical, religious, or personal reasons, as allowed by Section 53G-9-303, shall provide to the student's school or early childhood program the exemption form as set forth and required in Section 53G-9-304.

(2) Also, to qualify for the exemption, the school or early childhood program shall attach the Section 26B-7-118 Health Education form to the student's USIR indicating the parent received the required health education by online module or from an authorized local health authority.

R396-100-6. Reporting Requirements.

(1) Each school and early childhood program shall report the following to the department in the form or format prescribed by the department:

(a) by January 30 of each year, a statistical report of the immunization status of students enrolled in a licensed day care center, Head Start program, and kindergartens;

(b) by January 30 of each year, a statistical report of the two-dose measles, mumps, and rubella immunization status of all kindergarten through twelfth grade students;

(c) by January 30 of each year, a statistical report of tetanus, diphtheria, pertussis, hepatitis B, varicella, and the twodose measles, mumps, and rubella immunization status of all seventh grade students; and
(d) by June 15 of each year, a statistical follow-up report of those students not appropriately immunized from the January 30 report in all public schools, kindergarten through twelfth grade.

(2) The information that the department requires in the reports shall be in accordance with the Centers for Disease Control and Prevention guidelines.

R396-100-7. Conditional Enrollment, Extended Conditional Enrollment, and Exclusion.

(1) A student that at the time of enrollment has not provided a school or early childhood program with a complete immunization record, as required in this rule, may attend the school or early childhood program on a conditional enrollment for:

(a) the period in which the student's immunization record is under review by the school or early childhood program; or (b) 30 calendar days after the day the school or early childhood program provides a notice as described in Subsection 53G-9-308(3) to the enroller.

(2) A school or early childhood program with conditionally and extended conditionally enrolled students shall routinely review every 30 days the immunization status of all conditionally enrolled students until each student has completed the subsequent doses and provided written documentation to the school or early childhood program.

(3) Once the student has met the requirements of this rule, the school or early childhood program shall take the student off conditional status.

R396-100-8. Exclusions of Students Who Are Under Exemption, Conditionally, or Extended Conditionally Enrolled Status.

(1) A local or state health department representative may exclude a student, as authorized by Section 53G-9-302, who has claimed an exemption to all vaccines or to one vaccine, who is not immune to the outbreak disease, or who is conditionally or extended conditionally enrolled from school attendance if there is good cause to believe that the student has a vaccinepreventable disease, or:

(a) has been exposed to a vaccine-preventable disease; or

(b) will be exposed to a vaccine-preventable disease as a result of school attendance.

(2) An excluded student may not attend school until the local health officer is satisfied that a student is no longer at risk of contracting or transmitting a vaccine-preventable disease.

(3) Schools and early childhood programs shall comply with disease outbreak management options as described in Subsection 53G-9-309(3)(c).

R396-100-9. Penalties.

Enforcement provisions and penalties for the violation or for the enforcement of public health rules, including this Immunization Rule for Students, are prescribed under Section 26B-1-224.

KEY: immunizations, rules and procedures

Date of Last Change: February 25, 2024

Notice of Continuation: May 22, 2023

Authorizing, and Implemented or Interpreted Law: Title 53G Chapter 9 Part 3; 26B-7-118