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TITLE 25HEALTH SERVICES
PART 1DEPARTMENT OF STATE HEALTH SERVICES
CHAPTER 97COMMUNICABLE DISEASES
SUBCHAPTER BIMMUNIZATION REQUIREMENTS IN TEXAS ELEMENTARY AND SECONDARY SCHOOLS AND INSTITUTIONS OF HIGHER EDUCATION
RULE §97.63Immunization Requirements in Child-care Facilities, Pre-Kindergarten, Early Childhood Programs, and Texas Elementary and Secondary Schools

Every child in the state shall be vaccinated against vaccine-preventable diseases caused by infectious agents, in accordance with the following immunization schedule. While the department recommends that providers immunize children according to the recommendations found on the department's website at www.ImmunizeTexas.com, this section sets out minimum immunization requirements for school entry for the child. A copy of the current recommended schedule is available at www.ImmunizeTexas.com, or by mail by writing the Department of State Health Services, Mail Code 1946, P.O. Box 149347, Austin, Texas 78714-9347.

  (1) For those vaccines for which it is stated in this section that a certain dose must be received on or after a certain birthday, a vaccine administered up to four days prior to the deadline is considered compliant with that deadline.

  (2) For diseases listed below, a child or student shall show acceptable evidence of vaccination prior to entry, attendance, or transfer to a child-care facility or public or private elementary or secondary school.

    (A) Children enrolled in child-care facilities, pre-kindergarten, or early childhood programs shall be immunized against: diphtheria, pertussis, tetanus, poliomyelitis, Haemophilus influenzae type b (Hib), measles, mumps, rubella, hepatitis B, hepatitis A, invasive pneumococcal, and varicella diseases. In recognition of the fact that immunization needs vary depending on the age of the child, the minimum number of doses required for each vaccine is indicated in the schedule below:

Attached Graphic

    (B) Students in kindergarten through twelfth grade shall have the following vaccines, according to the schedule listed.

      (i) Poliomyelitis.

        (I) Kindergarten entry. Students are required to have four doses of polio vaccine--one of which must have been received on or after the fourth birthday. Or, if the third dose was administered on or after the fourth birthday, only three doses are required. Four doses of oral polio vaccine (OPV) or inactivated poliovirus vaccine (IPV) in any combination by age four to six years old is considered a complete series, regardless of age at the time of the third dose.

        (II) Polio vaccine is not required for persons eighteen years of age or older.

      (ii) Diphtheria/Tetanus/Pertussis.

        (I) Kindergarten entry. Students are required to have five doses of a diphtheria/tetanus/pertussis-containing vaccine-one of which must have been received on or after the fourth birthday. Or, if the fourth dose was administered on or after the fourth birthday, only four doses are required.

        (II) Students seven years of age or older. Students seven years of age or older are required to have at least three doses of a tetanus/diphtheria-containing vaccine, provided at least one dose was administered on or after the fourth birthday. Any combination of three doses of a tetanus/diphtheria-containing vaccine will meet this requirement.

        (III) Tdap.

          (-a-) For the school year (SY) 2008 - 2009 through the end of any summer session of the SY 2008 - 2009, students are required to have one dose of a tetanus/diphtheria-containing vaccine within the last ten years.

          (-b-) Seventh grade. Beginning SY 2009 - 2010, students will be required to have one booster dose of a tetanus/diphtheria/pertussis-containing vaccine for entry into the 7th grade, if at least five years have passed since the last dose of a tetanus-containing vaccine. If five years have not elapsed since the last dose of a tetanus-containing vaccine at entry into the 7th grade, then this dose will become due as soon as the five-year interval has passed. Td vaccine is an acceptable substitute, if Tdap vaccine is medically contraindicated.

          (-c-) Grades 8 - 12. Beginning SY 2009 - 2010, students who have not already received Tdap vaccine are required to receive one booster dose of Tdap when ten years have passed since the last dose of a tetanus-diphtheria-containing vaccine.

        (IV) Children who were enrolled in school, grades K - 12, prior to August 1, 2004, and who received a booster dose of DTaP or polio vaccine in the calendar month of (or prior to) their fourth birthday, shall be considered in compliance with clause (i)(I) (polio) and clause (ii)(I) (DTaP) of this subparagraph.

      (iii) MMR.

        (I) For the SY 2008 - 2009 through the end of any summer session of the SY 2008 - 2009, students are required to have two doses of a measles-containing vaccine, and one dose each of rubella vaccine and mumps vaccine.

        (II) Beginning SY 2009 - 2010, students are required to have two doses of MMR vaccine with the first dose received on or after the first birthday for the following grades and school years:

          (-a-) SY 2009 - 2010: K;

          (-b-) SY 2010 - 2011: K - 1;

          (-c-) SY 2011 - 2012: K - 2;

          (-d-) SY 2012 - 2013: K - 3;

          (-e-) SY 2013 - 2014: K - 4;

          (-f-) SY 2014 - 2015: K - 5;

          (-g-) SY 2015 - 2016: K - 6;

          (-h-) SY 2016 - 2017: K - 7;

          (-i-) SY 2017 - 2018: K - 8;

          (-j-) SY 2018 - 2019: K - 9;

          (-k-) SY 2019 - 2020: K - 10;

          (-l-) SY 2020 - 2021: K - 11; and

          (-m-) SY 2021 - 2022: K - 12.

      (iv) Hepatitis B.

        (I) Students are required to have three doses of hepatitis B vaccine no later than entry into kindergarten.

        (II) In some circumstances, the United States Food and Drug Administration may officially approve in writing the use of an alternative dosage schedule for this vaccine. Such an alternative regimen may be used to meet the requirements under this section only when alternative regimens are fully documented. Such documentation must include vaccine manufacturer and dosage received for each dose of that vaccine.

      (v) Varicella.

        (I) For the SY 2008 - 2009 through the end of any summer session of the SY 2008 - 2009, students are required to have one dose of varicella vaccine received on or after the first birthday for grades K - 12.

        (II) Beginning SY 2009 - 2010, students are required to have two doses of varicella vaccine received on or after the first birthday for the following grades and school years (Two doses are required if the child was thirteen years old or older at the time the first dose of varicella vaccine was received):

          (-a-) SY 2009 - 2010: K, 7;

          (-b-) SY 2010 - 2011: K - 1, 7 - 8;

          (-c-) SY 2011 - 2012: K - 2, 7 - 9;

          (-d-) SY 2012 - 2013: K - 3, 7 - 10;

          (-e-) SY 2013 - 2014: K - 4, 7 - 11;

          (-f-) SY 2014 - 2015: K - 5, 7 - 12; and

          (-g-) SY 2015 - 2016: K - 12.

      (vi) Hepatitis A.

        (I) For the SY 2008 - 2009 through the end of any summer session of the SY 2008 - 2009, upon entry into kindergarten through third grade, two doses of hepatitis A vaccine are required for students attending a school located in a high incidence geographic area as designated by the department. The first dose shall be administered on or after the second birthday. A current list of geographic areas, for which hepatitis A is mandated for this time period, is available at www.ImmunizeTexas.com, or by mail request at Department of State Health Services, P.O. Box 149347, Austin Texas 78714-9347.

        (II) For SY 2009 - 2010, students are required to have two doses of hepatitis A vaccine with the first dose received on or after the first birthday for the following grades and school years:

          (-a-) SY 2009 - 2010: K;

          (-b-) SY 2010 - 2011: K - 1;

          (-c-) SY 2011 - 2012: K - 2;

          (-d-) SY 2012 - 2013: K - 3;

          (-e-) SY 2013 - 2014: K - 4;

          (-f-) SY 2014 - 2015: K - 5;

          (-g-) SY 2015 - 2016: K - 6;

          (-h-) SY 2016 - 2017: K - 7;

          (-i-) SY 2017 - 2018: K - 8;

          (-j-) SY 2018 - 2019: K - 9;

          (-k-) SY 2019 - 2020: K - 10;

          (-l-) SY 2020 - 2021: K - 11; and

          (-m-) SY 2021 - 2022: K - 12.

      (vii) Meningococcal. Students are required to have one dose of meningococcal vaccine for the following grades and school years:

        (I) SY 2009 - 2010: 7;

        (II) SY 2010 - 2011: 7 - 8;

        (III) SY 2011 - 2012: 7 - 9;

        (IV) SY 2012 - 2013: 7 - 10;

        (V) SY 2013 - 2014: 7 - 11; and

        (VI) SY 2014 - 2015: 7 - 12.


Source Note: The provisions of this §97.63 adopted to be effective April 1, 2004, 29 TexReg 3188; amended to be effective December 10, 2006, 31 TexReg 9835; amended to be effective March 5, 2009, 34 TexReg 1433; amended to be effective July 20, 2011, 36 TexReg 4563

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