# Title 33 — State Department of Health

## Article 33-06 — Reportable Conditions

## Chapter 33-06-05 — School Immunization Requirements

### § 33-06-05-01. Requirements.

1. Definitions. As used in this section:
a. "Advisory committee on immunization practices" refers to a panel of experts in fields
associated with immunization who have been selected by the secretary of the United
States department of health and human services to provide advice and guidance to the
secretary, the assistant secretary for health, and the centers for disease control and
prevention on the most effective means to prevent vaccine-preventable diseases.
b. "Age-appropriate immunizations" refers to the vaccines a child should receive based on
age and previous immunization history as recommended by the advisory committee on
immunization practices of the United States department of health and human services
and outlined by the North Dakota immunization schedule.
c. "Beliefs" as used in subsection 3 of North Dakota Century Code section 23-07-17.1
means sincerely held religious, philosophical, or moral beliefs which are not a pretense
for avoiding legal requirements.
d. "Institution" includes all early childhood facilities, head start programs, preschool
educational facilities, public and private kindergartens, and elementary, middle, and high
schools operating in North Dakota.
e. "Institutional authority" means anyone designated by the governing body of an institution.
f. "Medical exemption" means an exemption from an immunization requirement based on a
form signed by a licensed physician stating that the physical condition of the child
seeking the exemption is such that the vaccine administered would endanger the life or
health of the child.
2. Minimum requirements.
a. Minimum requirements for children attending early childhood facilities, head start
programs, and preschool educational facilities shall be age-appropriate immunizations
against diphtheria, pertussis, tetanus, poliomyelitis, measles, mumps, rubella,
haemophilus influenzae type B disease, varicella (chickenpox), pneumococcal disease,
rotavirus, hepatitis A, and hepatitis B.
b. Minimum requirements for children attending kindergarten through grade twelve shall be
age-appropriate immunizations against diphtheria, pertussis, tetanus, poliomyelitis,
measles, mumps, rubella, varicella (chickenpox), meningococcal disease, and
hepatitis B.
3. Effective dates.
a. Effective with the 2008-09 school year, a student must receive a second dose of varicella
(chickenpox) vaccine before being admitted into kindergarten or first grade if the
student's school does not have a kindergarten. Each subsequent school year, the next
higher grade will be included in the second dose varicella (chickenpox) immunization
requirement so those students transferring into North Dakota schools are added to the
second dose varicella (chickenpox) immunization cohort.

b. Effective with the 2014-15 school year, a student must receive meningococcal conjugate
and tetanus, diphtheria, and pertussis (tdap) vaccine before being admitted into any
seventh grade.
c. Effective with the 2018-19 school year, a student must be adequately immunized
according to the advisory committee on immunization practices with tetanus, diphtheria,
and pertussis (tdap) vaccine before being admitted into eighth through twelfth grade.
d. Effective with the 2018-19 school year, a student must be adequately immunized
according to the advisory committee on immunization practices with meningococcal
conjugate vaccine before being admitted into eighth through twelfth grade.
4. Exemptions. A child with a medical or a beliefs exemption is exempt from any one or all of the
immunization requirements. A physician must sign an exemption form indicating the vaccines
that are included in the medical exemption. A parent or guardian must sign an exemption form
stating that the child has a beliefs exemption and indicate which vaccines are exempt because
of beliefs. A child with a reliable history of chickenpox, hepatitis A, hepatitis B, measles,
mumps, or rubella is exempt from applicable immunization requirements. A physician must
sign an exemption form stating that the child has had disease. Exemption forms must be kept
on file with the immunization records at the child's school, early childhood facility, head start
program, or preschool educational facility.
5. Recordkeeping and reporting. Records and reports requested by the state department of
health shall be completed and submitted to the state department of health.
a. Certificates of immunization, a North Dakota immunization information system (NDIIS)
record, or other official proof of immunization must be presented to the designated
institutional authority before any child is admitted to an institution.
b. Upon request by the institutional authority and approval by the department, the
department shall provide access to the NDIIS. The department of health shall disclose
immunization records maintained by the NDIIS to an institutional authority or designee to
fulfill the required proof of immunization.
c. The parent or guardian of a child claiming a medical, history of disease, or beliefs
exemption shall present an appropriately signed statement of exemption to the
designated institutional authority. Proof of immunization or the statement of exemption
must be maintained by the child's school or early childhood facility.
d. The school or early childhood facility immunization summary report must be submitted to
the state department of health by November first of each year or such other annual date
as the department may designate.
6. Appointment of an institutional authority. An institutional authority shall be appointed for
each institution by its governing board or authorized personnel. The authority must be an
employee of such institution.
7. Provisional admission - Exclusion. Any child admitted to school or early childhood facility
under the provision that such child is in the process of receiving the required immunizations
shall be required to receive the immunizations according to the recommended schedule set
forth by the state department of health. Any child admitted to school and not adhering to the
recommended schedule shall provide proof of immunization or a certificate of immunization by
October first or within thirty calendar days of enrollment if enrolling after October first or be
excluded from school. Any child admitted to an early childhood facility and not adhering to the
recommended schedule shall provide proof of immunization or a certificate of immunization
within thirty calendar days of enrollment or be excluded from the early childhood facility.

History: Amended effective November 1, 1979; September 1, 1991; January 1, 1998; February 1,
2000; January 1, 2004; January 1, 2008; January 1, 2014; January 1, 2018.
General Authority: NDCC 23-01-03
Law Implemented: NDCC 23-07-17.1
