NWESD Policy Manual & Administrative Procedures

3413-P – Student Immunization and Life-Threatening Health Conditions

Required Immunization Documentation

Immediately upon enrollment in a NWESD 189 student program, 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 the program until the completed CIS and/or COE is on file 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 NWESD 189 will provide access to immunization records of each student enrolled to agents of the state or local health department. The NWESD 189 will return the CIS and/or COE or a legible copy to the parent or legal guardian if the child is withdrawn or transferred from the program. The program may not withhold the CIS and/or COE for any reasons, including nonpayment of fees.

Certificate of Immunization

Program 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. Program staff will document this verification in the student’s cumulative record. If the immunizations are not complete in the IIS or the student’s member district is not actively using the IIS School Module, the immunization status must be documented on a completed CIS form.

All immunization information documented on a CIS by new enrollees starting the program 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 program administrator, program 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. Program staff may use the information on the medical immunization record to update the student’s existing CIS on file. If the student’s member district is using the IIS School Module, the program nurse or 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 the program in a temporary “conditional immunization status” provided that the student has received all of the immunizations that he/she is 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 time lines that follow. 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. If the thirty (30) calendar day period expires and documentation has not been given to the program 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

Any and all exemptions will be processed and recorded on a Certificate of Exemption (COE) form approved by the Washington Department of Health (DOH). All exemptions requested on a COE must be signed by the parent or legal guardian. Additionally, with the exception of a religious membership exemption, all COE forms presented on or after July 22, 2011, must also have the signature of a health care practitioner (HCP) saying they have given the parent or guardian information about the benefits and risks of immunizations. The form may be signed by a HCP at any time prior to the enrollment of the student in a program. Photocopies of the signed form or a letter from the HCP referencing the student’s name shall be accepted in lieu of the original form. Such a letter should be attached to the COE signed by the parent or legal guardian. Only a health care practitioner who is a physician (MD), physician assistant (PA), osteopath (DO), naturopath (ND), or advanced registered nurse practitioner (ARNP) licensed in Washington State may sign the COE.

The NWESD 189 will grant medical exemptions from one (1) or more of the required immunizations if the HCP indicates on the COE that in his/her opinion the vaccine is not advisable for the student. If the HCP indicates the medical exemption is temporary, an expiration date must be documented on the COE. When a temporary medical exemption expires, the student can attend the program in “conditional immunization status” for thirty (30) calendar days to get the missing immunization or another exemption. If the thirty (30) calendar day period expires and documentation has not been given to the program, 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.

The NWESD 189 will grant religious exemptions from one (1) or more of the required immunizations if the parent or legal guardiancompletes the religious exemption section of the COE. The NWESD 189 will grant religious membership exemptions from one (1) or more of the required immunizations if the parent or legal guardian completes the religious membership section of the COE and signs affirming they are a member in a religious body or church with beliefs or teachings that preclude a child from receiving medical treatment from a HCP. The HCP signature is not required for a religious membership exemption.

The NWESD 189 will grant personal/philosophical exemptions from one (1) or more of the required immunizations, except measles, mumps, or rubella, if the parent completes the personal/philosophical exemption section on the COE. The NWESD 189 will not grant an exemption for philosophical or personal reasons from the measles, mumps, or rubella immunization requirements.

Exclusion from Program

The program administrator 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 program will provide written notification as required in WAC 392-380-050. Written notification will:

1. Order that the student is excluded immediately, and
2. Be delivered in person or by certified mail, and
3. Be in the parent’s native language if possible, and
4. 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
5. Provide information regarding immunization services available through local health or other public agencies, and
6. Include notice that the parent/legal guardian and student has a right to a hearing provided they notify the program within three (3) days after receiving the exclusion order from the program administrator, and
7. Describe the hearing process, and
8. Explain that the exclusion continues until either the required immunization documentation, or a completed Certificate of Exemption form is turned in to the program, or a hearing officer determines that the student is no longer excluded from the program.

If the parent requests a hearing, the NWESD 189 will notify in writing the parent or guardian and program administrator of the time and place for the hearing and will present the case to a hearing officer appointed by the NWESD 189 Superintendent or designee.

List of Students Not Fully Immunized

The NWESD 189 will keep or be able to produce within twenty-four hours a current list of students 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 the program temporarily during a disease outbreak.

Presented to Board: 09/26/07
Revised: 10/26/11
Revised: 10/24/12
Revised: 12/10/12
Revised: 09/27/18
Revised: 01/23/19
Revised: 08/28/19
Revised: 06/24/20

Date Revised: 6/24/20