Register January 2009 No. 637
Chapter DHS 144
IMMUNIZATION OF STUDENTS
Minimum immunization requirements.
Waiver for health reasons.
Waiver for reason of religious or personal conviction.
Responsibilities of parents and adult students.
Responsibilities of schools and day care centers.
Responsibilities of local health departments.
Responsibilities of the department.
Ch. DHS 144 Note
Chapter H 44 as it existed on June 30, 1981, was repealed and a new chapter HSS 144 was created, effective July 1, 1981. Chapter HSS 144 was renumbered chapter HFS 144 under s. 13.93 (2m) (b) 1., Stats., and corrections made under s. 13.93 (2m) (b) 1., 6. and 7., Stats., Register, June, 1997, No. 498
Chapter HFS 144 was renumbered chapter DHS 144 under s. 13.92 (4) (b) 1., Stats., and corrections made under s. 13.92 (4) (b) 7., Stats., Register January 2009 No. 637.
Purpose and authority.
The purpose of immunization is to prevent disease and suffering and any permanent disability resulting from the disease. These rules implement s. 252.04
, Stats., which as public policy seeks to identify and immunize those students who are still susceptible to measles, mumps, rubella, polio, hepatitis B, varicella, diphtheria, tetanus and pertussis upon admission to an elementary, middle, junior or senior high school or a day care center, or Haemophilus influenzae b and pneumococcal infection upon admission to a day care center, in order to prevent transmission of these diseases.
(2) Relationship to infant and preschool immunization schedules.
The emphasis placed in this chapter on meeting minimum immunization requirements upon entry to Wisconsin schools at any grade level or to a day care center complements efforts by the department to promote early immunization of infants and preschoolers according to accepted immunization schedules. Children immunized according to accepted immunization schedules will exceed the minimum requirements set forth herein for all ages and grades.
DHS 144.01 History
Cr. Register, June, 1981, No. 306
, eff. 7-1-81; am. (1), Register, June, 1988, No. 390
, eff. 7-1-88; correction in (1) made under s. 13.93 (2m) (b) 7., Stats., Register, August, 1995, No. 476
; am. (1), Register, June, 1997, No. 498
, eff. 7-1-97; am. (1), Register, May, 2001, No. 545
, eff. 6-1-01; CR 07-077
: am. (1) Register February 2008 No. 626
, eff. 3-1-08.
Day care center" has the meaning prescribed in s. 48.65
, Stats., and includes nursery schools that fit that definition.
“Department" means the Wisconsin department of health services unless otherwise specified.
“DTP/DTaP/DT/Td/Tdap" means any combination of diphtheria, tetanus, and pertussis vaccine; diphtheria, tetanus and acellular pertussis vaccine; pediatric type diphtheria and tetanus vaccine; adult type tetanus and diphtheria vaccine; or tetanus, reduced diphtheria and acellular pertussis vaccine.
“Hib" means Haemophilus influenzae type b vaccine.
“Immunization" means the process of inducing immunity artificially by administering an immunobiologic.
“MMR" means measles, mumps and rubella vaccine administered in combination or as separate vaccines.
“Municipality" means any town, village, city or county.
“Parent" means the parent, parents, guardian or legal custodian of any minor student.
“Physician" means an individual possessing the degree of doctor of medicine or doctor of osteopathy or an equivalent degree as determined by the medical examining board under s. 448.05 (2)
, Stats., and holding a license granted by the medical examining board under s. 448.06
“School" means any public or private elementary, middle, junior or senior high school, which provides educational instruction to students in any grade kindergarten through 12, or in an ungraded educational setting, or to preschool children enrolled in early childhood programs.
“School day" in reference to schools has the meaning prescribed in s. 115.01 (10)
, Stats. A school day for a day care center is any day that the center is open and caring for children.
“Student" means any individual enrolled in a school or day care center or attending a school or day care center.
“Subsided" in reference to substantial outbreak means passage of 2 incubation periods for the disease causing the outbreak without additional cases unless a shorter period of time is judged adequate by the department.
“Substantial outbreak" means an occurrence of a vaccine-preventable disease covered by s. 252.04
, Stats., in a given school, day care center or municipality with an incidence exceeding one of the following:
For substantial outbreaks in a municipality, twice the incidence of that disease in the nation as a whole.
For substantial outbreaks in a school or day care center population, the following absolute limits:
“Vaccine provider" means a health care facility, as defined in s. 155.01 (6)
, Stats., which administers vaccines, or a local health department or a physician's office which administers vaccines.
“Var" means varicella vaccine. Varicella is commonly known as chickenpox.
“Written evidence of immunization" means a paper or an electronic record of at least the month and year that each required dose of vaccine was administered or the results of a laboratory test indicating immunity to the disease. Students who have not previously attended a Wisconsin school must provide the month, day and year for each required dose of vaccine.
DHS 144.02 History
Cr. Register, June, 1981, No. 306
, eff. 7-1-81; r. and recr. (12) (b), Register, June, 1988, No. 390
, eff. 7-1-88; correction in (12) made under s. 13.93 (2m) (b) 7., Stats., Register, August, 1995, No. 476
; am. (3), cr. (3g), (3m), (3r), (4m) and (13), r. and recr. (4), (6), (7) and (12), renum. (13) to be (14), Register, June, 1997, No. 498
, eff. 7-1-97; cr. (13m), Register, May, 2001, No. 545
, eff. 6-1-01; CR 07-077
: am. (3) and (14), cr. (6m) Register February 2008 No. 626
, eff. 3-1-08;
correction in (2) made under s. 13.92 (4) (b) 6., Stats., Register January 2009 No. 637.
Minimum immunization requirements. DHS 144.03(1)(1)
The minimum immunization requirements authorized by s. 252.04
, Stats., apply to any student admitted to a Wisconsin elementary, middle, junior or senior high school or to a Wisconsin day care center.
(2) Requirements for the 2008-09 school year and for school years following the 2008-09 school year. DHS 144.03(2)(a)(a)
Table DHS 144.03-A as qualified by pars. (b)
lists the number of doses of each required vaccine that each student in the 2008-09 school year and following school years shall have received since birth for the age or grade of the student. These comprise the minimum basic and booster immunizations required under s. 252.04 (2)
, Stats. They do not, however, represent all the recommended immunizations for those individuals who begin immunizations in infancy and follow currently accepted immunization schedules.
Immunization against measles, mumps and rubella shall have been received on or after the date of the first birthday. A dose received 4 days or less before the first birthday is acceptable.
- See PDF for table
Exceptions may be made in requirements for the fourth dose of DTP/DT/DTaP/Td vaccine and the fourth dose of polio vaccine. Students who receive the third dose of either of these vaccines after their fourth birthday are not required to receive a fourth dose of that vaccine. A dose received 4 days or less before the 4th birthday is acceptable.
For students in ungraded schools or students age 5 or older in day care centers, the immunization requirements are those for the grade which would normally correspond to the individual's age. Immunization against measles, mumps and rubella is also required for all students age 19 or older.
Exceptions may be made in requirements for Hib vaccine. Students who began the Hib series at 12 to 14 months are only required to receive 2 doses at least 2 months apart. Students who received one dose of Hib at 15 months of age or after are not required to obtain additional doses. A dose received 4 days or less before 15 months of age is acceptable.
Exceptions may be made in requirements for Var vaccine. Students who have a reliable history of varicella disease are not required to receive Var vaccine. A parent of a minor student or an adult student may indicate a reliable history of varicella by signing a statement that the student has had varicella disease.
Exceptions may be made in requirements for the third dose of Hep B vaccine. Students who receive two doses of a licensed two-dose formulation of Hep B vaccine are not required to receive a third dose of Hep B vaccine.