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Register January 2009 No. 637
Chapter DHS 144
IMMUNIZATION OF STUDENTS
DHS 144.01   Introduction.
DHS 144.02   Definitions.
DHS 144.03   Minimum immunization requirements.
DHS 144.04   Waiver for health reasons.
DHS 144.05   Waiver for reason of religious or personal conviction.
DHS 144.06   Responsibilities of parents and adult students.
DHS 144.07   Responsibilities of schools and day care centers.
DHS 144.08   Responsibilities of local health departments.
DHS 144.09   Responsibilities of the department.
Ch. DHS 144 Note Note: Chapter H 44 as it existed on June 30, 1981, was repealed and a new chapter HSS 144 was created, effective July 1, 1981.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.
DHS 144.01 DHS 144.01 Introduction.
DHS 144.01(1)(1) 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.
DHS 144.01(2) (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 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.
DHS 144.02 DHS 144.02 Definitions.
DHS 144.02(1)(1) “ Day care center" has the meaning prescribed in s. 48.65, Stats., and includes nursery schools that fit that definition.
DHS 144.02(2) (2) “Department" means the Wisconsin department of health services unless otherwise specified.
DHS 144.02(3) (3) “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.
DHS 144.02(3g) (3g) “Hib" means Haemophilus influenzae type b vaccine. 
DHS 144.02(3m) (3m) “Hep B" means hepatitis B vaccine. 
DHS 144.02(3r) (3r) “Immunization" means the process of inducing immunity artificially by administering an immunobiologic. 
DHS 144.02(4) (4) “Local health department" means any agency specified in s. 250.01 (4), Stats.
DHS 144.02(4m) (4m) “MMR" means measles, mumps and rubella vaccine administered in combination or as separate vaccines. 
DHS 144.02(5) (5) “Municipality" means any town, village, city or county.
DHS 144.02(6) (6) “Parent" means the parent, parents, guardian or legal custodian of any minor student.
DHS 144.02(6m) (6m) “PCV" means pneumococcal conjugate vaccine.
DHS 144.02(7) (7) “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, Stats.
DHS 144.02(8) (8) “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.
DHS 144.02(9) (9) “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.
DHS 144.02(10) (10) “Student" means any individual enrolled in a school or day care center or attending a school or day care center.
DHS 144.02(11) (11) “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.
DHS 144.02(12) (12) “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:
DHS 144.02(12)(a) (a) For substantial outbreaks in a municipality, twice the incidence of that disease in the nation as a whole.
DHS 144.02(12)(b) (b) For substantial outbreaks in a school or day care center population, the following absolute limits:
DHS 144.02(12)(b)1. 1. Measles, one case.
DHS 144.02(12)(b)2. 2. Mumps, 2% of the unvaccinated population.
DHS 144.02(12)(b)3. 3. Rubella, one case.
DHS 144.02(12)(b)4. 4. Polio, one case.
DHS 144.02(12)(b)5. 5. Pertussis, 2 cases in a 30-day period.
DHS 144.02(12)(b)6. 6. Diphtheria, one case.
DHS 144.02(12)(b)7. 7. Haemophilus influenzae b, one case in a day care center population.
DHS 144.02(13) (13) “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.
DHS 144.02(13m) (13m) “Var" means varicella vaccine. Varicella is commonly known as chickenpox.
DHS 144.02(14) (14) “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 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.
DHS 144.03 DHS 144.03 Minimum immunization requirements.
DHS 144.03(1)(1) Individuals included. 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.
DHS 144.03(2) (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) to (g) 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.
DHS 144.03(2)(b) (b) 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 PDF
DHS 144.03(2)(c) (c) 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.
DHS 144.03(2)(d) (d) 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.
DHS 144.03(2)(e) (e) 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.
DHS 144.03(2)(f) (f) 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.
DHS 144.03(2)(g) (g) 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.
DHS 144.03(2)(h) (h) Exceptions may be made in requirements for PCV. Students who begin the PCV series at 12 to 23 months of age are only required to receive 2 doses at least 2 months apart. Students who receive their first dose of PCV at 24 months of age or after are not required to obtain additional doses. A dose received 4 days or less before 24 months of age is acceptable.
DHS 144.03(2)(i) (i) Exceptions may be made in requirements for Tdap vaccine. Students who received a dose of tetanus or diphtheria containing vaccine within 5 years of entering a grade for which Tdap is required are not required to receive Tdap vaccine.
DHS 144.03(3) (3)Tdap vaccine coverage phase-in.
DHS 144.03(3)(a)(a) Beginning with the 2008-09 school year, students entering grades 6, 9 and 12 shall have received Tdap vaccine in addition to the other required vaccines listed in Table DHS 144.03-A as qualified by sub. (2) (b) to (i).
DHS 144.03(3)(b) (b) For the 2009-10 school year, the requirements for Tdap vaccine listed in par. (a) that apply to students in grades 6, 9 and 12 shall apply to students in grades 6, 7, 9, 10 and 12; and to students in grades 6 through 12 in 2010-11 and thereafter.
DHS 144.03(3m) (3m)Var vaccine coverage phase-in.
DHS 144.03(3m)(a)(a) Beginning with the 2008-09 school year, students entering grades K, 6 and 12 shall have received two doses of Var vaccine in addition to the other required vaccines listed in Table DHS 144.03-A as qualified by sub. (2) (b) to (i).
DHS 144.03(3m)(b) (b) For the 2009-10 school year, the requirements for two doses of Var vaccine listed in par. (a) that apply to students in grades K, 6 and 12 shall apply to students in grades K, 1, 6, 7 and 12; to students in grades K through 2, 6 through 8 and 12 in 2010-11; to students in grades K through 3, 6 through 9 and 12 in 2011-12; to students in grades K through 4, 6 through 10 and 12 in 2012-13; and to students in grades K through 12 in 2013-14 and thereafter.
DHS 144.03(4) (4)First deadline. Within 30 school days after having been admitted to a school or day care center, each student who has not filed a waiver form shall submit written evidence of having completed at least the first dose of each vaccine required for that student's age or grade, as outlined in Table DHS 144.03-A.
DHS 144.03(5) (5)Second deadline. Within 90 school days after having been admitted to a school or day care center, each student who has not filed a waiver form shall submit written evidence of having received the second dose of each vaccine required for that student's age or grade, as outlined in Table DHS 144.03-A.
DHS 144.03(6) (6)Final deadline. Within 30 school days after having been admitted to a school or day care center for the following school year, each student who has not filed a waiver form shall submit written evidence of having received the third and, if required, the fourth dose of both DTP/DTaP/DT/Td and polio vaccines and the final dose of Hep B in grades required under sub. (3) and, for students in day care centers, the final dose of Hib vaccine, if a dose has not been received at or after 15 months of age.
DHS 144.03(7) (7)Records of vaccination. Any person who immunizes a student under s. 252.04, Stats., shall maintain records identifying the manufacturer and lot number of the vaccine used, the date of immunization and the name and title of the person who immunized the student.
DHS 144.03(10) (10)Release of immunization information.
DHS 144.03(10)(a)(a) Between vaccine providers and schools or day care centers. Vaccine providers shall disclose a student's immunization information, including the student's name, date of birth and gender and the day, month, year and name of vaccine administered, to a school or day care center upon written or verbal request from the school or day care center. Written or verbal permission from a student or parent is not required to release this information to a school or day care center.
DHS 144.03(10)(b) (b) Among vaccine providers. Immunization information, including the student's name, date of birth and gender and the day, month, year and name of vaccine administered, shall be provided by one vaccine provider to another without written or verbal permission from the student or the parent.
DHS 144.03 History History: Cr. Register, June, 1981, No. 306, eff. 7-1-81; r. and recr. (2) and (3), am. (4) to (6), Register, June, 1988, No. 390, eff. 7-1-88; am. (2) (a) to (d), (3) (a) and (b), r. (2) (e), Register, January, 1989, No. 397, eff. 2-1-89; am. (2) (a), (4) and (5), r. and recr. (3), tables 144.03-A and B, Register, July, 1990, No. 415, eff. 8-1-90; corrections made under s. 13.93 (2m) (b) 7., Stats., Register, August, 1995, No. 476; r. and recr. (2) (a), Table 144.03-A and (3), am. (2) (c) and (4) to (7), cr. (2) (e) and (10), r. Table 144.03-B, Register, June, 1997, No. 498, eff. 7-1-97; r. and recr. (2) (a) and Table 144.03-A, cr. (2) (f), (g) and (3m), am. (3) (a) and (6), Register, May, 2001, No. 545, eff. 6-1-01; CR 03-033: am. (2) (b), (c), (e) and Table 144.03-A Register December 2003 No. 576, eff. 1-1-04; CR 07-077: r. and recr. (2) (a), (f), (3), (3m) and Table-A, cr. (2) (h) and (i), am. (10) (a) and (b) Register February 2008 No. 626, eff. 3-1-08.
DHS 144.04 DHS 144.04 Waiver for health reasons. Upon certification by a licensed physician that an immunization required under s. 252.04, Stats., is or may be harmful to the health of a student, the requirements for that immunization shall be waived by the department. Written evidence of any required immunization which the student has previously received shall be submitted to the school or day care center with the waiver form.
DHS 144.04 History History: Cr. Register, June, 1981, No. 306, eff. 7-1-81; correction made under s. 13.93 (2m) (b) 7., Stats., Register, August, 1995, No. 476.
DHS 144.05 DHS 144.05 Waiver for reason of religious or personal conviction. Immunization requirements under s. 252.04, Stats., shall be waived by the department upon presentation of a signed statement by the parent of a minor student or by the adult student which declares an objection to immunization on religious or personal conviction grounds. Written evidence of any required immunization which the student has previously received shall be submitted to the school or day care center with the waiver form.
DHS 144.05 History History: Cr. Register, June, 1981, No. 306, eff. 7-1-81; correction made under s. 13.93 (2m) (b) 7., Stats., Register, August, 1995, No. 476; am. Register, June, 1997, No. 498, eff. 7-1-97.
DHS 144.06 DHS 144.06 Responsibilities of parents and adult students. The parent of any minor student or the student, if an adult, shall secure the immunizations required under s. 252.04, Stats., from available health care sources such as physicians' offices, hospitals or local health departments, or shall submit the waiver form.
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Published under s. 35.93, Stats. Updated on the first day of each month. Entire code is always current. The Register date on each page is the date the chapter was last published.