Immunizations
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- Last Updated on Wednesday, 14 July 2021 10:04
- Published on Tuesday, 06 May 2014 17:52
2021-2022 Missouri School Immunization Requirements
- All students must present documentation of up-to-date immunization status, including month, day and year of each immunization before attending school.
- The advisory Committee on immunization Practices allows a 4-day grace period. Students in all grade levels may receive immunizations up to four days before the due date.
- For children beginning kindergarten during or after the 2003-04 school year, required immunizations should be administered according to the current Advisory Committee on Immunization Practices Schedule, including all spacing, (http://www.cdc.gov/vaccines/schedules/index.html).
- To remain in school, students "in progress" must have an Immunization In Progress form (Imm.P.14), which includes the appointment date for needed immunizations, on file and must receive immunizations as soon as they become due. The student is in compliance as long as he/she continues to receive the appropriate immunization(s) at the correct intervals according to the ACIP recommendations.
- In progress means that a child has begun the vaccine series and has an appointment for the next dose. This appointment must be kept and an updated record provided to the school. If the appointment is not kept, the child is no longer in progress and is non-compliant. (i.e., Hep B vaccine series was started but the child is not yet eligible to receive the next dose in the series.)
- Religious (Imm.P.11A) and Medical (Imm.P.12) exemptions are allowed. The appropriate exemption card must be on file. Unimmunized children are subject to exclusion from school when outbreaks of vaccine-preventable diseases occur.
- Last dose on or after the fourth birthday and the last dose of pediatric pertussis before the seventh birthday. Maximum needed: six doses.
- 8-12 Grades: Tdap, which contains pertussis vaccine, is required.
- Grade 8-11: One dose of MCV is required. Dose must be given after 10 years of age.
- Grade 12: Two doses of MCV is required unless the first dose was administered to a student who was 16 years of age or older, in which case only one dose is required.
- Kindergarten-6 Grade: Last dose must be administered on or after the fourth birthday. The interval between the next-to-last and last dose should be at least six month.
- 7-12 Grades: Last dose on or after the fourth birthday. If all four doses are administered appropriately and received prior to the fourth birthday, an additional does is not needed. Any combination of four doses of IPV and OPV by four-six years of age constitutes a complete series. Maximum needed: four doses.
- First dose must be given on or after twelve month of age.
- First dose must be given on or after twelve months of age.
- Kindergarten-6 Grade: As satisfactory evidence of disease, a licensed health care provider may sign and place on file with the school a written statement documenting the month and year of previous varicella (chickenpox) disease.
- 7-11 Grades: As satisfactory evidence of disease, a parent/guardian or MD or DO may sign and place on file with the school a written statement documenting the month and year of previous varicella (chickenpox) disease.
2021 Missouri Child Care and Preschool Immunization Requirements
- All children must present documentation of up-to-date immunization status, including month, day, and year of each immunization before attending child care/preschool.
- The Advisory Committee on Immunization Practices allows a 4-day grace period. Children may receive immunizations up to four days before the due date.
- Immunizations should be administered according to the current Advisory Committee on Immunization Practices Schedule, including all spacing, (http://www.cdc.gov/vaccines/schedules/index.html).
- Parent/Guardian (Imm.P.11) and Medical (Imm.P.12) exemptions are allowed. The appropriate exemption card must be on file. Unimmunized children are subject to exclusion from child care/preschool when outbreaks of vaccine-preventable diseases occur.
- To remain in child care/preschool, children "in progress" must have an Immunization In Progress form (Imm.P.14), which includes the appointment date for needed immunizations, on file and must receive immunizations as soon as they become due. In progress means that a child has begun the vaccine series and has an appointment for the next dose. This appointment must be kept and an updated record provided to the facility. If the appointment is not kept, the child is no longer in progress and is noncompliant. (i.e., Hep B vaccine series was started but the child is not yet eligible to receive the next dose in the series.)
#14. Diphtheria
Most of us only know diphtheria as an obscure disease from long ago, thanks to the diphtheria vaccine babies get. This vaccine, called DTaP, provides protection against diphtheria, tetanus, and pertussis (whooping cough). While preventable, diphtheria does still exist. It can cause a thick covering in the back of the nose or throat that makes it hard to breathe or swallow. Diphtheria can also lead to heart failure, paralysis, and even death. Make sure to vaccinate to help keep this dangerous infection from your kids.
Doctors recommend that your child get five doses of the DTaP vaccine for best protection. Your child will need one dose at each of the following ages: 2 months, 4 months, 6 months, 15 through 18 months, and 4 through 6 years.
#13. Chickenpox
Chickenpox is a disease that causes an itchy rash of blisters and a fever. A person with chickenpox may have a lot of blisters—as many as 500 all over their body. Chickenpox can be serious and even life-threatening, especially in babies, adults, and people with weakened immune systems. Even healthy children can get really sick. Vaccinating kids at an early age is especially important to keep your children healthy.
Doctors recommend that your child get two doses of the chickenpox shot for best protection. Your child will need one dose at each of the following ages: 12 through 15 months and 4 through 6 years.
#12. Mumps
Mumps is best known for causing puffy cheeks and a swollen jaw. This is due to swelling of the salivary glands. Other symptoms include fever, head and muscle aches, and tiredness. Mumps is a contagious disease and there is no treatment. Mumps is still a threat today—every year, people in the United States get mumps. In recent years, mumps outbreaks have occurred in settings where there was close, extended contact with infected people, such as being in the same classroom or playing on the same sports team. The MMR vaccine protects you and your family against mumps, measles, and rubella.
Doctors recommend that your child get two doses of the MMR shot for best protection. Your child will need one dose at each of the following ages: 12 through 15 months and 4 through 6 years.
#11. Rotavirus
Rotavirus is contagious and can cause severe watery diarrhea, often with vomiting, fever, and abdominal pain, mostly in infants and young children. Children can become severely dehydrated from the disease and need to be hospitalized. If a dehydrated child does not get needed care, they could die. Rotavirus is one of the first vaccines an infant can get; it’s the best way to protect your child from rotavirus disease.
Doctors recommend that your child get two or three doses of the vaccine (depending on the brand) for best protection. For both brands, babies should get their first dose at 2 months of age and a second dose at 4 months. If they are getting the RotaTeq vaccine, they’ll need a third dose at 6 months.
#10. Pneumococcal Disease
This disease is caused by bacteria called Streptococcus pneumoniae. It causes ear infections, sinus infections, pneumonia, and even meningitis, making it very dangerous for children. The germs can invade parts of the body—like the brain or spinal cord—that are normally free from germs. Make sure you keep kids safe from this dangerous disease by vaccinating.
Doctors recommend that your child get four doses of the pneumococcal conjugate vaccine (also called PCV13) for best protection. Your child will need one dose at each of the following ages: 2 months, 4 months, 6 months, and at 12 through 15 months.
Learn more about Pneumococcal Disease.
#9. Whooping Cough (Pertussis)
Whooping cough, or pertussis, is a highly contagious disease that can be deadly for babies. Whooping cough can cause uncontrollable, violent coughing, which often makes it hard to breathe. Its “whooping” name comes from the sharp breath intake sound right after a coughing fit. In babies, this disease also can cause life-threatening pauses in breathing with no cough at all. Whooping cough is especially dangerous to babies who are too young to be vaccinated themselves. Mothers should get the whooping cough vaccine during each pregnancy to pass some protection to their babies before birth. It is very important for your baby to get the whooping cough vaccine on time so he can start building his own protection against the disease. Since 2010, between 15,000 and 50,000 cases of whooping cough were reported each year in the United States, with cases reported in every state.
The DTaP vaccine provides protection against whooping cough, diphtheria, and tetanus. Doctors recommend that your child get five doses of the DTaP shot for best protection. Your child will need one dose at each of the following ages: 2 months, 4 months, 6 months, 15 through 18 months, and 4 through 6 years.
#8. Measles
Did you know your child can get measles by being in a room where a person with measles has been, even up to two hours after that person has left? Measles is very contagious, and it can be serious, especially for young children. Because measles is common in other parts of the world, unvaccinated people can get measles while traveling and bring it into the United States. Anyone who is not protected is at risk, so make sure to stay up to date on your child’s vaccines to minimize the risk of coming into contact with an imported case.
Doctors recommend that your child get two doses of the MMR shot for best protection. Your child will need one dose at each of the following ages: 12 through 15 months and 4 through 6 years.
Infants 6 to 11 months old should have one dose of the MMR shot before traveling abroad. Infants vaccinated before 12 months of age should be revaccinated on or after their first birthday with two doses, each dose separated by at least 28 days.
Learn more about Measles.
#7. Hib
Hib (or its official name, Haemophilus influenzae type b) isn’t as well-known as some of the other diseases, thanks to vaccines. Hib can do some serious damage to our kids’ immune systems and cause brain damage, hearing loss, or even death. Hib mostly affects kids under five years old. Before the vaccine, over 20,000 kids were infected each year. That’s about 400 yellow school busses worth of kids! Of these kids, one in five suffered brain damage or became deaf. Even with treatment, as many as one out of 20 kids with Hib meningitis dies. Get your child vaccinated to help them beat the odds!
Doctors recommend that your child get four doses of the Hib vaccine for best protection. Your child will need one dose at each of the following ages: 2 months, 4 months, 6 months (for some brands), and 12 through 15 months.
Learn more about Hib.
#6. Rubella
Rubella is spread by coughing and sneezing. It is especially dangerous for a pregnant woman and her developing baby. If an unvaccinated pregnant woman gets infected with rubella, she can have a miscarriage or her baby could die just after birth. Also, she can pass the disease to her developing baby who can develop serious birth defects. Make sure you and your child are protected from rubella by getting vaccinated on schedule.
Doctors recommend that your child get two doses of the MMR vaccine for best protection. Your child will need one dose at each of the following ages: 12 through 15 months and 4 through 6 years.
Learn more about Rubella.
#5. Hepatitis A
The Hepatitis A vaccine was developed in 1995 and since then has cut the number of cases dramatically in the United States. Hepatitis A is a contagious liver disease and is transmitted through person-to-person contact or through contaminated food and water. Vaccinating against hepatitis A is a good way to help your baby stay Hep A-free and healthy!
Doctors recommend that your child get two doses of the hepatitis A shot for best protection. Your child should get the first dose at 12 through 23 months and the second dose 6 to 18 months after the first.
Learn more about Hepatitis A.
#4. Hepatitis B
Did you know that worldwide more than 780,000 people per year die from complications to Hepatitis B? Hepatitis B is spread through blood or other bodily fluids. It’s especially dangerous for babies, since the hepatitis B virus can spread from an infected mother to child during birth. About nine out of every 10 infants who contract it from their mothers become chronically infected, which is why babies should get the first dose of the hepatitis B vaccine within 24 hours of birth. All pregnant women should be tested and all babies should be vaccinated.
Doctors recommend that your child get three doses of the Hepatitis B shot for best protection. Typically, your child will need one dose at each of the following ages: within 24 hours of birth, 1 through 2 months, and 6 months. Your child may get a fourth dose depending on your baby’s birth weight or the brand of vaccine the doctor uses.
Learn more about Hepatitis B.
#3. The Flu (Influenza)
Flu is a respiratory illness caused by the influenza virus that infects the nose, throat, and lungs. Flu can affect people differently based on their immune system, age, and health. Did you know that flu can be dangerous for children of any age? Flu symptoms in children can include coughing, fever, aches, fatigue, vomiting, and diarrhea. Not to mention, every year in the United States, otherwise healthy children are hospitalized or die from flu complications. In fact, CDC estimates that since 2010, flu-related hospitalizations among children younger than 5 years have ranged from 6,000 to 26,000 in the United States. It’s important to know that children younger than 6 months are more likely to end up in the hospital from flu, but are too young to get a flu vaccine. The best way to protect babies against flu is for the mother to get a flu vaccine during pregnancy and for all caregivers and close contacts of the infant to be vaccinated. Everyone 6 months and older should get a flu vaccine every year—protect yourself and your loved ones.
Doctors recommend that your child get the flu vaccine every year starting when they are 6 months old. Children younger than 9 years old who are getting vaccinated for the first time need two doses of flu vaccine, spaced at least 28 days apart.
Learn more about Influenza.
#2. Tetanus
Tetanus causes painful muscle stiffness and lockjaw and can be fatal. Parents used to warn kids about tetanus every time we scratched, scraped, poked, or sliced ourselves on something metal. Nowadays, the tetanus vaccine is part of a disease-fighting vaccine called DTaP, which provides protection against tetanus, diphtheria, and pertussis (whooping cough).
Doctors recommend that your child get five doses of the DTaP shot for best protection. Your child will need one dose at each of the following ages: 2 months, 4 months, 6 months, 15 through 18 months, and 4 through 6 years.
Learn more about Tetanus.
#1. Polio
Polio is a crippling and potentially deadly infectious disease that is caused by poliovirus. The virus spreads from person to person and can invade an infected person’s brain and spinal cord, causing paralysis. Polio was eliminated in the United States with vaccination, and continued use of polio vaccine has kept this country polio-free. But, polio is still a threat in some other countries. Making sure that infants and children are vaccinated is the best way to prevent polio from returning. Make sure your baby is protected with the polio vaccine.
Doctors recommend that your child get four doses of the polio vaccine (also called IPV) for best protection. Your child will need one dose at each of the following ages: 2 months, 4 months, 6 through 18 months, and 4 through 6 years.
Learn more about Polio.
Public Health Registered Nurse
Jayne White
BSN, RN - Director of Clinical and Emergency Operations
Phone: 816-324-3139
Jayne White resides in the rural area of Helena, Missouri on a small farm with her family. She brings a vast array of nursing experience and has been a BSN, RN since 2011. Jayne joined the Health Department in Nov. of 2018 as the Public Health Nurse and in June 2020 took on the role of Nurse Manager for the department. She is responsible for oversight of the nursing team, nursing programs and all clinical operations, as well the co-planner for emergency preparedness of the department.
Hillary Loucks
BSN, RN - Public Health Nurse
Hillary Loucks began her experience with the Health Department as a Student during her capstone with MWSU. Remaining PRN after graduation with a BSN in 2020, she gained experience in Emergency Medicine, and Long Term Care, ultimately joining the Health Department full time in 2020. She is responsible for the Health Departments Immunization Program, Child Care Health Consulting Program, Daycare & School Health Promotions, as well as a Carseat Technician & BLS instructor for the Department.
Flu Vaccine Finder
Stories put a face on vaccine-preventable diseases. Check out the collection of videos and written stories shared to educate and raise awareness of the value of vaccines.
Vaccine FAQs
-
What are vaccinations? +
Vaccinations (vaccines) protect your child against serious diseases by stimulating the immune system to create antibodies against certain bacteria or viruses. Most vaccinations are given as injections. -
What diseases do vaccines protect against? +
Vaccines protect against diseases like measles, mumps, rubella, influenza, hepatitis B, hepatitis A, polio, tetanus, whooping cough, chickenpox, rotavirus, and more. Vaccines can’t protect children from minor illnesses like colds, but they can keep children safe from many serious diseases. -
Are vaccinations safe? +
Vaccines are safe, and scientists continually work to make sure they become even safer. Every vaccine undergoes many tests before being licensed, and its safety continues to be monitored as long as the vaccine is in use. Most side effects from vaccination are minor, such as soreness where the injection was given or a low-grade fever. These side effects do not last long and are treatable. Serious reactions are very rare. The tiny risk of a serious vaccine reaction has to be weighed against the very real risk of getting a dangerous vaccine-preventable disease. If you have concerns or questions, talk to your child’s healthcare provider. -
How do I know when to take my baby in for shots? +
Your healthcare provider should give you a reminder when the next doses are due. If you are not sure, call your clinic or health- care provider’s office to find out when you should bring your child back. Doses cannot be given too close together or immunity doesn’t have time to build up. On the other hand, you don’t want to delay your child’s shots and get behind schedule because during this time, your child remains unprotected against these diseases. -
What if my baby has a cold or fever, or is taking antibiotics? Can he or she still get vaccinated? +
Yes. Your child can still be vaccinated if he or she has a mild illness, a low-grade fever, or is taking antibiotics. Ask your child’s healthcare provider if you have questions. How many times do I need to bring my baby in for vaccinations? At least five visits are needed before age two, but the visits can be timed to coincide with well-child check-ups. Your baby should get the first vaccine (hepatitis B) shortly after birth, while still in the hospital. Multiple visits during the first two years are necessary because there are 14 diseases your baby can be protected against, and most require several doses of vaccine for the best protection. -
What if I miss an appointment? Does my baby have to start the vaccines all over again? +
No. If your baby misses some doses, it’s not necessary to start over. Your provider will continue from where he or she left off. -
How do I keep track of my baby’s shots? +
Your healthcare provider should give you a personal record card for your child’s vaccinations. If you don’t receive one, ask! Bring the card to all medical appointments. Whenever your child receives a vaccine, make sure the card gets updated. Your child will benefit by retaining an accurate vaccination record throughout his or her life. What if my child isn’t a baby anymore? Is it too late to get him or her vaccinated? No. Although it’s best to have your child be¬gin vaccinations as a newborn, it’s never too late to start. If your child has not received any, or all, of his or her vaccinations, now is the best time to start. -
What if I can’t afford to get my child vaccinated? +
Vaccinations are usually free or low cost for children when families can’t afford them. You can call the CDC-INFO Contact Center at (800) 232-4636 or your local health department to find out where to go for affordable vaccinations. Your child’s health depends on it! -
Isn’t all this talk about diseases just a way to scare parents so they’ll bring their babies in for shots? +
No. These diseases can injure and kill children in the United States. For example, pertussis is a dangerous disease for infants. During 1997–2000, nearly 30,000 pertussis cases were reported; 62 resulted in death. In 2003 alone, 11,647 cases and 18 deaths from pertussis were reported. Influenza also takes a toll on children. During the 2003–04 influenza season, 40 states reported 152 influenza-related deaths among children younger than 18 years of age. -
I don’t know anybody who has had measles or rubella. Why does my baby need these shots? +
You might not think that measles and rubella are a threat today because you don’t see or hear much about them, but they are still around. These diseases are common in other parts of the world and are just a plane ride away. If we stop vaccinating against these diseases, many more people will become infected. Vaccinating your child will keep him or her safe. -
Isn’t there some way besides vaccination to protect my baby against these diseases? +
No. Breastfeeding offers temporary immunity against some minor infections like colds, but it is not an effective means of protecting a child from the specific diseases preventable by vaccines. Likewise, vitamins don’t protect against the specific bacteria and viruses that cause these serious diseases. Of course, infection usually results in immunity, and some parents think that getting the “natural” disease is preferable to “artificial” vaccination. Some even arrange chickenpox “parties” to ensure their child is infected. However, the price paid for natural disease can include paralysis, retardation, liver cancer, deafness, blindness, or even death. Vaccination is definitely a better choice!
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