January, 2007

Wisconsin Student Immunization Law

Dear Parents/Guardian:

All school children through Grade 12 attending Wisconsin Schools must show evidence of having received at least minimum protection against certain vaccine-preventable communicable diseases or must submit waivers to the contrary. The specific age/grade requirements are listed on the reverse. Please read, complete, sign and return the Student Immunization Record on the reverse side to your child's school. The month, day and year of all vaccines must be included on the form.

Within 30 days of enrollment, children must present evidence to their current school that they have received protection against measles, mumps, rubella (MMR), diphtheria, tetanus, pertussis, polio, hepatitis B and varicella.

• 3 doses of Hepatitis B vaccine are required for all grades. Students aged 11 through 15 years who received the licensed 2-dose formulation meet the Hepatitis B requirement.
• Both doses of MMR vaccine must be received on or after the first birthday. Children who received MMR before their first birthday may not be fully protected.
• For students in kindergarten, at least one dose of DTP/DTaP/DT must be received after the fourth birthday.
• Varicella (chicken pox) vaccine or a history of chicken pox disease is required for children in grades K-12. If a child has no history of chicken pox disease and the first dose of varicella vaccine is given on or after the 13th birthday, two doses are required to complete the series.
• The immunization law allows a "grace" period of 4 days. This means that MMR doses received 4 days or fewer before the first birthday, final DTaP doses received 4 days or less before the 4th birthday, and final polio doses received 4 days or less before the fourth birthday are all acceptable.

These communicable diseases could lead to serious complications if a child were to develop one of them. This law is for the protection of everyone in the school setting. Children can be excluded from school for up to ten days until a record of required vaccine(s) is provided or until a waiver is claimed.

If your child has previously attended another school and you completed an immunization record for use by that school, you may direct that school to forward this record to you or to us. However, you are still responsible to see that your child's current school receives this information.

Once this school receives your child's immunization record, the school nurse will review it and contact you if your child's immunizations do not meet the state minimum requirements for his/her grade level. If your child needs further immunizations, they can be received from your child's physician or a public health department clinic. For further information about public health department immunization clinic schedules, call 266-4821.

If you have any questions about the immunization form or the requirements, please contact your child's school nurse, your physician or your public health department. Your cooperation is appreciated. Thank you.

Sincerely,

Freddi Adelson, MS, RN, PNP
Health Services Coordinator

Health Information

For more information, contact:
Freddi Adelson, Health Services Coordinator
Madison Metropolitan School District
545 W. Dayton St.
Madison, WI 53703