Vaccine Preventable Disease Exclusion Guidelines in School Settings

There are two situations in which children who are not appropriately immunized may be admitted to

school:

1) a medical exemption is allowed if a physician submits documentation attesting that an

immunization is medically contraindicated; and

2) a religious exemption is allowed if a parent or guardian submits a written statement that

immunizations conflict with their sincere religious beliefs.

Philosophical exemptions are not allowed by law in Massachusetts, even if signed by a physician.  Only medical and religious exemptions are acceptable. These exemptions must be kept in the students’ files at school (105 CMR 220.000 and M.G.L. c.76, ss. 15, 15C and 15D).

The only exception for the exclusion of unimmunized or partially immunized children who do not have documentation of a medical or religious exemption is in the case of homeless children, whereby they cannot be denied entry to school if they do not have their immunization records. The federal McKinney-Vento Homeless Assistance Act states that if a homeless student does not have proper documentation of immunizations or any medical records, the Homeless Education Liaison at your school must immediately assist in obtaining them, and the student must be enrolled and permitted to attend school in the interim (as cited in the McKinney-Vento Homeless Assistance Act of 2001).

Exclusion During Disease Outbreaks

In situations when one or more cases of a vaccine-preventable or any other communicable disease are present in a school, all susceptibles, including those with medical or religious exemptions, are subject to exclusion as described in the Reportable Diseases and Isolation and Quarantine Requirements (105 CMR 300.000).  The reporting and control of diseases identified as posing a risk to public health is prescribed by state regulation and law.  The Isolation and Quarantine Requirements establish isolation and quarantine requirements for cases of certain diseases and their contacts in certain high-risk situations, including the school setting.