Logan Reed
Indiana has strict vaccination requirements for students, which are based on recommendations from the Advisory Committee on Immunization Practices (ACIP) and the CDC. Students of all ages must meet minimum immunization requirements, with exemptions for medical or religious reasons. Schools must notify parents of these requirements, and parents must provide documentation of their child's immunization or immunity. This documentation must include the student's name, date of birth, vaccine details, and date of each immunization. Laboratory results or a physician's certificate may also be required to prove immunity. If a student is exempt from vaccination, they may be excluded from campus activities during an outbreak of a vaccine-preventable disease.
| Characteristics | Values |
|---|---|
| Vaccination Requirements | Students in all grades are required to meet minimum immunization requirements. |
| Evidence of Immunity | Documentation of vaccine doses, positive IgG titer, or history of disease. |
| Medical Exemptions | Physician's written certification stating that a particular immunization is detrimental to the child's health. |
| Religious Exemptions | Written objection stating that immunization contradicts religious beliefs. |
| School Notification | Schools must notify parents of immunization requirements and provide information on certain diseases and available immunizations. |
| Parent Responsibility | Parents must furnish a written statement of the student's immunization status and any required documentation by the first day of school. |
| Immunization Records | Must include student's full name, be in English, and legible. Starting November 1, 2025, all records must be electronic/typed. |
| International Students | May require specific tests, such as QFT or T-Spot, completed in the United States before the start of classes. |
| Exclusion in Outbreak Situations | Students with exemptions may be excluded from campus activities during an outbreak of a vaccine-preventable disease for their protection. |
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What You'll Learn
Indiana's immunization requirements for school
Indiana's school immunization requirements follow the recommendations made by the Advisory Committee on Immunization Practices (ACIP) and are adopted by the CDC. These requirements extend to children ages 3 through 5 attending special education programs, child care, or preschool within the school building.
Parents must provide a written record of their child's immunization history, including the date of each immunization and any accompanying physician's certificates or other documentation. This written statement must be furnished no later than the first day of school. However, there are a few exceptions that allow a child to attend school beyond the first day without this documentation. These include:
- The school providing a waiver for a period not exceeding 20 days.
- The local health department or physician determining that the child's immunizations have been delayed due to extreme circumstances, and the required immunizations will not be completed by the first day of school. In this case, the parent must provide a written statement and a timeline approved by a physician or health department.
- A medical exemption or religious objection is on file.
Medical exemptions are provided by a physician who certifies that a particular immunization may be detrimental to the child's health. This must be stated in writing and a new exemption must be obtained for each school year. Religious objections must be made in writing, signed by the child's parent, and delivered to the school. There is no requirement for proof of religious objection, but it must be documented each school year.
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Medical exemptions
Indiana generally requires students in all grades to meet minimum immunization requirements. However, the state does allow for medical exemptions in certain cases.
A medical exemption is a physician's certification that a specific immunization may negatively impact the child's health. It must be stated in writing that the child has a medical contraindication to receiving a particular vaccine. This exemption must be obtained for each school year as contraindications are often not permanent. Additionally, as contraindications are vaccine-specific, exemptions must be written for each vaccine deemed unsafe.
The Indiana State Department of Health provides a medical exemption form on CHIRP, which providers should use to document medical exemptions. Once a valid medical exemption form is received by the school, the school nurse must document this exemption in CHIRP. Only a licensed physician (M.D. or D.O.) or an advanced practice provider (nurse practitioner or physician assistant under a physician's supervision) can provide a medical exemption.
To qualify for a medical exemption, a health care provider must provide a written statement detailing the nature and expected duration of the medical condition that contraindicates immunization. They must also identify the specific vaccine that could be detrimental to the student's health. This exemption applies until the immunization is no longer considered detrimental to the student's health.
It is important to note that medical exemptions are specific to individual vaccines and may not cover all immunization requirements for school entry. Parents or guardians should consult with healthcare professionals and follow the guidelines provided by the Indiana State Department of Health regarding medical exemptions for school vaccinations.
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Religious objections
In Indiana, students in all grades are required to meet the minimum immunization requirements. However, Indiana law does allow for religious objections to vaccinations. A religious objection must be made in writing, signed by the child's parent or guardian, and delivered to the school principal or the individual who might order an immunization. The objection must state that it is based on religious grounds.
While religious objections are allowed, there is some legal precedent for courts overturning these objections if they are found to be insincere. For example, in one case, a Court of Appeals in Indiana interpreted a custody decree to require a child to be vaccinated, overturning a previous ruling by a trial court that had allowed a religious objection. In another case, a mother signed a religious objection form, but the father challenged this in court, and the unvaccinated child was eventually vaccinated.
It is important to note that while religious objections may be permitted, schools in Indiana are still required to notify parents of the immunization requirements for enrollment and continued attendance. Parents must provide documentation of their child's immunization status or evidence of immunity. This can include laboratory results ordered by a physician or acceptable documentation of a history of the disease.
Additionally, Indiana law does not specify a formal investigation process for employers or schools to evaluate the sincerity of a religious exemption request. However, employers may challenge exemption requests if they suspect insincerity and have the burden of proving insincerity. Employers must also ensure that any adverse employment action related to vaccination requirements is applied consistently to avoid claims of discrimination under Title VII.
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Evidence of immunity
In the state of Indiana, school immunization requirements follow the recommendations made by the Advisory Committee on Immunization Practices (ACIP) and are adopted by the CDC. However, ACIP recommendations are not laws, and Indiana Code for immunization requirements for schools takes precedence over ACIP recommendations.
Indiana law requires that students in all grades meet the minimum immunization requirements. Evidence of immunity must be provided by the parent or guardian in order to meet school entry requirements. This evidence includes:
- Documentation of a valid dose(s) of vaccine: This includes the student's name, date of birth, the vaccine given, and the date of each immunization.
- Positive IgG titer: This may be acceptable for the vaccine dose in question.
- Acceptable documentation of the history of the disease: Laboratory results for evidence of disease immunity must be ordered by a physician. The ordering physician is responsible for interpreting the results and determining adequate evidence of immunity based on current medical guidelines. Laboratory evidence of immunity is a blood test for disease-specific immune globulin that measures immunity to the disease. This is often used to confirm immunity when immunization records are not available or when a parent reports a history of the disease.
It is important to note that lab evidence is not acceptable for Diphtheria, Pertussis, or Tetanus. Additionally, Indiana law allows for religious and medical exemptions from immunization requirements. A religious objection must be made in writing, signed by the child's parent, and delivered to the school. A medical exemption must be certified by a physician, stating that the immunization may be detrimental to the child's health.
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School notifications to parents
In Indiana, schools are required by law to notify parents of enrolled students about the state's immunization requirements. Schools must inform parents that their children need to be immunized for continued enrollment and attendance, unless a waiver is granted. This notification must be provided by the first day of school.
The notification to parents should include the specific immunization requirements, such as the vaccines needed and the documentation required to prove immunity. Schools may also inform parents about the potential consequences of not meeting these requirements, including school exclusion.
In the case of sixth-grade students, schools are required to provide parents with information about the link between cervical cancer and Human Papillomavirus (HPV) infection, as well as the availability of immunization against HPV. This information can be sent directly to parents or posted on the school's website.
Additionally, schools should notify parents about the process for obtaining a medical or religious exemption from immunizations. A medical exemption must be certified by a physician, stating that the immunization may be detrimental to the child's health. Religious exemptions must be based on bona fide religious grounds.
Schools in Indiana are also required to maintain accurate immunization records for their students. These records can be transferred between schools when a student transfers and can be accessed by the local health department.
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Frequently asked questions
Yes, students in all grades are required to meet the minimum immunization requirements.
A medical exemption form is available from the Indiana State Department of Health. This must be obtained for each school year as medical contraindications to vaccination are often not permanent.
Religious objections must be made in writing and must state that the objection is based on religious grounds.
The Tdap and MCV4 vaccines are licensed for use in persons 10 years of age and above. Immunization schedules are updated annually by the CDC.
Schools will allow extra time for completion of the vaccine course.
