Principals are to use the following guidelines in addition to those provided in Policy 5320.
Immunizations Which are Medically Contraindicated
A written statement from any licensed physician that an immunization is medically contraindicated for a specific
period of time and the reasons for the medical contraindications will exempt a student from the specific
immunization requirements for the period of time specified in the physicians statement. The physician's statement
shall be maintained by the school as part of the electronic immunization record of the student. A paper copy will
be maintained in the student's cumulative folder to preserve the physician's signature on the waiver.
Specific annual immunization requirements are available from the Wisconsin Department of Health and Family
Services and are published and made available to each school district annually. The standards are also available at the Department of Health and Family Services web site at www.dhfs.state.wi.us.immunization.
If the District conducts a preschool or day care program, all children must be immunized in accordance with the regulations provided by DHFS.
Admission to School
Before a student can be admitted to school, the parent/guardian must present documentation that their child has
received all required doses of vaccines or that their child has received at least one (1) dose of each of the required
vaccines and is waiting to receive the subsequent doses are the appropriate time intervals, or provide a signed
Exemptions: Parent Objections
Religious Waiver: A student shall be exempted from mandatory immunization if the parent objects in a written
signed statement upon the grounds that the proposed immunization interferes with the free exercise of the
student's religious rights.
Personal Conviction Waiver: A student shall be exempted from individual or all immunizations if the parent objects
in a signed waiver upon the grounds that the proposed immunization interferes with the parent's beliefs or
This statement will be kept, by the school, as part of the student's electronic immunization record. A paper copy of
the waiver shall be filed in the student's cumulative folder to maintain the signed copy of the waiver.
Documents Accepted as Evidence of Immunization
The following sources or documents will be accepted as evidence of a student's immunization history provided they
comply with State requirements and contain the date of administration for each immunization.
A. An official school record from any school
B. A record from any public health department
C. Waiver - a certificate signed by physicians or parent/guardian
D. A copy of the child's immunization record from the Wisconsin Immunization Registry (WIR) -
Any student admitted to any elementary, middle, or senior high school shall, within thirty (30) school days, present
written evidence to the school of having completed at least the first immunization for each vaccine required for the
student's age/grade. Within ninety (90) school days after having been admitted to a school each student who has
not filed a waiver form must submit written evidence of having received the second dose of each vaccine required for
that student's age or grade. By the 30th day of the following school year, all student who have been admitted to a
District school (and have not submitted a written waiver), shall submit written evidence of having received the final
dose of vaccine required for their age/grade.
Students may receive vaccines from their own private providers or obtain them from the Wauwatosa Health
Department or Milwaukee Health Department free of charge.
Each school shall maintain and electronic record of immunization for every student which shall include the date of
each individual immunization.
If a student transfers to another school, a copy of the electronic immunization record shall be sent to the new school.
Responsibilities of the School District
By the 15th day and again by the 25th school day, after a child is admitted to a school, the school will notify the
parent of any student who has not submitted written evidence of immunization or a waiver form. Notification will include a list of missing immunizations, the availability of waivers, and an explanation of the penalty for
Exclusion of Students
Students enrolled in grades K-5 who fail to satisfy the immunization requirements for age/grade by the 30th day of
school, shall be excluded for a period of no more than ten (10) consecutive days, beginning on the 31st day of
school. Parents are encouraged to obtain any recommended vaccines during this time or submit a written waiver.
Report to the Local Health Department
A report of the immunization status of the students in each school shall be sent to the local health department on
the 40th school day (no later than November 15th) each year.
Report to the District Attorney's Office
The school shall notify the District Attorney, of the county in which the student resides, of any student who has
failed to provide written documentation of completed immunizations or a written waiver within sixty (60) school days
after being admitted to the school. The school will provide the student's name, parent's name and address on the
Records Available for Inspection
The principal shall make immunization records available for inspection by authorized representatives of the DHFS
or the local or County Health Department.
Release of Immunization Information
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 upon written or verbal request
from the school. Written or verbal permission from the parent is not required for release of this information to a school.
Approved/Adopted: July 13, 2009