Adopted: January 2004
Revised: June 2014
Date: ______________________
Dear parent/guardian of an early childhood student,
A. Minnesota law requires ONE of the following in order to attend school:
· A month-day-year record of required immunizations, signed and submitted by parents;
· A signed statement from a physician or clinic stating the child has had at least one dose of each vaccine and is in the process of completing the series, or
· A notarized statement of conscientious objection or a physician’s signature stating medical exemption to vaccination.
B. To help insure the health of all children, state law requires that a child birth to five years of age (pre-kindergarten) must have the following immunizations in order to enroll or remain enrolled in school:
· DTaP
· Polio
· MMR
· Hib
· Varicella
· Pneumococal (2-24 months)
· Hepatitis A
· Hepatitis B
The vaccine dose requirement will be dependent on the age of the child at the time of their enrollment in the class. Refer to the Early Childhood Immunization Form for specific guidelines.
C. If you meet any one of the following Minnesota Vaccines for Children (MnVFC) eligibility criteria, you may call Dakota County Public Health (952-891-7999) to receive low-cost vaccinations (There may be no charge for the vaccine for children meeting the criteria listed below):
· You are uninsured;
· You are enrolled in Minnesota Medical Assistance (MA), Minnesota Care (MnCare) or Prepaid Medical Assistance Program (PMAP);
· You are an American Indian or Alaskan Native, or
· You have health insurance that does not cover the cost of the vaccine.
D. Submit proof of compliance with the state immunization law to the school nurse prior to the first day of class for your child. Call the school nurse if you have any questions regarding immunizations for your child.
School District Official _________________________ School Nurse _______________________________