Kansas Certificate Of Immunizations Page 2

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KANSAS IMMUNIZATION REQUIREMENTS: Based on age of child as of September 1 of current school year.
As per Kansas Statute 72-5209, all children upon entry to school must be appropriately vaccinated. In each column below, vaccines are required for all ages listed in that column.
Pre-Kindergarten Ages 0-4
Kindergarten through 12th Grade
ACIP Recommended Schedule
HEP B
DTaP: 5 Doses
MMR: 2 doses Grades K - 12th
Birth
a)
4 week minimum interval between first 3 doses; 6 month interval between dose 3
a)
First dose on or after the 1st birthday
and dose 4
b)
28 days minimum interval between doses
2 Months
DTaP/DT
b)
4 doses acceptable if dose 4 given on or after the 4th birthday
POLIO
c)
If dose 4 administered before 4th birthday, 5th dose must be given at 4-6 years
HEP B
of age
PCV
Varicella: 2 doses Grades K - 12th
ROTAVIRUS
a)
First dose on or after the 1st Birthday
Tdap/Td: 7 years and older
b)
Second dose must be given at least 28 days after first dose
3 doses if no history of any DTaP doses (a-b)
c)
No doses required if prior varicella disease verified by a physician
DTaP/DT
4 Months
a)
4 week minimum interval between dose 1 (Tdap) and dose 2 (Td); first dose must
POLIO
be Tdap
HIB
b)
6 months between dose 2 (Td) and 3 (Td)
Varicella-ACIP minimum interval for less than 13 yrs is 3 months; 13 yrs and
PCV
Single dose of Tdap for an incomplete primary DTaP series or;
c)
older is 4 weeks however, a 28 day interval regardless of age is valid.
ROTAVIRUS
d)
Single dose of Tdap required for Grades 7-12
Hepatitis B: 3 doses Grades K - 12th
6 Months
DTaP/DT
Polio: Grades K - 5, new students and students completing the polio series
a)
4 week minimum interval between dose 1 and dose 2
POLIO
All IPV or OPV Schedule
b)
8 week minimum interval between dose 2 and dose 3
HEP B
a)
4 week minimum interval between first 3 doses; 6 months interval between dose
c)
16 week minimum interval between dose 1 and dose 3
HIB
3 and dose 4; one dose after 4th birthday
d)
Dose 3 must be given after 24 weeks of age
PCV
b)
3 doses acceptable, if 4 weeks between dose 1 and 2; 6 months between dose
ROTAVIRUS
2 and 3; one dose after 4th birthday
12-15 Months
MMR
Combination IPV/OPV - 4 doses required
Additional Notes:
VAR
a)
4 week minimum interval between first 3 doses; 6 months interval between
-
Vaccine doses given up to 4 days before the minimum interval
HIB
dose 3 and dose 4; one dose after 4th birthday
or age may be considered valid.
PCV
b)
3 doses not acceptable with combination schedule
-
With the exception of Hepatitis B vaccine, immunizations given
HEP A
12-23 Months
before 6 weeks of age are not considered valid.
Polio: Grades 6 - 12th
-
Half doses or reduced doses of vaccine are not considered
DTaP/DT
15-18 Months
valid.
All IPV or OPV Schedule
a)
4 doses-4 weeks minimum interval betwen doses regardless of age given
6 Months
HEP A
b)
3 doses acceptable -4 weeks minimum interval between dose 1 and dose 2;
after 1st dose
dose 3 after 4th birthday
ACIP Recommended Schedule
Combination IPV/OPV - 4 Doses required
a) 4 weeks minimum interval regardless of age given
dules/
New students and students completing series must have 6 months between
last two doses with one dose after 4th birthday
PARENTS AND/OR GUARDIANS ARE NOT AUTHORIZED TO COMPLETE KCI FORMS.
KCI FORM B - MEDICAL EXEMPTION is located at
BLANK VERSION OF KCI FORM is available at
A ROSTER WITH THE NAMES OF ALL EXEMPT STUDENTS SHOULD BE MAINTAINED. PARENTS OR GUARDIANS OF EXEMPT CHILDREN SHOULD BE INFORMED THAT THEIR CHILDREN
SHALL BE EXCLUDED FROM SCHOOL IN THE EVENT OF AN OUTBREAK OR SUSPECTED CASE OF A VACCINE-PREVENTABLE DISEASE.

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