Changes to the Immunization Policy

As of January 1, 2018, the following changes have been made to North Dakota Administrative Rule 33-06-01 regarding child care immunization requirements.

  • Hepatitis B vaccine has been added to the list of required vaccines for children in child care facilities in North Dakota. Children will need to be age appropriately immunized against heptatis B vaccine to attend child care in North Dakota.
  • History of disease exemptions were added for all diseases that could potentially have an applicable history of disease, including hepatitis B, hepatitis A, varicella (chickenpox), measles, mumps, or rubella. Previously, history of disease exemptions were only allowed for varicella.
  • A physician signature is now required for a history of disease exemption. Previously, a parent could provide a signature for a history of disease exemption.

Enclosed you will find the 2018 Child Care and Early Childhood Facility immunization requirements. Please contact the North Dakota Department of Health Immunization Program at 701-328-3386 or 800-472-2180 (toll-free) with any questions regarding child care immunization requirements.

2018-2019 School Immunization Requirements

Number of Required Doeses

Number of required Doses
Vaccine TypeKindergarten-6th GradeGrades 7-10Grades 11-12
Hepatitis B333
Varicella (chickenpox)221

*One dose of DTaP (pediatric diphtheria, tetanus, and acellular pertussis) vaccine must have been given on or after the fourth birthday. Only four doses are necessary if the fourth dose was administered on or after the fourth birthday. Three doses of Tdap (adolescent/adult tetanus, diphtheria, and acellular pertussis)/Td are required for children ages seven or older who were not previously vaccinated. Tdap should be used as the first dose followed by two doses of Td for children age seven or older not previously vaccinated.

**For polio vaccination, in all-IPV or all-OPV schedule: one dose must have been given on or after the fourth birthday. The final dose in the series should be administered on or after the fourth birthday and at least six months after the previous dose. If four doses are administered prior to age four, a fifth dose should be administered on or after age four. Only three doses of IPV are required if the third dose is given on or after the fourth birthday. Children born before August 2005 only need four doses separated by at least four weeks. These children do not need a dose after the age of four.

***One dose of meningococcal conjugate vaccine {MCV4) must have been given on or after the tenth birthday. The second dose of iVlCV4 must be given on or afterthe sixteenth birthday. If the first dose of MCV4 is given after the sixteenth birthday, then only one dose of MCV4 is required for eleventh and twelfth grade.

****One dose of Tdap must have been given on or after the seventh birthday.


Students may be exempt from immunization requirements for the following reasons:

  • Medical Exemption: Requires a certificate signed by a licensed physician stating that the physical condition of the child is such that immunization would endanger the life or health of the child.
  • Personal Belief or Religious Belief Exemption: Requires a certificate signed by the parent or guardian whose sincerely held philosophical, moral or religious belief is opposed to such immunization.
  • History of Disease Exemption: Requires a certificate signed by a physician stating that the child has a reliable history of disease. History of disease exemptions may only be claimed for hepatitis B, varicella, measles, mumps, or rubella.


All children need to be up-to-date according to the school immunization requirements or have claimed an exemption by October 1" of each school year or they must be excluded from school. Children enrolling in school after October 1" have 30 days to be up-to-date or claim an exemption orthey must be excluded from school.

Posted: January 23, 2018


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