Administrative Rules of the State of Montana

(1) All children residing in the foster home other than the foster child shall be immunized against measles, rubella, mumps, poliomyelitis, diphtheria, pertussis, tetanus, varicella, hepatitis B, pneumococcal, and Haemophilus influenza type B according to the following schedule:

Total Immunizations Required, By Age

Age Number Doses - Vaccine Type

under 2 months old no vaccinations required

by 3 months of age 1 dose of polio vaccine

1 dose of DTP vaccine

1 dose of Hib vaccine

1 dose of Hep B vaccine

1 dose of PCV vaccine

by 5 months of age 2 doses of polio vaccine

2 doses of DTP vaccine

2 doses of Hib vaccine

2 doses of Hep B vaccine

2 doses of PCV vaccine

by 7 months of age 2 doses of polio vaccine

3 doses of DTP vaccine

*2 or 3 doses of Hib vaccine

2 doses of Hep B vaccine

3 doses of PCV vaccine

by 16 months of age 2 doses of polio vaccine

3 doses of DTP vaccine

1 dose of varicella vaccine

1 dose of MMR vaccine

*3 or 4 doses of Hib vaccine

2 doses of Hep B vaccine

*4 doses of PCV vaccine

by 19 months of age 1 dose of varicella vaccine

3 doses of polio vaccine

4 doses of DTP vaccine

1 dose of MMR vaccine

*3 or 4 doses of Hib vaccine

3 doses of Hep B vaccine

*4 doses of PCV vaccine

By 6 years of age 3 doses of polio vaccine, one given after the 4th birthday

4 doses of DTP vaccine, one given after the 4th birthday

2 doses of varicella vaccine

2 doses of MMR vaccine

3 doses of Hep B vaccine

By 12 years of age 3 doses of polio vaccine, one given after the 4th birthday

1 dose of Tdap vaccine

2 doses of varicella vaccine

2 doses of MMR vaccine

3 doses of Hep B vaccine

(*) varies depending on vaccine type used or the ACIP catch-up schedule.

(2) Hib and PCV vaccines are not required or recommended for children five years of age and older.

(3) Doses of MMR and varicella vaccines, to be acceptable under this rule, must be given no earlier than 12 months of age. A child who received a dose prior to 12 months of age must be revaccinated; however, vaccine doses given up to four days before the minimum interval or age are counted as valid. Live vaccines not administered at the same visit must be separated by at least four weeks.

(4) Vaccines immunizing against diphtheria, pertussis, and tetanus must be administered as follows:

(a) a child less than seven years of age must be administered four or more doses of DTP or DTaP vaccine, at least one dose of which must be given after the fourth birthday;

(b) DT vaccine administered to a child less than seven years of age is acceptable for purposes of this rule only if accompanied by a medical exemption meeting the requirements of ARM 37.114.715 that exempt the child from pertussis vaccination; and

(c) a child seven years old or older who has not completed the requirement in (1) must receive additional doses of Tdap vaccine or Td vaccine to become current in accordance with the ACIP schedule.

(5) Immunization history may be recorded on the certificate of immunization form (HES-101) provided by the department or on a physician- or clinic-provided immunization record, which must include:

(a) the name of the physician or clinic;

(b) the name and birth date of the child; and

(6) The immunization information is to be kept on file in both the foster home and the licensing file.

(7) A child residing in the foster home other than the foster child is not required to have any immunizations which are medically contraindicated. A written and signed statement from a physician that an immunization otherwise required by (1) of this rule is medically contraindicated will exempt a child from those immunization requirements as deemed necessary by the physician. It is preferred, but not mandatory, that a physician's medical exemption be recorded on HES-101, and medical exemption documentation must include:

(a) which specific immunization is contraindicated;

(b) the period of time during which the immunization is contraindicated;

(d) when deemed necessary by a physician, the results of immunity testing. The tests must indicate serological evidence of immunity and must be performed by a CLIA approved lab.