Montana State Vaccine Requirements

• General Information
• Vaccination Requirements
• Exemption Information

• General Information
• Vaccination Requirements
• Exemption Information

• General Information
• Vaccination Requirements
• Exemption Information

• State Healthcare Worker and Patient Vaccination Laws
• State of Montana Legislature – see applicable statutes and their hyperlinks below. Visit NVIC’s Advocacy Portal for information on legislation introduced impacting vaccine exemption rights.
• State of Montana Legislative Updates Service
• State of Montana Department of Health
• State of Montana Immunization Program
• State of Montana Vaccine Tracking System – You may also wish to contact your state’s vaccine tracking registry to determine if the ability to opt out is available.
• State of Montana Proposed Rule-Making – View your state’s registry to learn about proposed rule-making.

TITLE 20 EDUCATION
CHAPTER 5 PUPILS
PART 4 HEALTH

Mont. Code Anno., § 20-5-402. Definitions. As used in this part, the following definitions apply:

(1) "Department" means the department of public health and human services provided for in 2-15-2201.

(2) "Governing authority" means the board of trustees of a school district or the administrator of a private school, preschool, or postsecondary school.

(3) "Immunization" means induction of a state of resistance to a disease through administration of an immunizing agent.

(4) "Local health department" means a city, city-county, county, or district health department.

(5) "Local health officer" means a city, city-county, county, or district health officer.

(6) "Postsecondary school" means a community college, a unit of the Montana university system, or a private university or college.

(7) "Preschool" means a place or facility that provides, on a regular basis and as its primary purpose, educational instruction designed for children 5 years of age or younger and that:

(a) serves no child under 5 years of age for more than 3 hours a day;
and
(b) serves no child 5 years of age for more than 6 hours a day. (8) "School" means a place or institution for the teaching of individuals, the curriculum of which is composed of the work of:

(a) any combination of kindergarten through grade 12;
(b) a postsecondary school; or
(c) a preschool.
 

Mont. Code Anno., § 20-5-403 Immunization required -- release and acceptance of immunization records.

(1) The governing authority of any school other than a postsecondary school may not allow a person to attend as a pupil unless the person:

(a) has been immunized against diphtheria, pertussis, tetanus, poliomyelitis, rubella, mumps, and measles (rubeola) in the manner and with immunizing agents approved by the department, except that pertussis vaccination is not required for a person 7 years of age or older;
(b) has been immunized against Haemophilus influenza type "b" before enrolling in a preschool if under 5 years of age;
(c) qualifies for conditional attendance; or
(d) files for an exemption.

(2)

(a) The governing authority of a postsecondary school may not allow a person to  attend as a pupil unless the person:

(i) has been immunized against rubella and measles (rubeola) in the manner and with immunizing agents approved by the department; or
(ii) files for an exemption.

(b) The governing authority of a postsecondary school may impose immunization requirements as a condition of attendance that are more stringent than those required by this part.

(3) A pupil who transfers from one school district to another may photocopy immunization records in the possession of the school of origin. The school district to which a pupil transfers shall accept the photocopy as evidence of immunization. Within 30 days after a transferring pupil ceases attendance at the school of origin, the school shall retain a certified copy for the permanent record send the original immunization records for the pupil to the school district to which the pupil transfers.
 

Mont. Code Anno., § 20-5-404. Conditional attendance.

The governing authority of a school other than a postsecondary school may allow the commencement of attendance in school by a person who has not been immunized against each disease listed in 20-5-403 if that person has received one or more doses of polio, measles (rubeola), mumps, rubella, diphtheria, pertussis, Haemophilus influenza type "b", and tetanus vaccine, except that pertussis vaccine is not required for a person 7 years of age or older and Haemophilus influenza type "b" vaccine is required only for children under 5 years of age.
 

Mont. Code Anno., § 20-5-405 Medical or religious exemption. 

(1) When a parent, guardian, or adult who has the responsibility for the care and custody of a minor seeking to attend school or the person seeking to attend school, if an adult, signs and files with the governing authority, prior to the commencement of attendance each school year, a notarized affidavit on a form prescribed by the department stating that immunization is contrary to the religious tenets and practices of the signer, immunization of the person seeking to attend the school may not be required prior to attendance at the school. The statement must be maintained as part of the person's immunization records. A person who falsely claims a religious exemption is subject to the penalty for false swearing provided in 45-7-202.

(2) When a parent, guardian, or adult who has the responsibility for the care and custody of a minor seeking to attend school or the person seeking to attend school, if an adult, files with the governing authority a written statement signed by a physician licensed to practice medicine in any jurisdiction of the United States or Canada stating that the physical condition of the person seeking to attend school or medical circumstances relating to the person indicate that some or all of the required immunizations are not considered safe and indicating the specific nature and probable duration of the medical condition or circumstances that contraindicate immunization, the person is exempt from the requirements of this part to the extent indicated by the physician's statement. The statement must be maintained as part of the person's immunization records.

(3) Whenever there is good cause to believe that a person for whom an exemption has been filed under this section has a disease or has been exposed to a disease listed in 20-5-403 or will as the result of school attendance be exposed to the disease, the person may be excluded from the school by the local health officer or the department until the excluding authority is satisfied that the person no longer risks contracting or transmitting that disease.

 
Administrative Rules (found below)
ARM ARM 37.114.715 Medical exemption.
ARM ARM 37.114.716 Religious exemption. 

Attorney General's Opinions

Challenges to Mandatory Immunization on Religious Grounds -- Restraint Advisable: Although a school district has an undeniable compelling interest in protecting students from communicable diseases, it does not have unlimited discretion to determine the legitimacy or sincerity of the religious tenets and practices of one seeking an exemption pursuant to this section. Absent established uniform standards or procedures, a school district should refrain from challenging an affidavit claiming a religious exemption from mandatory immunization. 44 A.G. Op. 7 (1991).

Religious Exemption to Mandatory Immunization Not Limited to Established or Recognized Religion: The religious exemption to mandatory immunization of students in this section is not limited to beliefs or tenets of an established or recognized traditional religion but also encompasses sincerely held personal religious beliefs. 44 A.G. Op. 7 (1991).

 

ADMINISTATIVE RULES (OLD 16.28.707-708)
TITLE 37: DEPARTMENT OF PUBLIC HEALTH AND HUMAN SERVICES
CHAPTER 114: COMMUNICABLE DISEASE CONTROL
SUB-CHAPTER 7: IMMUNIZATION OF SCHOOL CHILDREN

MONT. ADMIN. R. 37.114.709 REQUIREMENTS FOR UNCONDITIONAL ATTENDANCE AT A POSTSECONDARY SCHOOL

(1) Before a prospective pupil may enter a Montana postsecondary school, the prospective pupil must provide the school with the proof of measles (rubeola) and rubella immunity as specified in (2) or (3), whichever is applicable.

(2) If a prospective pupil was born in 1957 or later, the school must receive either:

(a) adequate documentation that:

(i) the prospective pupil was administered two doses of live MMR or MR vaccine, or any equivalent combination of measles and rubella vaccines, subject to the restrictions in ARM 37.114.712(2); and
(ii) dose one was administered at or after 12 months of age, and dose two was administered at least 28 days after dose one; or

(b) a CLIA approved laboratory report that meets the requirements of ARM 37.114.712(2) and indicates the prospective pupil is immune to measles and rubella.

(3) If a prospective pupil was born prior to 1957, the school must receive either:

(a) one of the forms of proof of measles and rubella immunity cited in (2); or
(b) the evidence of date of birth before January 1, 1957, required by ARM 37.114.712(2).

(4) In the event of an outbreak of either measles or rubella, a pupil must provide the documentation required by either (2)(a) or (b) or be excluded from classes and other school sponsored activities until the local health officer indicates to the school that the outbreak is over. If the laboratory documentation required by (2)(b) is provided, the laboratory report need only show immunity to whichever of the two diseases is the cause of the outbreak.

(5) The school must maintain a list of pupils who were born prior to 1957 and who provide the school only with the documentation specified in (3)(b). In the event of an outbreak of measles or rubella, the school must exclude those pupils as required by (4).

(6) A pupil who enters a postsecondary school may be conditionally enrolled as allowed by ARM 37.114.711 if that pupil has received only one dose of MMR or MR, but must have received the second dose before being eligible to attend during the next school term.
 

MONT. ADMIN. R. 37.114.712 DOCUMENTATION OF IMMUNIZATION STATUS OF PERSONS COMMENCING ATTENDANCE IN A POSTSECONDARY SCHOOL

(1) Postsecondary schools must keep immunization data for each pupil either on HES 101 or on another document that includes, at a minimum:

(a) the pupil's name and birth date;
(b) the vaccination dose type administered to the pupil; and
(c) the month, day, and year each dose was administered, unless only the month and year of administration are known, in which case the administration date will be considered to be the first day of that month.

(2) Documentation of the proof of measles and rubella immunity required by ARM 37.114.709 must meet the following standards:

(a) there must be adequate documentation of the doses required by ARM 37.114.709, subject to the following restrictions:

(i) no measles vaccination given before 1967 is valid; and
(ii) no rubella vaccination given before 1969 is valid;

(b) if the pupil was born prior to January 1, 1957, proof of age must be made through a driver's license, school transcript, birth certificate, or passport, as long as the date of birth is indicated on the document;
(c) if a laboratory report is submitted to prove immunity, it must come from a CLIA approved laboratory report and:

(i) indicate that the person is immune to either measles and rubella;
(ii) specify the type of test performed and the test date; and
(iii) include a determination from the clinician interpreting the laboratory results.

(3) The documentation of immunization status must be kept on file with the immunization records required by (1). (History: 20-5-407, MCA; IMP, 20-5-406, MCA; NEW, 2005 MAR p. 1074, Eff. 7/1/05.)
 

MONT. ADMIN. R. 37.114.715 MEDICAL EXEMPTION

(1) A prospective pupil seeking to attend school is not required to have any immunizations which are medically contraindicated. A written and signed statement from a physician that an immunization is medically contraindicated will exempt a prospective pupil from those immunizations as deemed necessary  by the physician. The required vaccines are listed in 20-5-403, MCA.

(2) The statement must include:

(a) which specific immunization is contraindicated;
(b) the period of time during which the immunization is contraindicated;
(c) the reasons for the medical contraindication; and
(d) when deemed necessary by a physician, the results of immunity testing performed on a pupil entering kindergarten through grade 12. The tests must indicate serological evidence of immunity and must be performed by a CLIA approved lab. A copy of the test result must be attached to HES101, beginning with  school enterers in the school year 2005-2006.

(3) It is preferred, but not mandatory, that a physician's medical exemption be recorded on HES 101.

(4) The physician's written statement must be maintained by the school as part of the immunization record of the pupil qualifying for the exemption. In pre-school and kindergarten through grade 12 settings, the written statement must be attached to HES 101 beginning with the 2005-2006 school year.
 

MONT. ADMIN. R. 37.114.716 RELIGIOUS EXEMPTION

(1) A prospective pupil seeking to attend school is exempt from all or part of the immunization requirements if the parent or guardian of that prospective pupil, an adult responsible for that prospective pupil, or the prospective pupil himself if an adult or an emancipated minor, objects thereto in a signed, written statement indicating that the proposed immunization interferes with the free exercise of the religious beliefs of the person signing the statement.

(2) In any school other than a secondary school, a claim of exemption from immunization requirements on religious grounds must be notarized annually and maintained on a form HES 113.  Affidavit of Exemption on Religious Grounds, provided by the department. The form must be provided to the school prior to each school year by the parent or guardian or adult responsible for the pupil.  If the pupil is 18 years of age or older or emancipated, in which case the pupil may claim the exemption.

(3) In a postsecondary setting, a religious exemption must be maintained on orm HES 113 and signed, notarized and submitted each year of attendance, beginning with the date of initial attendance at the school. The form must be completed and resubmitted each year thereafter.

(4) The original copy of the claim of religious exemption must be kept by the school as part of the pupil's school record.
 

MONTANA ADMINISTRATIVE RULES
TITLE 37. PUBLIC HEALTH AND HUMAN SERVICES
CHAPTER 95. LICENSURE OF DAY CARE FACILITIES

MONT. ADMIN. R. 37.95.140 IMMUNIZATION

(1) Before a child may attend a Montana day care facility, that facility must be provided with the documentation required by (5) that the child has been immunized as required for the child's age group against measles, rubella, mumps, poliomyelitis, diphtheria, pertussis (whooping cough), tetanus, varicella, hepatitis B, pneumococcal, and Haemophilus influenza type B, unless the child qualifies for conditional attendance in accordance with (7):

Age at Entry

under 2 months old

Number of Doses-Vaccine Type

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

• 3 doses of polio vaccine
• 4 doses of DTP vaccine
• 1 dose of varicella 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 and 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 must be recorded on the Montana 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

(c) the date and type of immunization.

(6) In order to continue to attend a day care facility, a child must continue to be immunized on the schedule described in (1) and must be immediately excluded from attendance in the day care facility if the child is not vaccinated on that schedule with all of the required vaccines, or does not have on file at the day care facility a record of medical exemption or a conditional enrollment form which indicates that no vaccine dose is past due.

(7) A child may initially conditionally attend a day care facility if:

(a) the child has received at least one dose of each of the vaccines required for the child's age;

(b) a form prescribed by the department documenting the child's conditional immunization status is on file at the day care facility and is attached to the department's Montana certificate of immunization (HES-101); and

(c) the child is not past due for the next required dose (as noted on the conditional enrollment form) of the vaccine in question.

(8) If a child in attendance at the day care facility, a resident of the day care facility, or a staff member, or volunteer contracts any of the diseases for which this rule requires immunization, all individuals infected and all persons attending the day care facility who are not completely immunized against the disease in question or who are exempted from immunization must be excluded from the day care facility until the local health authority indicates to the day care facility that the outbreak is over.

(9) The day care facility must maintain a written record of immunization status of each staff member, enrolled child, and each child of a staff member who resides at the day care facility. The facility must make those records available during normal working hours to representatives of the department or the local health authority.

(10) A child under five years of age seeking to attend a day care facility is not required to be immunized against Haemophilus influenza type B if the parent or guardian of the child objects thereto in a signed, written statement indicating that the proposed immunization interferes with the free exercise of the religious beliefs of the person signing the statement. A claim of exemption on religious grounds must be notarized and maintained on an Affidavit of Exemption on Religious Grounds form (HES-113) provided by the department.

(11) A 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;

(c) the reasons for the medical contraindication; and

(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.