Immunization Rules (Missouri) [.2140 - .2231]

Last Modified on 10/22/2022 10:53 am CDT

Classic Path: System Administration > Health > Vaccines

Search Terms: Vaccines

Health vaccines and their associated compliance listings are based on state guidelines. While Infinite Campus maintains standard guidelines for all states, districts have the ability to enter additional compliances. The following information describes vaccine compliance rules as defined by the Missouri State Department of Health.

For more information on the creation, modification or deletion of vaccine compliances, see the Vaccines page.

General Compliance

  • Vaccine doses administered less than or equal to 4 days before the minimum interval or age are considered valid.
  • Doses administered 5 days earlier than the minimum interval or age are not considered valid doses and must be repeated as age-appropriate.
  • With the exception of Hepatitis B vaccine, immunizations given before 6 weeks of age are not considered valid.
  • Half doses or reduced doses of a vaccine are not considered valid.
  • Dose spacing is only enforced for students who entered kindergarten in the 2003-04 school year of after.

DTaP

RuleRequirements

0-2 Months

No Requirement

Students 0-2 months of age are not required to receive any doses of the DTaP, DTP vaccine.

3-4 Months

Compliant

The student is considered compliant if the following conditions have been met:

  • student is at least 3 months and no older than 4 months old,
  • the student receives 1 dose of the DT or DTaP-DTP vaccine, and
  • the difference between the dost and the student's birthdate is greater than 42 days with a 4 day tolerance.

5-6 Months

Compliant

The student is considered compliant if the following conditions have been met:

  • student is at least 5 months and no older than 6 months old,
  • the student receives 2 doses of the DT or DTaP-DTP vaccine, 
  • the difference between the dost and the student's birthdate is greater than 42 days with a 4 day tolerance, and
  • the difference between the second dose and previous is greater than 28 days with a 4 day tolerance.

7-18 Months

Compliant

The student is considered compliant if the following conditions have been met:

  • student is at least 7 months and no older than 18 months old,
  • the student receives 3 doses of the DT or DTaP-DTP vaccine, 
  • the difference between the dost and the student's birthdate is greater than 42 days with a 4 day tolerance, 
  • the difference between the second dose and previous is greater than 28 days with a 4 day tolerance, and
  • the difference between the third dose and the previous is greater than 28 days with a 4 day tolerance.

19 Months 

Compliant

The student is considered compliant if the following conditions have been met:

  • student is at least 19 months old,
  • the student is in state grade: PKA: Pre-Kindergarten AM, PKP: Pre-Kindergarten PM, PK: Pre-Kindergarten,
  • the student receives 4 doses of the DT or DTaP-DTP vaccine, 
  • the difference between the dost and the student's birthdate is greater than 42 days with a 4 day tolerance, 
  • the difference between the second dose and previous is greater than 28 days with a 4 day tolerance, 
  • the difference between the third dose and the previous is greater than 28 days with a 4 day tolerance, and
  • the difference between the fourth dose and the previous is greater than 4 months with a 4 day tolerance.

3 Doses

Compliant

The student is considered compliant if the following conditions have been met:

  • the student is in State Grade: K, KA, KP, 01, 02, 03, 04, 05, 06, 07, 08, 09, 10, 11, 12,
  • the student receives 3 doses of the DT, DTap/DTP, DTap-DTP, TD, or Tdap vaccine,
    • the difference between the last dose and the student's birthdate is greater than 84 months with a 4 day tolerance,
    • the difference between the first dose and the student's birthdate is greater than 42 days with a 4 day tolerance,
    • the difference between the second dose and the previous is greater than 28 days with a 4 day tolerance,
    • the difference between the third dose and the previous is greater than 28 days with a 4 day tolerance, and
  • one of the doses of the DT, DTap/DTP, DTap-DTP, TD, or Tdap vaccine the student receives must be 83 months with a 4 day tolerance from the student's birthdate.

6 Doses

Compliant

The student is considered compliant if the following conditions have been met:

  • the student receives 6 doses of the DT, DTap/DTP, DTap-DTP, TD, or Tdap vaccine, and
  • one of the doses of the DT, DTap/DTP, DTap-DTP, TD, or Tdap vaccine the student receives must be 83 months with a 4 day tolerance from the student's birthdate.

4 Doses

Compliant

The student is considered compliant if the following conditions have been met:

  • the student is in State Grade: K, KA, KP, 01, 02, 03, 04, 05, 06, 07, 08, 09, 10, 11, 12,
  • the student receives 4 doses of the DT, DTap/DTP, DTap-DTP, TD, or Tdap vaccine,
    • the difference between the last dose and the student's birthdate is greater than 48 months with a 4 day tolerance,
    • the difference between the first dose and the student's birthdate is greater than 42 days with a 4 day tolerance,
    • the difference between the first dose and the student's birthdate is less than 83 months with a 4 day tolerance,
    • the difference between the second dose and the previous is greater than 28 days with a 4 day tolerance,
    • the difference between the third dose and the previous is greater than 28 days with a 4 day tolerance, 
    • the difference between the fourth dose and the previous is greater than 4 months with a 4 day tolerance, and
  • one of the doses of the DT, DTap/DTP, DTap-DTP, TD, or Tdap vaccine the student receives must be 83 months with a 4 day tolerance from the student's birthdate.
2 dose after 7yo
Compliant		The student is considered compliant if the following conditions have been met:
  • the student receives 2 doses of the Td or Tdap vaccine,
    • the difference between the first dose and the student's birthdate is greater than 84 months with a 4 day tolerance,
    • the difference between the second dose and the previous is greater than 28 days with a 4 day tolerance,
  • the student receives 1 dose of the Tdap vaccine, and
    • the difference between the first dose and the student's birthdate is greater than 84 months with a 4 day tolerance.
3 dose after 7 yo start before 12 mos
Compliant		The student is considered compliant if the following conditions have been met:
  • the student receives 3 doses of the DT, DTaP/DTP, Td, or Tdap vaccine,
    • the difference between the first dose and the student's birthdate is less than 12 months with a 4 day tolerance,
    • the difference between the third dose and the previous is greater than 28 days with a 4 day tolerance,
    • the difference between the third dose and the student's birthdate is greater than 84 months with a 4 day tolerance,
  • the student receives 1 dose of the DT, DTaP/DTP, Td, or Tdap vaccine,
    • the difference between the first dose and the student's birthdate is less than 12 months with a 4 day tolerance,
  • the student receives 2 doses of the Td or Tdap vaccine,
    • the difference between the second dose and the previous is greater than 28 days with a 4 day tolerance, and
    • the difference between the second dose and the student's birthdate is greater than 84 months with a 4 day tolerance.
3 dose after 7 yo start after 12 mos
Compliant		The student is considered compliant if the following conditions have been met:
  • the student receives 3 doses of the DT, DTaP/DTP, Td, or Tdap vaccine,
    • the difference between the first dose and the student's birthdate is greater than 12 months with a 4 day tolerance,
    • the difference between the third dose and the previous is greater than 6 months with a 4 day tolerance,
    • the difference between the third dose and the student's birthdate is greater than 84 months with a 4 day tolerance,
  • the student receives 1 dose of the DT, DTaP/DTP, Td, or Tdap vaccine,
    • the difference between the first dose and the student's birthdate is greater than 12 months with a 4 day tolerance,
    • the difference between the first dose and the student's birthdate is less than 83 months with a 4 day tolerance,
  • the student receives 2 doses of the Td or Tdap vaccine,
    • the difference between the second dose and the previous is greater than 6 months with a 4 day tolerance, and
    • the difference between the second dose and the student's birthdate is greater than 84 months with a 4 day tolerance.
3 dose after 7 yo
Complaint		The student is considered compliant if the following conditions have been met:
  • the student receives 3 doses of the Td, or Tdap vaccine,
    • the difference between the first dose and the student's birthdate is greater than 84 months with a 4 day tolerance,
    • the difference between the second dose and the previous is greater than 28 days with a 4 day tolerance,
    • the difference between the third dose and the previous is greater than 6 months with a 4 day tolerance,
  • the student receives 1 dose of the Tdap vaccine, and
    • the difference between the first dose and the student's birthdate is greater than 84 months with a 4 day tolerance.

In Progress

A student is considered to be in progress for compliance if:

  • The student has had 1 dose, having received the dose within the past 4 weeks, and is not compliant.
  • The student has had 2 doses, with a difference between the two doses is less than 4 weeks, and is not compliant.
  • The student has had 3 doses, having received the most recent dose within the past 6 months, and is not compliant.

Tdap

RuleRequirement

1 Dose Grade 8-12

Compliant

The student is considered compliant if the following conditions have been met:

  • Student is in State Grade: 08, 09, 10, 11, or 12, and
  • student receives 1 dose of Tetanus, Diptheria, and Accellular Pertussis (Tdap), and
  • the difference between the dose and the student's birthdate is greater than or equal to 84 months with a 4 day tolerance.

No-doses Grade 8-12

Non-Compliant

The student is considered non-compliant if the following conditions have been met:

  • Student is in State Grade: 08, 09, 10, 11, or 12 , and
  • student has received no doses of Tetanus, Diptheria, and Accellular Pertussis (Tdap).
No RequirementN/A

Hepatitis B

RuleRequirements

1 dose

Compliant

The student is considered compliant if the following conditions have been met:

  • student is at least 4 months old, and
  • the student receives 1 dose of the Hepatitis B vaccine.

2 doses

Compliant


The student is considered compliant if the following conditions have been met:

  • the student is at least 5 months and no older than 18 months old,
  • the student receives 2 doses of the Hepatitis B vaccine, and
  • the difference between the second dose and the previous is greater than 28 days with a 4 day tolerance.

3 doses

Compliant

The student is considered compliant if the following conditions have been met:

  • the student is at least 19 months old,
  • the student receives 3 doses of the Hepatitis B vaccine,
  • the difference between the second dose and the previous is greater than 28 days with a 4 day tolerance,
  • the difference between the last dose and the second valid dose is greater than 56 days with a 4 day tolerance,
  • the difference between the last dose and the first valid dose is greater than 112 days with a 4 day tolerance, and
  • the difference between the last dose and the student's birthdate is greater than 168 days with a 4 day tolerance,

2 doses

In Progress

The student is considered In Progress if the following conditions have been met:

  • the student receives 2 doses of the Hepatitis B vaccine, and
  • the difference between last dose and effective date is less than 56 days with a 0 (zero) day tolerance.

1 dose

In Progress

The student is considered In Progress if the following conditions have been met:

  • the student receives 1 dose of the Hepatitis B vaccine
  • the difference between last dose and effective date is less than 28 days with a 0 (zero) day tolerance.

MMR

Missouri immunization rules use CDC spacing requirements which require the first dose of MMR be given on or after 12 months of age.

Rules

Requirements

18 Months

No Requirement

Students 18 months of age and younger are not required to receive any doses of the DTaP, DTP vaccine.

19 months - MMR

Compliant

The student is considered compliant if the following conditions have been met:

  • the student is no older than 18 months old,
  • the student is in state grade: PKA: Pre-Kindergarten AM, PKP: Pre-Kindergarten PM, PK: Pre-Kindergarten,
  • the student receives 1 dose of the MMR or MMRV vaccine, and
  • the difference between the dose and the student's birthdate is greater than 12 months with a 4 day tolerance.

19 months M,M,R

Compliant

The student is considered compliant if the following conditions have been met:

  • the student is at least 19 months old,
  • the student is in state grade: PKA: Pre-Kindergarten AM, PKP: Pre-Kindergarten PM, PK: Pre-Kindergarten,
  • the student receives 1 dose of the Measles vaccine, AND
    • the difference between the dose and the student's birthdate is greater than 12 months with a 4 day tolerance,
  • the student receives 1 dose of the Mumps vaccine, AND
    • the difference between the dose and the student's birthdate is greater than 12 months with a 4 day tolerance,
  • the student receives 1 dose of the Rubella vaccine, AND
    • the difference between the dose and the student's birthdate is greater than 12 months with a 4 day tolerance.

2 MMR

Compliant

The student is considered compliant if the following conditions have been met:

  • the student receives 2 doses of the MMR or MMRV vaccine,
  • the difference between the second dose and the previous is greater than 28 days with a 4 day tolerance, and
  • the difference between the first dose and the student's birthdate is greater than 12 months with a 4 day tolerance.

2 M,M,R

Compliant

The student is considered compliant if the following conditions have been met:

  • the student receives 2 doses of the Measles vaccine, AND
    • the difference between the second dose and the previous is greater than 28 days with a 4 day tolerance, and
    • the difference between the dose and the student's birthdate is greater than 12 months with a 4 day tolerance,
  • the student receives 2 doses of the Mumps vaccine, AND
    • the difference between the second dose and the previous is greater than 28 days with a 4 day tolerance, and
    • the difference between the dose and the student's birthdate is greater than 12 months with a 4 day tolerance,
  • the student receives 2 doses of the Rubella vaccine, AND
    • the difference between the second dose and the previous is greater than 28 days with a 4 day tolerance, and
    • the difference between the dose and the student's birthdate is greater than 12 months with a 4 day tolerance.

1 MMR, 1M, 1M, 1R

Compliant

The student is considered compliant if the following conditions have been met:

  • the student receives 2 doses of the Measles, MMR, or MMRV vaccine, AND
    • the difference between the second dose and the previous is greater than 28 days with a 4 day tolerance, and
    • the difference between the dose and the student's birthdate is greater than 12 months with a 4 day tolerance,
  • the student receives 2 doses of the Mumps, MMR, or MMRV vaccine, AND
    • the difference between the second dose and the previous is greater than 28 days with a 4 day tolerance, and
    • the difference between the dose and the student's birthdate is greater than 12 months with a 4 day tolerance,
  • the student receives 2 doses of the Rubella, MMR, or MMRV vaccine, AND
    • the difference between the second dose and the previous is greater than 28 days with a 4 day tolerance, and
    • the difference between the dose and the student's birthdate is greater than 12 months with a 4 day tolerance.

In Progress

A student is considered to be in progress if the student has had one dose of MMR or Measles within the past 28 days and is not compliant.

Varicella

RuleDose Requirements

1 Dose 21-22 

Compliant

Active Start Date: 07/01/2021


The student is considered compliant if the following conditions have been met:

  • the student receives 1 dose of the Varicella and MMRV vaccine,
  • the student is in State Grade: 12, PKA, PKP, PK, and
  • the difference between the last dose and the student's birthdate is greater than or equal to 12 months with a 4 day tolerance.

2 Doses - Compliant 21-22

Active Start Date: 07/01/2021


The student is considered compliant if the following conditions have been met:

  • the student receives 2 doses of the Varicella or MMRV vaccine,
  • the student is in State Grade: K, KA, KP, 01, 02, 03, 04, 05, 06, 07, 08, 09, 10,11,
  • the difference between the first dose and the student's birthdate is greater than or equal to 12 months with a 4 day tolerance, and
  • the difference between the second dose and the previous is greater than 28 days with a 4 day tolerance.

1 Dose

In Progress

The student is considered in progress if the following conditions have been met:

  • the student receives 1 dose of the Varicella vaccine, and
  • the student is in State Grade: K, KA, KP, 01, 02, 03, 04, 05, 06, 07, 08, 09, 10, 11.

In Progress

A student is considered to be In Progress if the student has had one dose of Varicella or MMRV within the past 2 months, is not compliant, and is in state grade level:KG-08.

Polio

Rule

Requirements

0-2 Mos

No Requirements

Students 0-2 months of age are not required to receive any doses of the Polio vaccine.

3 Mos

Compliant

The student is considered compliant if the following conditions have been met:

  • the student is at least 3 months old and no older than 4 months old, and
  • the student receives 1 dose of the IPV, OPV, or IPV/OPV vaccine.

5 Mos

Compliant

The student is considered compliant if the following conditions have been met:

  • the student is at least 5 months old and no older than 18 months old, 
  • the student receives 2 doses of the IPV, OPV, or IPV/OPV vaccine,
  • the difference between the first dose and the student's birthdate is greater than 42 days with a 4 day tolerance, and
  • the difference between the second dose and the previous is greater than 28 days with a 4 day tolerance.

19 Mos

Compliant

The student is considered compliant if the following conditions have been met:

  • the student is at least 19 months old, 
  • the student is in state grade: PKA: Pre-Kindergarten AM, PKP: Pre-Kindergarten PM, PK: Pre-Kindergarten,
  • the student receives 3 doses of the IPV, OPV, or IPV/OPV vaccine,
  • the difference between the first dose and the student's birthdate is greater than 42 days with a 4 day tolerance,
  • the difference between the second dose and the previous is greater than 28 days with a 4 day tolerance, and
  • the difference between the third dose and the previous is greater than 28 days with a 4 day tolerance.

3 doses grades 10-12

Compliant

Active Start Date: 07/01/2019 

Active End Date: 06/30/2020

The student is considered compliant if the following conditions have been met:

  • the student is in state grade: 10, 11, 12,
  • the student receives 3 doses of the IPV or IPV/OPV vaccine,
  • the difference between the last dose and the student's birthdate is greater than 48 months with a 4 day tolerance,
  • the difference between the first dose and the student's birthdate is greater than 42 days with a 4 day tolerance,
  • the difference between the second dose and the previous is greater than 28 days with a 4 day tolerance, and
  • the difference between the third dose and the previous is greater than 28 days with a 4 day tolerance.

3 doses grades 11-12

Compliant

Active Start Date: 07/01/2020 

Active End Date: 06/30/2021

The student is considered compliant if the following conditions have been met:

  • the student is in state grade: 11, 12,
  • the student receives 3 doses of the IPV or IPV/OPV vaccine,
  • the difference between the last dose and the student's birthdate is greater than 48 months with a 4 day tolerance,
  • the difference between the first dose and the student's birthdate is greater than 42 days with a 4 day tolerance,
  • the difference between the second dose and the previous is greater than 28 days with a 4 day tolerance, and
  • the difference between the third dose and the previous is greater than 28 days with a 4 day tolerance.

3 doses grades 12

Compliant

Active Start Date: 07/01/2021

Active End Date: 06/30/2022

The student is considered compliant if the following conditions have been met:

  • the student is in state grade: 12,
  • the student receives 3 doses of the IPV or IPV/OPV vaccine,
  • the difference between the last dose and the student's birthdate is greater than 48 months with a 4 day tolerance,
  • the difference between the first dose and the student's birthdate is greater than 42 days with a 4 day tolerance,
  • the difference between the second dose and the previous is greater than 28 days with a 4 day tolerance, and
  • the difference between the third dose and the previous is greater than 28 days with a 4 day tolerance.

3 doses

Compliant

The student is considered compliant if the following conditions have been met:

  • the student receives 3 doses of the IPV or IPV/OPV vaccine,
  • the difference between the last dose and the student's birthdate is greater than 48 months with a 4 day tolerance,
  • the difference between the first dose and the student's birthdate is greater than 42 days with a 4 day tolerance,
  • the difference between the second dose and the previous is greater than 28 days with a 4 day tolerance, and
  • the difference between the third dose and the previous is greater than 6 months with a 4 day tolerance.

4 doses grades 10-12

Compliant

Active End Date: 06/30/2020

The student is considered compliant if the following conditions have been met:

  • the student is in state grade: 10, 11, 12, and
  • the student receives 4 doses of the IPV, OPV, or IPV/OPV vaccine.

4 doses grades 11-12

Compliant

Active End Date: 06/30/2021

The student is considered compliant if the following conditions have been met:

  • the student is in state grade: 11, 12, and
  • the student receives 4 doses of the IPV, OPV, or IPV/OPV vaccine.

4 doses grades 12

Compliant

Active End Date: 06/30/2022

The student is considered compliant if the following conditions have been met:

  • the student is in state grade: 12, and
  • the student receives 4 doses of the IPV, OPV, or IPV/OPV vaccine.

Dose 2 to 3 Age 4

In Progress

The student is considered in progress if the following conditions have been met:

  • the student is at least 48 months (4 years) old, 
  • the student receives 2 doses of the IPV, OPV, or IPV/OPV vaccine, and
  • the difference between the last dose and the effective date is less than 5 months with a 1 day tolerance.

Dose 2 to 3

In Progress

The student is considered in progress if the following conditions have been met:

  • the student receives 2 doses of the IPV, OPV, or IPV/OPV vaccine, and
  • the difference between the last dose and the effective date is less than 28 days with a 0 (zero) day tolerance.

Dose 1 to 2

In Progress

The student is considered in progress if the following conditions have been met:

  • the student receives 1 dose of the IPV, OPV, or IPV/OPV vaccine, and
  • the difference between the last dose and the effective date is less than 28 days with a 0 (zero) day tolerance.

Pneumococcal PPV

Rule

Requirements

0-2 Mos

No Requirements

Students 0-2 months of age are not required to receive any doses of the Pneumococcal (PPV) vaccine.

1 dose 3 - 4 months

Compliant

The student is considered compliant if the following conditions have been met:

  • the student is at least 3 months old and at least 4 months old, and
  • the student receives 1 dose of the Pneumococcal (PPV) vaccine.

2 doses 5 - 6 mos

Compliant

The student is considered compliant if the following conditions have been met:

  • the student is at least 5 months old and at least 6 months old, and
  • the student receives 2 doses of the Pneumococcal (PPV) vaccine.

3 doses 7 - 18 mos

Compliant

The student is considered compliant if the following conditions have been met:

  • the student is at least 7 months old and at least 18 months old, and
  • the student receives 3 doses of the Pneumococcal (PPV) vaccine.

1st dose after 24 months

Compliant

The student is considered compliant if the following conditions have been met:

  • the student is no older than 59 months old,
  • the student receives 1 dose of the Pneumococcal (PPV) vaccine, and
  • the difference between the dose and the student's birthdate is greater than 24 months with a 4 day tolerance.

2 doses after 12 months

Compliant

The student is considered compliant if the following conditions have been met:

  • the student is no older than 59 months old,
  • the student receives 2 doses of the Pneumococcal (PPV) vaccine, and
  • the difference between the first dose and the student's birthdate is greater than 12 months with a 4 day tolerance.

3 doses Last after 12 months

Compliant

The student is considered compliant if the following conditions have been met:

  • the student is no older than 59 months old,
  • the student receives 3 doses of the Pneumococcal (PPV) vaccine, and
  • the difference between the last dose and the student's birthdate is greater than 12 months with a 4 day tolerance.

4 doses 19+ Mos

Compliant

The student is considered compliant if the following conditions have been met:

  • the student is no older than 59 months old, and
  • the student receives 4 doses of the Pneumococcal (PPV) vaccine.

3 - 59 mos

Non-compliant

The student is considered non-compliant if the student is between 3 and 59 months and has not received any doses of the Pneumococcal (PPV) vaccine.

Hib

Rule

Requirements

0-2 Mos

No Requirements

Students 0-2 months of age are not required to receive any doses of the Haemophilus influenza, type B (Hib) vaccine.

3 Mos

Compliant

The student is considered compliant if the following conditions have been met:

  • the student is at least 3 months old and no older than 6 months old, and
  • the student receives 1 dose of the Hib vaccine.

7 Mos

Compliant

The student is considered compliant if the following conditions have been met:

  • the student is at least 7 months old and no older than 18 months old, and
  • the student receives 2 doses of the Hib vaccine.

19 Mos

Compliant

The student is considered compliant if the following conditions have been met:

  • the student is at least 19 months old and no older than 59 months old, and
  • the student receives 3 doses of the Hib vaccine.

15 Mos 1 dose

Compliant

The student is considered compliant if the following conditions have been met:

  • the student is at least 15 months old and no older than 59 months old,
  • the student receives 1 doses of the Hib vaccine, and
  • the difference between the last dose and the student's birthdate is greater than 15 months with a 4 day tolerance.

Over 60 Mos

No Requirement

Students 60 months (5 years) old and older are not required to receive any doses of the Haemophilus influenza, type B (Hib) vaccine.

Meningococcal MCV4

RuleRequirements

1 Dose - Compliant

The student is considered compliant if the following conditions have been met:

  • the student receives 1 dose of the Meningococcal (MCV4) vaccine,
  • the student is in State Grade: 08, 09, 10, 11, and
  • the difference between the last dose and the student's birthdate is greater than or equal to 120 months with a 4 day tolerance.

2 Doses - Compliant

The student is considered compliant if the following conditions have been met:

  • the student receives 2 doses of the Meningococcal (MCV4) vaccine,
  • the student is in State Grade: 12,
  • the difference between the second dose and the student's birthdate is greater than or equal to 192 months with a 4 day tolerance, and
  • the difference between the second dose and the previous is greater than or equal to 56 days with a 4 day tolerance.

Default 8-12

Non-compliant

The student is considered non-compliant if the following conditions have been met:

  • the student is in State Grade: 08, 09, 10, 11, 12, and
  • the student has not received any doses of the Meningococcal (MCV4) vaccine.

Previous Versions

Immunization Rules (Missouri) [.2120 - .2136]

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