Health
Health Guidelines for School Attendance
Keeping a sick child home protects other children, school staff, and visiting community members from catching an illness that can be spread from person to person.
A sick child who is unable to participate at school should be kept home to rest and recover until symptoms improve. Please be aware of the following guidelines for school attendance.
A student with any of the following symptoms should not attend school:
- Temperature of 100 degrees or higher
- Nausea, Vomiting, or Diarrhea
- Eye redness and/or drainage
- Undetermined rash and/or scaly patches over any part of the body or scalp
- Intense itching with signs and symptoms of secondary infection
- Open, draining lesions
A child with any of these symptoms must stay home until they are symptom-free for 24 hours and without the use of medication before returning to school.
If a parent suspects that his or her child has a contagious disease, the parent should contact the school nurse so that other students who might have been exposed to the disease can be alerted. Remember, hand washing can prevent the spread of diseases.
When you take your child to a healthcare provider for an evaluation of illness or injury, please be sure to request a written letter stating when your child may return to school and any accommodations required upon his/her return.
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Common Illnesses
When can my child return to school?
When on antibiotics and fever-free for 24 hours without the use of fever-suppressing medication and approval by a healthcare provider.
When all lesions have crusted over and it has been at least 24 hours since the last new lesion appeared.
When fever-free for 24 hours without the use of fever-suppressing medication.
A doctor's note is required unless symptoms have resolved.
When diarrhea-free for 24 hours without the use of diarrhea-suppressing medication.
Fever
When fever-free (< 100.0 F) for 24 hours without the use of fever-suppressing medication.
When fever-free for 24 hours without the use of fever-suppressing medication.
When fever-free for 24 hours without the use of fever-suppressing medication.
When diarrhea-free and fever-free for 24 hours without the use of fever-suppressing or anti-diarrheal medication.
After completion of five days of antibiotic therapy.
Unless directed by a physician, students with MRSA infections should not be excluded from attending school. Exclusion from school/sports activities should be reserved for these with wound drainage that cannot be completely covered and contained by a clean, dry bandage and those who cannot maintain good personal hygiene.
When diarrhea-free and fever-free for 24 hours without the use of fever-suppressing or anti-diarrheal medication.
When on antibiotics and fever-free for 24 hours without the use of fever-suppressing medication.
Vomiting
When able to tolerate food and liquids without any recurrence of vomiting, typically 24 hours after the last episode.
For more information:
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All immunizations must be completed by the first date of attendance. The law requires that students be fully vaccinated against the specified diseases.
Provisional enrollment allows a student meeting certain specific criteria to be admitted to school on a temporary basis for up to 30 days.
A student may be enrolled provisionally if the student has an immunization record that indicates the student has received at least one dose of each specified age-appropriate vaccine required by this rule. A student must not be overdue for the next dose in a series to be considered provisional. To remain enrolled, the student must complete the required subsequent doses in each vaccine series on schedule and as rapidly as is medically feasible and provide acceptable evidence of vaccination to the school.
A school nurse or school administrator shall review the immunization status of a provisionally enrolled student every 30 days to ensure continued compliance in completing the required doses of vaccination.
During this 30-day period, the parent is responsible for ensuring that the student receives the necessary vaccine(s) as fast as is medically feasible, and/or providing a complete and current immunization record to the school. Texas schools are also responsible for ensuring that immunization records are sent to requesting Texas schools within the 30-day period.
If, at the end of the 30-day period, a student has not received a subsequent dose of vaccine, the student is not in compliance and the school shall exclude the student from school attendance until the required dose is administered.
Additional guidelines for provisional enrollment of students can be found in the Texas Department of State Health Services, Immunizations Provisional Enrollment for Students Flow chart (pg. 2).Provisional enrollment allows a student to enroll in school under the following situations:
- Transfer Students
Students transferring from one Texas public or private school to another can be enrolled provisionally for no more than 30 days while awaiting the transfer of the immunization record.
- Homeless Students
Students who are defined as homeless according to the federal McKinney-Vento Act, 42 U.S.C. §11434a can be admitted provisionally for 30 days if acceptable evidence of vaccination is not available. The school shall promptly refer the student to appropriate public health programs to obtain the required vaccinations.
- Students In-Progress
Students who have received at least one dose of each specified age-appropriate vaccine required by the DSHS rules. To remain enrolled, students must complete the required subsequent doses of each vaccine series on schedule and as rapidly as is medically feasible and provide acceptable evidence of vaccination to the school. A school nurse or school administrator shall review the immunization status of a provisionally enrolled student every 30 days to ensure continued compliance in completing the required doses of vaccination. If, at the end of the 30-day period, a student has not received a subsequent dose of vaccine, the student is not in compliance and the school shall exclude the student from school attendance until the required dose(s) is (are) administered.
- Military Dependents
A dependent of a person who is on active duty with the armed forces of the United States can be enrolled provisionally for no more than 30 days if he/she transfers from one school to another and is awaiting the transfer of the immunization record.
Texas Administrative Code (TAC) §97.62 and 97.69
Can a child without an immunization record be enrolled provisionally if they are not homeless, are not transferring from a Texas school or are not progressing towards obtaining immunizations as fast as is medically feasible?
No. The child must obtain the first doses of the required vaccines and then they can be admitted provisionally as long as they are progressing towards receiving the remaining required vaccines as fast as is medically feasible.
More FAQ:
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The Texas Department of State Health Services (DSHS) considers vaccines to be very safe and encourages all Texans to be vaccinated.
Exemptions for Medical Reasons:
DSHS recognizes that there may be valid medical reasons for which they cannot receive certain vaccines.
Texas law allows physicians to write medical exemption statements which clearly state a medical reason exists that a student cannot receive specific vaccines. Unless the exemption states a lifelong condition, the exemption is only valid for one year.
For students claiming medical exemptions, a written statement by a US- licensed MD or DO that clearly states a medical reason for which the student cannot receive specific vaccines, must be submitted to the school. Unless it is written in the statement that a lifelong condition exists, the exemption statement is valid for only one year from the date signed by the physician.
Exemptions for Reasons of Conscience:
Parents/guardians can choose an exemption from immunization requirements for reasons of conscience, including a religious belief.
The law does not allow parents/guardians to elect an exemption simply because of inconvenience (for example, a record is lost or incomplete and it is too much trouble to go to a physician or clinic to correct the problem). Schools should maintain an up-to-date list of students with exemptions, so they may be excluded in times of emergency or epidemic declared by the commissioner of public health.
To claim an exclusion for reasons of conscience, including a religious belief, the child’s parent, legal guardian, or a student 18 years of age or older must present to the school or child-care facility a completed, signed and notarized affidavit in Texas on a form provided by the department stating that the child’s parent, legal guardian, or the student declines vaccinations for reasons of conscience, including because of the person’s religious beliefs.
The affidavit will be valid for a two-year period from the date of notarization. A child or student who has not received the required immunizations for reasons of conscience, including religious beliefs, may be excluded from school in times of emergency or epidemic declared by the commissioner of the department.
Please note the Notary needs to be registered to notarize in Texas on the approved Exemption Affidavit which is only valid for 2 years. After 2 years you will need to request for another Exemption Affidavit from the Texas Department of Health and complete the process again.
How to Obtain an Affidavit:
- Requesting an Affidavit Online: Texas DSHS staff continue to process conscientious exemption requests. Exemption requests are processed in the order they are received and it may take up to 3 weeks for requested affidavits to be mailed.
- Request for Exemption from Immunization for Reasons of Conscience Form (English/Español):
- Send completed form by Mail:
Texas Department of State Health Services
Immunization Section, Mail Code 1946
P.O. Box 149347
Austin, Texas 78714-9347
- Send completed form by Mail:
Please turn in the completed original Exemption Affidavit to your child’s Nurse at their attending school.