The Law on Immunizations in Illinois Public Schools

With the recent arrival of measles to Illinois, public debate over vaccination requirements has resurfaced with a vengeance.  Everyone has an opinion.  But what is the law on this issue and what are peoples’ rights and obligations in Illinois with respect to immunizations?

The Illinois Code (105 ILCS 5/27-8.1) provides, in pertinent part:

Health examinations and immunizations.

(1)     In compliance with rules and regulations which the Department of Public Health shall promulgate, and except as hereinafter provided, all children in Illinois shall have a health examination as follows: within one year prior to entering kindergarten or the first grade of any public, private, or parochial elementary school; upon entering the sixth and ninth grades of any public, private, or parochial school; prior to entrance into any public, private, or parochial nursery school; and, irrespective of grade, immediately prior to or upon entrance into any public, private, or parochial school or nursery school, each child shall present proof of having been examined in accordance with this Section and the rules and regulations promulgated hereunder. Any child who received a health examination within one year prior to entering the fifth grade for the 2007-2008 school year is not required to receive an additional health examination in order to comply with the provisions of Public Act 95-422 when he or she attends school for the 2008-2009 school year, unless the child is attending school for the first time as provided in this paragraph.

As indicated there, the Department of Public Health has established rules as to what these health examinations are to include – in particular, the vaccination schedule.  The rules provide immunization schedules for (1) diphtheria, pertussis, tetanus; (2) polio; (3) measles; (4) rubella; (5) mumps; (6) haemophilus influenza tybe b; (7) hepatitis B; (8) varicella; (9) invasive pheumococcal disease; and (10) meningococcal disease.  For example, 77 Illinois Administrative Code 665.240(c) provides the following schedule for measles: 

1)         Any child two years of age or older entering a child care facility or school program below the kindergarten level shall show proof of having received one dose of live measles virus vaccine on or after the first birthday, or other proof of immunity described in Section 665.250(c).


2)         Children entering school at any grade level (kindergarten through 12) shall show proof of having received two doses of live measles virus vaccine, the first dose on or after the first birthday and the second dose no less than four weeks (28 days) after the first or other proof of immunity described in Section 665.250(c).


3)         For students attending school programs where grade levels (kindergarten through 12) are not assigned, including special education programs, proof of two doses of live measles virus vaccine as described in subsection (c)(2) shall be submitted prior to the school years in which the child reaches the ages of five, 11 and 15.


Schools are required to then report to the State Board of Education by November 15 each year the number of children who have received the necessary immunizations and required health examinations as verified by the Certificate of Health Examination form that all children are to turn in when the school year starts.   If the number of children with proof of immunizations is less than 90% of the total students enrolled, 10% of the student aid received by that school is to be withheld until the school is in compliance.  That said, the State Board of Education has indicated that no school has ever been sanctioned and nor do they want to penalize school. 

It is important to note that Illinois, like many states, has carved out two exemptions to the vaccination requirements: (1) medical exemptions; and (2) religious exemptions. 

Physicians have two routes for asserting a medical exemption.  A licensed physician can either provide a written statement that they believe a child is already protected against the disease for which immunization is required or provide a statement in writing that the physical condition of a child is such that the administration of one of the required immunizations is medically contradicted.  Either statement must be attached to the child’s “Certificate of Health Examination” form and submitted to the Illinois Department of Public Health for approval.  If approved, the student will be considered “protected and in compliance.”

In order to obtain a religious exemption, a parent or legal guardian who objects to immunizations or any required health examination on religious grounds must set forth the specific religious belief that conflicts with the required immunization.  Further, Administrative Code, Section 695.30 provides that “The religious objection may be personal and need not be directed by the tents of an established religious organization.”  It is clear that there is room for interpretation in this regulation, which could lend itself to disputes down the road.  For now, though, the Illinois State Board of Education recommends that parents seeking a religious exemption provide original written statements setting forth fully the religious belief that is the basis for the objection, “instead of relying on a prepared form which may not accurately or sufficiently describe their religious belief.”  See Illinois State Board of Education Guidelines Applicable to Medical and Religious Immunization Exemptions.

If you have questions about your children’s school’s compliance or would like to know more about the Illinois Department of Public Health rules on required immunizations or health, eye, or dental examinations, call Lavelle Law, Ltd. at (847) 705-7555 with your questions.