Immunization Requirements

The State’s New Mexico Childcare/Pre-School/School Entry Immunization Requirements are released annually.

New Mexico Immunization Law

New Mexico law requires that all students be immunized against certain vaccine-preventable communicable diseases. See NMSA § 24, Health and Safety. These requirements are determined by the NMDOH in collaboration with the New Mexico Vaccine Advisory Committee, using recommendations from the national Advisory Committee on Immunization Practices.

In the school setting, the School Nurse is best qualified to determine which students are missing required vaccinations and subsequently notify parents/guardians. The NM Immunization Program surveys immunization records annually. All public, private, and charter schools are required to complete a self-reported immunization coverage survey by December of each year. The Immunization Program then conducts validation on coverage data for a sample of schools.

New Mexico Immunization Exemption Law

Any minor child through his parent or guardian may file with the health authority charged with the duty of enforcing the immunization laws:

1. A certificate from a licensed physician, physician assistant, or certified nurse practitioner stating that the physical condition of the child is such that immunization would seriously endanger the life or health of the child; or
2. Affidavits or written affirmation from an officer of a recognized religious denomination that such child’s parents or guardians are bona fide members of a denomination whose religious teaching requires reliance upon prayer or spiritual means alone for healing; or
3. Affidavits or written affirmation from the parent or legal guardian that religious beliefs, held either individually or jointly with others, do not permit the administration of vaccine or other immunizing agent.

NMSA § 24.5.3

New Mexico law does not grant immunization exemptions for philosophical or personal reasons.

Reporting in New Mexico Statewide Immunization Information System (NMSIIS)

Physicians, nurses, pharmacists and other health care providers shall report on immunization to the immunization registry unless the patient, or the patient's guardian if the patient is a minor, refuses to allow reporting of this information.

NMSA § 24.5.8

It is state law that all immunizations given in the State of New Mexico must be entered into NMSIIS. The signed consent gives authorization from a parent or guardian for this to occur. School Nurses may have access to NMSIIS and may use it to look up records, enter records from school records as historical, and enter any immunizations the School Nurse gives during school immunization clinics.

The School Consent Form used to enter records into NMSIIS is a customizable form for schools to collect consent from parents so students’ historic immunization records may be added to NMSIIS. If collaborating with public health for a vaccine clinic, the responsibility of entering the vaccine falls to public health.

Public Health Authority for School Health Offices

State law requires New Mexico schools to:

• Maintain records of students’ immunizations.
• Make those records available to the NMDOH.
• Report immunization status of students to the NMDOH.
• Commence disenrollment proceedings on students who do not have satisfactory evidence of immunizations or a valid exemption. Students whom the School Nurse deems to be in-process may continue attending school or may register if not yet attending.

To accomplish this, the NMDOH grants school nursing offices the authority, under the Health Insurance Portability and Accountability Act, to serve as “public health authority” to collect immunization information for school-aged children without a release of information from parents. This Public Health Authority Letter may be used as proof of this role.

Some resources for school nursing offices to use to obtain immunization information include:

• NMSIIS.
• Health care providers who give immunizations to children.
• Immunization records supplied by parents.
• Immunization records from other schools.

New Mexico Administrative Codes on Immunizations

Within 60 days of receipt of a request for exemption from immunization, the department of health immunization program manager shall review the request to determine whether the certificate has been duly completed. Incomplete requests shall be returned to the requester with information regarding what elements are missing.

NMAC § 7.5.3.8

For more information, see:

• NMAC § 6.12.2 — Public School Administration, Health and Safety
• NMAC § 7.5.2 — Immunization Requirement
• NMAC § 7.5.3 — Immunization Exemptions

Immunization Exemption

A student in New Mexico may be exempt from NM Department of Health and NM Public Education Department immunization requirements by completing the current Exemption from Immunization Form. See the Immunization Exemption Form 2025 in English and the Immunization Exemption Form 2025 in Spanish.

Who May Use the Exemption from Immunization Form?

• Individuals requesting a religious or medical exemption to immunization may use this form.
• This form must be used for all children with an exemption going into any public, private, or parochial preschool, kindergarten, elementary, secondary school, or home school. It also must be used for children attending daycare or childcare facilities.
• This form must not be used for exemption from immunization for personal or philosophical reasons. New Mexico law does not allow for such exemptions.

How to Complete the Exemption from Immunization Form

• Fill out all blank lines and check boxes, including the check boxes for the religious or medical options.
• For medical exemptions, attach the letter from your duly licensed physician to this form.
• For religious exemptions using an affidavit or statement of fact, attach the affidavit to this form.
• A notary public must sign the form. The date that the notary public signs the form must match the date that the parent/guardian signs the form.
• Mail the form to the New Mexico Department of Health at the address shown on the form. You may also submit your form in a drop box located at the Department of Health in Santa Fe, Runnels Building, 1190 S Saint Francis Dr, Santa Fe, NM 87505.

Department of Health Exemption from Immunization Form Processing

• The Department of Health has 60 days from receipt of the Exemption from Immunization Form to either approve or disapprove the form. Make sure the Department of Health receives the form at least 60 days before the child starts school.
• Upon approval, the Department of Health will mail one copy of the approved form to the parent/guardian. The parent/guardian must provide a copy of the approved form to the child’s preschool, school, daycare, or childcare facility.
• The School Nurse may also choose to review and print approved exemption requests in NMSIIS. In NMSIIS, under Patients/Exemptions, a “Patient Exemptions Letter” link is available and allows the school to print an official exemption letter for the student’s file.
• If a request is not approved, the parent/guardian will receive a letter from the Department of Health explaining why the request was denied. They will also receive information on how to arrange a meeting with the Department of Health should they wish to protest.
• Exemptions are valid for one year and must be resubmitted each academic year, including any supporting medical documentation, which must also be current.

Immunization Assessment

• Students who are up-to-date in accordance with the current NM Childcare/Pre-School/School Entry Immunization Requirements Schedule meet New Mexico immunization standards and may enroll in and attend school.
• For students who have no immunization record but were formerly enrolled in a school in the United States, a formal request for immunization records must be made by the School Nurse to the previous school attended. The student should not be enrolled until records are received. If the student is up-to-date, according to NM Childcare/Pre-School/School Entry Immunization Requirements, the student may be enrolled.
• If the student was formerly enrolled in a school in another country and has no record or contact information to acquire records, initiation of required immunizations must begin immediately for the student to be enrolled in any public, private, or charter school in New Mexico. Exceptions apply if the child is certified as homeless or if the child’s parent or guardian is active military.
• Students whose immunizations are not up-to-date but who have received all immunizations currently permissible by a medical practice are considered in-process and may be enrolled.
• Students who are attempting to reach compliance but are behind on a vaccination series are no longer considered in-process. The CDC Catch-up Immunization Schedule should be used to help assess what the student needs to become compliant. If the student is currently enrolled, disenrollment proceedings should be initiated immediately. When any student is kept out of school longer than five consecutive days for noncompliance, the school nurse must notify the local Regional Health Officer for the NMDOH.
• Children who are younger than five years of age and attend childcare or early childhood development programs must comply with the NM Childcare/Pre-School/School Entry Immunization Requirements.

For immunization questions, available resources include:

• CDC’s Epidemiology and Prevention of Vaccine-Preventable Diseases — The Pink Book.
• NMDOH’s Immunization — Rules, Regulations & Protocols.
• The School Health Advocate assigned to your respective Public Health Region.
• The local Public Health Office for your county.
• NMDOH’s Gatekeeper Training on assessment of student immunization records for school personnel.

School and Community-Based Immunization Outreach Clinics

School nurses may be involved in coordinating or assisting with on-site school and community-based immunization activities, outreach clinics, or points of dispensing. Depending on available staff and resources, partnering in these activities usually occurs between the School Nurse and the local Public Health Office, as well as with the Immunization Program at the state level. Schools are encouraged to participate with outside entities that can provide mass vaccination clinics during flu season.

Vaccine for Children Providers (VFC)

Several schools and school districts in New Mexico are Vaccines for Children providers. These school-based sites make it easier for children to receive scheduled immunizations and help prevent parents from missing work time to take a child to the doctor. They also contribute to improved immunization rates in New Mexico.

Schools are encouraged to become independent Vaccines for Children providers and receive vaccines for school-based health or immunization clinics at no cost from the VFC Program. Contact the VFC Program Manager, Lynne Padilla, to start the application process: lynne.padilla-truji@state.nm.us.

Physician Coverage and Standing Orders

School- and community-based immunization projects supported by the NMDOH Immunization Program are considered Public Health clinics. It is not required that a licensed physician be on the premises when immunizations are administered by a licensed nurse, pharmacist, or EMT. This clarification was issued by the NM Secretary of Health and DOH Chief Medical Officer in 1996.

However, all School Nurses and School VFC providers must follow the Regional Health Officers and Public Health Division’s Medical Director Standing Order for Administration of Immunizations. See Chapter 15 in this manual and the NM Department of Health Immunization — Rules, Regulations & Protocols. The School Nurse should also notify the local Public Health Office, Regional Health Officer, or School Health Advocate when engaging in school-based immunization clinic activities.

Documentation

Immunization Documentation

School Immunization forms are downloadable on the NM Immunization Program’s website for school nurses whose schools or districts are VFC providers. These forms, the School Immunization Consent Form — English and School Immunization Consent Form — Spanish, must be used to obtain consent and provide documentation of vaccines administered.

The consent form was designed for schools so it may be used to consent to a series of vaccinations. The immunizations needed must be identified for the parent or guardian. A current Vaccine Information Statement for each vaccination needed must accompany the consent form. The VIS date should be filled out on the form as the date the sheets were sent home to the parent or guardian.

The signed immunization consent will also be used as consent to enter students’ information and establish an immunization record in NMSIIS. The most up-to-date versions of the VIS sheets are available on the CDC website.

New Mexico Statewide Immunization Information System

The New Mexico Statewide Immunization Information System is New Mexico’s web-based registry of all vaccinations administered in New Mexico. NMSIIS should be the central depository for immunization records from birth to death. NMSIIS includes a school module that can be used to track a student’s immunization history and vaccine exemptions. Schools using the NMSIIS school module can use it to produce reports needed for mandatory school immunization compliance reporting.

A NMSIIS Quick Reference Guide helps school nurses effectively use NMSIIS.

Nurses who want to use NMSIIS may obtain access by completing the NMSIIS Read Only Training located on the NMDOH website. After training is completed, the nurse will be contacted by a NMSIIS staff member with their username and password.

Foreign Language Vaccine-Related Terms

Many immunization records come from outside the United States.

The Pink Book foreign vaccine tables can assist with interpretation from other countries. The Pink Book can answer many questions related to immunizations.

Primary Editors: Crista Pierce, SW SHA and Anna Pentler, NMIC Executive Director

Secondary Editor: Katherine LaRose, NE SHA