Immunization Report Instructions & Training

Each year in January and February, all schools and child care facilities must report the immunization status of their students to the Health Department

Reporting Forms Immunization Primary Review Summary Forms:

Step 1: Collect Information for All of Your StudentsForms you will need: Certificate of Immunization Status Form

Step 2: Assess Student Immunization RecordsForms you will need:

Step 3: Fill Out the Primary Review SummaryForms you will need:

Step 4: Send the First ReportDue by January 11, 2023

Mail, email, fax or drop off the forms to Jackson County Public Health:

Step 5: Fill Out Section D and Cancel Exclusion OrdersBetween February 1 - February 15, 2023

  • Fill out Section D (page 2) of the Immunization Primary Review Summary, include the dates that the records were returned to you.
  • Keep your copy of exclusion orders for children at your site, and be prepared to enforce them. If a student’s record is not up-to-date by the beginning of school on February 15, 2023, they are not able to attend until you have an updated record.
  • If updated records are returned AFTER the beginning of school on February 15, 2023, the student is “excluded.” Mark a “Y” in the column in Section D (page 2) of the Primary Review Summary. Keep a copy for your records.
Step 6: Complete and Send Pages 3 and 4 of the Primary Review SummaryBy February 27, 2023

Using the Tally Worksheet, complete page 3 of the Immunization Primary Review Summary (Sections E, F and G) and Section H as appropriate for your facility:

  • Section E for preschool, day care or Head Start
  • Section F for kindergarten
  • Section G for 7th graders
  • Section H for kindergarten through 12 graders
Mail, email, fax or drop off the forms to Jackson County Public Health (keep a copy for your records):

  • Page 2 (Section D) of the Primary Review Summary
  • Page 3 (Sections E, F, G) of the Primary Review Summary
  • Page 4 (Section H) of the Primary Review Summary
Step-by-Step Video TutorialsIntroduction

Step 1: Collect Student Information

Step 2: Assess Student Immunization Records

Step 3: Fill Out the Primary Review Summary

Step 4: Send the First Report

Step 5: Fill Out Section D and Cancel Exclusion Orders

Step 6: Send Pages 3-4 of the Primary Review Summary

Tally Tutorial

Introducción

Paso 1: recopilar información del estudiante

Paso 2: Evaluar los registros de vacunación de los estudiantes

Paso 3: complete el resumen de revisión principal

Paso 4: envíe el primer informe

Paso 5: Llene la Sección D y Cancele las Órdenes de Exclusión

Paso 6: Envíe las páginas 3 y 4 del resumen de la revisión principal

Tutorial de conteo