1. (1) Children attending all licensed and registered Montana child care facilities are required to be immunized against certain diseases. Minimum child immunization requirements apply to children in all child care facilities with exceptions described in ARM 37.96.805. Before a child may attend any licensed or registered Montana child care program, a program must be provided with documentation that the child has been vaccinated, as required for the child's age group, against measles, rubella, mumps, poliomyelitis, diphtheria, pertussis (whooping cough), tetanus, varicella, hepatitis B, pneumococcal disease (pneumonia), and Haemophilus influenza type B, unless the child qualifies for conditional attendance in accordance with (5) or has a medical or religious exemption:

   Age at Entry	Number of Doses – Vaccine Type
   under 2 months old	no vaccinations required
   by 3 months old	1 dose of polio vaccine
   	1 dose of DTP vaccine
   	1 dose of Hib vaccine
   	1 dose of Hep B vaccine
   	1 dose of PCV vaccine
   by 5 months old	2 doses of polio vaccine
   	2 doses of DTP vaccine
   	2 doses of Hib vaccine
   	2 doses of Hep B vaccine
   	2 doses of PCV vaccine
   by 7 months old	2 doses of polio vaccine
   	3 doses of DTP vaccine
   	2 or 3 doses of Hib vaccine*
   	2 doses of Hep B vaccine
   	3 doses of PCV vaccine
   by 16 months old	2 doses of polio vaccine
   	3 doses of DTP vaccine
   	1 dose of varicella vaccine
   	1 dose of MMR vaccine
   	3 or 4 doses of Hib vaccine*
   	2 doses of Hep B vaccine
   	4 doses of PCV vaccine*
   by 19 months old	1 dose of varicella vaccine
   	3 doses of polio vaccine
   	4 doses of DTP vaccine
   	1 dose of MMR vaccine
   	3 or 4 doses of Hib vaccine*
   	3 doses of Hep B vaccine
   	4 doses of PCV vaccine*
   by 6 years old	3 doses of polio vaccine, one given after the 4th birthday
   	4 doses of DTP vaccine, one given after the 4th birthday
   	2 doses of varicella vaccine
   	2 doses of MMR vaccine
   	3 doses of Hep B vaccine
   by 12 years old	3 doses of polio vaccine, one given after the 4th birthday
   	1 dose of Tdap vaccine
   	2 doses of varicella vaccine
   	2 doses of MMR vaccine
   	3 doses of Hep B vaccine

   (*) varies depending on vaccine type used or the ACIP catch-up schedule.

2. (2) Hib and PCV vaccines are not required or recommended for children five years old and older.
3. (3) Doses of MMR and varicella vaccines, to be acceptable under this rule, must be given no earlier than 12 months old, and a child who received a dose prior to 12 months old must be revaccinated; however, vaccine doses given up to four days before the minimum interval or age are counted as valid. Live vaccines not administered at the same visit must be separated by at least four weeks.

4. (4) Vaccines immunizing against diphtheria, pertussis, and tetanus must be administered as follows:

   1. (a) a child less than seven years old must be administered four or more doses of DTP or DTaP vaccine, at least one dose of which must be given after the fourth birthday;
   2. (b) DT vaccine administered to a child less than seven years old is acceptable for purposes of this rule only if accompanied by a medical or religious exemption exempting the child from pertussis vaccination; and
   3. (c) a child seven years old or older who has not completed the requirement in (1) must receive additional doses of Tdap vaccine or Td vaccine to become current in accordance with the ACIP schedule.

5. (5) A child may initially conditionally attend a child care facility if:

   1. (a) the child has received at least one dose of each of the vaccines required for the child's age;
   2. (b) documentation of the child's conditional immunization status is on file at the child care facility; and
   3. (c) the child is not past due for the next required dose (as noted on the conditional enrollment form) of the vaccine in question.
6. (6) Children attending licensed school-age care facilities serving only school-age children must meet the minimum student immunization requirements defined in ARM 37.114.702 and 20-5-403, MCA.
7. (7) Children in a sibling group receiving care from a registered FFN in the children's home are not subject to the immunization requirements, provided there are no unrelated children also receiving care.
8. (8) Children receiving care through registered RCE providers are not subject to vaccination requirements.

Authorizing statute(s): 52-2-704, 52-2-735, MCA

Implementing statute(s): 52-2-704, 52-2-723, 52-2-731, 52-2-735, MCA

History: NEW, 2025 MAR, 37-1044, Eff. 5/1/25.