Immunization Data Report (IDR)

This school-level report includes student immunization compliance totals for DTaP/DTP/DT, Tdap, Meningococcal (ACWY or MCV4), Polio, MMR, Hepatitis B, Varicella and any immunization exemptions on file. There are three separate report outputs for kindergarten, sixth grade and tenth grade. Use the data from this report to enter immunization compliance numbers in the state online Immunization Data Report (IDR) form. School districts without access to the online form may send the hard copy to the state Immunization Data Report (IDR) web application.

The report outputs a zip file containing two files:

IDR 2012.pdf – Contains information for submission to the state.
IDR 2012 Audit.csv – Contains a list of students who are out of compliance or exempt from the reported vaccines.

Note: The audit file is always included with the report output.

The report output is documented in four separate tables for the following:

Report Output – Kindergarten Immunization Data Report
Report Output – Sixth Grade Immunization Data Report
Report Output – Tenth Grade Immunization Data Report
Report Output – Audit Results

Selection Criteria

Selection criteria determine which database records are used in the report. Refer to selection criteria for analysis when the report does not return the correct records.

Student Selection

The report selects records from the [Students] table based on the following criteria:

The student must be enrolled in the school on or between the School Start Date and Date of Report entered at report runtime.
The student’s entry date does not equal his exit date (no shows or summer withdraws)
The student must be enrolled in the appropriate grade level: kindergarten, sixth grade, or tenth grade.

Note: The report uses the Date of Report to determine the student’s age for immunization compliance.

Report Input

For help with navigation and running the report, see How to Find and Generate a Report.

Field	Description
Current Selection Students	Indicate which students to include in the report by selecting one of the following options: The selected [number] students only – Run the report for students in the current selection. All students – Run the report for all students in the current school or district that meet the selection criteria. Note: If running the report for a single student, or group of students, select the students prior to running report.
First Day of School	Enter the first day of the school year.
Date of Report	Enter the date of the report. This value is usually either the current date, or November 15^th, the date the report is due.
Grade Level	Choose the grade level to include in the report from the pop-up menu.
Preparer’s Name	Enter the name of the person to be reported as preparing the form.
Preparer’s Email	Enter the email address of the person to be reported as preparing the form.

Report Output

Each of the fields displayed in the output of the reports are described below. See Understanding the Report Output Table for a definition of each column in the table.

Kindergarten Immunization Data Report

Data Element	Description	[Table]FieldName
School Name	The name of the school.	[Schools]Name
Public/Charter School CTDS#	The CTDS number (county-type-district-school number).	[Prefs]Value [Prefs]Name=districtnumber [Schools]School_Number
Mailing Address, City, Zip	The mailing address for the school.	[Schools]Address [Schools]SchoolCity [Schools]SchoolZip
County where school is located	The county in which the school is located.	[Schools]CountyName
Phone	The phone number for the school.	[Schools]SchoolPhone
Fax	The fax number for the school.	[Schools]SchoolFax
Date of Report	The date entered at report runtime.	N/A
Principal’s Name	The principal’s name.	[Schools]Principal
E-Mail Address	The principal’s email address.	[Schools]PrincipalEmail
Name of Person Completing Report	The name of the person completing the report, entered at report runtime.	N/A
E-Mail Address	The email address of the person completing the report, entered at report runtime.	N/A
Is this person a nurse?	This value is not reported and should be entered manually.	N/A
Type of School	This value is not reported and should be entered manually.	N/A
Does this school have a 6^th grade?	This value is not reported and should be entered manually.	N/A
Does this school have a 10^th grade?	This value is not reported and should be entered manually.	N/A
1. How many students are enrolled in kindergarten?	The number of students enrolled between the Start of School and the Date of Report dates entered at runtime.	[Students]Grade_Level = 0 [Students]EntryDate [Students]ExitDate
2. How many students have an immunization record OR a valid exemption on file?	The number of students who have either an immunization record for one of the vaccines included below, or an exemption, on file.	[Students]Grade_Level = 0 [HealthStudImmRec]StudentID [HealthStudImmRec]HealthVaccineID [HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionExpiryDate
3. DTaP/DTP/DT Note: The Date of Report entered at report runtime is used to determine the student’s age for immunization compliance.
How many students have received either 4-5 doses with one dose at 4 years of age or older, OR a total of 6 doses?	The number of students who received four or five doses of the DTaP/DTP/DT vaccine with one dose at four years of age or older, or students who received a total of six doses, regardless of their age at the time of the immunization.	[Students]DOB [HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered
How many students have not received either 4-5 doses with one dose at 4 years of age or older OR a total of 6 doses?	The number of students who have not received four or five doses of the DTaP/DTP/DT vaccine with one dose at four years of age or older, and who have not received a total of six doses.	[Students]DOB [HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered
Total	The report totals the number of students from the previous two lines. This value should equal the number of students enrolled in kindergarten from line 1.	N/A
How many students (if any) are exempt from DTaP/DTP/DT immunization?	The number of students who are exempt from receiving the DTaP/DTP/DT vaccine.	[HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionExpiryDate
Conditional Admssn	The number of students who are in a conditional admission/catch-up status for DTaP/DTP/DT.	[S_AZ_STU_HIR_X]DtapConditionalAdmission
4. Polio Note: The Date of Report entered at report runtime is used to determine the student’s age for immunization compliance.
How many students have received either a total of 4 doses OR a total of 3 doses with the 3^rd dose given at 4 years of age or older?	The number of students who received either four doses of the polio vaccine or three doses with the third dose received at age four or older.	[Students]DOB [HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered
How many students have not received the doses described above?	The number of students who did not received four doses of the polio vaccine or three polio doses with the third dose received at age four or older.	[Students]DOB [HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered
Total	The report totals the number of students from the previous two lines. This value should equal the number of students enrolled in kindergarten from line 1.	N/A
How many students (if any) are exempt from Polio immunization?	The number of students who are exempt from receiving the Polio vaccine.	[HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionExpiryDate
Conditional Admssn	The number of students who are in a conditional admission/catch-up status for Polio.	[S_AZ_STU_HIR_X]PolioConditionalAdmission
5. MMR Note: The Date of Report entered at report runtime is used to determine the student’s age for immunization compliance.
How many students have received 2 doses, both given at 12 months of age or older?	The number of students who received two doses of the MMR vaccine at twelve months of age or older.	[Students]DOB [HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered
How many students have not received 2 doses, both at 12 months of age or older?	The number of students who did not receive two doses of the MMR vaccine at twelve months of age or older.	[Students]DOB [HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered
Total	The report adds the number of students from the previous two lines. This value should equal the number of students enrolled in kindergarten from line 1.	N/A
How many students (if any) are exempt from MMR immunization?	The number of students who are exempt from receiving the MMR vaccine.	[HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionExpiryDate
Conditional Admssn	The number of students who are in a conditional admission/catch-up status for MMR.	[S_AZ_STU_HIR_X]MmrConditionalAdmission
6. Hepatitis B
How many students meet the requirement with 3 or more doses?	The number of students who received three or more doses of the Hepatitis B vaccine.	[HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered
How many students do not meet the requirement with at least 3 doses?	The number of students who received less than three doses of the Hepatitis B vaccine.	[HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered
Total	The report adds the number of students from the previous two lines. This value should equal the number of students enrolled in kindergarten from line 1.	N/A
How many students (if any) are exempt from Hepatitis B immunization?	The number of students who are exempt from receiving the Hepatitis B vaccine.	[HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionExpiryDate
Conditional Admssn	The number of students who are in a conditional admission/catch-up status for Hepatitis B.	[S_AZ_STU_HIR_X]HepBConditionalAdmission
7. Varicella
How many students have received 2 doses of Varicella vaccine? (Include those who have had chicken pox disease in addition to the immunizations.)	The number of students who received two doses of the Varicella vaccine, including students who have had the chicken pox disease.	[HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered
How many students have received one dose of Varicella vaccine, or established their history of chicken pox disease before 9/1/2011, or have both the vaccine and history of disease?	The number of students who received one dose of the Varicella vaccine or who established a history of the chicken pox disease before 9/1/2011, or both. A history of chicken pox is determined by assigning the Exemption “History of Disease / Parental Recall of Disease” to the student for their Varicella vaccine.	[HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered [HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionDate [HealthImmExempt]StateReportCode = Hist_Recall
How many students have no Varicella vaccine doses and no history of chicken pox established before 9/1/2011?	The number of students who have not received the Varicella vaccine and have no history of chicken pox established before 9/1/2011. A history of chicken pox is determined by assigning the Exemption “History of Disease / Parental Recall of Disease” to the student for their Varicella vaccine.	[HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered [HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionDate [HealthImmExempt]StateReportCode = Hist_Recall
Total	The report totals the number of students from the previous three lines. This value should equal the number of students enrolled in kindergarten from line 1.	N/A
How many students (if any) are exempt from Varicella immunization?	The number of students who are exempt from receiving the Varicella vaccine.	[HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionExpiryDate
8. Exemptions
What is the total number of students who have a Temporary Personal Beliefs exemption?	The number of students with a Temporary Personal Beliefs exemption.	[HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionExpiryDate [HealthImmExempt]StateReportCode = Temp_Pers
What is the total number of students who have a Permanent Personal Beliefs exemption?	The number of students with a Permanent Personal Beliefs exemption.	[HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionExpiryDate [HealthImmExempt]StateReportCode = Perm_Pers
What is the total number of students who have a Temporary Medical exemption?	The number of students with a Temporary Medical exemption.	[HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionExpiryDate [HealthImmExempt]StateReportCode = Temp_Med
What is the total number of students who have a Permanent Medical exemption?	The number of students with a Permanent Medical exemption.	[HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionExpiryDate [HealthImmExempt]StateReportCode = Perm_Pers
What is the total number of students who have Laboratory Evidence of Immunity?	The number of students with Laboratory Evidence of Immunity.	[HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionExpiryDate [HealthImmExempt]StateReportCode = Lab_Immun

Sixth Grade Immunization Data Report

Data Element	Description	[Table]FieldName
School Name	The name of the school.	[Schools]Name
Public/Charter School CTDS#	The CTDS number (county-type-district-school number).	[Prefs]Value [Prefs]Name=districtnumber [Schools]School_Number
Mailing Address, City, Zip	The mailing address for the school.	[Schools]Address [Schools]SchoolCity [Schools]SchoolZip
County where school is located	The county in which the school is located.	[Schools]CountyName
Phone	The phone number for the school.	[Schools]SchoolPhone
Fax	The fax number for the school.	[Schools]SchoolFax
Date of Report	The date entered at report runtime.	N/A
Principal’s Name	The principal’s name.	[Schools]Principal
E-Mail Address	The principal’s email address.	[Schools]PrincipalEmail
Name of Person Completing Report	The name of the person completing the report, entered at report runtime.	N/A
E-Mail Address	The email address of the person completing the report, entered at report runtime.	N/A
Is this person a nurse?	This value is not reported and should be entered manually.	N/A
Type of School	This value is not reported and should be entered manually.	N/A
Does this school have a kindergarten?	This value is not reported and should be entered manually.	N/A
Does this school have a 10^th grade?	This value is not reported and should be entered manually.	N/A
1. How many students are enrolled in 6^th grade?	The number of students enrolled in sixth grade on the snapshot date.	[Students]Grade_Level = 6 [Students]EntryDate [Students]ExitDate
2. How many 6^th graders have an immunization record or a valid exemption on file?	The number of students who have either an immunization record for one of the vaccines included below, or an exemption, on file.	[Students]Grade_Level = 6 [HealthStudImmRec]StudentID [HealthStudImmRec]HealthVaccineID [HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionExpiryDate
3. DTaP/DTP/Td Note: The Date of Report entered at report runtime is used to determine the student’s age for immunization compliance.
How many students have at least 4 doses, or at least 3 doses given after 1 year of age?	The number of students who received three or four doses of the DTap/DTP/Td vaccine after one year of age.	[Students]DOB [HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered
How many students have not received the doses described above?	The number of students who did not receive three or four doses of the DTap/DTP/Td vaccine after one year of age.	[Students]DOB [HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered
Total	The report totals the number of students from the previous two lines. This value should equal the number of students enrolled in sixth grade from line 1.	N/A
How many students (if any) are exempt from DTaP/DTP/Td immunization?	The number of students who are exempt from receiving the DTaP/DTP/Td vaccine.	[HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionExpiryDate
Conditional Admssn	The number of students who are in a conditional admission/catch-up status for DTaP/DTP.	[S_AZ_STU_HIR_X]DtapConditionalAdmission
4. Tdap
How many students have received 1 dose of Tdap?	The number of students who received one dose of the Tdap vaccine.	[HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered
How many students have not received 1 dose of Tdap?	The number of students who have not received any doses of the Tdap vaccine.	[HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered
Total	The total of the previous two lines. This value should equal the number of students enrolled in sixth grade from line 1.	N/A
How many students (if any) are exemption from the Tdap immunization?	The number of students who are exempt from receiving the Tdap vacine.	[HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionExpiryDate
How many students did not receive Tdap because they received DTaP/DTP/Td within the last 5 years?	The number of students who didn’t receive the Tdap vaccine because they received the DTaP/DTP/Td vaccine within the last five years.	[HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered
How many 6^th grade students are under the age of 11?	The number of sixth grade students under the age of eleven.	[Students]DOB
5. Meningococcal (ACWY / MCV4)
How many students have received 1 dose of ACWY or MCV4?	The number of students who received one dose of the ACWY or MCV4 vaccine.	[HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered
How many students have not received 1 dose of ACWY or MCV4?	The number of students who did not receive any doses of the ACWY or MCV4 vaccine.	[HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered
Total	The total of the previous two lines. This value should equal the number of students enrolled in sixth grade from line 1.	N/A
How many students (if any) are exempt from ACWY/MCV4 immunization?	The number of students who are exempt from receiving the ACWY or MCV4 vaccine.	[HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionExpiryDate
6. Polio Note: The Date of Report entered at report runtime is used to determine the student’s age for immunization compliance.
How many students have received either a total of 4 doses or a total of 3 doses with the 3^rd dose given at 4 years of age or older?	The number of students who received four doses of the Polio vaccine or three doses of the vaccine with the third dose administered when the student was four years or older.	[Students]DOB [HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered
How many students have not received the doses described above?	The number of students who have not received four doses of the Polio vaccine and who did not receive three doses of the vaccine with the third dose administered when the student was four years or older.	[Students]DOB [HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered
Total	The total of the previous two lines. This value should equal the number of students enrolled in sixth grade from line 1.	N/A
How many students (if any) are exempt from Polio immunization?	The number of students who are exempt from receiving the Polio vaccine.	[HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionExpiryDate
Conditional Admssn	The number of students who are in a conditional admission/catch-up status for Polio.	[S_AZ_STU_HIR_X]PolioConditionalAdmission
7. MMR
How many students received 2 doses, both given at 12 months of age or older?	The number of students who received two doses of the MMR vaccine, both given at twelve months of age or older.	[Students]DOB [HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered
How many students have not received the doses described above?	The number of students who did not receive two doses of the MMR vaccine at twelve months of age or older.	[Students]DOB [HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered
Total	The total of the previous two lines. This value should equal the number of students enrolled in sixth grade from line 1.	N/A
How many students (if any) are exempt from MMR immunization?	The number of students who are exempt from receiving the MMR vaccine.	[HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionExpiryDate
Conditional Admssn	The number of students who are in a conditional admission/catch-up status for MMR.	[S_AZ_STU_HIR_X]MmrConditionalAdmission
8. Hepatitis B
How many students have completed the Hepatitis B series with at least 3 doses (or documentation that they completed the special 2-dose adolescent Hepatitis B series)?	The number of students who completed the Hepatitis B series by receiving three doses of the vaccine, or who have documentation that they received the special two-dose adolescent Hepatitis B series. This value is reported as: Three Dose (Two Dose) / Total.	[HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered
How many students have not completed the Hepatitis B series?	The number of students who have not completed the Hepatitis B series.	[HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered
Total	The total of the previous two lines. This value should equal the number of students enrolled in sixth grade from line 1.	N/A
How many students (if any) are exempt from Hepatitis B immunization?	The number of students who are exempt from receiving the Hepatitis B vaccine.	[HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionExpiryDate
Conditional Admssn	The number of students who are in a conditional admission/catch-up status for Hepatitis B.	[S_AZ_STU_HIR_X]HepBConditionalAdmission
9. Varicella(chicken pox)
How many students have received 2 doses of Varicella vaccine? (Include those who have had chicken pox disease in addition to the immunizations?	The number of students who received two doses of the Varicella vaccine, including those who also had the chicken pox.	[HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered
How many students have received one dose of Varicella vaccine, or established their history of chicken pox disease before 9/1/2011, or have both the vaccine and history of disease?	The number of students who received one dose of the Varicella vaccine or have a history of the chicken pox established before 9/1/2011, or both. A history of chicken pox is determined by assigning the Exemption “History of Disease / Parental Recall of Disease” to the student for their Varicella vaccine.	[HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered [HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionDate [HealthImmExempt]StateReportCode = Hist_Recall
How many students have no Varicella vaccine doses and no history of chicken pox established before 9/1/2011?	The number of students who have not received the Varicella vaccination and did not establish a history of the chicken pox before 9/1/2011. A history of chicken pox is determined by assigning the Exemption “History of Disease / Parental Recall of Disease” to the student for their Varicella vaccine.	[HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered [HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionDate [HealthImmExempt]StateReportCode = Hist_Recall
Total	The total of the previous two lines. This value should equal the number of students enrolled in sixth grade from line 1	N/A
Exemption Notes How many students (if any) are exempt from Varicella immunization?	The number of students who are exempt from receiving the Varicella vaccine.	[HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionExpiryDate
10. Exemptions
Permanent Personal Beliefs	The number of students with a Permanent Personal Beliefs exemption.	[HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionExpiryDate [HealthImmExempt]StateReportCode = Perm_Pers
Temporary Personal Beliefs	The number of students with a Temporary Personal Beliefs exemption.	[HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionExpiryDate [HealthImmExempt]StateReportCode = Temp_Pers
Permanent Medical and/or Laboratory Evidence of Immunity	The number of students with a Permanent Medical Exemption and/or laboratory evidence of immunity.	[HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionExpiryDate [HealthImmExempt]StateReportCode = Lab_Immun
Temporary Medical	The number of students with a Temporary Medical Exemption.	[HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionExpiryDate [HealthImmExempt]StateReportCode = Temp_Med

Tenth Grade Immunization Data Report

Data Element	Description	[Table]FieldName
School Name	The name of the school.	[Schools]Name
Public/Charter School CTDS#	The CTDS number (county-type-district-school number).	[Prefs]Value [Prefs]Name=districtnumber [Schools]School_Number
Mailing Address, City, Zip	The mailing address for the school.	[Schools]Address [Schools]SchoolCity [Schools]SchoolZip
County where school is located	The county in which the school is located.	[Schools]CountyName
Phone	The phone number for the school.	[Schools]SchoolPhone
Fax	The fax number for the school.	[Schools]SchoolFax
Date of Report	The date entered at report runtime.	N/A
Principal’s Name	The principal’s name.	[Schools]Principal
E-Mail Address	The principal’s email address.	[Schools]PrincipalEmail
Name of Person Completing Report	The name of the person completing the report, entered at report runtime.	N/A
E-Mail Address	The email address of the person completing the report, entered at report runtime.	N/A
Is this person a nurse?	This value is not reported and should be entered manually.	N/A
Type of School	This value is not reported and should be entered manually.	N/A
Does this school have a kindergarten?	This value is not reported and should be entered manually.	N/A
Does this school have a 6^th grade?	This value is not reported and should be entered manually.	N/A
1. How many students are enrolled in 10^th grade?	The number of students enrolled in tenth grade on the snapshot date.	[Students]Grade_Level = 10 [Students]EntryDate [Students]ExitDate
2. How many 10^th graders have an immunization record or a valid exemption on file?	The number of students who have either an immunization record for one of the vaccines included below, or an exemption, on file.	[Students]Grade_Level = 10 [HealthStudImmRec]StudentID [HealthStudImmRec]HealthVaccineID [HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionExpiryDate
3. Tdap
How many students have received 1 dose of Tdap?	The number of students who received one dose of the Tdap vaccine.	[HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered
How many students have not received 1 dose of Tdap?	The number of students who have not received any doses of the Tdap vaccine.	[HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered
Total	The total of the previous two lines. This value should equal the number of students enrolled in sixth grade from line 1.	N/A
How many students (if any) are exempt from the Tdap immunization?	The number of students who are exempt from receiving the Tdap vaccine.	[HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionExpiryDate
How many students received a DTaP, DTP, or Td dose within the last 5 years?	The number of students who received a dose of the DTaP, DTP, or Td vaccine within the last ten years.	[HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered
4. Meningococcal (ACWY / MCV4)
How many students have received 1 dose of ACWY or MCV4?	The number of students who received one dose of the ACWY or MCV4 vaccine.	[HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered
How many students have not received one dose of ACWY or MCV4?	The number of students who did not receive any doses of the ACWY or MCV4 vaccine.	[HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered
Total	The total of the previous two lines. This value should equal the number of students enrolled in sixth grade from line 1	N/A
How many students (if any) are exempt from MV/MCV immunization?	The number of students who are exempt from receiving the MV/MCV vaccine.	[HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionExpiryDate
5. MMR
How many students have received 2 doses, both given at 12 months of age or older?	The number of students who received two doses of the MMR vaccine, both given at twelve months of age or older.	[Students]DOB [HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered
How many students have not received the doses described above?	The number of students who did not receive two doses of the MMR vaccine at twelve months of age or older.	[Students]DOB [HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered
Total	The total of the previous two lines. This value should equal the number of students enrolled in sixth grade from line 1.	N/A
How many students (if any) are exempt from MMR immunization?	The number of students who are exempt from receiving the MMR vaccine.	[HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionExpiryDate
Conditional Admssn	The number of students who are in a conditional admission/catch-up status for MMR.	[S_AZ_STU_HIR_X]MmrConditionalAdmission
6. Hepatitis B
How many students have completed the Hepatitis B series with at least 3 doses (or documentation that they completed the special 2-dose adolescent Hepatitis B series)?	The number of students who completed the Hepatitis B series by receiving three doses of the vaccine, or who have documentation that they received the special two-dose adolescent Hepatitis B series. This value is reported as: Three Dose (Two Dose) / Total.	[HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered
How many students have not completed the Hepatitis B series?	The number of students who have not completed the Hepatitis B series.	[HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered
Total	The total of the previous two lines. This value should equal the number of students enrolled in sixth grade from line 1.	N/A
How many students (if any) are exempt from Hepatitis B immunization?	The number of students who are exempt from receiving the Hepatitis B vaccine.	[HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionExpiryDate
Conditional Admssn	The number of students who are in a conditional admission/catch-up status for Hepatitis B.	[S_AZ_STU_HIR_X]HepBConditionalAdmission
7. Varicella(chicken pox)
How many students have received 2 doses of Varicella vaccine? (Include those who have had chicken pox disease in addition to the immunizations?	The number of students who received two doses of the Varicella vaccine, including those who also had the chicken pox.	[HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered
How many students have received one dose of Varcella vaccine, or established their history of chicken pox disease before 9/1/2011, or have both the vaccine and history of disease?	The number of students who received one dose of the Varicella vaccine or have a history of the chicken pox established before 9/1/2011, or both. A history of chicken pox is determined by assigning the Exemption “History of Disease / Parental Recall of Disease” to the student for their Varicella vaccine.	[HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered [HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionDate [HealthImmExempt]StateReportCode = Hist_Recall
How many students have no Varicella vaccine doses and no history of chicken pox established before 9/1/2011?	The number of students who have not received the Varicella vaccination and did not establish a history of the chicken pox before 9/1/2011. A history of chicken pox is determined by assigning the Exemption “History of Disease / Parental Recall of Disease” to the student for their Varicella vaccine.	[HealthStudDoseRec]Dose [HealthStudDoseRec]DateAdministered [HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionDate [HealthImmExempt]StateReportCode = Hist_Recall
Total	The total of the previous two lines. This value should equal the number of students enrolled in sixth grade from line 1	N/A
Exemption Notes How many students (if any) are exempt from Varicella immunization?	The number of students who are exempt from receiving the Varicella vaccine.	[HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionExpiryDate
8. Exemptions
Permanent Personal Beliefs	The number of students with a Permanent Personal Beliefs exemption.	[HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionExpiryDate [HealthImmExempt]StateReportCode = Perm_Pers
Temporary Personal Beliefs	The number of students with a Temporary Personal Beliefs exemption.	[HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionExpiryDate [HealthImmExempt]StateReportCode = Temp_Pers
Permanent Medical and/or Laboratory Evidence of Immunity	The number of students with a Permanent Medical Exemption and/or laboratory evidence of immunity.	[HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionExpiryDate [HealthImmExempt]StateReportCode = Lab_Immun
Temporary Medical	The number of students with a Temporary Medical Exemption.	[HealthStudImmRec]HealthImmExemptID [HealthStudImmRec]ExemptionExpiryDate [HealthImmExempt]StateReportCode = Temp_Med

Audit Results

An audit result file is included with the report. The audit file includes a list of all the students included in the report who are out of compliance or exempt for any of the vaccines reported.

Data Element

Description

[Table]FieldName

Student Number

The locally assigned student identifier.

[Students]Student_Number

Student Name

The student’s last name and first name.

[Students]LastFirst

Student DOB

The student’s date of birth.

[Students]DOB

Has Record

Indicates if the student has an immunization record or valid exemption on file.

[HealthStudImmRec]StudentID

[HealthStudImmRec]HealthVaccineID

[HealthStudImmRec]HealthImmExemptID

[HealthStudImmRec]ExemptionExpiryDate

DTaP/DTP/DT Compliant

Reported: Kindergarten, 6^th grade

Indicates if the student meets the criteria for the DTaP/DTP/DT vaccine for their grade level.

No is reported if the student is not compliant.

[Students]DOB

[HealthStudDoseRec]Dose

[HealthStudDoseRec]DateAdministered

Tdap Compliant

Reported: 6^th grade, 10^th grade

Indicates if the student meets the criteria for the Tdap vaccine for their grade level.

No is reported if the student is not compliant.

[Students]DOB

[HealthStudDoseRec]Dose

[HealthStudDoseRec]DateAdministered

ACWY / MCV4 Compliant

Reported: 6^th grade, 10^th grade

Indicates if the student meets the criteria for the ACWY / MCV4 vaccine for their grade level.

No is reported if the student is not compliant.

[Students]DOB

[HealthStudDoseRec]Dose

[HealthStudDoseRec]DateAdministered

Polio Compliant

Reported: Kindergarten, 6^th grade

Indicates if the student meets the criteria for the Polio vaccine for their grade level.

No is reported if the student is not compliant.

[Students]DOB

[HealthStudDoseRec]Dose

[HealthStudDoseRec]DateAdministered

MMR Compliant

Reported: 6^th grade, 10^th grade

Indicates if the student meets the criteria for the MMR vaccine for their grade level.

No is reported if the student is not compliant.

[Students]DOB

[HealthStudDoseRec]Dose

[HealthStudDoseRec]DateAdministered

Hepatitis B Compliant

Reported: Kindergarten, 6^th grade, 10^th grade

Indicates if the student meets the criteria for the Hepatitis B vaccine for their grade level.

No is reported if the student is not compliant.

[Students]DOB

[HealthStudDoseRec]Dose

[HealthStudDoseRec]DateAdministered

Varicella Compliant

Reported: Kindergarten, 6^th grade, 10^th grade

Indicates if the student meets the criteria for the Varicella vaccine for their grade level.

No is reported if the student is not compliant.

[Students]DOB

[HealthStudDoseRec]Dose

[HealthStudDoseRec]DateAdministered

Permanent Personal Exempt

Reported: Kindergarten, 6^th grade, 10^th grade

Indicates if the student has a Permanent Personal Beliefs exemption.

An “X” is reported if the student has the exemption.

[HealthStudImmRec]HealthImmExemptID

[HealthStudImmRec]ExemptionExpiryDate

[HealthImmExempt]StateReportCode = Perm_Pers

Temporary Personal Exempt

Reported: Kindergarten, 6^th grade, 10^th grade

Indicates if the student has a Temporary Personal Beliefs exemption.

An “X” is reported if the student has the exemption.

[HealthStudImmRec]HealthImmExemptID

[HealthStudImmRec]ExemptionExpiryDate

[HealthImmExempt]StateReportCode = Temp_Pers

Permanent Medical/Lab Immunity Exempt

Reported: Kindergarten, 6^th grade, 10^th grade

Indicates if the student has a Permanent Medical Exemption and/or laboratory evidence of immunity.

An “X” is reported if the student has the exemption.

Note: Permanent Medical and Laboratory Immunity are reported separately for the kindergarten audit file.

[HealthStudImmRec]HealthImmExemptID

[HealthStudImmRec]ExemptionExpiryDate

[HealthImmExempt]StateReportCode = Lab_Immun

Temporary Medical Exempt

Reported: Kindergarten, 6^th grade, 10^th grade

Indicates if the student has a Temporary Medical Exemption.

An “X” is reported if the student has the exemption.

[HealthStudImmRec]HealthImmExemptID

[HealthStudImmRec]ExemptionExpiryDate

[HealthImmExempt]StateReportCode = Temp_Med

Totals

The total number of students for each of the vaccines and exemptions.

N/A