Amend Amendment No. 5 by Zedler (page 3, prefiled amendments packet) to CSHB 39 on page 1, line 5, between "examination" and the underlined period, by inserting ", except that a physician may administer a tetanus vaccination if the physician determines that an emergency circumstance requires the administration of the vaccination. The prohibition on the administration of a vaccine does not apply after the department has been named managing conservator of the child after a hearing under Section 262.106 or 262.201".