Current through Register Vol. 50, No. 9, March 1, 2024
RELATES TO:
KRS
158.035,
211.090,
211.220,
214.032-214.036
NECESSITY, FUNCTION, AND CONFORMITY:
KRS
194A.050 requires the secretary for the
Cabinet for Health and Family Services to promulgate administrative regulations
necessary to operate the programs and fulfill the responsibilities vested in
the cabinet. KRS
211.190(3) requires the
secretary to promulgate administrative regulations necessary to regulate and
control all matters set forth in
KRS
211.180.
KRS
214.034(1) requires the
cabinet to promulgate administrative regulations to establish immunization
schedules. This administrative regulation establishes the mandatory
immunization schedule for attendance at child day care centers, certified
family child care homes, other licensed facilities which care for children,
preschool programs, and public and private primary and secondary
schools.
Section 1. Definitions.
(1) "Advanced practice registered nurse" or
"APRN" means a nurse designated to engage in advanced registered nursing as
defined in KRS
314.011.
(2) "Advisory Committee on Immunization
Practices" or "ACIP" means the United States Department of Health and Human
Services (HHS) Committee that makes national immunization recommendations to
the Secretary of the HHS, the Assistant Secretary for Health, and the Director
of the Centers for Disease Control and Prevention or CDC.
(3) "Child" means a person less than eighteen
(18) years of age.
(4)
"Commonwealth of Kentucky Parent or Guardian's Declination on Religious Grounds
to Required Immunizations" means an original, written, sworn, and notarized
statement of a parent or guardian's objection to medical immunization against
disease of a child on religious grounds.
(5) "Dose" means a measured quantity of
vaccine, specified in the package insert provided by the
manufacturer.
(6) "DT" means
diphtheria and tetanus toxoids.
(7)
"DTaP" means diphtheria and tetanus toxoids and acellular pertussis
vaccine.
(8) "DTP" means diphtheria
and tetanus toxoids and pertussis vaccine.
(9) "Healthcare provider" means a person
licensed under KRS
311.530 to
311.620,
311.840 to
311.862, and a nurse designated
to engage in advanced practice registered nursing as defined in
KRS
314.011 and
314.042.
(10) "HepA" means hepatitis A
vaccine.
(11) "HepB" means
hepatitis B vaccine.
(12) "Hib"
means Haemophilus influenzae type b conjugate vaccine.
(13) "IPV" means inactivated poliovirus
vaccine.
(14) "MenACWY" means
serogroups A, C, W, and Y meningococcal conjugate vaccine.
(15) "MMR" means measles, mumps, and rubella
virus vaccine.24)
(16) "OPV" means
trivalent oral poliovirus vaccine.
(17) "PCV" means pneumococcal conjugate
vaccine.
(18) "Pharmacist" means a
person licensed under
KRS
315.002 to
315.050.
(19) "Physician assistant" means a person
licensed under KRS
311.840 to
311.862.
(20) "Td" means tetanus and diphtheria
toxoids for adult use.
(21) "Tdap"
means tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis
vaccine.
(22) "Varicella" means
varicella vaccine.
(23) "Varicella
immunity (non-vaccine)" means:
(a) Diagnosis
of varicella disease by a healthcare provider;
(b) Verification of a history of varicella
disease by a healthcare provider;
(c) Diagnosis of herpes zoster by a
healthcare provider; or
(d)
Verification of a history of herpes zoster by a healthcare provider.
Section 2. Immunization
Schedules. Except as provided in Section 3 of this administrative regulation:
(1) A current Commonwealth of Kentucky
Certificate of Immunization Status shall be required to attend a:
(a) Child day care center, beginning at age
three (3) months;
(b) Certified
family child care home, beginning at age three (3) months;
(c) Licensed facility that cares for
children, beginning at age three (3) months;
(d) Preschool program; or
(e) Public or private primary or secondary
school.
(2) A current
Commonwealth of Kentucky Certificate of Immunization Status shall be required
for a child that is otherwise homeschooled in order to attend one (1) or more
in-school classes or to participate in sports or any school-sponsored
extra-curricular activities.
(3) A
Commonwealth of Kentucky Certificate of Immunization Status of a child shall be
considered current for age-appropriate vaccines if the child is:
(a) At least aged three (3) months and less
than five (5) months and has received at least:
1. One (1) dose of DTaP or DTP;
2. One (1) dose of IPV or OPV;
3. One (1) dose of Hib;
4. One (1) dose of HepB; and
5. One (1) dose of PCV;
(b) At least aged five (5) months and less
than seven (7) months and has received at least:
1. Two (2) doses of DTaP or DTP or
combinations of the two (2) vaccines;
2. Two (2) doses of IPV or OPV or
combinations of the two (2) vaccines;
3. Two (2) doses of Hib;
4. Two (2) doses of HepB; and
5. Two (2) doses of PCV;
(c) At least aged seven (7) months and less
than twelve (12) months and has received at least:
1. Three (3) doses of DTaP or DTP or
combinations or the two (2) vaccines;
2. Two (2) doses of IPV or OPV or
combinations of the two (2) vaccines;
3. Two (2) doses of Hib;
4. Two (2) doses of HepB; and
5.
a. Three
(3) doses of PCV; or
b. Two (2)
doses of PCV if the first dose was received when aged seven (7) months through
eleven (11) months;
(d) At least aged twelve (12) months and less
than sixteen (16) months and has received at least:
1. Three (3) doses of DTaP or DTP or
combinations of the two (2) vaccines;
2. Two (2) doses of IPV or OPV or
combinations of the two (2) vaccines;
3.
a. Three
(3) doses of Hib;
b. Two (2) doses
of Hib if the first dose was received when aged seven (7) months through eleven
(11) months;
c. One (1) dose of Hib
if the first dose was received when aged twelve (12) months through fourteen
(14) months; or
d. One (1) dose of
Hib if the first dose was received when aged fifteen (15) months;
4. One (1) dose of HepA;
5. Two (2) doses of HepB; and
6.
a. Four
(4) doses of PCV with one (1) dose when aged twelve (12) months through fifteen
(15) months;
b. Three (3) doses of
PCV if the first dose was received when aged seven (7) months through eleven
(11) months, with at least one (1) dose received when aged twelve (12) months
through fifteen (15) months; or
c.
Two (2) doses of PCV if the first dose was received when aged twelve (12)
months through fifteen (15) months;
(e) At least aged sixteen (16) months and
less than nineteen (19) months and has received at least:
1. Four (4) doses of DTaP or DTP or
combinations of the two (2) vaccines;
2. Two (2) doses of IPV or OPV or
combinations of the two (2) vaccines;
3.
a. Four
(4) doses of Hib;
b. Three (3)
doses of Hib if the first dose was received before aged twelve (12) months, and
the second dose was received when younger than aged fifteen (15)
months;
c. Two (2) doses of Hib if
the first dose was received when aged twelve (12) months through fourteen (14)
months; or
d. One (1) dose of Hib
if the first dose was received when aged fifteen (15) months through eighteen
(18) months;
4. One (1)
dose of HepA;
5. Two (2) doses of
HepB;
6.
a. Four (4) doses of PCV with one (1) dose
when aged twelve (12) months through eighteen (18) months;
b. Three (3) doses of PCV if the first dose
was received when aged seven (7) months through eleven (11) months, with at
least one dose when aged twelve (12) months through eighteen (18) months;
or
c. Two (2) doses of PCV if the
first dose was received when aged twelve (12) months through eighteen (18)
months;
7. One (1) dose
of MMR; and
8.
a. One (1) dose of Varicella; or
b. A diagnosis or verification from a
healthcare provider that the child has varicella immunity
(non-vaccine);
(f) At least aged nineteen (19) months and
less than forty-eight (48) months and has received at least:
1. Four (4) doses of DTaP or DTP or
combinations of the two (2) vaccines;
2. Three (3) doses of IPV or OPV or
combinations of the two (2) vaccines:
3.
a. Four
(4) doses of Hib;
b. Three (3)
doses of Hib if the first dose was received before aged twelve (12) months, and
the second dose was received when younger than aged fifteen (15)
months;
c. Two (2) doses of Hib if
the first dose was received when aged twelve (12) months through fourteen (14)
months; or
d. One (1) dose of Hib
if the first dose was received when aged fifteen (15) months through
forty-seven (47) months;
4. Two (2) doses of HepA;
5. Three (3) doses of HepB;
6.
a. Four
(4) doses of PCV with one (1) dose when aged twelve (12) months through fifteen
(15) months;
b. Three (3) doses of
PCV if the first dose was received when aged seven (7) months through eleven
(11) months, with at least one (1) dose when aged twelve (12) months through
forty-seven (47) months;
c. Two (2)
doses of PCV if the first dose was received when aged twelve (12) months
through twenty-three (23) months; or
d. One (1) dose of PCV if the first dose was
received when aged twenty-four (24) months through forty-seven (47)
months;
7. One (1) dose
of MMR; and
8.
a. One (1) dose of Varicella; or
b. A diagnosis or verification from a
healthcare provider that the child has varicella immunity
(non-vaccine);
(g) At least aged forty-eight (48) months and
less than five (5) years and has received at least:
1. Four (4) doses of DTaP or DTP or
combinations of the two (2) vaccines;
2. Three (3) doses of IPV or OPV or
combinations of the two (2) vaccines;
3.
a. Four
(4) doses of Hib;
b. Three (3)
doses of Hib if the first dose was received before aged twelve (12) months, and
the second dose was received when younger than aged fifteen (15)
months;
c. Two (2) doses of Hib if
the first dose was received when aged twelve (12) months through fourteen (14)
months; or
d. One (1) dose of Hib
if the first dose was received when aged fifteen (15) months through fifty-nine
(59) months;
4. Two (2)
doses of HepA;
5. Three (3) doses
of HepB;
6.
a. Four (4) doses of PCV with one (1) dose
when aged twelve (12) months through fifteen (15) months;
b. Three (3) doses of PCV if the first dose
was received when aged seven (7) months through eleven (11) months, with at
least one (1) dose when aged twelve (12) months through fifty-nine (59)
months;
c. Two (2) doses of PCV if
the first dose was received when aged twelve (12) months through twenty-three
(23) months; or
d. One (1) dose of
PCV if the first dose was received when aged twenty-four (24) months through
fifty-nine (59) months;
7. Two (2) doses of MMR; and
8.
a. Two
(2) doses of Varicella; or
b. A
diagnosis or verification from a healthcare provider that the child has
varicella immunity (non-vaccine);
(h) At least aged five (5) years and less
than seven (7) years and has received at least:
1.
a. Five
(5) doses of DTaP or DTP or combinations of the two (2) vaccines; or
b. Four (4) doses of DTaP or DTP or
combinations of the two (2) vaccines if the fourth dose was received when aged
four (4) years or older and at least six (6) months after the previous
dose;
2.
a. Four (4) doses of IPV or OPV or
combinations of the two (2) vaccines with the fourth dose received when aged
four (4) years through six (6) years and at least six (6) months after the
previous dose;
b. Four (4) or more
doses of IPV or OPV or combinations of the two (2) vaccines received before age
four (4) years and an additional dose received when aged four (4) years through
six (6) years and at least six (6) months after the previous dose; or
c. Three (3) doses of IPV or OPV or
combinations of the two (2) vaccines if the third dose was received when aged
four (4) years or older and at least six (6) months after the previous
dose;
3. Two (2) doses of
HepA;
4. Three (3) doses of
HepB;
5. Two (2) doses of MMR;
and
6.
a. Two (2) doses of Varicella; or
b. A diagnosis or verification from a
healthcare provider that the child has varicella immunity
(non-vaccine);
(i) At least aged seven (7) years and less
than eleven (11) years and has received at least:
1.
a. Five
(5) doses of DTaP or DTP or combinations of the two (2) vaccines;
b. Four (4) doses of DTaP or DTP or
combinations of the two (2) vaccines if the fourth dose was received when aged
four (4) years or older and at least six (6) months after the previous dose;
or
c. A dose of Td that was
preceded by two (2) doses of DTaP, DTP, DT, or Td or combinations of the four
(4) vaccines;
2.
a. Four (4) doses of IPV or OPV or
combinations of the two (2) vaccines with the fourth dose received when aged
four (4) years or older and at least six (6) months after the previous
dose;
b. Four (4) or more doses of
IPV or OPV or combinations of the two (2) vaccines received before age four (4)
years and an additional dose received when aged four (4) years or older and at
least six (6) months after the previous dose;
c. Four (4) doses of IPV or OPV or
combinations of the two (2) vaccines if the fourth dose was received before
August 7, 2009, with all doses separated by at least four (4) weeks;
or
d. Three (3) doses of IPV or OPV
or combinations of the two (2) vaccines if the third dose was received when
aged four (4) years or older and at least six (6) months after the previous
dose;
3. Two (2) doses of
HepA;
4. Three (3) doses of
HepB;
5. Two (2) doses of MMR;
and
6.
a. Two (2) doses of Varicella; or
b. A diagnosis or verification from a
healthcare provider that the child has varicella immunity
(non-vaccine);
(j) At least aged eleven (11) years and less
than thirteen (13) years and has received at least:
1. One (1) dose of Tdap;
2.
a. Five
(5) doses of DTaP or DTP or combinations of the two (2) vaccines;
b. Four (4) doses of DTaP or DTP or
combinations of the two (2) vaccines if the fourth dose was received when aged
four (4) years or older and at least six (6) months after the previous
dose;
c. A dose of Td that was
preceded by two (2) doses of DTaP, DTP, DT, or Td or combinations of the four
(4) vaccines; or
d. Two (2) doses
of Td after the dose of Tdap;
3.
a. Four
(4) doses of IPV or OPV or combinations of the two (2) vaccines with the fourth
dose received when aged four (4) years and older and at least six (6) months
after the previous dose;
b. Four
(4) or more doses of IPV or OPV or combinations of the two (2) vaccines
received before age four (4) years and an additional dose received when aged
four (4) years or older and at least six (6) months after the previous
dose;
c. Four (4) doses of IPV or
OPV or combinations of the two (2) vaccines if the fourth dose was received
before August 7, 2009, with all doses separated by at least four (4) weeks;
or
d. Three (3) doses of IPV or OPV
or combinations of the two (2) vaccines if the third dose was received when
aged four (4) years or older and at least six (6) months after the previous
dose;
4. Two (2) doses of
HepA;
5.
a. Three (3) doses of HepB; or
b. Two (2) doses of adult HepB approved by
the FDA to be used for an alternative schedule for adolescents aged eleven (11)
years through fifteen (15) years;
6. Two (2) doses of MMR;
7.
a. Two
(2) doses of Varicella; or
b. A
diagnosis or verification from a healthcare provider that the child has
varicella immunity (non-vaccine); and
8. One (1) dose of MenACWY;
(k) At least aged thirteen (13)
years and less than sixteen (16) years and has received at least:
1. One (1) dose of Tdap;
2.
a. Five
(5) doses of DTaP or DTP or combinations of the two (2) vaccines;
b. Four (4) doses of DTaP or DTP or
combinations of the two (2) vaccines if the fourth dose was received when aged
four (4) years or older and at least six (6) months after the previous
dose;
c. A dose of Td that was
preceded by two (2) doses of DTaP, DTP, DT, or Td or combinations of the four
(4) vaccines; or
d. Two (2) doses
of Td after the dose of Tdap;
3.
a. Four
(4) doses of IPV or OPV or combinations of the two (2) vaccines with the fourth
dose received when aged four (4) years or older and at least six (6) months
after the previous dose;
b. Four
(4) or more doses of IPV or OPV or combinations of the two (2) vaccines
received before age four (4) years and an additional dose received when aged
four (4) years or older and at least six (6) months after the previous
dose;
c. Four (4) doses of IPV or
OPV or combinations of the two (2) vaccines if the fourth dose was received
before August 7, 2009, with all doses separated by at least four (4) weeks;
or
d. Three (3) doses of IPV or OPV
or combinations of the two (2) vaccines if the third dose was received when
aged four (4) years or older and at least six (6) months after the previous
dose;
4. Two (2) doses of
HepA;
5.
a. Three (3) doses of HepB; or
b. Two (2) doses of adult HepB approved by
the FDA to be used for an alternative schedule for adolescents aged eleven (11)
through fifteen (15) years;
6. Two (2) doses of MMR;
7.
a. Two
(2) doses of Varicella; or
b. A
diagnosis or verification from a healthcare provider that the child has
varicella immunity (non-vaccine); and
8. One (1) dose of MenACWY;
(l) At least aged sixteen (16)
years or older and has received at least:
1.
One (1) dose of Tdap;
2.
a. Five (5) doses of DTaP or DTP or
combinations of the two (2) vaccines;
b. Four (4) doses of DTaP or DTP or
combinations of the two (2) vaccines if the fourth dose was received when aged
four (4) years or older and at least six (6) months after the previous
dose;
c. A dose of Td that was
preceded by two (2) doses of DTaP, DTP, DT, or Td or combinations of the four
(4) vaccines; or
d. Two (2) doses
of Td after the dose of Tdap;
3.
a. Four
(4) doses of IPV or OPV or combinations of the two (2) vaccines with the fourth
dose received when aged four (4) years and older and at least six (6) months
after the previous dose;
b. Four
(4) or more doses of IPV or OPV or combinations of the two (2) vaccines
received before age four (4) years and an additional dose received when aged
four (4) years or older and at least six (6) months after the previous
dose;
c. Four (4) doses of IPV or
OPV or combinations of the two (2) vaccines if the fourth dose was received
before August 7, 2009, with all doses separated by at least four (4) weeks;
or
d. Three (3) doses of IPV or OPV
or combinations of the two (2) vaccines if the third dose was received when
aged four (4) years or older and at least six (6) months after the previous
dose;
4. Two (2) doses of
HepA;
5.
a. Three (3) doses of HepB; or
b. Two (2) doses of adult HepB approved by
the FDA to be used for an alternative schedule for adolescents aged eleven (11)
years through fifteen (15) years;
6. Two (2) doses of MMR;
7.
a. Two
(2) doses of Varicella; or
b. A
diagnosis or verification from a healthcare provider that the child has
varicella immunity (non-vaccine); and
8.
a. Two
(2) doses of MenACWY; or
b. One (1)
dose of MenACWY if that dose was received at age sixteen (16) years or
older.
(4) Immunizations shall be received in
accordance with the minimum ages and intervals between doses recommended by the
ACIP. Partial, split, half, or fractionated doses or quantities shall not be
administered and shall not be counted as a valid dose.
Section 3. Exceptions and Exemptions to the
Required Immunization Schedules in Section 2.
(1) If the first two (2) doses of Hib vaccine
were meningococcal group B outer membrane protein (PRP-OMP) vaccines, the third
dose may be omitted.
(2) A child
with a medical contraindication to pertussis vaccine may be given DT in lieu of
DTaP or Td in lieu of Tdap.
(3)
(a) If both IPV and OPV were administered as
part of a series, a total of four (4) doses shall be administered.
(b) If only OPV was administered, and all
doses were received prior to four (4) years of age, one (1) dose of IPV shall
be administered when aged four (4) years or older and at least four (4) weeks
after the last OPV dose.
(4) A child aged seven (7) years or older may
receive one (1) dose of Tdap in the catch-up series if the child is not fully
immunized with DTaP vaccine.
(5) A
Commonwealth of Kentucky Certificate of Immunization Status marked to designate
a medical exemption shall be issued for a child with a temporary or permanent
medical contraindication to receiving a vaccine.
(6)
(a) If
an immunization is administered but another is objected to on religious
grounds, a healthcare provider, pharmacist, local health department, or other
licensed healthcare facility administering immunizations:
1. May request that a parent or guardian
complete the Commonwealth of Kentucky Parent or Guardian's Declination on
Religious Grounds to Required Immunizations form to be submitted upon
enrollment in a child care facility or school;
2. Shall issue a Commonwealth of Kentucky
Certificate of Immunization Status marked to designate "religious objection" to
the requirements of Section 2 of this administrative regulation, in compliance
with KRS
214.036; and
3. Shall list administered immunizations on
the Commonwealth of Kentucky Certificate of Immunization
Status.
(b) An EPID 230A
form, Commonwealth of Kentucky Parent or Guardian's Declination on Religious
Grounds to Required Immunizations, shall:
1.
Be valid for the requirements of Section 2 of this administrative
regulation;
2. List the
immunizations that a parent or guardian objects to being administered to a
child based on religious grounds;
3. Be an original document written, sworn,
and signed before a notary public; and
4. Be submitted at the time of enrollment in
a child care facility or school.
(7) A Commonwealth of Kentucky Certificate of
Immunization Status marked to designate "Provisional Status" shall:
(a) Be issued for a child who is behind in
required immunizations listed in Section 2 of this administrative
regulation;
(b) Be issued for a
child who has received at least one (1) dose of each of the required vaccines
but has not completed all the required immunizations;
(c) Permit a child to attend a child day care
center, certified family child care home, licensed facility which cares for
children, preschool program, or primary or secondary school until the child
reaches the appropriate age or upon passage of the time interval between
required doses;
(d) Expire:
1. Fourteen (14) days from the date the next
dose is required to be given for school use; or
2. Thirty (30) days from the date the next
dose is required to be given for use in a day care center, certified family
child-care home, or other licensed facility which cares for children;
and
(e) Not be valid for
more than one (1) year.
Section 4. Commonwealth of Kentucky
Certificate of Immunization Status.
(1) A
Commonwealth of Kentucky Certificate of Immunization Status shall be issued by:
(a) A physician licensed in any
state;
(b) An advanced practice
registered nurse licensed in any state;
(c) A physician assistant licensed in
Kentucky;
(d) A pharmacist licensed
in Kentucky;
(e) A local health
department in Kentucky;
(f) A
licensed healthcare facility administering immunizations in Kentucky;
or
(g) An authorized user of the
Kentucky Immunization Registry.
(2) Signatures on the Commonwealth of
Kentucky Certificate of Immunization Status shall:
(a) Contain the printed name;
(b) Be in ink or an electronic
signature;
(c) Be dated;
and
(d) Be that of:
1. A physician;
2. An advanced practice registered
nurse;
3. A physician
assistant;
4. A
pharmacist;
5. The local health
department administrator; or
6. A
registered nurse or licensed practical nurse designee of a physician, local
health department administrator, or other licensed healthcare
facility.
(3) A
Commonwealth of Kentucky Certificate of Immunization Status printed from the
Kentucky Immunization Registry shall not require a signature.
(4) A healthcare provider, pharmacist, local
health department, or other licensed healthcare facility administering
immunizations may obtain a blank hard copy of the following from the Cabinet
for Health and Family Services:
(a)
Commonwealth of Kentucky Certificate of Immunization Status; and
(b) Commonwealth of Kentucky Parent or
Guardian's Declination on Religious Grounds to Required
Immunizations.
(5) The
Commonwealth of Kentucky Certificate of Immunization Status shall:
(a) Be on a hard copy provided by the Cabinet
for Health and Family Services; or
(b) Be a copy electronically produced in the
size, orientation, and format printed by:
1. A
Kentucky medical provider's electronic medical record system;
2. A local health department's electronic
medical record system;
3. A
Kentucky licensed healthcare facility administering immunizations electronic
medical record system; or
4. The
Kentucky Immunization Registry.
(6) An electronically produced copy of a
Commonwealth of Kentucky Certificate of Immunization Status shall contain at
least the following information:
(a) The name
of the child;
(b) The birthdate of
the child;
(c) The name of the
parent or guardian of the child;
(d) The address of the child, including
street, city, state, and ZIP Code;
(e) The type(s) of vaccine(s) administered to
the child;
(f) The date that each
dose of each vaccine was administered;
(g) Certification that the child is current
for immunizations until a specified date, including a statement that the
certificate shall not be valid after the specified date;
(h) The printed name, ink or electronic
signature, and date as described in subsection (2) of this section;
and
(i) The name, address, and
telephone number of the healthcare provider practice, pharmacy, local health
department, or licensed health care facility issuing the certificate.
(7) A signed certificate or a
certificate printed from the Kentucky Immunization Registry may be faxed from a
medical office to a:
(a) Medical
office;
(b) Healthcare
facility;
(c) Child care
facility;
(d) School; or
(e) State or local health
department.
(8) All
immunizations required by Section 2 of this administrative regulation and
received by a child shall be included on the Commonwealth of Kentucky
Certificate of Immunization Status.
(9) All ACIP recommended immunizations a
child has received in addition to the immunizations required by Section 2 of
this administrative regulation may be included on the Commonwealth of Kentucky
Certificate of Immunization Status.
(10) A completed Commonwealth of Kentucky
Certificate of Immunization Status shall be:
(a) On file for a child:
1. Cared for in a:
a. Child day care center;
b. Certified family child care home;
or
c. Licensed facility that cares
for children; or
2.
Enrolled in a:
a. Preschool program;
b. Public or private primary or secondary
school; or
c. Preschool program or
a public or private primary or secondary school for all in-school classes or to
participate in sports or any school sponsored extra-curricular activities if
the child is otherwise homeschooled; and
(b) Available for inspection and review by a
representative of the Cabinet for Health and Family Services or a
representative of a local health department.
Section 5. Out-of-State Certificate of
Immunization Status
(1) An Out-of-State
Certificate of Immunization Status shall be accepted when completed by an
out-of-state physician or advanced practice registered nurse.
(2) The out-of-state certificate shall
contain at least the following information:
(a) The name of the child;
(b) The birthdate of the child;
(c) The name of the parent or guardian of the
child;
(d) The address of the
child, including street, city, state, and ZIP Code;
(e) The type(s) of vaccine(s) administered to
the child;
(f) The date that each
dose of each vaccine was administered;
(g) All age appropriate immunizations
required in Kentucky as identified in Section 2(3) of this administrative
regulation;
(h) Certification that
the child is current for immunizations until a specified date, including a
statement that the certificate shall not be valid after the specified
date;
(i) A printed name, ink or
electronic signature, and date as described in Section 4(2) of this
administrative regulation; and
(j)
The name, address, and telephone number of the healthcare provider practice,
local health department, or licensed health care facility issuing the
certificate.
(3) The
Out-of-State Certificate of Immunization Status may be in the size,
orientation, and format required by another state.
(4) Immunizations documented on an
out-of-state certificate shall be transferred to a hard copy of a Commonwealth
of Kentucky Certificate of Immunization Status or shall be documented on an
electronically produced Commonwealth of Kentucky Certificate of Immunization
Status when one (1) or more immunizations are administered in
Kentucky.
Section 6.
Review of Immunization Status.
(1) A current
Commonwealth of Kentucky Certificate of Immunization Status or an Out-of-State
Certificate of Immunization Status for a child shall be provided by a parent or
guardian:
(a) Upon enrollment in a:
1. Child day care center;
2. Certified family child care
home;
3. Licensed facility that
cares for a child; or
4. School at:
a. Kindergarten entry;
b. Seventh grade entry;
c. Eleventh grade entry;
d. Twelfth grade entry for the first twelve
(12) months this administrative regulation is effective; and
e. New enrollment at any grade resulting from
a transfer to:
(i) Kentucky from another
state;
(ii) Kentucky from a country
outside the United States; or
(iii)
A school from another school within Kentucky;
(b) Upon legal name change;
or
(c) At a school required
examination pursuant to
702 KAR
1:160.
(2) Upon review of a Commonwealth of Kentucky
Certificate of Immunization Status or an Out-of-State Certificate of
Immunization Status:
(a) A child whose
certificate has exceeded the date for the certificate to be valid shall be
recommended to visit the child's medical provider or local health department to
receive immunizations required by this administrative regulation; and
(b) An updated and current certificate shall
be provided to the:
1. Day care center,
certified family child care home, or other licensed facility that cares for
children by a parent or guardian within thirty (30) days from when the
certificate was found be invalid; or
2. School by a parent or guardian within
fourteen (14) days from when the certificate was found to be invalid.
(3) A Commonwealth of
Kentucky Certificate of Immunization Status or an Out-of-State Certificate of
Immunization Status for a child or group of children shall be reviewed upon
request of a local health department as part of controlling an outbreak of a
vaccine preventable disease.
Section
7. Effective Date. For all child day cares, certified family child
care homes, other licensed facilities which care for children, preschool
programs, and public or private primary and secondary schools:
(1) This administrative regulation, except
for Section 2, shall become effective for the school year beginning on or after
July 1, 2017; and
(2) Section 2 of
this administrative regulation shall become effective for the school year
beginning on or after July 1, 2018.
Section 8. Incorporation by Reference.
(1) The following material is incorporated by
reference:
(a) Form "EPID 230, Commonwealth of
Kentucky Certificate of Immunization Status", 1/2017; and
(b) Form "EPID 230A, Commonwealth of Kentucky
Parent or Guardian's Declination on Religious Grounds to Required
Immunizations", 6/2017.
(2) This material may be inspected, copied,
or obtained, subject to applicable copyright law, at the Department for Public
Health, 275 East Main Street, Frankfort Kentucky 40621, Monday through Friday,
8 a.m. to 4:30 p.m.
STATUTORY AUTHORITY:
KRS
194A.050(1),
211.090(3),
211.180(1)(a),
(e),
214.034(1)