Current through Register Vol. 39, No. 6, September 16, 2024
(a) Every
individual in North Carolina required to be immunized pursuant to
G.S.
130A-152 through
130A-157 shall be immunized
against the following diseases and have documentation of age-appropriate
vaccination in accordance with the Advisory Committee on Immunization Practices
(ACIP).
(1) Diphtheria, tetanus, and
pertussis (whooping cough) - five doses: three doses by age seven months; and 2
booster doses, the first by age 19 months and the second on or after the fourth
birthday and before entering school for the first time. However:
(A) Individuals who receive the first booster
dose of diphtheria/tetanus/pertussis vaccine on or after the fourth birthday
are not required to have a second booster.
(B) Individuals entering college or
university for the first time on or after July 1, 2008 must have had three
doses of tetanus/diphtheria toxoid; one of which must be
tetanus/diphtheria/pertussis.
(C) A
booster dose of tetanus/diphtheria/pertussis vaccine is required for
individuals who have not previously received it and are entering the seventh
grade or by 12 years of age, whichever comes first.
(2) Poliomyelitis vaccine - four doses: two
doses of trivalent type by age five months; a third dose trivalent type before
age 19 months; and a booster dose of trivalent type on or after his or her
fourth birthday and before entering school for the first time. However:
(A) An individual attending school who has
attained his or her 18th birthday is not required to receive a polio
vaccine.
(B) The requirements for
the booster dose on or after the fourth birthday do not apply to individuals
who began school before July 1, 2015.
(C) Individuals who receive the third dose of
poliomyelitis vaccine on or after the fourth birthday are not required to
receive a fourth dose if the third dose is given at least six months after the
second dose.
(3) Measles
(rubeola) vaccine - two doses of live, attenuated vaccine administered at least
28 days apart: the first dose on or after age 12 months and before age 16
months; and a second dose before entering school for the first time. However:
(A) An individual who has been documented by
serological testing to have a protective antibody titer against measles is not
required to receive measles vaccine.
(B) An individual who has been diagnosed
before January 1, 1994, by a physician (or designee such as a nurse
practitioner or physician's assistant) as having measles (rubeola) disease is
not required to receive measles vaccine.
(C) An individual born before 1957 is not
required to receive measles vaccine except in measles outbreak
situations.
(D) The requirement for
a second dose of measles vaccine does not apply to individuals who enter school
or in college or university for the first time before July 1, 1994.
(4) Rubella vaccine - one dose of
live, attenuated vaccine on or after age 12 months and before age 16 months.
However:
(A) An individual who has laboratory
confirmation of rubella disease or who has been documented by serological
testing to have a protective antibody titer against rubella is not required to
receive rubella vaccine.
(B) An
individual who has attained his or her fiftieth birthday is not required to
receive rubella vaccine except in outbreak situations.
(C) An individual who entered a college or
university after his or her thirtieth birthday and before February 1, 1989 is
not required to meet the requirement for rubella vaccine except in outbreak
situations.
(5) Mumps
vaccine - two doses: the first dose of live, attenuated vaccine administered on
or after age 12 months and before age 16 months; and a second dose before
entering school, college or university for the first time. However:
(A) An individual who has laboratory
confirmation of disease, or has been documented by serological testing to have
a protective antibody titer against mumps is not required to receive the mumps
vaccine.
(B) An individual born
before 1957 is not required to receive the mumps vaccine.
(C) The requirements for the mumps vaccine do
not apply to individuals who entered the first grade for the first time before
July 1, 1987 or college or university before July 1, 1994.
(D) An individual entering school, college or
university before July 1, 2008 is not required to receive a second dose of
mumps vaccine.
(6)
Haemophilus influenzae, b conjugate vaccine - three doses of HbOC or PRP-T or
two doses of PRP-OMP before age 7 months and a booster dose of any type on or
after age 12 months and by age 16 months. However:
(A) Individuals who receive the first dose of
Haemophilus influenzae, b vaccine on or after 7 months of age and before 12
months of age are required to have two doses of HbOC, PRP-T or PRP-OMP and a
booster dose on or after 12 months of age and by age 16 months.
(B) Individuals who receive the first dose of
Haemophilus influenzae, b vaccine on or after 12 months of age and before 15
months of age are required to have only 2 doses of HbOC, PRP-T or PRP-OMP and a
booster dose two months later.
(C)
Individuals who receive the first dose of Haemophilus influenzae, b vaccine on
or after 15 months of age are required to have only one dose of any of the
Haemophilus influenzae b conjugate vaccines.
(D) No individual who has passed his or her
fifth birthday is required to be vaccinated against Haemophilus influenzae,
b.
(7) Hepatitis B
vaccine - three doses: the first dose by age 3 months, a second dose before age
5 months and a third dose by age 19 months. However:
(A) The last dose of the hepatitis B vaccine
series shall not be administered before 24 weeks of age.
(B) Individuals born before July 1, 1994 are
not required to be vaccinated against hepatitis B.
(8) Varicella vaccine - two doses
administered at least 28 days apart; one dose on or after age 12 months of age
and before age 19 months; and a second dose before entering school for the
first time. However:
(A) An individual who has
laboratory confirmation of varicella disease immunity or has been documented by
serological testing to have a protective antibody titer against varicella is
not required to varicella vaccine.
(B) An individual who has documentation from
a physician, nurse practitioner, or physician's assistant verifying history of
varicella disease is not required to receive varicella vaccine. The
documentation shall include the name of the individual with a history of
varicella disease, the approximate date or age of infection, and a healthcare
provider signature.
(C) An
individual born before April 1, 2001 is not required to receive varicella
vaccine.
(D) The requirement for
the second dose of varicella vaccine shall not apply to individuals who enter
Kindergarten or first grade for the first time before July 1, 2015.
(9) Pneumococcal conjugate vaccine
- Four doses; 3 doses by age 7 months and a booster dose at 12 through 15
months of age. However:
(A) Individuals who
receive the first dose of pneumococcal conjugate vaccine on or after 7 months
of age and before 12 months of age are required to have 2 doses at least 4
weeks apart; and a booster dose at 12 through 15 months of age.
(B) Individuals who receive the first dose of
pneumococcal conjugate vaccine on or after 12 months of age and before 24
months of age are required to have 2 doses at least 8 weeks apart to complete
the series.
(C) Individuals who
receive the first dose of pneumococcal conjugate vaccine on or after 24 months
of age and before 5 years are required to have 1 dose to complete the
series.
(D) No individual who has
passed his or her fifth birthday shall be required to be vaccinated against
pneumococcal disease.
(E) An
individual born before July 1, 2015 shall not be required to receive
pneumococcal conjugate vaccine.
(10) Meningococcal conjugate vaccine - two
doses: one dose is required for individuals entering the seventh grade or by 12
years of age, whichever comes first, on or after July 1, 2015. A booster dose
is required by 17 years of age or by entering the 12th grade. However:
(A) The first dose does not apply to
individuals who entered seventh grade before July 1, 2015.
(B) The booster dose does not apply to
individuals who entered the 12th grade before August
1, 2020.
(C) If the first dose is
administered on or after the 16th birthday, a
booster dose is not required.
(D)
An individual born before January 1, 2003 shall not be required to receive a
meningococcal conjugate vaccine.
(b) The healthcare provider shall administer
immunizations in accordance with this Rule. However, if a healthcare provider
administers vaccine up to and including the fourth day prior to the required
minimum age, the individual dose is not required to be repeated. Doses
administered more than four days prior to the requirements are considered
invalid doses and shall be repeated.
(c) The State Health Director may suspend
temporarily any portion of the requirements of this Rule due to emergency
conditions, such as the unavailability of vaccine. The Department shall give
notice in writing to all local health departments and other providers currently
receiving vaccine from the Department when the suspension takes effect and when
the suspension is lifted. When any vaccine series is disrupted by such a
suspension, the next dose shall be administered within 90 days of the lifting
of the suspension and the series resumed in accordance with intervals
determined by the most recent recommendations of the Advisory Committee on
Immunization Practices. These recommendations may be accessed free of charge at
http://www.cdc.gov/vaccines/acip/.
