Current through February, 2024
Section 1.0 Authority
1.1 This rule is adopted pursuant to
18 V.S.A. §
1123.
Section 2.0 Purpose
2.1 This rule establishes an immunization
schedule, minimum requirements for attendance at child care facilities,
pre-kindergarten, public or independent kindergartens, elementary, secondary
and postsecondary schools, in order to prevent the introduction and/or
transmission of vaccine-preventable diseases.
Section 3.0 Scope
3.1 This rule applies to any child or student
enrolled in a childcare facility, school, or post-secondary
institution.
Section 4.0
Definitions
4.1 "Campus" means the grounds and
collection of buildings of a post-secondary institution where students
regularly congregate in such areas as, but not limited to: residence halls,
classrooms, athletic facilities, chapels, assembly halls, dining facilities,
clubs, lounges, fraternities and sororities, and internal transportation
systems. Campus does not mean a stand-alone facility used only for
administrative and instructional purposes.
4.2 "Child" means a person younger than 18
years of age
4.3 "Child care
administrator" means administrator or other person in charge of a child care
facility.
4.4 "Child care facility"
means a child care facility or family child care home licensed or registered
under chapter 35 of Title 33.
4.5
"Department" means the Vermont Department of Health.
4.6 "Enroll" in kindergarten through 12 [th
]grade means attending one or more classes. For post-secondary "enroll" means
enrolled full time, as defined by the institution, and any students enrolled in
an allied health science program. Students whose instruction is solely on-line
are not considered "enrolled" under this rule.
4.7 "Health care practitioner" means a person
licensed, certified or authorized by law to provide professional health care
service in this state to an individual during that individual's medical care,
treatment or confinement.
4.8
"Non-recurring services" means early childhood programs designed to meet the
short-term needs of families arising from tourism, recreation or
shopping.
4.9 "Post-secondary
institution" means any person who offers or operates a program of college or
professional education for credit or degree.
4.10 "School" means a public or independent
prekindergarten, kindergarten, elementary, secondary or post-secondary school
as defined in
16 V.S.A. §
11.
4.11 "School administrator" means principal,
headmaster, registrar, or other person in charge of a school.
4.12 "Student" means a person in attendance
at any school.
4.13 "Vermont
Immunization Advisory Council" or "VIAC" means the council established for the
purpose of providing education policy, medical, and epidemiological expertise
and advice to the Department with regard to the safety of immunizations and
immunization schedules.
Section
5.0 Provisional admittance
5.1 A
child or student may be provisionally admitted to a child care facility or a
school if a health care practitioner authorized to prescribe vaccines or a
health clinic indicates the child is in the process of complying with all
immunization requirements. Such provisional admission shall be for a reasonable
length of time that is consistent with the immunization schedule but shall not
exceed 6 months after the child is admitted to the child care facility or
school
5.2 The person or, in the
case of a child, the person's parent or guardian, must present a Department
published form, signed by a health care practitioner authorized to prescribe
vaccines or a health clinic, indicating the person is in the process of being
immunized.
5.3 Any child care
facility or school receiving a form as required by this section shall store the
form as part of the child's or student's immunization record.
5.4 The school shall maintain a roster of
provisionally admitted students and continue follow-up until all immunization
requirements are met.
Section
6.0 Exemptions
6.1 Medical
Exemptions: A person may remain in school or in a child care facility without a
required immunization if the person or, in the case of a child, the person's
parent or guardian, presents a Department- published form, signed by a health
care practitioner authorized to prescribe vaccines, certifying that a specific
immunization is or may be detrimental to the person's health. The practitioner
shall specify the required immunization in question as well as the probable
duration of the condition or circumstance that is or may be detrimental to the
person's health. Any exemption certified under this subdivision shall terminate
when the condition or circumstance cited no longer applies. Any child care
facility or school receiving a form as required by this section shall store the
form as part of the child's or student's immunization record.
6.2 Religious Exemptions: A person may remain
in school or in a child care facility without a required immunization if the
person or, in the case of a child, the person's parent or guardian, annually
provides a signed statement to the school or child care facility on a
Department- published form, indicating that the person, parent, or guardian:
6.2.1 holds religious beliefs opposed to
immunizations; and
6.2.2 has
reviewed the evidence-based educational material provided by the Department
regarding immunizations, including:
6.2.2.1
the information about the risks of adverse reactions to immunization;
6.2.2.2 the information that failure to
complete the required vaccination schedule increases risk to the person and
others of contracting or carrying a vaccine-preventable infectious disease;
and
6.2.2.3 the information that
there are persons with special health needs attending schools and child care
facilities who are unable to be vaccinated or who are at heightened risk of
contracting a vaccine-preventable communicable disease and for whom such a
disease could be life-threatening.
6.3 Any child care facility or school
receiving a form as required by this section shall store the form as part of
the child's or student's immunization record.
Section 7.0 Required Immunization Schedule
The Vermont Recommended Immunization Schedule is based on
the Advisory Committee on Immunization Practices (ACIP) as approved and
published by the Centers for Disease Control. All vaccines required for child
care or school must be administered in accordance with recommended age and
intervals, allowing for the ACIP approved four-day grace period.
7.1 Children enrolled in childcare must
provide documentation of the following at enrollment and annually thereafter.
7.1.1 Children 2-3 months: One dose each of
DTaP (diphtheria, tetanus and perussis), hepatitis B, polio, Hib (Haemophilus
influenzae B) and PCV (pneumocococcal conjugate) vaccine.
7.1.2 Children 4-5 months: Two doses each of
DTaP (diphtheria, tetanus and perussis), hepatitis B, polio, Hib (Haemophilus
influenzae B) and PCV (pneumocococcal conjugate) vaccine.
7.1.3 Children 6-14 months: Three doses each
of DTaP (diphtheria, tetanus and perussis), hepatitis B, polio, Hib
(Haemophilus influenzae B) and PCV (pneumocococcal conjugate)
vaccine.
7.1.4 Children 15-17
months: Three doses each of DTaP (diphtheria, tetanus and perussis), Hepatitis
B and polio vaccine; one dose of MMR (measles, mumps, and rubella) and
varicella vaccine and between one and four doses of Hib (Haemophilus influenzae
B) and PCV (pneumocococcal conjugate) vaccine.
7.1.5 Children 18 months - 4 years: Four
doses of DTaP (diphtheria, tetanus and perussis), three doses of hepatitis B
and polio vaccine; one dose of MMR (measles, mumps, and rubella) and varicella
vaccine and between one and four doses of Hib (Haemophilus influenzae B) and
PCV (pneumocococcal conjugate) vaccine.
7.2 Students entering kindergarten must
provide documentation of the following:
7.2.1
Five doses of DTaP (diphtheria, tetanus, and pertussis) vaccine;
7.2.2 Four doses of the polio
vaccine;
7.2.3 Two doses of the MMR
(measles, mumps, and rubella) vaccine;
7.2.4 Three doses of the hepatitis B vaccine;
and
7.2.5 Two doses of the
chickenpox (varicella) vaccine.
7.2.5.1 Not
required if the student has previously had chickenpox disease and the parents
may submit documentation or sign the Health Department-published
form.
7.3
Students entering the seventh grade must provide documentation of the
following:
7.3.1 All of the immunizations
listed in 7.1;
7.3.2 One dose of
the Tdap (tetanus, diphtheria, and pertussis) vaccine; and
7.3.3 One dose of the meningococcal vaccine
for residential students
7.4 Students entering a post-secondary school
must provide documentation of the following:
7.4.1 One dose of a Tdap (tetanus,
diphtheria, and pertussis) vaccine.
7.4.2 Two doses of MMR(measles, mumps, and
rubella) vaccine.
7.4.3 Two doses
of meningococcal vaccine (or one dose if the first dose was given after age 16)
for first year residential students [less than or equal] 21 years.
7.4.4 Three doses of Hepatitis B
vaccine
7.4.5 Two doses of
chickenpox (varicella) vaccine
7.4.5.1 Not
required if the student has previously had chickenpox disease and the student
(or in the case of a minor, the parent) submits documentation or sign a Health
Department published form.
7.5 Deviations from the above-schedule are
permissible if such deviances are necessary to protect the health of the
recipient and are consistent with recommendations from the Centers for Disease
Control.
Section 8.0
Adoption of Immunization Schedule
8.1 The
Commissioner of Health shall annually convene the Vermont Immunization Advisory
Council (VIAC) to assist in the determination of whether the Immunization
Schedule found in Section
7
of this rule should be updated in accordance with the published Centers for
Disease Control (CDC) immunization schedule.
8.2 Phase-In Periods
8.2.1 Following release of a CDC vaccine
recommendation, two-year phase-in period will pass before children and students
will be required to have the vaccine in order to enroll in a child care
facility or school.
8.2.2 If
necessary to protect the public's health, the Commissioner may require a
shorter phase-in period.
Section 9.0 Acceptable Records
The following will be accepted as evidence of a child or
student's immunization history:
9.1 A
record of immunizations generated by an electronic health record that includes
the complete date (mm/dd/yyyy) each immunization was administered.
9.2 A record from any public health
department listing the individual immunizations and the complete date
(mm/dd/yyyy) each immunization was administered.
9.3 A record from State Immunization Registry
or other registry approved by the Department listing the individual
immunizations and the complete date (mm/dd/yyyy) each immunization was
administered.
9.4 A laboratory
report of a titer indicating evidence of immunity to each disease for which
immunization is required.
9.5 An
official school record from any school listing the individual immunizations and
the complete date (mm/dd/yyyy) the immunization was administered.
9.6 A certificate signed by a health care
practitioner listing the individual immunizations and the complete date
(mm/dd/yyyy) the immunization was administered.
9.7 For varicella disease only, a statement
by the health care practitioner or parent/guardian that the child has had the
disease. Use of a form published by the department is optional for this purpose
only.
Section 10.0
Verification of Compliance
10.1 According to
the following schedule, child care or school administrators shall verify that
children entering child care and students entering school have received all
required immunizations:
10.1.1 For child care
- at enrollment and annually thereafter.
10.1.2 Upon entry into
kindergarten.
10.1.3 Upon entry
into the 7th grade.
10.1.4 Upon
initial enrollment into a post-secondary school.
10.1.5 Whenever a student enrolls for the
first time into any school, including high school or other secondary
schools.
Section
11.0 Reporting of Aggregated Immunization Data
11.1 Child care administrators, using a
format approved by the Department, shall report aggregated data on the
immunization status of all children enrolled in their facility. The annual
report shall identify the immunization status of the children enrolled as of
the date the form is completed. The data reported shall include the aggregated
immunization rates for each required vaccine, the number of medical and
religious exemptions filed and the number of students with provisional
admittance for each required vaccine This report must be received by the
Department by January 1 [st. ]
11.2
School administrators, using a format approved by the Department, shall report
aggregated data on the immunization status of all students enrolled in the
school. The annual report shall identify the immunization status of students
enrolled as of the date the form is completed. The data reported shall include
the aggregated immunization rates for students in the kindergarten, first,
seventh and eighth grades for each required vaccine, the number of medical, and
religious exemptions filed and the number of students with provisional
admittance for each required vaccine. This report must be received by the
Department by January 1 [st. ]
11.3
Privacy: To the extent permitted under the Federal Education Rights and Privacy
Act Privacy,
20 U.S.C. §
1232g and to the extent applicable and
permitted under the federal Health Insurance Portability and Accountability
Act, Pub. L.
104-91, all schools and child care facilities
shall make publicly available the aggregated immunization rates of the children
and students for each required vaccine using a standardized form supplied by
the Department. For purposes of this section only, "child care facility" shall
exclude a family day care home licensed or registered under 33 V.S.A. chapter
35.
Section 12.0
Exclusion from School or Child Care Facility and Penalty for Noncompliance
12.1 Children not in compliance with all
immunization requirements or eligible for provisional admittance shall not be
allowed to enter or be retained in child care facilities. The child's parent or
guardian must receive written notification by mail or in-person from the child
care facility that the child is not in compliance as well as the steps needed
to comply. A Department- published form is available for this purpose. In the
event of exclusion, the childcare administrator shall notify the
Department.
12.2 No child care
administrator shall knowingly admit or retain any child who has not submitted
acceptable evidence of immunization or evidence of eligibility for provisional
admittance, except where the infant or child meets one of the exemptions
provided under part VI. of these rules, or is afforded provisional admittance
as provided under part V. of these rules.
12.3 If a child care facility is found to be
out of compliance with these rules they will be subject to actions by the
Department for Children and Families under chapter 35 of Title 33 and the Early
Childhood Program Licensing Regulations.
12.4 Students not in compliance with all
immunization requirements or eligible for provisional admittance shall not be
allowed to enter or be retained in school. The student or in the case of a
minor the student's parent or guardian must receive written notification by
mail or in-person from the school that the student is not in compliance as well
as the steps needed to comply. A Department published-form is available for
this purpose. In the event of exclusion, school officials shall notify the
Department of Health.
12.5 No
school administrator shall knowingly admit or retain any student who has not
submitted acceptable evidence of immunization except where the student meets
one of the exemptions provided under part VI of these rules, or is afforded
provisional admittance as provided under part V of these rules.
12.6 If a school administrator in charge of a
school is found to be out of compliance with these rules they will be subject
to actions by the Agency of Education under Title 16.
Section 13.0 Retention, Transfer and Release
of Records
13.1 Each child care facility and
school shall maintain an immunization record for each student. This record
shall include the immunization and the date (mm/dd/yyyy) of each
immunization.
13.2 Each child care
facility and school shall maintain a roster of students who are exempt from
immunizations as well as those who are provisionally admitted.
13.3 If a student transfers from one school
to another, the original school shall transfer the immunization record or a
copy thereof. The original school shall keep a log indicating where and when
the records were sent.
13.4
Immunization records shall remain with the child's record in accordance with
the record retention policies of the child care facility or school.
13.5 Upon request, and with written parental
consent, child care administrators may have read-only access to the child care
section in the Immunization Registry identifying vaccinations which are
complete or incomplete.
13.6 School
nurses and, in the absence of a school nurse on staff, school administrators
shall be granted access to the Immunization Registry.
Section 14.0 Access to Records by the
Department
14.1 The child care administrator
or school administrator shall make immunization records available for
inspection by authorized representatives of the Department.