Subchapter C. IMMUNIZATION

 This subchapter has been promulgated to insure that school children are immunized against diseases which spread easily in schools and interrupt school life and learning for individuals and groups. This subchapter affects public, private and parochial schools, including kindergartens, special education classes, home education programs and vocational classes in this Commonwealth.

   The provisions of this §  23.81 amended through September 17, 1982, effective August 1, 1983, 12 Pa.B. 3288; amended August 22, 1997, effective August 23, 1997, 27 Pa.B. 4317. Immediately preceding text appears at serial page (164331).

 The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise:

   Ascertain—To determine whether or not a child is immunized as defined in this subchapter.

   Attendance at school—The attendance at a grade, or special classes, kindergarten through 12th grade, including public, private, parochial, vocational, intermediate unit and home education students.

   Certificate of immunization—The official form furnished by the Department. The certificate is filled out by the parent or health care provider and signed by the health care provider, public health official or school nurse or a designee. The certificate is given to the school as proof of immunization. The school maintains the certificate as the official school immunization record or stores the details of the record in a computer data base.

   Department—The Department of Health of the Commonwealth.

   Immunization—The requisite number of dosages of the specific antigens at the recommended time intervals under this subchapter.

   Record of immunization—A written document showing the date of immunization—that is, baby book, Health Passport, family Bible, other states’ official immunization documents, International Health Certificate, immigration records, physician record, school health records and other similar documents or history.

   Secretary—The Secretary of the Department.

   The provisions of this §  23.82 amended through September 17, 1982, effective August 1, 1983, 12 Pa.B. 3288; amended August 22, 1997, effective August 23, 1997, 27 Pa.B. 4317. Immediately preceding text appears at serial page (164331).

 (a)  Required for entry. The following immunizations are required for entry into school for the first time at the kindergarten or first grade level, at public, private or parochial schools in this Commonwealth, including special education and home education programs:

   (1)  Hepatitis B. Three properly-spaced doses of hepatitis B vaccine or a history of hepatitis B immunity proved by laboratory testing.

   (2)  Diphtheria. Four or more properly-spaced doses of diphtheria toxoid, which may be administered as a single antigen vaccine, in combination with tetanus toxoid or in combination with tetanus toxoid and pertussis vaccine. One dose shall be administered on or after the 4th birthday.

   (3)  Tetanus. Four or more properly-spaced doses of tetanus toxoid, which may be administered as a single antigen vaccine, in combination with diphtheria toxoid or in combination with diphtheria toxoid and pertussis vaccine. One dose shall be administered on or after the 4th birthday.

   (4)  Poliomyelitis. Three or more properly-spaced doses of any combination of oral polio vaccine or enhanced inactivated polio vaccine.

   (5)  Measles (rubeola). Two properly-spaced doses of live attenuated measles vaccine, the first dose administered at 12 months of age or older, or a history of measles immunity proved by serological evidence showing antibody to measles as determined by the hemagglutination inhibition test or a comparable test. Each dose of measles vaccine may be administered as a single antigen vaccine.

   (6)  German measles (rubella). One dose of live attenuated rubella vaccine, administered at 12 months of age or older or a history of rubella immunity proved by serological evidence showing antibody to rubella determined by the hemagglutination inhibition test or any comparable test. Rubella vaccine may be administered as a single antigen vaccine.

   (7)  Mumps. One dose of live attenuated mumps vaccine, administered at 12 months of age or older or a physician diagnosis of mumps disease indicated by a written record signed by the physician or the physician’s designee. Mumps vaccine may be administered as a single antigen vaccine.

   (8)  Chickenpox (varicella). One of the following:

     (i)   One dose of varicella vaccine, administered at 12 months of age or older.

     (ii)   A history of chickenpox immunity proved by laboratory testing or a written statement of history of chickenpox disease from a parent, guardian or physician.

 (b)  Required for attendance. The following immunizations are required as a condition of attendance at school in this Commonwealth if the child has not received the immunizations required for school entry listed in subsection (a).

   (1)  Diphtheria. Three or more properly spaced doses of diphtheria toxoid, which may be administered as a single antigen vaccine, in combination with tetanus toxoid or in combination with tetanus toxoid and pertussis vaccine.

   (2)  Tetanus. Three or more properly spaced doses of tetanus toxoid, which may be administered as a single antigen vaccine, in combination with diphtheria toxoid or in combination with diphtheria toxoid and pertussis vaccine.

   (3)  Poliomyelitis. Three or more properly spaced doses of either oral polio vaccine or enhanced inactivated polio vaccine. If a child received any doses of inactivated polio vaccine administered prior to 1988, a fourth dose of inactivated polio vaccine is required.

   (4)  Measles (rubeola). Two properly spaced doses of live attenuated measles vaccine, administered at 12 months of age or older or a history of measles immunity proved by serological evidence showing antibody to measles determined by the hemagglutination inhibition test or a comparable test. Each dose of measles vaccine may be administered as a single antigen vaccine.

   (5)  German measles (rubella). One dose of live attenuated rubella vaccine, administered at 12 months of age or older or a history of rubella immunity proved by serological evidence showing antibody to rubella determined by the hemagglutination inhibition test or any comparable test. Rubella vaccine may be administered as a single antigen vaccine.

   (6)  Mumps. One dose of live attenuated mumps vaccine, administered at 12 months of age or older or a physician diagnosis of mumps disease indicated by a written record signed by the physician or the physician’s designee. Mumps vaccine may be administered as a single antigen vaccine.

 (c)  Required for entry into 7th grade. In addition to the immunizations listed in subsection (b), the following immunizations are required at any public, private, parochial or vocational school in this Commonwealth, including special education and home education programs, as a condition of entry for students entering the 7th grade; or, in an ungraded class, for students in the school year that the student is 12 years of age:

   (1)  Hepatitis B. Three properly-spaced doses of hepatitis B vaccine or a history of hepatitis B immunity proved by laboratory testing.

   (2)  Chickenpox (varicella). One of the following:

     (i)   One dose of varicella vaccine, administered at 12 months of age or older.

     (ii)   Two properly-spaced doses of varicella vaccine for children 13 years of age and older.

     (iii)   A history of chickenpox immunity proved by laboratory testing, or a written statement of history of chickenpox disease from the parent, guardian, emancipated child or physician.

   The provisions of this §  23.83 amended through September 17, 1982, effective August 1, 1983, 12 Pa.B. 3288; amended August 22, 1997, effective August 23, 1997, 27 Pa.B. 4317; amended September 28, 2001, effective September 29, 2001, 31 Pa.B. 5525. Immediately preceding text appears at serial pages (232756) to (232758).

 (a)  Medical exemption. Children need not be immunized if a physician or the physician’s designee provides a written statement that immunization may be detrimental to the health of the child. When the physician determines that immunization is no longer detrimental to the health of the child, the child shall be immunized according to this subchapter.

 (b)  Religious exemption. Children need not be immunized if the parent, guardian or emancipated child objects in writing to the immunization on religious grounds or on the basis of a strong moral or ethical conviction similar to a religious belief.

   The provisions of this §  23.84 amended through September 17, 1982, effective August 1, 1983, 12 Pa.B. 3288; amended August 22, 1997, effective August 23, 1997, 27 Pa.B. 4317. Immediately preceding text appears at serial pages (164332) to (164333) and (129145).

 (a)  The administrator in charge of a school shall appoint a knowledgeable person to perform the following:

   (1)  Inform the parent, guardian or emancipated child at registration or prior to registration, if possible, of the requirements of this subchapter.

   (2)  Ascertain the immunization status of a child prior to admission to school or continued attendance at school.

     (i)   The parent, guardian or emancipated child shall be asked for a completed certificate of immunization.

     (ii)   In the absence of a certificate of immunization, the parent, guardian or emancipated child shall be asked for a record or history of immunization which indicates the month, day and year that immunizations were given. This information shall be recorded on the certificate of immunization and signed by the school official or the official’s designee, or the details of the record shall be stored in a computer database.

 (b)  If the knowledgeable person designated by the school administrator is unable to ascertain whether a child has received the immunizations required by §  23.83 (relating to immunization requirements) or by subsection (e) or is exempt under §  23.84 (relating to exemption for immunization), the school administrator may admit the child to school or allow the child’s continued attendance at school only according to the requirements of subsections (d) and (e).

 (c)  The parent or guardian of a child or the emancipated child who has not received the immunizations required by §  23.83 shall be informed of the specific immunizations required and advised to go to the child’s usual source of care or nearest public clinic to obtain the required immunizations.

 (d)  A child not previously admitted to or not allowed to continue attendance at school because the child has not had the required immunizations shall be admitted to or permitted to continue attendance at school only upon presentation to the school administrator or school administrator’s designee of a completed certificate of immunization or immunization record, upon submission of information sufficient for an exemption under §  23.84, or upon compliance with subsection (e).

 (e)  If a child has not received all the antigens described in §  23.83, the child may be provisionally admitted to school only if evidence of the administration of at least one dose of each antigen described in §  23.83 is given to the school administrator or the administrator’s designee and the parent or guardian’s plan for completion of the required immunizations is made part of the child’s health record. The plan for completion of the required immunizations shall be reviewed every 60 days by the school administrator or the administrator’s designee. Subsequent immunizations shall be entered on the certificate of immunization or entered in the school’s computer database. Immunization requirements described in §  23.83 shall be completed within 8 months of the date of provisional admission to school. If the requirements are not met, the school administrator may not admit the child to school or permit continued attendance.

 (f)  A school shall maintain on file a certificate of immunization for a child enrolled. An alternative to maintaining a certificate on file is to transfer the immunization information from the certificate to a computer database. The certificate of immunization or a facsimile thereof generated by computer shall be returned to the parent, guardian or emancipated child or the school shall transfer the certificate of immunization (or facsimile) with the child’s record to the new school when a child withdraws, transfers, is promoted, graduates or otherwise leaves the school.

   The provisions of this §  23.85 amended through September 17, 1982, effective August 1, 1983, 12 Pa.B. 3288; amended August 22, 1997, effective August 23, 1997, 27 Pa.B. 4317. Immediately preceding text appears at serial pages (129145) to (129146).

 (a)  A public, private or parochial school shall report immunization data to the Department by October 15 of each year, using forms provided by the Department.

 (b)  The school administrator or the administrator’s designee shall forward the reports to the Immunization Program, Bureau of Communicable Diseases, Post Office Box 90, Harrisburg, Pennsylvania 17108.

 (c)  Duplicate reports shall be submitted to the county health department if the school is situated in a county with a full-time health department.

 (d)  Content of the reports shall include the following information:

   (1)  The identification of the school including the name of the school, the school district, the county, the intermediate unit and the type of school.

   (2)  The month, day and year of report.

   (3)  The number of students attending school by grade-level.

   (4)  The number of students attending school by grade-level who were completely immunized.

   (5)  The number of students attending school by grade-level who were classed as medical exemptions.

   (6)  The number of students attending school by grade-level who were classed as religious exemptions.

   (7)  The number of students provisionally admitted.

   (8)  The number of children who were denied admission because of their inability to qualify for provisional admission.

   (9)  Other information as required by the Department.

 (e)  For purposes of reporting the immunization status of a school’s students to the Department, the following grade-levels will be used: kindergarten, grades 1-6, 7-9, 10-12 and special education.

   The provisions of this §  23.86 amended through September 17, 1982, effective August 1, 1983, 12 Pa.B. 3288; amended January 23, 1987, effective January 24, 1987, 17 Pa.B. 375; amended August 22, 1997, effective August 23, 1997, 27 Pa.B. 4317. Immediately preceding text appears at serial pages (129146) and (116439).

 (a)  The Department will provide the certificates of immunization to schools.

 (b)  The Department will monitor school districts for compliance with this subchapter and shall have access to school immunization records whether the records are maintained as certificates or whether the records are contained in a school’s computer database.

 (c)  Questions concerning this subchapter should be addressed to the Immunization Program, Bureau of Communicable Diseases, Post Office Box 90, Harrisburg, Pennsylvania 17108, (717) 787-5681.

   The provisions of this §  23.87 amended through September 17, 1982, effective August 1, 1983, 12 Pa.B. 3288; amended August 22, 1997, effective August 23, 1997, 27 Pa.B. 4317. Immediately preceding text appears at serial page (116439).

   This section cited in 28 Pa. Code §  27.77 (relating to immunization requirements for children in child care group settings).