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—

     (i)   The attendance at a grade, or special classes, kindergarten through 12th grade, including public, private, parochial, vocational, intermediate unit and home education students and students of cyber and charter schools.

     (ii)   The term does not cover the attendance of children at a childcare group setting, defined in §  27.1 (relating to definitions), located in a public, private, or vocational school, or in an intermediate unit.

   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 under section 1303 of the Public School Code of 1949 (24 P. S. §  13-1303); section 16(b) of the Disease Prevention and Control Law of 1955 (35 P. S. §  521.16(b)); and section 2102(g) of The Administrative Code of 1929 (71 P. S. §  532(g)).

   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; amended May 28, 2010, effective August 1, 2011, 40 Pa.B. 2747. Immediately preceding text appears at serial page (315784).

 (a)  Duties of a school director, superintendent, principal or other person in charge of a public, private, parochial or nonpublic school. Each school director, superintendent, principal, or other person in charge of a public, private, parochial or nonpublic school in this Commonwealth, including vocational schools, intermediate units, and special education and home education programs, cyber and charter schools, shall ascertain that a child has been immunized in accordance with the requirements in subsections (b), (c) and (e) prior to admission to school for the first time, under section 1303 of the Public School Code of 1949 (24 P. S. §  13-1303a) regarding immunization required; penalty.

 (b)  Required for attendance. The following immunizations are required as a condition of attendance at school in this Commonwealth:

   (1)  Diphtheria. Four or more properly-spaced doses of diphtheria toxoid, which may be administered as a single antigen vaccine or in a combination form. The fourth dose shall be administered on or after the 4th birthday.

   (2)  Tetanus. Four or more properly-spaced doses of tetanus toxoid, which may be administered as a single antigen vaccine or in a combination form. The fourth dose shall be administered on or after the 4th birthday.

   (3)  Poliomyelitis. Three or more properly spaced doses of either oral polio vaccine or enhanced activated polio vaccine, which may be administered as a single antigen vaccine, or in a combination form. 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, the first dose administered at 12 months of age or older, or a history of measles immunity proved by laboratory testing by a laboratory with the appropriate certification. Each dose of measles vaccine may be administered as a single antigen vaccine or in a combination form.

   (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 laboratory testing by a laboratory with the appropriate certification. Rubella vaccine may be administered as a single antigen vaccine or in a combination form.

   (6)  Mumps. Two properly-spaced doses 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 or in a combination form.

   (7)  Hepatitis B. Three properly-spaced doses of hepatitis B vaccine, unless a child receives a vaccine as approved by the Food and Drug Administration for a two-dose regimen, or a history of hepatitis B immunity proved by laboratory testing. Hepatitis B vaccine may be administered as single antigen vaccine or in a combination form.

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

     (i)   Varicella vaccine. Two properly-spaced doses of varicella vaccine, the first dose administered at 12 months of age or older. Varicella vaccine may be administered as a single antigen vaccine or in a combination form.

     (ii)   Evidence of immunity. Evidence of immunity may be shown by one of the following:

       (A)   Laboratory evidence of immunity or laboratory confirmation of disease.

       (B)   A written statement of a history of chickenpox disease from a parent, guardian or physician.

 (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 nonpublic school in this Commonwealth, including vocational schools, intermediate unit, special education and home education programs, and cyber and charter schools 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)  Tetanus and diphtheria toxoid and acellular pertussis vaccine (TdaP). One dose if at least 5 years have elapsed since the last dose of a vaccine containing tetanus and diphtheria as required in subsection (b). TdaP may be administered as a single antigen vaccine or in a combination form.

   (2)  Meningococcal Conjugate Vaccine (MCV). One dose of Meningococcal Conjugate Vaccine. MCV may be administered as a single antigen vaccine or in a combination form.

 (d)  Child care group setting. Attendance at a child care group setting located in a public, private or vocational school, or in an intermediate unit is conditional upon the child’s satisfaction of the immunization requirements in §  27.77 (relating to immunization requirements for children in child care group settings).

 (e)  Prekindergarten programs, Early Intervention programs’ early childhood special education classrooms and private academic preschools. Attendance at a prekindergarten program operated by a school district, an early intervention program operated by a contractor or subcontractor including intermediate units, school districts and private vendors, or at private academic preschools is conditional upon the child’s satisfaction of the immunization requirements in §  27.77.

 (f)  Grace period. A vaccine dose administered within the 4-day period prior to the minimum age for the vaccination or prior to the end of the minimum interval between doses shall be considered to be a valid dose of the vaccine for purposes of this chapter. A dose administered greater than 4 days prior to minimum age or interval for a dose is invalid for purposes of this regulation and shall be repeated.

   The provisions of this §  23.83 amended under section 1303 of the Public School Code of 1949 (24 P. S. §  13-1303); section 16(b) of the Disease Prevention and Control Law of 1955 (35 P. S. §  521.16(b)); and section 2102(g) of The Administrative Code of 1929 (71 P. S. §  532(g)).

   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; amended May 28, 2010, effective August 1, 2011, 40 Pa.B. 2747. Immediately preceding text appears at serial pages (315784) and (287119) to (287120).

 (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 under §  23.83 (relating to immunization requirements) or under 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 under §  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)  Provisional admittance to school.

   (1)  Multiple dose vaccine series. If a child has not received all the antigens for a multiple dose vaccine series 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 for multiple dose vaccine series 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.

   (2)  Single dose vaccines. If a child has not received a vaccine for which only a single dose is required, the child may be provisionally admitted to school if the parent or guardian’s plan for obtaining the required immunization is made a part of the child’s health record.

   (3)  Completion of required immunizations. The plan for completion of the required immunizations shall be reviewed every 60 days by the school administrator or the school 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 after that 8 month provisional period.

 (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 under section 1303 of the Public School Code of 1949 (24 P. S. §  13-1303); section 16(b) of the Disease Prevention and Control Law of 1955 (35 P. S. §  521.16(b)); and section 2102(g) of The Administrative Code of 1929 (71 P. S. §  532(g)).

   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; amended May 28, 2010, effective August 1, 2011, 40 Pa.B. 2747. Immediately preceding text appears at serial pages (287121) to (287122).

 (a)  A public, private, parochial or nonpublic school in this Commonwealth, including vocational schools, intermediate units, special education and home education programs and cyber and charter schools, 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 Department as indicated on the reporting form provided by the Department.

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

 (d)  The school administrator or the administrator’s designee shall ensure that the school’s identification information, including the name of the school, school district, county and school address, is correct, and shall make any necessary corrections, prior to submitting the report.

 (e)  Content of the reports must include the following information:

   (1)  The month, day and year of the report.

   (2)  The number of students attending school in each grade-level, or in an ungraded school in each age group, as indicated on the reporting form.

   (3)  The number of doses of each individual antigen given in each grade-level, or in an ungraded school, in each age group, as indicated on the reporting form.

   (4)  The number of students attending school who were classed as medical exemptions in each grade-level, or in an ungraded school, in each age group, as indicated on the reporting form.

   (5)  The number of students attending school who were classed as religious exemptions in each grade level, or in an ungraded school, in each age group, as indicated on the reporting form.

   (6)  The number of students provisionally admitted in each grade level or, in an ungraded school, in any age group as indicated on the reporting form.

   (7)  The number of students in each grade level who were denied admission because of the student’s inability to qualify for provisional admission or, in an ungraded school, in each age group as indicated on the reporting form.

   (8)  Other information as required by the Department.

   The provisions of this §  23.86 amended under section 1303 of the Public School Code of 1949 (24 P. S. §  13-1303); section 16(b) of the Disease Prevention and Control Law of 1955 (35 P. S. §  521.16(b)); and section 2102(g) of The Administrative Code of 1929 (71 P. S. §  532(g)).

   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; amended May 28, 2010, effective August 1, 2011, 40 Pa.B. 2747. Immediately preceding text appears at serial pages (287122) to (287123).

 (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, 625 Forester St., Room 1026, Harrisburg, Pennsylvania 17120, (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 22 Pa. Code §  405.49 (relating to immunizations); and 28 Pa. Code §  27.77 (relating to immunization requirements for children in child care group settings).