Subchapter C. IMMUNIZATION


Sec.


23.81.    Purpose and scope.
23.82.    Definitions.
23.83.    Immunization requirements.
23.84.    Exemption from immunization.
23.85.    Responsibilities of schools and school administrators.
23.86.    School reporting.
23.87.    Responsibilities of the Department.

Authority

   The provisions of this Subchapter C issued under the Disease Prevention and Control Law of 1955 (35 P. S. § §  521.1—521.21); the act of April 11, 1974 (P. L. 257, No. 66) (71 P. S. §  541(c.1)); and section 1303a of the Public School Code of 1949 (24 P. S. §  13-1303a); amended under section 1303a of the Public School Code of 1949 (24 P. S. §  13-1303a); section 16(a)(6) and (7) of the Disease Prevention and Control Law of 1955 (35 P. S. §  521.16(a)(6) and (7)); section 2111(c.1) of The Administrative Code of 1929 (71 P. S. §  541(c.1)); and Hepatitis B Prevention Act (35 P. S. § §  630.1—630.3), unless otherwise noted.

Source

   The provisions of this Subchapter C adopted August 2, 1974, effective August 3, 1974, 4 Pa.B. 1626, unless otherwise noted.

Cross References

   This subchapter cited in 22 Pa. Code §  11.20 (relating to nonimmunized children); and 22 Pa. Code §  51.13 (relating to immunization).

§ 23.81. Purpose and scope.

 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.

Source

   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).

Cross References

   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).

§ 23.82. Definitions.

 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 full immunization. The school maintains the certificate as the official school immunization record or stores the details of the record in a computer database.

   Department—The Department of Health of the Commonwealth.

   Full immunization—The completion of the requisite number of dosages of the specific antigens at recommended time and age intervals as set forth in §  23.83 (relating to immunization requirements).

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

   Medical certificate—The official form furnished by the Department setting out the immunization plan for a student who is not fully immunized, filled out and signed by a physician, certified registered nurse practitioner or physician assistant, or by a public health official when the immunization is provided by the Department or a local health department, and given to a school as proof that the student is scheduled to complete the required immunizations.

   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.

Authority

   The provisions of this §  23.82 amended under section 1303 of the Public School Code of 1949 (24 P.S. §  13-1303); section 16(a)(6) and (b) of the Disease Prevention and Control Law of 1955 (35 P.S. §  521.16(a)(6) and (b)); and sections 2102(g) and 2111 of The Administrative Code of 1929 (71 P.S. § §  532(g) and 541).

Source

   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; amended March 3, 2017, effective August 1, 2017, 47 Pa.B. 1300. Immediately preceding text appears at serial pages (386396) and (349627).

Cross References

   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).

§ 23.83. Immunization requirements.

 (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. All of the following immunizations are required as a condition of attendance at school in this Commonwealth:

   (1)  Diphtheria, tetanus and pertussis. Four or more properly-spaced doses administered in a combination form (diphtheria and tetanus toxoids and acellular pertussis (DTaP) or diphtheria and tetanus toxoids and pertussis (DTP)). If a child has a contraindication to pertussis vaccine, the child shall receive diphtheria—tetanus toxoid vaccine (DT) to complete the vaccination series. The fourth dose shall be administered on or after the 4th birthday.

   (2)  Poliomyelitis. Four properly-spaced doses of either oral polio vaccine or inactivated polio vaccine, 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 and at least 6 months after the previous dose.

   (3)  Measles (rubeola), mumps and rubella (German measles). One of the following:

     (i)   Multiple antigens. Two properly-spaced doses of live attenuated measles, mumps, rubella combination vaccine, the first dose administered at 12 months of age or older.

     (ii)   Single antigens. In the event the antigens were given separately, and not in a combination vaccine, the dosage is as follows:

       (A)   Two properly-spaced doses of live attenuated measles vaccine, the first dose administered at 12 months of age or older.

       (B)   One dose of live attenuated rubella vaccine, administered at 12 months of age or older.

       (C)   Two properly-spaced doses of live attenuated mumps vaccine, administered at 12 months of age or older.

     (iii)   Evidence of immunity. Evidence of immunity may be shown by a history of measles and rubella immunity proved by laboratory testing by a laboratory with the appropriate certification and a written statement of a history of mumps disease from a physician, certified registered nurse practitioner or physician assistant.

   (4)  Hepatitis B. Three properly-spaced doses of hepatitis B vaccine, unless a child receives a vaccine as approved by the United States 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.

   (5)  Varicella (chickenpox). 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, physician, certified registered nurse practitioner or physician assistant.

 (c)  Special requirements for tetanus and diphtheria toxoids and acellular pertussis vaccine and meningococcal conjugate vaccine (MCV).

   (1)  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 units, 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:

     (i)   Tetanus and diphtheria toxoids and acellular pertussis vaccine (Tdap). One dose of Tdap in a combination form.

     (ii)   Meningococcal conjugate vaccine (MCV). One dose of MCV.

     (iii)   Exclusion. A child who does not have an exemption as permitted by §  23.84 (relating to exemption from immunization) and who does not receive the immunizations as required in subparagraphs (i) and (ii) may be excluded in that school year and each succeeding school year that the child fails to obtain the required immunization.

   (2)  Required for entry into 12th grade. In addition to the immunizations listed in subsection (b) and this subsection, one dose of MCV is required for entry into 12th grade at any 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, or, in an ungraded class, for students in the school year that the student is 18 years of age, if the child has not received a previous dose on or after the child’s 16th birthday. A dose of MCV received at 16 years of age or older shall count as the 12th grade dose.

 (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 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.

Authority

   The provisions of this §  23.83 amended under section 1303 of the Public School Code of 1949 (24 P.S. §  13-1303); section 16(a)(6) and (b) of the Disease Prevention and Control Law of 1955 (35 P.S. §  521.16(a)(6) and (b)); and sections 2102(g) and 2111 of The Administrative Code of 1929 (71 P.S. § §  532(g) and 541).

Source

   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; amended March 3, 2017, effective August 1, 2017, 47 Pa.B. 1300. Immediately preceding text appears at serial pages (349627) to (349629).

Cross References

   This section cited in 22 Pa. Code §  405.49 (relating to immunizations); 28 Pa. Code §  23.82 (relating to definitions); 28 Pa. Code §  23.85 (relating to responsibilities of schools and school administrators); and 28 Pa. Code §  27.77 (relating to immunization requirements for children in child care group settings).

§ 23.84. Exemption from immunization.

 (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.

Source

   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).

Cross References

   This section cited in 22 Pa. Code §  51.13 (relating to immunization); 22 Pa. Code §  405.49 (relating to immunizations); 28 Pa. code §  23.83 (relating to immunization requirements); 28 Pa. Code §  23.85 (relating to responsibilities of schools and school administrators); and 28 Pa. Code §  27.77 (relating to immunization requirements for children in child care group settings).

§ 23.85. Responsibilities of schools and school administrators.

 (a)  Inform of requirements and ascertain immunization status. The administrator in charge of a school shall appoint a knowledgeable person to perform all of 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 school official’s designee, or the details of the record shall be stored in a computer database.

 (b)  Admission to school or continued attendance. 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 from 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)  Inform of specific immunization requirements. 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)  Requirements under which admission or continued attendance is permitted. 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 of the antigens for a multiple dose vaccine series described in §  23.83 on the child’s first day of attendance for that school year, the school administrator or the school administrator’s designee may not provisionally admit the child to school unless the child has at least one dose of each multiple dose vaccine series required under §  23.83, and one of the following occurs:

     (i)   The child receives the final dose of each multiple dose vaccine series required under §  23.83 within 5 school days of the child’s first day of attendance, and the child’s parent or guardian provides a certificate of immunization on or before the 5th school day.

     (ii)   If the child needs additional doses of a multiple dose vaccine series to meet the requirements of §  23.83, the child receives the next scheduled dose during the 5 school days referenced in subparagraph (i), and the child’s parent or guardian provides a medical certificate on or before the 5th school day scheduling the additional required doses.

     (iii)   If the child needs additional doses of a multiple dose vaccine series to meet the requirements of §  23.83, but the next dose is not medically appropriate during the 5 school days referenced in subparagraph (i), the child’s parent or guardian provides a medical certificate on or before the 5th school day scheduling the additional required doses.

   (2)  Single dose vaccines. If a child has not received a vaccine for which only a single dose is required on the child’s first day of attendance for that school year, the child may not be admitted to school.

   (3)  Completion of required immunizations. The medical certificate shall be reviewed at least every 30 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 in accordance with the requirements of the medical certificate. If, upon review, the requirements of the medical certificate are not met, the school administrator or the school administrator’s designee may exclude the child from school.

   (4)  Medical certificate. A school shall maintain the medical certificate until the official school immunization record is completed.

 (f)  Certificate of immunization. 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.

 (g)  Applicability. This section does not apply to a child if one of the following occurs:

   (1)  The child has not been immunized or is unable to provide immunization records due to being homeless. A school shall comply with Federal laws pertaining to the educational rights of homeless children, including the McKinney-Vento Homeless Education Assistance Improvements Act of 2001 (42 U.S.C.A. § §  11431—11435).

   (2)  The child, when moving or transferring into a school in this Commonwealth, is unable to provide immunization records immediately upon enrollment into the school. The child’s parent or guardian shall have 30 days to provide immunization records to the school to show proof of immunization as set forth in §  23.83, a medical certificate as set forth in subsection (e) or to satisfy the requirements for an exemption as set forth in §  23.84. A child who is unable to provide the necessary records, medical certificate or exemption may be excluded at the end of the 30-day period and in subsequent school years until the requirements of this subchapter are met.

   (3)  The child has not been immunized or is unable to provide immunization records on the first day of attendance for the school year due to being in foster care. A school shall comply with Federal laws pertaining to the educational rights of children in foster care, including the Fostering Connections to Success and Increasing Adoptions Act of 2008 (42 U.S.C.A. § §  670—679c). The child’s foster parent shall have 30 days to provide immunization records to the school to show proof of immunization as set forth in §  23.83, a medical certificate as set forth in subsection (e) or to satisfy the requirements for an exemption as set forth in §  23.84. A child who is unable to provide the necessary records, medical certificate or exemption may be excluded at the end of the 30-day period and in subsequent school years until the requirements of this subchapter are met.

   (4)  The child obtains an exemption under §  23.84.

 (h)  Temporary waiver. The Secretary may issue a temporary waiver of the immunization requirements in §  23.83. The details of the temporary waiver will be set out in a notice published in the Pennsylvania Bulletin. A temporary waiver may be issued under either of the following circumstances:

   (1)  The Centers for Disease Control and Prevention, United States Department of Health and Human Services, recognizes a Nationwide shortage of supply for a particular vaccine.

   (2)  In the event of a disaster impacting the ability of children transferring into a school to provide immunization records.

Authority

   The provisions of this §  23.85 amended under section 1303 of the Public School Code of 1949 (24 P. S. §  13-1303); section 16(a)(6) and (b) of the Disease Prevention and Control Law of 1955 (35 P.S. §  521.16(a)(6) and (b)); and sections 2102(g) and 2111 of The Administrative Code of 1929 (71 P.S. § §  532(g) and 541).

Source

   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; amended March 3, 2017, effective August 1, 2017, 47 Pa.B. 1300. Immediately preceding text appears at serial pages (349629) to (349631).

Cross References

   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).

§ 23.86. School reporting.

 (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 electronically by December 31 of each year using a format and system provided by the Department.

 (b)  In the event a public, private, parochial or nonpublic school is unable to complete its report electronically, it shall report to the Department by December 15 of each year using a form provided by the Department.

 (c)  The school administrator or the school administrator’s designee shall forward the reports to the Department as indicated on the reporting form provided by the Department.

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

 (e)  The school administrator or the school 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.

 (f)  Content of the reports must include all of 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 kindergarten, 7th grade or in an ungraded school, 12 years of age only, who were denied admission because of the student’s inability to provide documentation of the required vaccine doses.

   (8)  Other information as required by the Department.

Authority

   The provisions of this §  23.86 amended under section 1303 of the Public School Code of 1949 (24 P.S. §  13-1303); section 16(a)(6) and (b) of the Disease Prevention and Control Law of 1955 (35 P.S. §  521.16(a)(6) and (b)); and sections 2102(g) and 2111 of The Administrative Code of 1929 (71 P.S. § §  532(g) and 541).

Source

   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; amended March 3, 2017, effective August 1, 2017, 47 Pa.B. 1300. Immediately preceding text appears at serial pages (349631) to (349632).

Cross References

   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).

§ 23.87. Responsibilities of the Department.

 (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.

Source

   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).

Cross References

   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).



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