§ 27.77. Immunization requirements for children in child care group settings.

 (a)  Caregiver responsibilities.

   (1)  Except as exempted in subsection (d), effective March 27, 2002, the caregiver at a child care group setting may not accept or retain a child 2 months of age or older at the setting, for more than 60 days, unless the caregiver has received a written objection to a child being vaccinated on religious grounds from a parent or guardian, or one of the following:

     (i)   For all children not exempt under subsection (d)(1)(ii), an initial written verification from a physician, the Department or a local health department of the dates (month, day and year) the child was administered any vaccines recommended by ACIP. The verification must also specify any vaccination not given due to medical condition of the child and state whether the condition is temporary or permanent. The verification must show compliance with the vaccination requirements in subsection (b).

     (ii)   For all children for whom vaccinations remain outstanding following the caregiver’s receipt of the initial written verification, subsequent written verifications from a physician, the Department or a local health department as additional vaccinations become due. These verifications shall be prepared in the same manner as set forth in subparagraph (i), but need not repeat information contained in a previously submitted verification. The verifications must demonstrate continuing compliance with the vaccination requirements in subsection (b).

   (2)  If the caregiver receives a written verification under paragraph (1) explaining that timely vaccination did not occur due to a temporary medical condition, the caregiver shall exclude the child from the child care group setting after an additional 30 days unless the caregiver receives, within that 30-day period, written verification from a physician, the Department or a local health department that the child was vaccinated or that the temporary medical condition still exists. If the caregiver receives a written verification that vaccination has not occurred because the temporary condition persists, the caregiver shall require the presentation of a new verification at 30-day intervals. If a verification is not received as required, the caregiver shall exclude the child from the child care group setting and not readmit the child until the caregiver receives a verification that meets the requirements of this section.

   (3)  The caregiver shall retain the written verification or objection referenced in paragraphs (1) and (2) for 60 days following the termination of the child’s attendance.

   (4)  The caregiver shall ensure that a certificate of immunization is completed and signed for each child enrolled in the child care group setting. The certificates shall be updated by the caregiver to include the information provided to the caregiver under subsection (a) when that additional information is received. The immunization status of each enrolled child shall be summarized and reported on an annual basis to the Department at the time prescribed by the Department and on the form provided by the Department.

 (b)  Vaccination requirements. Each child enrolled in a child care group setting shall be immunized in accordance with ACIP standards in effect on January 1, 1999, governing the issuance of ACIP recommendations for the immunization of children.

   (1)  The standards are as follows:

     (i)   The immunization practice is supported by both published and unpublished scientific literature as a means to address the morbidity and mortality of the disease.

     (ii)   The labeling and packaging inserts for the immunizing agent are considered.

     (iii)   The immunizing agent is safe and effective.

     (iv)   The schedule for use of the immunizing agent is administratively feasible.

   (2)  The Department will deem an ACIP recommendation pertaining to the immunization of children to satisfy the standards in this subsection unless ACIP alters its standards for recommending immunizations for children by eliminating a standard set forth in this subsection and the recommendation is issued under those changed standards.

 (c)  Notice. The Department will place a notice in the Pennsylvania Bulletin listing publications containing ACIP recommendations issued under the standards in subsection (b). The Department published the initial notice at 32 Pa.B. 539 (January 26, 2002), contemporaneously with the adoption of amendments to this chapter. The Department will update that list in a notice which it will publish in the Pennsylvania Bulletin within 30 days after ACIP issues a recommendation which satisfies the criteria of this section.

 (d)  Exemptions.

   (1)  This section does not apply to the following:

     (i)   Children attending kindergarten, elementary school or higher school who are 5 years of age or older. These caregivers shall comply with § §  23.81—23.87 (relating to immunization).

     (ii)   A caregiver who does not serve as a caregiver for at least 40 hours during at least 1 month.

   (2)  The requirement imposed by subsection (a), to not accept a child into a child care group setting without receiving an initial written verification or objection specified in subsection (a), does not apply during a month the caregiver does not serve as a caregiver for at least 40 hours.

 (e)  Exclusion when disease is present. Whenever one of the diseases in §  27.76 (relating to exclusion and readmission of children, and staff having contact with children, in child care group settings) has been identified within a child care group setting, the Department or a local health department may order the exclusion from the child care group setting or any other child care group setting which is determined to be at high-risk of transmission of that disease, of an individual susceptible to that disease in accordance with public health standards as determined by the Department.


   The provisions of this §  27.77 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 §  27.77 adopted January 25, 2002, effective January 26, 2002, 32 Pa.B. 491; amended May 28, 2010, effective August 1, 2011, 40 Pa.B. 2747. Immediately preceding text appears at serial pages (287157) to (287158) and (334685).

Cross References

   This section cited in 22 Pa. Code §  405.49 (relating to immunizations); 28 Pa. Code §  23.83 (relating to immunization requirements); 55 Pa. Code §  3270.131 (relating to health information); 55 Pa. Code §  3280.131 (relating to health information); and 55 Pa. Code §  3290.131 (relating to health information).

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