Department of Public Health | 10-204a-1 to 10-204a-4 - School Immunizations Requirements

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Regulations of Connecticut State Agencies TITLE 10. Education and Culture

Agency Department of Public Health

Subject School Immunizations Requirements

Inclusive Sections §§ 10-204a-1—10-204a-4

CONTENTS

Sec. 10-204a-1. Definitions Sec. 10-204a-2. Repealed Sec. 10-204a-2a. Adequate immunization Sec. 10-204a-3. Repealed Sec. 10-204a-3a. Immunization in progress Sec. 10-204a-4. Procedures for reporting immunization data

Revised: 2015-3-6 R.C.S.A. §§ 10-204a-1—10-204a-4 - I -

Regulations of Connecticut State Agencies TITLE 10. Education and Culture

Department of Public Health §10-204a-2a

School Immunizations Requirements Immunization of School Children Against Measles, Mumps, Rubella, Poliomyelitis, Diphtheria, Tetanus, Pertussis, Hemophilus influenzae Type B (HIB), Hepatitis B,

and Varicella

Sec. 10-204a-1. Definitions As used in sections 10-204a-2 through 10-204a-4 of the Regulations of Connecticut State

Agencies: (a) “Commissioner” means the Commissioner of Public Health. (b) “Department” means the Department of Public Health. (c) “Local health authority” means and includes the town, city, borough and local district

director of health, local superintendent and Commissioner of Public Health and any officer or person having the usual powers and duties of a local director of health. (Effective September 25, 1996; Amended February 25, 2000; Amended January 3, 2011)

Sec. 10-204a-2. Repealed Repealed July 26, 1993.

Sec. 10-204a-2a. Adequate immunization (a) Measles. An individual shall be considered adequately protected against measles if

that individual: (1) is enrolled in preschool and was immunized by use of one (1) dose of live attenuated

measles vaccine on or after that individual’s first birthday; or (2) on or after August 1, 2011, is enrolled in kindergarten through grade 12 and was

immunized against measles by use of two (2) doses of a live attenuated measles vaccine given at least twenty-eight (28) days apart, the first on or after that individual’s first birthday; or

(3) has had protection against measles confirmed in writing by a physician, physician assistant or advanced practice registered nurse based on specific blood testing by a certified laboratory.

(b) Rubella. An individual shall be considered adequately protected against rubella, if that individual:

(1) is enrolled in preschool and was immunized by use of one (1) dose of live attenuated rubella vaccine on or after that individual’s first birthday; or

(2) on or after August 1, 2011, is enrolled in kindergarten through grade 12 and was immunized against rubella by use of two (2) doses of a live attenuated rubella vaccine given at least twenty-eight (28) days apart, the first on or after that individual’s first birthday; or

(3) has had protection against rubella confirmed in writing by a physician, physician assistant or advanced practice registered nurse based on specific blood testing by a certified laboratory.

(c) Poliomyelitis

Revised: 2015-3-6 R.C.S.A. §§ 10-204a-1—10-204a-4 - 1 -

Regulations of Connecticut State Agencies TITLE 10. Education and Culture

§10-204a-2a Department of Public Health

(1) An individual eighteen (18) months of age or older shall be considered adequately protected against poliomyelitis if that individual has had a minimum of (3) doses of either trivalent oral polio vaccine (TOPV) or inactivated polio vaccine (IPV), two (2) doses of polio vaccine given at least four (4) weeks apart and a third dose given at least two (2) months after the previous dose.

(2) For individuals enrolled in grades kindergarten through twelve (12) and at least forty- eight (48) months of age, at least one (1) dose of polio vaccine must been given on or after the fourth birthday.

(d) Diphtheria, Tetanus, Pertussis (1) An individual eighteen to eighty-three (18-83) months of age shall be considered

adequately protected against diphtheria, tetanus and pertussis if such individual was immunized with a minimum of four (4) doses of diphtheria, tetanus, and pertussis containing vaccine, three (3) doses given at a minimum of four (4) week intervals followed by a fourth dose at least six (6) months after the third.

(2) For individuals enrolled in grades kindergarten and above, at least one (1) dose of diphtheria, tetanus and pertussis containing vaccine must have been given on or after the fourth birthday.

(3) An individual eighty-four (84) months of age or older shall be considered adequately protected if such individual was immunized with a minimum of two (2) doses of tetanus, diphtheria toxoid at a minimum of four (4) week intervals, followed by a third dose of tetanus, diphtheria toxoid at least six (6) months after the second dose.

(4) On or after August 1, 2011, an individual eleven (11) years of age or older enrolled in the seventh grade shall show proof of one (1) dose of diphtheria, tetanus and pertussis containing vaccine in addition to completion of the recommended primary diphtheria, tetanus and pertussis containing vaccination series unless such individual has a medical exemption for this dose confirmed in writing by a physician, physician assistant or advanced practice registered nurse based on having last received diphtheria, tetanus and pertussis containing vaccine less than five (5) years earlier and no increased risk of pertussis according to the most recent standards of care for immunizations in Connecticut as prescribed in section 19a-7f of the Connecticut General Statutes.

(e) Mumps. An individual shall be considered adequately protected against mumps if such individual:

(1) is enrolled in preschool and was immunized by use of one (1) dose of live attenuated mumps vaccine on or after that individual’s first birthday; or

(2) on or after August 1, 2011, is enrolled in kindergarten through grade 12 and was immunized against mumps by use of two (2) doses of a live attenuated mumps vaccine given at least twenty-eight (28) days apart, the first on or after that individual’s first birthday; or

(3) has had protection against rubella confirmed in writing by a physician, physician assistant or advanced practice registered nurse based on specific blood testing by a certified laboratory.

R.C.S.A. §§ 10-204a-1—10-204a-4 Revised: 2015-3-6 - 2 -

Regulations of Connecticut State Agencies TITLE 10. Education and Culture

Department of Public Health §10-204a-2a

(f) Hemophilus influenzae Type b (Hib). An individual shall be considered adequately protected against Hib invasive disease if such individual:

(1) was immunized before age five (5) years with a single dose of Hib vaccine given at age twelve (12) months or older, or

(2) is currently age five (5) years or older, or (3) had a natural laboratory confirmed infection with hemophilus influenzae type b at

age twenty-four (24) months or older confirmed in writing by a physician, physician assistant or advanced practice registered nurse.

(g) Hepatitis B. An individual shall be considered adequately protected against hepatitis B if such individual:

(1) is enrolled in preschool through grade 12 and was immunized with three (3) doses of hepatitis B vaccine as follows: two (2) doses given at least four (4) weeks apart followed by a third dose at least sixteen (16) weeks after the first dose and at least eight (8) weeks after the second dose, and the third dose shall be given no earlier than twenty-four (24) weeks of age; or

(2) has had protection against hepatitis B confirmed in writing by a physician, physician assistant or advanced practice registered nurse based on specific blood testing by a certified laboratory.

(h) Varicella. An individual shall be considered adequately protected against varicella if that individual:

(1) is enrolled in preschool and was immunized with one (1) dose of live attenuated varicella vaccine on or after that individual’s first birthday; or

(2) on or before July 31, 2011, is enrolled in kindegarten through grade 12 and was immunized with one (1) dose of live attenuated varicella vaccine on or after that individual’s first birthday; or

(3) on or after August 1, 2011, is enrolled in kindergarten and was immunized against varicella by use of two (2) doses of live attenuated varicella vaccine given at least three (3) months apart, the first dose on or after that individual’s first birthday; or

(4) on or after August 1, 2011, is enrolled in seventh (7th) grade and was immunized with two doses of live attenuated varicella vaccine given at least three (3) months apart, the first dose on or after that individual’s first birthday and before that individual’s thirteenth birthday or two (2) doses of live attenuated varicella vaccine given at least twenty eight (28) days apart if the first dose was given on or after the individual’s thirteenth birthday; or

(5) on or after August 1, 2011, is enrolled in preschool or kindergarten and has a written statement signed and dated by a physician, physician assistant or advanced practice registered nurse indicating that the individual has already had varicella based on diagnosis of varicella or verification of history of varicella according to the most recent standards of care for immunizations in Connecticut as prescribed in section 19a-7f of the Connecticut General Statutes; or

(6) has had protection against varicella confirmed in writing by a physician, physician assistant or advanced practice registered nurse based on specific blood testing by a certified

Revised: 2015-3-6 R.C.S.A. §§ 10-204a-1—10-204a-4 - 3 -

Regulations of Connecticut State Agencies TITLE 10. Education and Culture

§10-204a-2a Department of Public Health

laboratory; or (7) has a written statement signed and dated by a physician, physician assistant or

advanced practice registered nurse indicating that the individual has a history of herpes zoster; or

(8) is enrolled in seventh grade on or after August 1, 2011 and has a written statement signed and dated by a physician, physician assistant or advanced practice registered nurse indicating that the individual has already had varicella based on family or medical history.

(i) Hepatitis A. An individual shall be considered adequately protected against hepatitis A if that individual:

(1) was born on or after January 1, 2007, is enrolled in preschool or kindergarten on or after August 1, 2011, and was immunized with at least two (2) doses of hepatitis A virus vaccine given at least six (6) months apart, the first dose given on or after that individual’s first birthday; or

(2) has had protection against hepatitis A confirmed in writing by a physician, physician assistant or advanced practice registered nurse based on specific blood testing by a certified laboratory.

(j) Pneumococcal disease. An individual shall be considered adequately protected against pneumococcal disease if that individual:

(1) was born on or after January 1, 2007, is enrolled in preschool or kindergarten on or after August 1, 2011 and was immunized with one dose of pneumococcal conjugate vaccine on or after the individual’s first birthday; or

(2) is currently age five (5) years or older. (k) Influenza (Flu). On or after August 1, 2011, an individual enrolled in preschool shall

be considered adequately protected against flu if that individual is not less than twenty-four (24) months and not more than fifty-nine (59) months of age and annually has received one (1) dose of flu vaccine between August 1st and December 31st, except that individuals receiving flu vaccine for the first time must be given a second dose at least twenty-eight (28) days after the first dose.

(l) Meningococcal disease. An individual shall be considered adequately protected against meningococcal disease if that individual is enrolled in seventh (7th) grade on or after August 1, 2011 and was immunized with at least one dose of meningococcal vaccine.

(m) Religious exemption. Any individual whose parents or guardian presents a statement that such immunization is contrary to the religious beliefs of such child is exempted from immunization requirements.

(n) Medical exemption. Any individual whose parents or guardian presents a statement from a physician licensed to practice medicine in the United States that such immunization is medically contraindicated in accordance with the current recommendation of the National Centers for Disease Control and Prevention Advisory Committee on Immunization Practices shall be exempted from immunization requirements. (Effective September 25, 1996; Amended February 25, 2000; Amended October 3, 2005; Amended January 3, 2011)

R.C.S.A. §§ 10-204a-1—10-204a-4 Revised: 2015-3-6 - 4 -

Regulations of Connecticut State Agencies TITLE 10. Education and Culture

Department of Public Health §10-204a-4

Sec. 10-204a-3. Repealed Repealed July 26, 1993.

Sec. 10-204a-3a. Immunization in progress (a) In those instances at school entry where a school-aged child is not adequately

immunized school attendance shall be permitted only if that child: (1) has received a dose of each required vaccine for which that child is behind in the

month prior to first attendance; and (2) continues on the catch-up schedule recommended in the most recent standards of

care for immunizations in Connecticut as prescribed in accordance with the provisions of section 19a-7f of the Connecticut General Statutes until adequately immunized.

(b) Any individual who fails to comply with the immunization schedule provided in subsection (a) of this section shall present a written statement from a physician or local health authority stating that such individual has been rescheduled to a new date. Such statement shall specify the medical reason for rescheduling.

(c) An individual without a statement from a physician or local health authority explaining his or her failure to comply with an immunization schedule as provided by subsections (a) and (b) of this section shall be excluded from school pending compliance with subsection (a) or (b) of this section.

(d) An individual for whom a medical contraindication has been determined shall not be further reviewed if such individual’s physical condition renders the exemption permanent.

(e) An individual for whom a medical contraindication has been determined to be of a temporary nature shall be reviewed by a physician, physician assistant, certified nurse practitioner or local health authority at least annually in order to determine that the contraindication continues to exist. In the event that the contraindication is no longer valid the individual must be placed in compliance with subsection (a) or (b) of this section or excluded from school until compliance is established. (Effective September 25, 1996; Amended February 25, 2000; Amended January 3, 2011)

Sec. 10-204a-4. Procedures for reporting immunization data (a) Immunization data specific to the individual shall be recorded on a student’s health

assessment record according to Connecticut General Statutes, Section 10-206 (d). (b) Annually, the department shall prepare and distribute to all public and nonpublic

schools a school immunization survey summary form. Schools shall complete the survey form and return the completed form to the department at a place and time determined by the department.

(c) All immunization information collected by the department shall be confidential. (Effective July 26, 1993)

Revised: 2015-3-6 R.C.S.A. §§ 10-204a-1—10-204a-4 - 5 -