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TITLE 22.1 EDUCATION
CHAPTER 14. PUPILS
VCA § 22.1-271.1 (2007)
§ 22.1-271.1. Definitions.
For the purpose of § 22.1-271.2:
"Admit" or "admission"
means the official enrollment or reenrollment for attendance at
any grade level, whether full-time or part-time, of any student
by any school.
"Admitting official" means the school
principal or his designated representative if a public school;
if a nonpublic school or child-care center, the principal, headmaster
or director of the school or center.
"Documentary proof" means written
certification that a student has been immunized, such certificate
to be on a form provided by the State Department of Health and
signed by the licensed immunizing physician or an employee of
the immunizing local health department.
"Student" means any person who seeks
admission to a school, or for whom admission to a school is sought
by a parent or guardian, and who will not have attained the age
of 20 years by the start of the school term for which admission
is sought.
"Immunized" or "immunization"
means initial immunization and any boosters or reimmunizations
required by § 32.1-46.
"School" means
(i) any public school from kindergarten through
grade 12 operated under the authority of any locality within
the Commonwealth,
(ii) any private or religious school that offers instruction
at any level or grade from kindergarten through grade twelve,
and
(iii) any private or religious nursery school or preschool,
or any private or religious child-care center required to be
licensed by the Commonwealth.
VCA § 22.1-271.2 (2007)
§ 22.1-271.2. Immunization requirements
A. No student shall be admitted by a school unless
at the time of admission the student or his parent or guardian submits
documentary proof of immunization to the admitting official of the
school or unless the student is exempted from immunization pursuant
to subsection C or is a homeless child or youth as defined in subdivision
6 of § 22.1-3. If a student does not have documentary proof
of immunization, the school shall notify the student or his parent
or guardian
(i) that it has no documentary proof of immunization
for the student;
(ii) that it may not admit the student without proof unless the
student is exempted pursuant to subsection C including any homeless
child or youth as defined in subdivision 6 of § 22.1-3;
(iii) that the student may be immunized and receive certification
by a licensed physician, registered nurse or an employee of a
local health department; and (iv) how to contact the local health
department to learn where and when it performs these services.
Neither this Commonwealth nor any school or admitting official
shall be liable in damages to any person for complying with this
section.
Any physician, registered nurse or local health
department employee performing immunizations shall provide to any
person who has been immunized or to his parent or guardian, upon
request, documentary proof of immunizations conforming with the
requirements of this section.
B. Any student whose immunizations are incomplete
may be admitted conditionally if that student provides documentary
proof at the time of enrollment of having received at least one
dose of the required immunizations accompanied by a schedule for
completion of the required doses within ninety days.
The immunization record of each student admitted
conditionally shall be reviewed periodically until the required
immunizations have been received.
Any student admitted conditionally and who fails
to comply with his schedule for completion of the required immunizations
shall be excluded from school until his immunizations are resumed.
C. No certificate of immunization shall be required
for the admission to school of any student if
(i) the student or his parent or guardian submits
an affidavit to the admitting official stating that the administration
of immunizing agents conflicts with the student's religious tenets
or practices; or
(ii) the school has written certification from a licensed physician
or a local health department that one or more of the required
immunizations may be detrimental to the student's health, indicating
the specific nature and probable duration of the medical condition
or circumstance that contraindicates immunization.
However, if a student is a homeless child or
youth as defined in subdivision 6" of § 22.1-3 and
(a) does not have documentary proof of necessary
immunizations or has incomplete immunizations and
(b) is not exempted from immunization pursuant to clauses (i)
or (ii) of this subsection, the school division shall immediately
admit such student and shall immediately refer the student to
the local school division liaison, as described in the federal
McKinney-Vento Homeless Education Assistance Improvements Act
of 2001, as amended (42 U.S.C. § 11431 et seq.) (the Act),
who shall assist in obtaining the documentary proof of, or completing,
immunization and other services required by such Act.
D. The admitting official of a school shall exclude
from the school any student for whom he does not have documentary
proof of immunization or notice of exemption pursuant to subsection
C, including notice that such student is a homeless child or youth
as
defined in subdivision 6 of § 22.1-3.
E. Every school shall record each student's immunizations
on the school immunization record. The school immunization record
shall be a standardized form provided by the State Department of
Health, which shall be a part of the mandatory permanent student
record. Such record shall be open to inspection by officials of
the State Department of Health and the local health departments.
The school immunization record shall be transferred
by the school whenever the school transfers any student's permanent
academic or scholastic records.
Within thirty calendar days after the beginning
of each school year or entrance of a student, each admitting official
shall file a report with the local health department. The report
shall be filed on forms prepared by the State Department of Health
and shall state the number of students admitted to school with documentary
proof of immunization, the number of students who have been admitted
with a medical or religious exemption and the number of students
who have been conditionally admitted, including those students who
are homeless children or youths as defined in subdivision 6 of §
22.1-3.
F. The requirement for Haemophilus Influenzae
Type b immunization as provided in § 32.1-46 shall not apply
to any child admitted to any grade level, kindergarten through grade
twelve.
G. The Board of Health shall promulgate rules
and regulations for the implementation of this section in congruence
with rules and regulations of the Board of Health promulgated under
§ 32.1-46 and in cooperation with the Board of Education.
HISTORY: 1982, c. 510; 1983, c. 433; 1988, c.
216; 1989, c. 382; 2000, c. 476.
VCA § 22.1-271.4 (2007)
§ 22.1-271.4. Health requirements for
home-instructed, exempted, and excused children.
In addition to compliance with the requirements
of subsection B, C, or H of § 22.1-254 or § 22.1-254.1,
any parent, guardian or other person having control or charge of
a child being home instructed, exempted or excused from school attendance
shall comply with the immunization requirements provided in §
32.1-46 in the same manner and to the same extent as if the child
has been enrolled in and is attending school.
Upon request by the division superintendent,
the parent shall submit to such division superintendent documentary
proof of immunization in compliance with § 32.1-46.
No proof of immunization shall be required of
any child upon submission of
(i) an affidavit to the division superintendent
stating that the administration of immunizing agents conflicts
with the parent's or guardian's religious tenets or practices
or
(ii) a written certification from a licensed physician that one
or more of the required immunizations may be detrimental to the
child's health, indicating the specific nature of the medical
condition or circumstance that contraindicates immunization.
TITLE 32.1. HEALTH
CHAPTER 2. DISEASE PREVENTION AND CONTROL
ARTICLE 3. DISEASE CONTROL MEASURES
VCA § 32.1-46 (2007)
§ 32.1-46. Immunization of patients
against certain diseases.
A. The parent, guardian or person standing in
loco parentis of each child within this Commonwealth shall cause
such child to be immunized in accordance with the Immunization Schedule
developed and published by the Centers for Disease Control and Prevention
(CDC), Advisory Committee on Immunization Practices (ACIP), the
American Academy of Pediatrics (AAP), and the American Academy of
Family Physicians (AAFP). The required immunizations for attendance
at a public or private elementary, middle or secondary school, child
care center, nursery school, family day care home or developmental
center shall be those set forth in the State Board of Health Regulations
for the Immunization of School Children. The Board's regulations
shall at a minimum require:
1. A minimum of three properly spaced
doses of hepatitis B vaccine (HepB).
2. A minimum of three or more properly spaced doses of diphtheria
toxoid. One dose shall be administered on or after the fourth
birthday. A booster dose shall be administered prior to entering
the sixth grade if at least five years have passed since the last
dose of diphtheria toxoid.
3. A minimum of three or more properly spaced doses of tetanus
toxoid. One dose shall be administered on or after the fourth
birthday. A booster dose of Tdap vaccine shall be administered
prior to entering the sixth grade if at least five years have
passed since the last dose of tetanus toxoid.
4. A minimum of three or more properly spaced doses of acellular
pertussis vaccine. One dose shall be administered on or after
the fourth birthday. A booster dose shall be administered prior
to entry into the sixth grade if at least five years have passed
since the last dose of pertussis vaccine.
5. Two or three primary doses of Haemophilus influenzae type b
(Hib) vaccine, depending on the manufacturer, for children up
to 60 months of age.
6. Two properly spaced doses of live attenuated measles (rubeola)
vaccine. The first dose shall be administered at age 12 months
or older.
7. One dose of live attenuated rubella vaccine shall be administered
at age 12 months or older.
8. One dose of live attenuated mumps vaccine shall be administered
at age 12 months or older.
9. All susceptible children born on and after January 1, 1997,
shall be required to have one dose of varicella vaccine on or
after 12 months.
10. Three or more properly spaced doses of oral polio vaccine
(OPV) or inactivated polio vaccine (IPV). One dose shall be administered
on or after the fourth birthday. A fourth dose shall be required
if the three dose primary series consisted of a combination of
OPV and IPV.
11. Two to four doses, dependent on age at first dose, of properly
spaced pneumococcal 7-valent conjugate (PVC) vaccine for children
less than two years of age.
12. (Effective October 1, 2008) Three doses of properly spaced
human papillomavirus (HPV) vaccine for females. The first dose
shall be administered before the child enters the sixth grade.
The parent, guardian or person standing in loco
parentis may have such child immunized by a physician or registered
nurse or may present the child to the appropriate local health department,
which shall administer the vaccines required by the State Board
of Health Regulations for the Immunization of School Children without
charge.
B. A physician, registered nurse or local health
department administering a vaccine required by this section shall
provide to the person who presents the child for immunizations a
certificate which shall state the diseases for which the child has
been immunized, the numbers of doses given, the dates when administered
and any further immunizations indicated.
C. The vaccines required by this section shall
meet the standards prescribed in, and be administered in accordance
with, regulations of the Board.
D. The provisions of this section shall not apply
if:
1. The parent or guardian of the child objects
thereto on the grounds that the administration of immunizing agents
conflicts with his religious tenets or practices, unless an emergency
or epidemic of disease has been declared by the Board, or
2. The parent or guardian presents a statement from a physician
licensed to practice medicine in Virginia, or a licensed nurse
practitioner, which states that the physical condition of the
child is such that the administration of one or more of the required
immunizing agents would be detrimental to the health of the child;
or
3. (Effective October 1, 2008) Because the human papillomavirus
is not communicable in a school setting, a parent or guardian,
at the parent's or guardian's sole discretion, may elect for the
parent's or guardian's child not to receive the human papillomavirus
vaccine, after having reviewed materials describing the link between
the human papillomavirus and cervical cancer approved for such
use by the Board.
E. For the purpose of protecting the public
health by ensuring that each child receives age-appropriate immunizations,
any physician, physician assistant, nurse practitioner, licensed
institutional health care provider, local or district health department,
the Virginia Immunization Information System, and the Department
of Health may share immunization and patient locator information
without parental authorization, including, but not limited to, the
month, day, and year of each administered immunization; the patient's
name, address, telephone number, birth date, and social security
number; and the parents' names. The immunization information; the
patient's name, address, telephone number, birth date, and social
security number; and the parents' names shall be confidential and
shall only be shared for the purposes set out in this subsection.
F. The State Board of Health shall review this
section annually and make recommendations for revision by September
1 to the Governor, the General Assembly, and the Joint Commission
on Health Care.
TITLE 23. EDUCATIONAL INSTITUTIONS
CHAPTER 1. GENERAL PROVISIONS
VCA § 23-7.5 (2007)
§ 23-7.5. Health histories required;
immunizations
A. No full-time student shall be enrolled for
the first time in any four-year, public institution of higher education
in this Commonwealth unless he has furnished, before the beginning
of the second semester or quarter of enrollment, a health history
consistent with guidelines adopted by each institution's board of
visitors, pursuant to the requirements of this section. Any student
who fails to furnish the history will not be eligible for registration
for the second semester or quarter. Any student who objects on religious
grounds shall be exempt from the health history requirement set
forth in this section.
B. The health history shall include documented
evidence, provided by a licensed health professional or health facility,
of the diseases for which the student has been immunized, the numbers
of doses given, the dates when administered and any further immunizations
indicated. Prior to enrollment, all students shall be immunized
by vaccine against diphtheria, tetanus, poliomyelitis, measles (rubeola),
German measles (rubella), and mumps according to the guidelines
of the American College Health Association.
C. In addition to the immunization requirements
set forth in subsection B, all incoming full-time students, prior
to enrollment in any public four-year institution of higher education,
shall be vaccinated against
(i) meningococcal disease and
(ii) hepatitis B.
However, if the institution of higher education
provides the student or, if the student is a minor, the student's
parent or other legal representative, detailed information on the
risks associated with meningococcal disease and hepatitis B and
on the availability and effectiveness of any vaccine, the student
or, if the student is a minor, the student's parent or other legal
representative may sign a written waiver stating that he has received
and reviewed the information on meningococcal disease and hepatitis
B and the availability and effectiveness of any vaccine and has
chosen not to be or not to have the student vaccinated.
D. Any student shall be exempt from the immunization
requirements set forth in this section who
(i) objects on the grounds that administration
of immunizing agents conflicts with his religious tenets or practices,
unless an emergency or epidemic of disease has been declared by
the Board of Health, or
(ii) presents a statement from a licensed physician which states
that his physical condition is such that administration of one
or more of the required immunizing agents would be detrimental
to his health.
E. The Board and Commissioner of Health shall
cooperate with any board of visitors seeking assistance in the implementation
of this section.
F. Further, the State Council of Higher Education
shall, in cooperation with the Board and Commissioner of Health,
encourage private colleges and universities to develop a procedure
for providing information about the risks associated with meningococcal
disease and hepatitis B and the availability and effectiveness of
any vaccine against meningococcal disease and hepatitis B.
TITLE 22. SOCIAL SERVICES
AGENCY NO. 15. CHILD DAY-CARE COUNCIL
CHAPTER 30. STANDARDS FOR LICENSED CHILD DAY CENTERS
PART II. ADMINISTRATION
22 VAC 15-30-150 (2007)
22 VAC 15-30-150 Immunizations for children.
A. The center shall obtain documentation that
each child has received the immunizations required by the State
Board of Health before the child can attend the center.
Exemptions (subsection C of § 22.1-271.2
of the Code of Virginia and 12 VAC 5-110-110 of the Regulations
for the Immunizations of School Children): Documentation of immunizations
is not required for any child whose
(i) parent submits an affidavit to the center,
on the form entitled "Certification of Religious Exemption,"
stating that the administration of immunizing agents conflicts
with the parent's or child's religious tenets or practices, or
(ii) physician or a local health department states on a MCH 213B
or MCH 213C, or other Department of Health-approved formthat one
or more of the required immunizations may be detrimental to the
child's health.
B. The center shall obtain documentation of additional
immunizations once every six months for children under the age of
two years.
C. The center shall obtain documentation of
additional immunizations once between each child's fourth and sixth
birthdays.
TITLE 12. HEALTH
AGENCY NO. 5. DEPARTMENT OF HEALTH
DISEASE PREVENTION AND CONTROL
CHAPTER 110. REGULATIONS FOR THE IMMUNIZATION OF SCHOOL CHILDREN
PART III. IMMUNIZATION REQUIREMENTS
12 VAC 5-110-30 (2007)
12 VAC 5-110-30 Administration.
A. The Board of Health has the responsibility
for promulgating regulations pertaining to the implementation of
the school immunization law and standards of immunization by which
a child attending a school or child care center may be judged to
be adequately immunized.
B. The State Health Commissioner is the executive
officer for the State Board of Health with the authority of the
board when it is not in session, subject to the rules and regulations
of the board.
C. The local health director is responsible for
providing assistance in implementing this chapter to the school
divisions in his jurisdiction and for providing immunizations to
children determined not to be adequately immunized, who present
themselves to the local health department for immunization.
D. The school principals of public schools and
the principals, headmasters and directors of nonpublic schools and
child care centers shall require each student attending their institutions
to provide documentary proof of immunization against the diseases
listed in 12 VAC 5-110-70.
12 VAC 5-110-70 (2007)
12 VAC 5-110-70 Immunization requirements.
Every new student and every child attending a
licensed child care center shall provide documentary proof of adequate
immunization with the prescribed number of doses of each of the
vaccines and toxoids listed in the following subdivisions, as appropriate
for his age. A copy of every student's immunization record shall
be on file in his school record.
1. Diphtheria and Tetanus Toxoids and Pertussis
Vaccine (DTP). For students less than seven years of age, a minimum
of three doses of DTP, with one dose administered after the student's
fourth birthday. If any of these three doses must be administered
on or after the seventh birthday, Td (adult tetanus toxoid full
dose and diphtheria toxoid reduced dose) should be used instead
of DTP.
2. Poliomyelitis Vaccine. A minimum of three
doses of trivalent oral poliomyelitis vaccine (OPV), with one dose
administered after the fourth birthday or three doses of enhanced-potency
inactivated poliomyelitis vaccine (IPV), with one dose administered
after the fourth birthday when OPV is contraindicated.
3. Measles (Rubeola) Vaccine. For students enrolling
in kindergarten or first grade on and after July 1, 1991, one dose
of live measles vaccine administered at age 12 months or older,
and a second dose administered prior to entering kindergarten or
first grade, whichever occurs first. The two doses must be administered
at least one month apart. Students entering sixth grade on and after
July 1, 1992, shall also have received two doses of live measles
vaccine, with the first dose administered at age 12 months or older
and the second dose at least one month after the first dose. All
other students shall have received at least one dose of live measles
vaccine. Any measles immunization received after 1968 should be
considered to have been administered using a live virus vaccine.
4. German Measles (Rubella) Vaccine. A minimum
of one dose of rubella virus vaccine administered at age 12 months
or older.
5. Mumps Vaccine. A minimum of one dose of mumps
virus vaccine administered at age 12 months or older. The requirement
for mumps vaccine shall not apply to any child admitted for the
first time to any grade level, kindergarten through grade 12 of
a school prior to August 1, 1981.
6. Haemophilus Influenzae Type b (Hib) Vaccine.
A complete series of Hib vaccine i.e., up to a maximum of four doses
of vaccine as appropriate for the age of the child and the age at
which the immunization series was initiated. The number of doses
administered shall be in accordance with current recommendations
of either the American Academy of Pediatrics or those of the U.S.
Public Health Service. Attestation by the physician or his designee
on the temporary form documenting immunizations against Hib, that
portion of Form MCH 213C pertaining to Hib vaccine, a computer generated
facsimile of MCH 213C, or on the MCH 213C Supplement as defined
in 12 VAC 5-110-10 under "documentary proof'' shall mean that
the child has satisfied the requirements of this section. This section
shall not apply to children older than 30 months of age.
The dosage schedule for Hib vaccine varies with
the manufacturer. The number of doses of vaccine required is also
governed by the age at which immunization is initiated. Hence the
reason why the requirements for Hib vaccine are prescribed in a
manner different from those for the other vaccines.
7. Hepatitis B Vaccine. A minimum of three doses
of hepatitis B vaccine for all children born on or after January
1, 1994
12 VAC 5-110-80 (2007)
12 VAC 5-110-80 Exemptions from immunization
requirements.
A. Religious and medical exemptions. No certificate
of immunization shall be required of any student for admission to
school if:
1. The student or his parent or guardian submits
a Certificate of Religious Exemption (Form CRE 1), to the admitting
official of the school to which the student is seeking admission.
Form CRE 1 is an affidavit stating that the administration of
immunizing agents conflicts with the student's religious tenets
or practices. For a student enrolled before July 1, 1983, any
document present in the student's permanent school record claiming
religious exemption shall be acceptable, or
2. The school has written certification on any of the documents
specified under "documentary proof'' in 12 VAC 5-110-10 from
a physician or a local health department that one or more of the
required immunizations may be detrimental to the student's health.
Such certification of medical exemption shall specify the nature
and probable duration of the medical condition or circumstance
that contraindicates immunization. For a student enrolled before
July 1, 1983, any document attesting to the fact that one or more
of the required immunizations may be detrimental to the student's
health shall be acceptable.
B. Demonstration of existing immunity. The demonstration
in a student of antibodies against either rubeola or rubella in
sufficient quantity to ensure protection of that student against
that disease, shall render that student exempt from the immunization
requirements contained in 12 VAC 5-110-70 for the disease in question.
Such protection should be demonstrated by means of a serological
testing method appropriate for measuring protective antibodies against
rubeola or rubella respectively.
Statutory Authority: §§ 22.1-271.1,
22.1-271.2, 32.1-12, and 32.1-46 of the Code of Virginia.
12 VAC 5-90-110 (2007)
12 VAC 5-90-110 Dosage and age requirements
for immunizations; obtaining immunizations.
A. Every child in Virginia shall be immunized
against the following diseases by receiving the specified number
of doses of vaccine by the specified ages unless replaced by a revised
schedule of the U.S. Public Health Service:
1. Diphtheria, Tetanus, and Pertussis Vaccine—three
doses by one year of age of toxoids of diphtheria and tetanus,
combined with pertussis vaccine with the remaining two doses administered
in accordance with the most recent schedule of the American Academy
of Pediatrics or the U.S. Public Health Service.
2. Poliomyelitis Vaccine, trivalent type—three doses of
inactivated poliomyelitis vaccine, preferably by one year of age
and no later than 18 months of age. Attenuated (live virus) oral
polio vaccine may be used if the attending physician feels it
is clinically appropriate for a given patient.
3. Measles (Rubeola) Vaccine—one dose of further attenuated
(live virus) measles vaccine between 12-15 months of age and no
later than two years of age. A second dose shall also be required
at the time of initial entry to school. For those children who
did not receive a second dose at initial school entry, a second
dose shall be required at the time of entry to grade six.
4. Rubella Vaccine—one dose of attenuated (live virus) rubella
vaccine between 12-15 months of age and no later than two years
of age.
5. Mumps Vaccine—one dose of attenuated (live virus) mumps
vaccine between 12-15 months of age and no later than two years
of age.
6. Haemophilus influenzae type b (Hib) Vaccine—a maximum
of four doses of Hib vaccine for children up to 30 months of age
as appropriate for the child's age and in accordance with current
recommendations of either the American Academy of Pediatrics or
the U.S. Public Health Service.
7. Hepatitis B Vaccine—three doses by 12 months of age and
no later than 18 months of age. For children not receiving three
doses by 18 months of age, three doses will be required at initial
school entry for all children born
on or after January 1, 1994. Since July 1 2001, all children who
have not received a complete series of hepatitis B vaccine are
required to receive such immunization prior to entering the sixth
grade.
8. Varicella (Chickenpox) Vaccine—one dose of varicella
vaccine between 12-18 months of age. For those children who did
not receive a dose of vaccine between 12-18 months of age, a dose
will be required at initial school entry
B. The required immunizations may be obtained
from a physician licensed to practice medicine or from the local
health department.
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