TITLE 10 EDUCATION
DEPARTMENT OF PUBLIC HEALTH
SCHOOL-RELATED IMMUNIZATIONS
Regs., Conn. State Agencies § 10-204a-1 (2003)
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.
(d) "Medically contraindicated immunization" means an immunization that is not in the best health interest of an individual as determined by a physician licensed to practice medicine in the United States and in accordance with:
(1) the then current recommendation of the United States Public Health Service Advisory Committee on Immunization Practices, Centers for Disease Control or American Academy of Pediatrics Committee on Infectious Diseases; or
(2) written approval of the commissioner for any case not resolvable by reference to the recommendations specified in subdivision (1) of this subsection.
REGULATIONS OF CONNECTICUT STATE AGENCIES
TITLE 10 EDUCATION
DEPARTMENT OF PUBLIC HEALTH
IMMUNIZATION OF SCHOOL CHILDREN
Regs., Conn. State Agencies § 10-204a-2a (2003)
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 is less than four (4) years of age and was immunized by use of live attenuated measles vaccine on or after that individual's first birthday; or
(2) is or has been enrolled in kindergarten on or after August 2000 and was immunized against measles by use of two (2) doses of a live attenuated measles vaccine given at least thirty (30) days apart, the first on or after that individual's first birthday; or
(3) is or has been enrolled in seventh grade after September 1992 and had two (2) doses of a live attenuated measles vaccine, the first on or after that individual's first birthday; or
(4) 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) was immunized at one (1) year or older with a rubella vaccine; or
(2) has had protection against rubella confirmed in writing by specific blood testing conducted by a certified laboratory.
(c) Poliomyelitis
(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 (DTP)
(1) An individual eighteen to seventy-one (18-71) 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 toxoid, three (3) doses given at a minimum of four (4) week intervals followed by a fourth DTP dose at least six (6) months after the third.
(2) For individuals forty eight (48) to seventy-one (48-71) months of age and enrolled in grades kindergarten and above, at least one (1) dose of DTP vaccine must have been given on or after the fourth birthday.
(3) An individual seventy-two (72) 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 (td) 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 and on or after the fourth birthday.
(e) Mumps. An individual shall be considered adequately protected against mumps if such individual:
(1) was immunized at one (1) year of age or older with live mumps vaccine, or
(2) has protection against mumps confirmed in writing by a physician based on specific blood testing by a certified laboratory.
(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.
(g) Hepatitis B (HBV)
(1) An individual born January 1, 1994, or later shall be considered adequately protected against Hepatitis B if that individual:
(A) 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 four (4) months after the second; or
(B) has had protection against Hepatitis B confirmed in writing by a physician based on specific blood testing conducted by a certified laboratory.
An individual born before January 1, 1994, and enrolled in seventh (7th) grade in August 2000 or later, shall have begun vaccination against Hepatitis B to enter seventh (7th) grade. Such individual shall be considered to have begun vaccination against Hepatitis B if that individual:
(A) was immunized with at least one (1) dose of Hepatitis B vaccine at the time of seventh (7th) grade entry; or
(B) has had protection against Hepatitis B confirmed in writing by specific blood testing conducted by a certified laboratory.
(3) An individual born before January 1, 1994 and enrolled in eighth (8th) grade in August 2001 or later, shall be adequately protected against Hepatitis B to enter eighth (8th) grade. Such individual shall be considered adequately protected against Hepatitis B if that individual:
(A) was immunized with at least three (3) doses of Hepatitis B vaccine, two (2) doses given at least four weeks apart followed by a third dose at least four (4) months after the second; or
(B) has had protection against Hepatitis B confirmed in writing by specific blood testing conducted by a certified laboratory.
(h) Varicella. An individual shall be considered adequately protected against Varicella if that individual:
(1) was born January 1, 1997 or later and was immunized with one (1) dose of Varicella vaccine on or after that individual's first birthday and before that individual's thirteenth birthday or two (2) doses of Varicella vaccine given at least four weeks apart if the first dose was given on or after the individual's thirteenth birthday; or
(2) was born before January 1, 1997 and is enrolled in seventh (7th) grade in August 2000 or later and was immunized with one (1) dose of Varicella vaccine on or after that individual's first birthday and before that individual's thirteenth birthday or two (2) doses of Varicella vaccine given at least four weeks apart if the first dose was given on or after the individual's thirteenth birthday; or
(3) 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 and/or medical history; or
(4) has had protection against Varicella confirmed in writing by specific blood testing conducted by a certified laboratory.
(i) 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.
TITLE 10. EDUCATION AND CULTURE
CHAPTER 169 SCHOOL HEALTH AND SANITATION
Conn. Gen. Stat. § 10-204a (2001)
§ 10-204a. Required immunizations.
(a) Each local or regional board of education, or similar body governing a nonpublic school or schools, shall require each child to be protected by adequate immunization against diphtheria, pertussis, tetanus, poliomyelitis, measles, mumps, rubella, hemophilus influenzae type B and any other vaccine required by the schedule for active immunization adopted pursuant to section 19a-7f before being permitted to enroll in any program operated by a public or nonpublic school under its jurisdiction. Before being permitted to enter seventh grade, a child shall receive a second immunization against measles. Any such child who (1) presents a certificate from a physician or local health agency stating that initial immunizations have been given to such child and additional immunizations are in process under guidelines and schedules specified by the Commissioner of Public Health; or (2) presents a certificate from a physician stating that in the opinion of such physician, such immunization is medically contraindicated because of the physical condition of such child; or (3) presents a statement from the parents or guardian of such child that such immunization would be contrary to the religious beliefs of such child; or (4) in the case of measles, mumps or rubella, presents a certificate from a physician or from the director of health in such child's present or previous town of residence, stating that the child has had a confirmed case of such disease; or (5) in the case of hemophilus influenzae type B has passed his fifth birthday or (6) in the case of pertussis, has passed his sixth birthday, shall be exempt from the appropriate provisions of this section. If the parents or guardians of any children are unable to pay for such immunizations, the expense of such immunizations shall, on the recommendations of such board of education, be paid by the town.
(b) The definitions of adequate immunization shall reflect the schedule for active immunization adopted pursuant to section 19a-7f and be established by regulation adopted in accordance with the provisions of chapter 54 by the Commissioner of Public Health, who shall also be responsible for providing procedures under which said boards and said similar governing bodies shall collect and report immunization data on each child to the Department of Public Health for compilation and analysis by said department.
TITLE 19A. PUBLIC HEALTH AND WELL-BEING
CHAPTER 368a DEPARTMENT OF PUBLIC HEALTH
Conn. Gen. Stat. § 19a-7f (2001)
§ 19a-7f. Childhood immunization schedule.
The standard of care for immunization for the children of this state shall be the recommended schedule for active immunization for normal infants and children published by the committee on infectious diseases of the American Academy of Pediatrics or the schedule published by the National Immunization Practices Advisory Committee, as determined by the Commissioner of Public Health. The commissioner shall establish, within available appropriations, an immunization program which shall: (1) Provide vaccine at no cost to health care providers in Connecticut to administer to children so that cost of vaccine will not be a barrier to age-appropriate vaccination in this state; (2) with the assistance of hospital maternity programs, provide all parents in this state with the recommended immunization schedule for normal infants and children, a booklet to record immunizations at the time of the infant's discharge from the hospital nursery and a list of sites where immunization may be provided; (3) inform in a timely manner all health care providers of changes in the recommended immunization schedule; (4) assist hospitals, local health providers and local health departments to develop and implement record-keeping and outreach programs to identify and immunize those children who have fallen behind the recommended immunization schedule or who lack access to regular preventative health care and have the authority to gather such data as may be needed to evaluate such efforts; (5) assist in the development of a program to assess the vaccination status of children who are clients of state and federal programs serving the health and welfare of children and make provision for vaccination of those who are behind the recommended immunization schedule; (6) access available state and federal funds including, but not limited to, any funds available through the federal Childhood Immunization Reauthorization or any funds available through the Medicaid program; (7) solicit, receive and expend funds from any public or private source; and (8) develop and make available to parents and health care providers public health educational materials about the benefits of timely immunization.
Conn. Gen. Stat. § 19a-7g (2003)
§ 19a-7g. Childhood Immunization Advisory Council.
There is established a Childhood Immunization Advisory Council consisting of the Commissioners of Public Health, Education and Social Services or their designees; a representative of the Commission on Children; a representative of the American Academy of Pediatrics, to be appointed by the president pro tempore of the Senate; a representative of the Association of Primary Health Care Providers, to be appointed by the minority leader of the Senate; a representative of the Legal Aid Society, to be appointed by the speaker of the House of Representatives; and a public member who is a parent of a child who is eligible for Medicaid or uninsured, to be appointed by the minority leader of the House of Representatives. The chairperson and the vice-chairperson of the council shall be elected by the full membership of the council and shall serve for a term of one year. The council shall meet at least twice a year. Council members shall serve without compensation. The council shall advise the Department of Public Health on the development, implementation, monitoring and evaluation of the universal childhood immunization program established pursuant to section 19a-7f.
Conn. Gen. Stat. § 19a-79 (2001)
§ 19a-79. (Formerly Sec. 19-43d). Regulations. Exemptions.
(a) The Commissioner of Public Health shall adopt regulations, in accordance with the provisions of chapter 54, to further the purposes of sections 19a-77 to 19a-80, inclusive, and 19a-82 to 19a-87, inclusive, and to assure that child day care centers and group day care homes shall meet the health, educational and social needs of children utilizing such centers and group day care homes. Such regulations shall (1) specify that before being permitted to attend any child day care center or group day care home, each child must be protected as age-appropriate by adequate immunization against diphtheria, pertussis, tetanus, poliomyelitis, measles, mumps, rubella, hemophilus influenzae type B and any other vaccine required by the schedule of active immunization adopted pursuant to section 19a-7f including appropriate exemptions for children for whom such immunization is medically contraindicated and for children whose parents object to such immunization on religious grounds, (2) specify conditions under which child day care center directors and teachers and group day care home providers may administer tests to monitor glucose levels in a child with diagnosed diabetes mellitus, and administer medicinal preparations, including controlled drugs specified in the regulations by the commissioner, to a child receiving child day care services at such center or group day care home pursuant to the written order of a physician licensed to practice medicine or a dentist licensed to practice dental medicine in this or another state, or an advanced practice registered nurse licensed to prescribe in accordance with section 20-94a, or a physician assistant licensed to prescribe in accordance with section 20-12d, and the written authorization of a parent or guardian of such child, (3) specify that an operator of a child day care center or group day care home, licensed before January 1, 1986, or an operator who receives a license after January 1, 1986, for a facility licensed prior to January 1, 1986, shall provide a minimum of thirty square feet per child of total indoor usable space, free of furniture except that needed for the children's purposes, exclusive of toilet rooms, bathrooms, coatrooms, kitchens, halls, isolation room or other rooms used for purposes other than the activities of the children, and (4) specify that a child day care center or group day care home licensed after January 1, 1986, shall provide thirty-five square feet per child of total indoor usable space.
(b) The Commissioner of Public Health may adopt regulations, pursuant to chapter 54, to establish civil penalties of not more than one hundred dollars per day for each day of violation and other disciplinary remedies that may be imposed, following a contested-case hearing, upon the holder of a license issued under section 19a-80 to operate a child day care center or group day care home or upon the holder of a license issued under section 19a-87b to operate a family day care home.
(c) The Commissioner of Public Health shall exempt Montessori schools accredited by the American Montessori Society or the Association Montessori Internationale from any provision in regulations adopted pursuant to subsection (a) of this section which sets requirements on group size or child to staff ratios or the provision of cots.
The U.S. State of Connecticut
Medical exemptions
