Immunizations

COLORADO LAW REGARDING IMMUNIZATION OF STUDENTS

UPDATE (4/12/17): Joint memo from Colorado Department of Health and the Colorado Department of Education states that the CDPHE non-medical exemption form is not required and that schools must accept a written statement as described in C.R.S. 25-4-903(2)(b) (see below). Read the memo here.

UPDATE (9/2/16): In response to HSLDA’s efforts, CDPHE has modified the vaccine exemption form to remove the unconstitutional compelled speech. Read HSLDA’s notice here.

UPDATE (8/18/16): HSLDA has posted a petition to eliminate unconstitutional language on the vaccine exemption form issued by CDPHE. View the petition here.

UPDATE (8/11/16): The vaccine exemption form issued by the CDPHE on July 1st, 2016 is currently being challenged by HSLDA. Read their comments and Letter to CDPHE.

25-4-902. Immunization prior to attending school – standardized immunization information

(1) Except as provided in section 25-4-903, no child shall attend any school in the state of Colorado on or after the dates specified in section 25-4-906 (4) unless he or she has presented the following to the appropriate school official:

(a) An up-to-date certificate of immunization from a licensed physician, a licensed advanced practice nurse, or authorized representative of the department of public health and environment or county, district, or municipal public health agency stating that the child has received immunization against communicable diseases as specified by the state board of health, based on recommendations of the advisory committee on immunization practices of the United States department of health and human services or the American academy of pediatrics; or

(b) A written authorization signed by one parent or guardian or an authorization signed by the emancipated child requesting that local health officials administer the immunizations.

(c) (Deleted by amendment, L. 97, p. 408, § 1, effective July 1, 1997.)

(2) If the student’s certificate of immunization is not up-to-date according to the requirements of the state board of health, the parent or guardian or the emancipated student or the student eighteen years of age or older shall submit to the school, within fourteen days after receiving direct personal notification that the certificate is not up-to-date, documentation that the next required immunization has been given and a written plan for completion of all required immunizations. The scheduling of immunizations in the written plan shall follow medically recommended minimum intervals approved by the state board of health. If the student begins but does not continue or complete the written plan, he or she shall be suspended or expelled pursuant to this part 9.

(3) Notwithstanding the provisions of subsection (1) of this section, a school shall enroll a student who is in out-of-home placement within five school days after receiving the student’s education information and records as required in section 22-32-138, C.R.S., regardless of whether the school has received the items specified in subsection (1) of this section. Upon enrolling the student, the school shall notify the student’s legal guardian that, unless the school receives the student’s certificate of immunization or a written authorization for administration of immunizations within fourteen days after the student enrolls, the school shall suspend the student until such time as the school receives the certificate of immunization or the authorization.

(4) On or before March 1, 2011, the department of public health and environment shall develop and provide to the department of education a standardized document regarding childhood immunizations. The department of education shall post the standardized immunization document on its web site on or before January 15, 2011, and each year thereafter. The standardized document shall be updated annually and shall include, but need not be limited to:

(a) A list of the immunizations required for enrollment in a school and the age at which the immunization is required; and

(b) A list of immunizations currently recommended for children by the center for disease control advisory committee on immunization practices and the recommended age at which each immunization should be given.

(5) The document created pursuant to subsection (4) of this section shall comply with the provisions of section 25-4-903 (4) regarding allowable exemptions from required immunizations.

Ref: C.R.S. 25-4-902

25-4-903. Exemptions from immunization – rules

(1) (Deleted by amendment, L. 97, p. 409, § 2, effective July 1, 1997.)

(2) It is the responsibility of the parent or legal guardian to have his or her child immunized unless the child is exempted pursuant to this section. A student shall be exempted from receiving the required immunizations in the following manner:

(a) By submitting to the student’s school certification from a licensed physician, physician assistant authorized under section 12-36-106 (5), C.R.S., or advanced practice nurse that the physical condition of the student is such that one or more specified immunizations would endanger his or her life or health or is medically contraindicated due to other medical conditions; or

(b) By submitting to the student’s school a statement of exemption signed by one parent or guardian or the emancipated student or student eighteen years of age or older that the parent, guardian, or student is an adherent to a religious belief whose teachings are opposed to immunizations or that the parent or guardian or the emancipated student or student eighteen years of age or older has a personal belief that is opposed to immunizations.

(2.5) The state board of health shall promulgate rules regarding:

(a) Immunization information, including exemption rates, that is available to the public through the department, including evidence-based research, resources and information from credible scientific and public health organizations, peer-reviewed studies, and an online learning module; and

(b) The frequency of submission of exemption forms.

(3) The state board of health may provide, by regulation, for further exemptions to immunization based upon sound medical practice.

(4) All information distributed to parents by school districts regarding immunization shall inform them of their rights under subsection (2) of this section.

(5) Each school shall make the immunization and exemption rates of their enrolled student population publicly available upon request.

Ref: C.R.S. 25-4-903

25-4-904. Rules and regulations – immunization rules – rule-making authority of state board of health

(1) The state board of health shall establish rules and regulations for administering this part 9. Such rules and regulations shall establish which immunizations shall be required and the manner and frequency of their administration and shall conform to recognized standard medical practices. Such rules and regulations may also require the reporting of statistical information and names of noncompliers by the schools. The department of public health and environment shall administer and enforce the immunization requirements.

(2) All rule-making authority granted to the state board of health under the provisions of this article is granted on the condition that the general assembly reserves the power to delete or rescind any rule of the board. All rules promulgated pursuant to this subsection (2) shall be subject to sections 24-4-103 (8) (c)and (8) (d) and 24-4-108, C.R.S.

Ref: C.R.S. 25-4-904

6 C.C.R. 1009-2 The Infant Immunization Program and Immunization of Students Attending School

VI. Official school immunization records

A. Official school immunization records shall include:

1. An official Certificate of Immunization or an Alternate Certificate of Immunization approved by the Department of Public Health and Environment shall include one of the following forms of documentation with the dates and types of immunizations administered to a student:

a. A paper or electronic document that includes information transferred from the records of a licensed physician, registered nurse, or public health official, or

b. An electronic file or hard copy of an electronic file provided to the school directly from the immunization tracking system established pursuant to Section 25-4- 2403, C.R.S., or from a software program approved by the Department of Public Health and Environment, or

2. An official medical exemption form with the date and vaccines exempted from, or CODE OF COLORADO REGULATIONS 6 CCR 1009-2 Disease Control and Environmental Epidemiology Division 6

3. An official nonmedical exemption form with the date, type of exemption taken and the vaccines exempted from.

B. Any immunization record (original or copy) provided by a physician licensed to practice medicine or osteopathic medicine in any state or territory of the United States, registered nurse, or public health official may be accepted by the school official as proof of immunization. The information is to be verified by the school official and transferred to an official Certificate of Immunization.

C. Schools shall have on file an official school immunization record for every student enrolled. The official school immunization record will be kept apart from other school records. When a student withdraws, transfers, or is promoted to a new school, the school official shall return the Certificate of Immunization to the parent(s) or emancipated student upon request or transfer it with the student’s school records to the new school. Upon a college or university student’s request, the Certificate of Immunization shall be forwarded as specified by the student.

Ref: 6 C.C.R. 1009-2