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Explanation of Immunization Laws

Statute References*:
Virginia Code §22.1-271.2§22.1-271.4, and §32.1-46

Health requirements for home-instructed, exempted, and excused children

All home-educated children in the Commonwealth of Virginia are required to be immunized, including those taught by a certified tutor and those under religious exemption. However, there are exemptions:

  • “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.” §22.1-271.4
  •  “The parent, guardian or person standing in loco parentis of each child within this Commonwealth shall cause such child to be immunized with the Immunization Schedule….”§32.1-46(A)

 

Designated Immunizations Set Forth in the State Board of Health Regulations for the Immunization of School Children

(For the most current, up-to-date requirements, please view §32.1-46.) 

§32.1-46 “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.

3. A minimum of three or more properly spaced doses of tetanus toxoid. One dose shall be administered on or after the fourth birthday.

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.

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 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. One to four doses, dependent on age at first dose, of properly spaced pneumococcal conjugate (PCV) vaccine for children up to 60 months of age.

12. Three doses of properly spaced human papillomavirus (HPV) vaccine* for females. The first dose shall be administered before the child enters the sixth grade.”

*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. §32.1-46 (D)(3)

 

Reporting

Parents are NOT required to submit proof of immunization unless the local division superintendent has specifically requested it.

“Upon request by the division superintendent, the parent shall submit to such division superintendent documentary proof of immunization in compliance with §32.1-46” §22.1-271.4.

 

Administrative Agents

A physician, registered nurse, or health department personnel may give immunizations without charge for qualifying students.

“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 to the parent of or person standing in loco parentis to the child if (i) the child is eligible for the Vaccines for Children Program or (ii) the child is eligible for coverages issued pursuant to Title XVIII of the Social Security Act, 42 U.S.C. § 1395 et seq. (Medicare), Title XIX of the Social Security Act, 42 U.S.C. § 1396 et seq. (Medicaid), Title XXI of the Social Security Act, 42 U.S.C. § 1397aa et seq. (CHIP), or 10 U.S.C. § 1071 et seq. (CHAMPUS). In all cases in which a child is covered by a health carrier, Medicare, Medicaid, CHIP, or CHAMPUS, the Department shall seek reimbursement from the health carrier, Medicare, Medicaid, CHIP, or CHAMPUS for all allowable costs associated with the provision of the vaccine. For the purposes of this section, the Department shall be deemed a participating provider with a managed care health insurance plan as defined in § 32.1-137.1.” §32.1-46.

 

 

Records

Persons giving immunizations must provide documentation of the type of immunization given, numbers of doses, date, and any further immunizations required.

“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.” §32.1-46

 

Information Sharing

Certain designated persons may share confidential immunization information including the child’s name, address, phone number, birth date, social security number, and the parents’ names.

“For the purpose of protecting the public health by ensuring that each child receives age-appropriate immunizations, any physician, licensed institutional health care provider, local or district health department, and the Department of Health may share immunization and child locator information, including, but not limited to, the month, day, and year of each administered immunization; the child’s name, address, telephone number, birth date, and social security number; and the parents’ names. The immunization information; the child’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” §32.1-46. (E).

 

Exceptions

Parents may obtain both religious and medical exemptions to immunizations. For a religious objection to immunizations, a Certificate of Religious Exemption (Form CRE 1) may be obtained from a local health department or you may download the form here. For a medical exemption, you must have documentary proof from a physician or local health department that one or more immunizations may be detrimental to the student’s health.

The provisions of §32.1-46 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;
  2. The parent or guardian presents a statement from a physician licensed to practice medicine in Virginia, a licensed nurse practitioner, or a local health department that 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;

 

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” §22.1-271.4.

 

 

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.

*Excerpted from the Code of Virginia, 1950, as amended; revised July 2014.

 

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