TITLE 24. EDUCATION CHAPTER 1. PUBLIC SCHOOL CODE OF 1949 ARTICLE

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TITLE 24. EDUCATION
CHAPTER 1. PUBLIC SCHOOL CODE OF 1949
ARTICLE XIII. PUPILS AND ATTENDANCE
(A) ATTENDANCE

24 P.S.  13-1303a (2007)

 13-1303a. Immunization required; penalty

(a) It shall be the duty of all school directors, superintendents, principals, or other persons
in charge of any public, private, parochial, or other school including kindergarten, to
ascertain that every child, prior to admission to school for the first time has been
immunized, as the Secretary of Health may direct, against such diseases as shall appear
on a list to be made and from time to time reviewed by the Advisory Health Board. All
certificates of immunization shall be issued in accordance with the rules and regulations
promulgated by the Secretary of Health with the sanction and advice of the Advisory
Health Board.

(b) Any person who shall fail, neglect, or refuse to comply with, or who shall violate, any
of the provisions or requirements of this section, except as hereinafter provided, shall, for
every such offense, upon summary conviction thereof, be sentenced to pay a fine of not
less than five dollars ($ 5) nor more than one hundred dollars ($ 100), and in default
thereof, to undergo an imprisonment in the jail of the proper county for a period not
exceeding sixty (60) days. All such fines shall be paid into the treasury of the school
district.

(c) The provisions of this section shall not apply in the case of any child deemed to have
a medical contraindication which may contraindicate immunization and so certified by a
physician. Such certificates may be accepted in lieu of a certificate of immunization.

(d) The provisions of this section shall not apply in the case of any child whose parent or
guardian objects in writing to such immunization on religious grounds.



TITLE 28. HEALTH AND SAFETY
CHAPTER 23. SCHOOL HEALTH
SUBCHAPTER C. IMMUNIZATION

28 Pa. Code.  23.83 (2007)

 23.83. Immunization requirements.

(a) Required for entry. The following immunizations are required for entry into school for
the first time at the kindergarten or first grade level, at public, private or parochial
schools in this Commonwealth, including special education and home education
programs:

(1) Hepatitis B. Three properly-spaced doses of hepatitis B vaccine or a history of
hepatitis B immunity proved by laboratory testing.
(2) Diphtheria. Four or more properly-spaced doses of diphtheria toxoid, which may be
administered as a single antigen vaccine, in combination with tetanus toxoid or in
combination with tetanus toxoid and pertussis vaccine. One dose shall be administered on
or after the 4th birthday.
(3) Tetanus. Four or more properly-spaced doses of tetanus toxoid, which may be
administered as a single antigen vaccine, in combination with diphtheria toxoid or in
combination with diphtheria toxoid and pertussis vaccine. One dose shall be administered
on or after the 4th birthday.
(4) Poliomyelitis. Three or more properly-spaced doses of any combination of oral polio
vaccine or enhanced inactivated polio vaccine.
(5) Measles (rubeola). Two properly-spaced doses of live attenuated measles vaccine, the
first dose administered at 12 months of age or older, or a history of measles immunity
proved by serological evidence showing antibody to measles as determined by the
hemagglutination inhibition test or a comparable test. Each dose of measles vaccine may
be administered as a single antigen vaccine.
(6) German measles (rubella). One dose of live attenuated rubella vaccine, administered
at 12 months of age or older or a history of rubella immunity proved by serological
evidence showing antibody to rubella determined by the hemagglutination inhibition test
or any comparable test. Rubella vaccine may be administered as a single antigen vaccine.
(7) Mumps. One dose of live attenuated mumps vaccine, administered at 12 months of
age or older or a physician diagnosis of mumps disease indicated by a written record
signed by the physician or the physician's designee. Mumps vaccine may be administered
as a single antigen vaccine.
(8) Chickenpox (varicella). One of the following:

(i) One dose of varicella vaccine, administered at 12 months of age or older.
(ii) A history of chickenpox immunity proved by laboratory testing or a written statement
of history of chickenpox disease from a parent, guardian or physician.

(b) Required for attendance. The following immunizations are required as a condition of
attendance at school in this Commonwealth if the child has not received the
immunizations required for school entry listed in subsection (a).

(1) Diphtheria. Three or more properly spaced doses of diphtheria toxoid, which may be
administered as a single antigen vaccine, in combination with tetanus toxoid or in
combination with tetanus toxoid and pertussis vaccine.
(2) Tetanus. Three or more properly spaced doses of tetanus toxoid, which may be
administered as a single antigen vaccine, in combination with diphtheria toxoid or in
combination with diphtheria toxoid and pertussis vaccine.
(3) Poliomyelitis. Three or more properly spaced doses of either oral polio vaccine or
enhanced inactivated polio vaccine. If a child received any doses of inactivated polio
vaccine administered prior to 1988, a fourth dose of inactivated polio vaccine is required.
(4) Measles (rubeola). Two properly spaced doses of live attenuated measles vaccine,
administered at 12 months of age or older or a history of measles immunity proved by
serological evidence showing antibody to measles determined by the hemagglutination
inhibition test or a comparable test. Each dose of measles vaccine may be administered as
a single antigen vaccine.
(5) German measles (rubella). One dose of live attenuated rubella vaccine, administered
at 12 months of age or older or a history of rubella immunity proved by serological
evidence showing antibody to rubella determined by the hemagglutination inhibition test
or any comparable test. Rubella vaccine may be administered as a single antigen vaccine.
(6) Mumps. One dose of live attenuated mumps vaccine, administered at 12 months of
age or older or a physician diagnosis of mumps disease indicated by a written record
signed by the physician or the physician's designee. Mumps vaccine may be administered
as a single antigen vaccine.

(c) Required for entry into 7th grade. In addition to the immunizations listed in
subsection (b), the following immunizations are required at any public, private, parochial
or vocational school in this Commonwealth, including special education and home
education programs, as a condition of entry for students entering the 7th grade; or, in an
ungraded class, for students in the school year that the student is 12 years of age:

(1) Hepatitis B. Three properly-spaced doses of hepatitis B vaccine or a history of
hepatitis B immunity proved by laboratory testing.
(2) Chickenpox (varicella). One of the following:

(i) One dose of varicella vaccine, administered at 12 months of age or older.
(ii) Two properly-spaced doses of varicella vaccine for children 13 years of age and
older.
(iii) A history of chickenpox immunity proved by laboratory testing, or a written
statement of history of chickenpox disease from the parent, guardian, emancipated child
or physician.

28 Pa. Code.  23.84 (2007)

 23.84. Exemption from immunization.

(a) Medical exemption. Children need not be immunized if a physician or the physician's
designee provides a written statement that immunization may be detrimental to the health
of the child. When the physician determines that immunization is no longer detrimental to
the health of the child, the child shall be immunized according to this subchapter.

(b) Religious exemption. Children need not be immunized if the parent, guardian or
emancipated child objects in writing to the immunization on religious grounds or on the
basis of a strong moral or ethical conviction similar to a religious belief.

Source
The provisions of this  23.84 amended through September 17, 1982, effective August 1,
1983, 12 Pa.B. 3288; amended August 22, 1997, effective August 23, 1997, 27 Pa.B.
4317. Immediately preceding text appears at serial pages (164332) to (164333) and
(129145).

Cross References

This section cited in 22 Pa. Code  11.20 (relating to nonimmunizated children); 22 Pa.
Code  51.13 (relating to immunization); 28 Pa. Code  23.85 (relating to responsibilities
of schools and school administrators); and 28 Pa. Code  27.77 (relating to immunization
requirements for children in child care group settings).



TITLE 28. HEALTH AND SAFETY
CHAPTER 27. COMMUNICABLE AND NONCOMMUNICABLE DISEASES
SUBCHAPTER C. QUARANTINE AND ISOLATION
COMMUNICABLE DISEASES IN CHILDREN AND STAFF ATTENDING
SCHOOLS AND CHILD CARE GROUP SETTINGS

28 Pa. Code.  27.77 (2007)

 27.77. Immunization requirements for children in child care group settings.

(a) Caregiver responsibilities.

(1) Except as exempted in subsection (d), effective March 27, 2002, the caregiver at a
child care group setting may not accept or retain a child 2 months of age or older at the
setting, for more than 60 days, unless the caregiver has received a written objection to a
child being vaccinated on religious grounds from a parent or guardian, or one of the
following:

(i) For all children not exempt under subsection (d)(1)(ii), an initial written verification
from a physician, the Department or a local health department of the dates (month, day
and year) the child was administered any vaccines ecommended by ACIP. The
verification shall also specify any vaccination not given due to medical condition of the
child and shall state whether the condition is temporary or permanent. The verification
shall show compliance with the vaccination requirements in subsection (b).
(ii) For all children for whom vaccinations remain outstanding following the caregiver's
receipt of the initial written verification, subsequent written verifications from a
physician, the Department or a local health department as additional vaccinations become
due. These verifications shall be prepared in the same manner as set forth in
subparagraph (i), but need not repeat information contained in a previously submitted
verification. The verifications shall demonstrate continuing compliance with the
vaccination requirements in subsection (b).
(2) If the caregiver receives a written verification under paragraph (1) explaining that
timely vaccination did not occur due to a temporary medical condition, the caregiver shall
exclude the child from the child care group setting after an additional 30 days unless the
caregiver receives, within that 30-day period, written verification from a physician, the
Department or a local health department that the child was vaccinated or that the
temporary medical condition still exists. If the caregiver receives a written verification
that vaccination has not occurred because the temporary condition persists, the caregiver
shall require the presentation of a new verification at 30-day intervals. If a verification is
not received as required, the caregiver shall exclude the child from the child care group
setting and not readmit the child until the caregiver receives a verification that meets the
requirements of this section.
(3) The caregiver shall retain the written verification or objection referenced in
paragraphs (1) and (2) for 60 days following the termination of the child's attendance.
(4) The caregiver shall ensure that a certificate of immunization is completed and signed
for each child enrolled in the child care group setting. The certificates shall be updated by
the caregiver to include the information provided to the caregiver under subsection (a)
when that additional information is received. The immunization status of each enrolled
child shall be summarized and reported on an annual basis to the Department at the time
prescribed by the Department and on the form provided by the Department.

(b) Vaccination requirements. Each child enrolled in a child care group setting shall be
immunized in accordance with ACIP standards in effect on January 1, 1999, governing
the issuance of ACIP recommendations for the immunization of children.

(1) The standards are as follows:

(i) The immunization practice is supported by both published and unpublished scientific
literature as a means to address the morbidity and mortality of the disease.
(ii) The labeling and packaging inserts for the immunizing agent are considered.
(iii) The immunizing agent is safe and effective.
(iv) The schedule for use of the immunizing agent is administratively feasible.

(2) The Department will deem an ACIP recommendation pertaining to the immunization
of children to satisfy the standards in this subsection unless ACIP alters its standards for
recommending immunizations for children by eliminating a standard set forth in this
subsection and the recommendation is issued under those changed standards.

(c) Notice. The Department will place a notice in the Pennsylvania Bulletin listing
publications containing ACIP recommendations issued under the standards in subsection
(b). The Department will publish the initial notice at 32 Pa.B. 539 (January 26, 2002),
contemporaneously with the adoption of amendments to this chapter. The Department
will update that list in a notice which it will publish in the Pennsylvania Bulletin within
30 days after ACIP issues a recommendation which satisfies the criteria of this section.

(d) Exemptions.
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