(1) All children residing in the foster home, other than the foster child, shall be immunized against measles, rubella, mumps, poliomyelitis, diphtheria, pertussis, tetanus, varicella, hepatitis B, pneumococcal, and Haemophilus influenza type B according to the following schedule or have a religious or medical exemption:

 

                  Total Immunizations Required, By Age

 

Age                                                     Number Doses - Vaccine Type

 

under 2 months old                             no vaccinations required

 

by 3 months of age                             1 dose of polio vaccine

                                                            1 dose of DTP vaccine

                                                            1 dose of Hib vaccine

                                                            1 dose of Hep B vaccine

                                                            1 dose of PCV vaccine

 

by 5 months of age                              2 doses of polio vaccine

                                                             2 doses of DTP vaccine

                                                             2 doses of Hib vaccine

                                                             2 doses of Hep B vaccine

                                                             2 doses of PCV vaccine

 

by 7 months of age                              2 doses of polio vaccine

                                                             3 doses of DTP vaccine

                                                            *2 or 3 doses of Hib vaccine

                                                              2 doses of Hep B vaccine

                                                              3 doses of PCV vaccine

 

by 16 months of age                             2 doses of polio vaccine

                                                              3 doses of DTP vaccine

                                                              1 dose of varicella vaccine

                                                              1 dose of MMR vaccine

                                                             *3 or 4 doses of Hib vaccine

                                                              2 doses of Hep B vaccine

                                                             *4 doses of PCV vaccine

 

by 19 months of age                             1 dose of varicella vaccine

                                                              3 doses of polio vaccine

                                                              4 doses of DTP vaccine

                                                              1 dose of MMR vaccine

                                                             *3 or 4 doses of Hib vaccine

                                                              3 doses of Hep B vaccine

                                                             *4 doses of PCV vaccine

 

By 6 years of age                                 3 doses of polio vaccine, one given after the 4th birthday

                                                             4 doses of DTP vaccine, one given after the 4th birthday

                                                             2 doses of varicella vaccine

                                                             2 doses of MMR vaccine

                                                             3 doses of Hep B vaccine

 

By 12 years of age                               3 doses of polio vaccine, one given after the 4th birthday

                                                             1 dose of Tdap vaccine

                                                             2 doses of varicella vaccine

                                                             2 doses of MMR vaccine

                                                             3 doses of Hep B vaccine

 

(*) varies depending on vaccine type used or the ACIP catch-up schedule.

 

(2) Hib and PCV vaccines are not required or recommended for children five years of age and older.

(3) Doses of MMR and varicella vaccines, to be acceptable under this rule, must be given no earlier than 12 months of age. A child who received a dose prior to 12 months of age must be revaccinated; however, vaccine doses given up to four days before the minimum interval or age are counted as valid. Live vaccines not administered at the same visit must be separated by at least four weeks.

(4) Vaccines immunizing against diphtheria, pertussis, and tetanus must be administered as follows:

(a) a child less than seven years of age must be administered four or more doses of DTP or DTaP vaccine, at least one dose of which must be given after the fourth birthday;

(b) DT vaccine administered to a child less than seven years of age is acceptable for purposes of this rule only if accompanied by a medical or religious exemption; and

(c) a child seven years old or older who has not completed the requirement in (1) must receive additional doses of Tdap vaccine or Td vaccine to become current in accordance with the ACIP schedule.

(5) The following are considered adequate documentation of vaccination for the purposes of this subchapter:

(a) a record from any local health department in the United States, signed by a local officer or nurse;

(b) a certificate signed by a local health officer or nurse; 

(c) any official immunization record, if information has been recorded and signed by a physician, physician's designee, local health officer, or that officer's designee; or an official report from the statewide immunization information system, or a health care provider's medical record system;

(d) immunization recorded on a form approved by the U.S. government;

(e) any state's official parent-maintained immunization record;

(f) the international certificates of vaccination approved by the World Health Organization; or

(g) in the case of vaccine administrated outside of the United States, a record of the vaccination signed by an official of the principal public health agency of the country where the vaccination occurred.

(6) Vaccine administration data may not be filled out by a parent, guardian, or other person unless they are a health care provider, health department official, or person otherwise authorized to do so by this subchapter.

(7) The immunization information is to be kept on file in both the foster home and the licensing file.

(8) A child residing in the foster home, other than the foster child, is not required to have any immunizations which are medically contraindicated or contrary to the religious belief, observance, or practice of the child's custodial parent or legal guardian. 

(a) A written and signed statement from a health care provider that an immunization otherwise required by (1) of this rule is medically contraindicated will exempt a child from those immunization requirements as deemed necessary by the physician. It is preferred, but not mandatory, that a health care provider's medical exemption be recorded on HES-101A, and medical exemption documentation must include:

(i) which specific immunization is contraindicated;

(ii) the period of time during which the immunization is contraindicated;

(iii) the reasons for the medical contraindication; and

(iv) when deemed necessary by a health care provider, the results of immunity testing. The tests must indicate serological evidence of immunity and must be performed by a CLIA approved laboratory.

(b) A notarized affidavit of exemption on religious grounds attesting that receipt of a vaccine or vaccines is contrary to an individual's religious belief, observance, or practice;

(i)  the religious exemption affidavit will be prepared on a form provided by the department;

(ii)  the form must be provided to the department prior to licensure; and

(iii)  the original claim of the religious exemption must be kept by the department in the licensing record.