Purpose
The Pennsylvania Department of Health (DOH) promulgates immunization regulations (28 Pa. Code §§ 23.81-87) that require parents or guardians of students enrolled in grades K-12 to have their children immunized against various communicable diseases. The regulations, which implement 24 P.S. § 13-1303a, apply to kindergarten, elementary, and secondary students enrolled in a public school, private school, other nonpublic school, and home education.
While recommendations on immunization requirements may be made at the federal level, the authority to establish immunization requirements for school enrollment remains with the DOH. As such, there are no changes in vaccine recommendations in Pennsylvania, including those for children to attend school.
The DOH recommends following the most recent immunization recommendations issued by the American Academy of Pediatrics, as well as the American College of Obstetricians and Gynecologists and the American Academy of Family Physicians. General immunization guidance and links to these recommendations are available on the DOH website.
This Basic Education Circular (BEC) addresses questions concerning DOH immunization regulations, including:
- Whether students lacking the full series of required immunizations may nevertheless be permitted to attend school pending completion of the immunization series;
- Whether the compulsory attendance laws provide a mechanism whereby school districts may compel non-immunized students excluded from school to receive the necessary vaccinations; and
- Whether non-immunized students excluded from school may be counted toward calculation of state subsidy.
Admission of Students Lacking Full Series of Immunizations
Under the School Code and current DOH immunization regulations, students may not be admitted to school unless exempted from immunization for medical or religious reasons, or on the basis of a strong moral or ethical conviction similar to a religious belief (28 Pa. Code § 23.84; see also 24 P.S. § 1303a(c) and (d). Students must complete the full series of all immunizations (antigens) required by 28 Pa. Code § 23.83 for admittance to school.
However, 28 Pa. Code § 23.85 permits school administrators to admit those students who (1) have received all single dose vaccines before the first day of school and (2) will receive any missing doses of the required multiple dose vaccine series within a medically appropriate time period. If it is medically appropriate, the student must receive the next dose of a multiple dose vaccine series by their fifth day of school and submit a written medical plan certificate or risk exclusion. If it is not medically appropriate for the student to receive the next dose of a multiple dose vaccine series within five school days of the student’s first day of attendance, the student must provide a medical certificate (PDF) clearly indicating the schedule for the remaining doses. The medical certificate must be reviewed at least every 30 days. If the requirements of the medical certificate are not met, the student may be excluded from school. See 28 Pa. Code § 23.85(e).
The DOH immunization requirements do not apply to a student if any of the following apply:
- The student has not been immunized or is unable to provide records on the first day of attendance due to being homeless. Children experiencing homelessness are exempt from school immunization requirements and are not required to submit any documentation of immunization or exemption (McKinney-Vento Homeless Education Assistance Act );
- The student has not been immunized or is unable to provide records on the first day of attendance due to being in foster care. Enrollment for youth in foster care must not be denied or delayed because documents and records normally required for school entry have not been provided. A student in foster care shall have 30 days to provide immunization records or to complete an exemption;
- The student is moving or transferring into a school in Pennsylvania and is unable to provide immunization records immediately upon enrollment in the school. The child’s parent or guardian shall have 30 days to provide immunization records or a medical certificate, or to complete an exemption; or
- The Pennsylvania Secretary of Health has issued a temporary waiver because of national vaccine shortages or a disaster that impacts ability to provide immunization records pursuant to 28 Pa. Code § 23.85(h).
If a student has not satisfied the immunization requirements or has not submitted completed exemption forms on or before the date of the expiration of the five-day provisional period, the Pennsylvania Department of Education (PDE) recommends that school entities consider individual circumstances and consult with their solicitors on how to proceed.
School administrators should assist parents by informing them of the immunizations that their children are lacking, available county or local immunization services, and the consequences of noncompliance. Additional information for parents and schools is available on the DOH website. Questions should be directed to the DOH Division of Immunizations at 717-787-5681.
For the reasons stated later in this BEC, students excluded from school attendance under the immunization regulations may not be counted toward calculation of state reimbursement for the period of their non-attendance.
Special Education Students
Special consideration should be given to students identified as eligible to receive special education services. School administrators must assist parents by informing them of the county or local immunization services available, in addition to the consequences of noncompliance. Any assistance offered should be documented. If a parent or guardian of a special education student refuses to comply with the immunization requirements for attendance and refuses to request an exemption for medical or religious reasons or on the basis of a strong moral or ethical conviction similar to a religious belief, school entities should consider the notification and other procedures under applicable law for voluntary revocation of services by parents.
Applicability of Compulsory Attendance Laws to Students Excluded Under the Immunization Regulations
Pursuant to 24 P.S. § 14-1417, a school cannot seek commencement of proceedings or imposition of penalties against any person on the basis of a violation of compulsory attendance requirements that resulted from failure of a student to comply with the immunization requirements. Section 1417 does not relieve a student from complying with the requirements concerning compulsory attendance if exclusion from attendance is a result of the refusal to comply with the immunization requirements. Schools are advised to consult with their solicitors on this issue.
School Child Accounting for Non-immunized Students Not in Attendance
PDE does not maintain a separate code for reporting students who have been excluded from attendance because of the PA School Code and DOH’s immunization regulations. For reporting purposes, such students should be reported as having unexcused absences.
Resources
References
Purdon's Statutes
24 P.S. § 13-1303a
24 P.S. § 14-1417
Department of Health Regulations
28 Pa. Code §§ 23.81-87 Immunization
State Board of Education Regulations
22 Pa. Code § 11.20 Nonimmunized Children
Federal Regulations
Bureau/Office Contact
School Services Office
Pennsylvania Department of Education
Forum Building
607 South Drive
Harrisburg, PA 17120
Phone: 717-787-4860