Recent Changes to Immunization Statute

In SB 20-163, the General Assembly made a number of changes to the immunization statute (C.R.S. §§ 25-4-901, et seq.)  The basic requirements of the statute are summarized below.

Section 902(1) states that a student may not attend any school in Colorado unless he or she has presented:

(a)  a certificate of immunization;

(b)  an authorization signed by a parent requesting that a health official provide the immunization; or

(c)  a certificate of medical exemption, a certificate of completion of the online education module, or a certificate of nonmedical exemption.

A homeschool student is not required to comply with Section 902(1), except:

(a)  a school district may require homeschool students to comply with Section 902(1) under certain circumstances, but the district may only obtain either the students immunization records as provided by the student’s parents or a statement signed by the student’s parents that the student is exempt from immunization;

(b)  an Institute charter school may require compliance with Section 902(1) if a homeschool student attends the school for a portion of the day; and

(c)  a private school may require compliance with Section 902(1) if a homeschool student attends the school for a portion of the day.

CDE and the Department of Human Services are required to post a standardized immunization data form for use by schools by January 31, 2021.  The form will set forth:

(a) a list of required immunizations;

(b)  a list of recommended but not required immunizations;

(c)  the school’s immunization and exemption rates; and

(d)  a statement that the school is required to collect and report immunization and exemption data.

On or before February 15 of each year, each school shall update and distribute its immunization data form to show its immunization and exemption rates for the prior school year.  The school must compare its rate to the “vaccinated children standard” set forth in Section 911 of the statute. Section 903 sets forth the various exemptions from the immunization requirement and the procedures for claiming the exemptions.  A student is exempt if his or her parents submit one of the following certificates:

(a)  a certificate of medical exemption from a healthcare practitioner stating that the immunization is medically contraindicated; or

(b) a certificate of completion of the “online education module;” or

(c) a certificate of nonmedical exemption that states that the parent is an adherent to a religious belief whose teachings are opposed to immunizations or has a personal belief that is opposed to immunization.

In order to claim a medical or non-medical exemption, a parent can obtain an exemption form from their healthcare provider.  Each form must be signed by a healthcare provider.

A certificate of completion of an online education module is available for download upon completion of the module

All information distributed to parents by school districts regarding immunization shall inform them of their exemption rights.

A school is required to suspend or expel any student not otherwise exempted who fails to comply with the provisions of the statute.  In the event of suspension or expulsion of a student, school officials shall notify the Department of Public Health and Environment or the county, district, and municipal public health agency.

If in the opinion of a state or local health department, there is a danger of an epidemic from any of the communicable diseases for which an immunization is required, no exemption or exception from immunization against such disease shall be recognized.  Quarantine by the health department is authorized as a legal alternative to immunization.

The General Assembly has established a vaccinated children standard, whereby the immunization rate goal for every school is ninety-five percent of the student population to be vaccinated.  The Department of Public Health and Environment is required to collaborate with local public health agencies and schools to provide information and technical assistance regarding best practices to educate and engage with students and families about vaccines, the risks of vaccine-preventable diseases, and where vaccines are administered.

All immunization and exemption data that is submitted to the Tracking System is subject to the confidentiality provisions contained in the Tracking System statute.

The Tracking System Statute

In a number of  places the immunization statute refers to the Tracking Statute set forth at C.R.S. § 25-4-2403.  That statute requires the Department of Public Health and Environment to maintain a comprehensive immunization tracking system with immunization information gathered by state and local public health officials from healthcare practitioners; clinics; schools; parents; individuals; managed care organizations or health insurance plans; hospitals; the Department of Health Care Policy and Financing; and persons and entities that have contracted with the state pursuant to the statute.

Healthcare practitioners are required to submit immunization, medical exemption, or nonmedical exemption data to the Tracking System.

Records in the immunization tracking system are required to be kept strictly confidential and shall not be released, shared with any agency or institution, or made public upon subpoena, search warrant, discovery proceedings, or otherwise, except under certain conditions specified in the statute.  It is a class 1 misdemeanor for a person to violate the law by releasing or making public confidential immunization records or epidemiological information in the Tracking System or by otherwise breaching the confidentiality requirements of the law.

A parent may exclude immunization information from the Tracking System.  The parent may remove such immunization information from the Tracking System at any time.  The Department shall ensure that the process to exclude immunization information from the Tracking System is readily available and not burdensome.  A healthcare practitioner shall inform the individual or parent of the option to exclude such information from the system and the potential benefits of inclusion in the system.  In addition, healthcare practitioners shall inform parents of the option to refuse an immunization on the grounds of medical, religious, or personal belief considerations.  Neither refusing an immunization on the grounds of medical, religious, or personal belief considerations, nor opting to exclude immunization notification information from the Tracking System shall, by itself, constitute child abuse or neglect by a parent.

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