Part 66 - Immunizations and Communicable Diseases

Effective Date: 
Thursday, July 9, 2020
Doc Status: 
Complete
Statutory Authority: 
Public Health Law, Sections 2164, 2165, 2168

SubPart 66-1 - School Immunization Requirements

Effective Date: 
Tuesday, December 31, 2019
Doc Status: 
Complete
Statutory Authority: 
Public Health Law, Section 2164 and 2168

Section 66-1.1 - Definitions

Section 66-1.1 Definitions.

As used in this Subpart unless the context otherwise requires:

(a) School means and includes a public, private or parochial child-caring center, day-care agency providing day care of children as defined in this section, nursery school as defined in this section, kindergarten, and any elementary, intermediate or secondary class or school building.

(b) Child means and includes any person between the ages of two months and 18 years.

(c) Day care of children means:

(1) outside the City of New York, care provided to children away from the child's residence, for less than 24 hours per day in a licensed child day care center or a group family day care, for compensation or otherwise, for at least three hours a day.

(2) in the City of New York, any service which, during all or part of the day, regularly gives care to six or more children, not of common parentage, who are under six years of age, whether or not the care is given for compensation and whether or not it has a stated educational purpose. The total number of children receiving care shall be counted, including children or foster children of the owner or person in charge, in determining the applicability of this definition. The term shall not, however, include a service which gives care to children for five or less hours a week or a service which operates for one month a year or less.

(d) Nursery school means a place, other than one providing day care of children as defined in this section, in which organized instruction is provided for children prior to entering any public or non-public school.

(e) Health practitioner means any person authorized by law to administer an immunization. This includes a physician, nurse practitioner, nurse-midwife caring for a pregnant student, registered nurse, licensed practical nurse under the direction of a registered nurse, or physician's assistant.

(f) Fully immunized means that an adequate dosage and number of doses of an immunizing agent licensed by the United States Food and Drug Administration has been received commensurate with the child's age, or the child has been demonstrated to have immunity as defined in this section. 

(1) For those immunizations required by section 2164 of the Public Health Law only, the number of doses that a child shall have at any given age, and the minimum intervals between these doses, shall be in accordance with the Advisory Committee on Immunization Practices Recommended Child and Adolescent Immunization Schedule for ages 18 years or younger, issued by the Advisory Committee on Immunization Practices (ACIP) as referenced in Chapter 35 of the Laws of 2019 and posted on the Centers for Disease Control and Prevention website. Any child who completed an immunization series following minimum intervals prescribed in an ACIP Recommended Immunization Schedule pre-dating February 2019 shall continue to be deemed in compliance as long as the number of vaccine doses the child received conforms to the current ACIP Recommended Immunization Schedule. 

(i) For all vaccinations, except as provided in subparagraphs (ii) through (vii) of this paragraph, children shall be assessed upon school entry or attendance, and annually thereafter, and be fully immunized commensurate with their age. 

(ii) Any child who has satisfied the immunization requirements in effect in regulation on June 30, 2014, entering twelfth grade (or comparable age level grade equivalents) in the 2019-2020 school year only, shall be deemed in compliance with the immunization requirements set forth in this section, including those set forth in subparagraphs (iii) through (vi) of this paragraph, until such child graduates from school; provided, however, that such child shall comply with the meningococcal vaccination requirement set forth in subparagraph (vii) of this paragraph.  

(iii) Any child entering or attending kindergarten through twelfth grade must have received the following vaccine doses, with the minimum intervals between these doses as established by the Advisory Committee on Immunization Practices Recommended Child and Adolescent Immunization Schedule for ages 18 years or younger:  

(a) Two adequate doses of measles containing vaccine, two adequate doses of mumps containing vaccine, and at least one adequate dose of rubella containing vaccine; and 

(b) Five adequate doses of diphtheria and tetanus toxoids and acellular pertussis vaccine. If, however, the fourth dose of diphtheria and tetanus toxoids and acellular pertussis vaccine was given at 48 months of age or older, only four adequate doses of vaccine are required. The final dose of vaccine must be received no sooner than 48 months of age. Doses given after age seven should start with one dose of Tdap.  

(iv) Four adequate doses of poliomyelitis vaccine. If, however, the third adequate dose of poliomyelitis vaccine was given at 48 months of age or older, only three adequate doses of vaccine are required. The final dose of vaccine must be received no sooner than 48 months of age. Beginning on or after September 1, 2016, children shall be assessed upon entry or attendance to child-caring centers, day-care agencies, nursery schools and pre-kindergarten programs and must be fully immunized against poliomyelitis commensurate with their age. 

(v) Two adequate doses of varicella vaccine.  

(vi) By entry to sixth grade or a comparable age level grade equivalent, any child 11 years of age or older must have received one dose of a booster immunization containing tetanus and diphtheria toxoids and acellular pertussis vaccine. 

(vii) For meningococcal vaccination, beginning on and after September 1, 2016, children shall be assessed upon entry or attendance to seventh grade, or a comparable age level grade equivalent, and must have received one adequate dose of vaccine upon such entry or attendance. Children shall be assessed upon entry or attendance to twelfth grade, or a comparable age level grade, and must have received two adequate doses of meningococcal vaccine upon such entry or attendance. If, however, the first dose of meningococcal vaccine was given at 16 years of age or older, then only one adequate dose of meningococcal vaccine is required for twelfth grade.

(2) If a child is not fully immunized, catch-up immunization must then take place according to the Advisory Committee on Immunization Practices Recommended Child and Adolescent Immunization Schedule for ages 18 years or younger.

(g) Immunity means that:

(1) for measles, mumps, and rubella, a child has had a positive serologic test, as defined in subdivision (h) of this section, for those diseases, or laboratory confirmation of disease, as defined in subdivision (k) of this section;

(2) for varicella, a child has either had a positive serologic test, as defined in subdivision (h) of this section; laboratory confirmation of disease, as defined in subdivision (k) of this section; or had the disease as verified by a physician, nurse practitioner, or physician's assistant statement;

(3) for hepatitis B, a child has had a positive serologic test, as defined in subdivision (h) of this section; or

(4) for poliomyelitis, positive serologic tests, as defined in subdivision (h) of this section, for all three serotypes of poliomyelitis, performed prior to September 1, 2019. Serologic tests against poliomyelitis performed on or after September 1, 2019 will not be accepted in place of poliomyelitis vaccination.

(h) Serologic test means a blood test for Immunoglobulin G (IgG), or for hepatitis B, a blood test for hepatitis B surface antibody, as determined by the testing lab's criteria. Serology results reported as equivocal are not acceptable proof of immunity. A positive serologic test can be accepted in place of vaccination only for the following diseases: measles, mumps, rubella, varicella, and hepatitis B and all three serotypes of poliomyelitis found in the polio vaccines.

(i) Age appropriate means that vaccine doses administered within four calendar days of the recommended minimum age or interval will be considered valid.

(j) In process means that:

(1) a child has received at least the first dose in each immunization series required by section 2164 of the Public Health Law (except in the case of live vaccines in which a child should wait 28 days after one live vaccine administration before receiving another live vaccine, if the vaccines were not given on the same day) and has age appropriate appointments to complete the immunization series according to the Advisory Committee on Immunization Practices Recommended Child and Adolescent Immunization Schedule for ages 18 years or younger; or

(2) a child has had blood drawn for a serologic test and is awaiting test results within 14 days after the blood draw; or

(3) a child's serologic test(s) are negative, and therefore the child in question has appointments to be immunized within 30 days of notification of the parent/guardian to complete, or begin completion, of the immunization series based on the Advisory Committee on Immunization Practices Recommended Child and Adolescent Immunization Schedule for ages 18 years or younger.

(4) Children who are not fully immunized can only continue to attend school if they are in the process of completing the immunization series based on the Advisory Committee on Immunization Practices Recommended Child and Adolescent Immunization Schedule for ages 18 years or younger. If a child does not receive subsequent doses of vaccine in an immunization series according to the age appropriate ACIP catch-up schedule, including at appropriate intervals, the child is no longer in process and must be excluded from school within 14 days after the minimum interval identified by the ACIP catch-up schedule, if not otherwise exempt in accordance with section 66-1.3 of this Subpart.

(k) Laboratory confirmation of disease means, for measles, mumps, rubella or varicella, a positive laboratory test, either culture or polymerase chain reaction, detecting either the virus or viral-specific nucleic acid in a clinical specimen from the child or, for measles or rubella, a positive blood test for Immunoglobulin M (IgM) where such positive laboratory test is not otherwise explained by recent vaccination.

(l) May be detrimental to the child’s health means that a physician has determined that a child has a medical contraindication or precaution to a specific immunization consistent with ACIP guidance or other nationally recognized evidence-based standard of care.

(m) Attend or admit means enrolled in, or admitted to, a school for the purpose of participating in or receiving services at such school, including but not limited to special education or related services, participating in intra-scholastic or interscholastic sports, or other school-sponsored events or activities; or being transported on a school bus or vehicle with other school children; except where such services, transportation, events, or activities are open to the general public.

 

Effective Date: 
Tuesday, December 31, 2019
Doc Status: 
Complete
Statutory Authority: 
Public Health Law Sections 2164 and 2168

Section 66-1.2 - Statewide Immunization Information System

66-1.2 Statewide Immunization Information System

(a) Definitions

(1) Statewide immunization information system shall mean the statewide (except New York City) computerized database of immunizations developed and maintained by the New York State Department of Health, known as the New York State Immunization Information System ("NYSIIS" or "system").

(2) Citywide Immunization Registry (CIR) shall mean the immunization information system maintained by the New York City Department of Health and Mental Hygiene, capable of collecting, storing and disclosing the electronic and paper records of vaccinations administered to persons less than 19 years of age and those persons 19 and older with consent in accordance with the New York City Health Code. For the purposes of this definition the term New York City Department of Health and Mental Hygiene shall mean such agency or any successor agency responsible for the CIR.

(3) Health care provider for the purposes of this section shall mean any person authorized by law to order an immunization or any health care facility licensed under Article 28 of the Public Health Law or any certified home health agency established under Section 3606 of the Public Health Law.

(4) Designees shall mean individuals, acting under the authority of a health care provider or another category of authorized user, who have been specifically delegated responsibility to access NYSIIS or the CIR and perform the functions permitted the primary authorized user.

(5) Emancipated minors shall mean those children less than 18 years of age who by virtue of a court decision declaring them emancipated, or who because they are otherwise emancipated under the law, are able to make their own decisions regarding health care services.

(6) Registrants shall mean all indivduals for whom an immunization or exemption to immunization or blood lead analysis is recorded in the system, at any time following January 1, 2008 for NYSIIS and January 1, 1994 for the CIR. Registrants also include individuals born in New York State (outside of New York City) on or after January 1, 2004 for NYSIIS or born in New York City on or after January 1, 1996 for the CIR.

(7) School, for the purposes of this section, shall mean any agency or entity required by law or regulation to verify immunization status for participants prior to or at selected times during enrollment, including licensed day care facilities. Such verification is an authorized delegation of public health authority for the purposes of fulfilling this public health mandate related to verification of immunization status.

(8) Authorized users of NYSIIS and the CIR shall mean the following categories of users, who are permitted access only to records of registrants falling within their administrative or clinical responsibilities. An authorized user in a category below may designate the ability to access the system to others where indicated.

(i) health care providers who order an immunization, and their designees, including Regional Health Information Organizations or other Health Information Technology entities as defined in subparagraph 2 of subdivision h of Section 504.9 of Title 18 of the New York Codes Rules and Regulations;

(ii) local health districts;

(iii) Commissioners of local social services districts and their designees;

(iv) the Commissioner of the Office of Children and Family Services and his/her designees;

(v) schools;

(vi) Third party payers;

(vii) WIC programs;

(viii) Colleges;

(ix) Professional and technical schools;

(x) Children’s overnight camps and summer day camps;

(xi) registered professional nurses; and

(xii) pharmacists authorized to administer immunizations pursuant to subdivision   two of section sixty-eight hundred one of the Education Law.

(b) Mandated Reporting

(1) Mandated reporters to NYSIIS and the CIR include any health care provider, as defined in section 66-1.2 who administers an immunization or conducts a blood lead analysis of a sample.

(2) Mandated reporters must report any immunization to a child less than 19 years of age to either NYSIIS or the CIR, depending on the location of administration of the vaccine.

(3) Article 28 facilities or certified home health agencies established under section 3606 of the Public Health Law in which providers are responsible for administration of vaccines may, when agreed to by the facility and the provider ordering the vaccination, assume reporting responsibility for the authorized individuals administering vaccines within their facilities.

(4) A person who administers but does not order immunizations is not responsible for reporting the immunizations to the system, unless acting as a designee of the health care provider who ordered the immunization and under whose supervision the vaccine was administered. The ordering health care provider remains responsible for supervising his/her designee and ensuring that appropriate and timely reporting occurs.

(5) When vaccines are administered based on non-patient specific orders, the health care provider ordering the immunizations shall ensure that required data elements for each vaccination are submitted to NYSIIS or the CIR, depending on the location of administration of the vaccine.

(c) Information required to be reported, methods of reporting, exceptions and timeliness of reporting

(1) Information required to be reported to NYSIIS or the CIR, to the extent available to the provider shall include: the patient's name (first, middle and last); date of birth; gender; race; ethnicity; address, including zip code; telephone numbers; birth order (if multiple birth); birth state/country; mother's maiden name; mother's or other responsible party's name (first, middle and last); Vaccines for Children program eligibility; Medicaid number; and vaccine administration date, type, lot number and manufacturer, except as noted in subdivision (3) below. A provider should report elements for any additional data fields in NYSIIS or the CIR when available.

(2) Methods of reporting. All data elements reported to the NYSIIS or the CIR must be submitted electronically except as provided in subdivision (3) below.

(i) Direct online entry of immunization information into NYSIIS. Authorized users with read/write access and their designees may submit information directly to the statewide system using their individual access accounts.

(ii) Health care providers with existing electronic information systems compatible with NYSIIS. Such providers may request, on an individual or group basis, permission to download information from current systems into a Department-prescribed file format for transfer directly to NYSIIS. The provider is responsible for the costs/programming needed to effect these data transfers, ensuring that transfers are completed on a timely basis and updating provider-specific data systems when changes are made to these systems.

(iii) Historical immunization information previously submitted to a regional registry. Health care providers who have submitted immunization records to one of the regional immunization registries (Healthy Shot or Immunization Registry and Information Source ("IRIS") may authorize submission of this regionally-archived immunization history information to the statewide system.

(iv) Submission of immunization information to NYSIIS or the CIR. Providers must submit immunization information to NYSIIS or the CIR, dependent upon the IIS operating in the area in which they practice, not the IIS appropriate to the patient's area of residence. Exchange of information between IIS's will be the responsibility of NYSIIS and the CIR.

(3) Exceptions to reporting requirements to NYSIIS.

(i) Hospitals participating in the Statewide Perinatal Data System are exempted from entering immunization information directly into NYSIIS for newborns during their initial hospital stay. Information submitted through the Statewide Perinatal Data System will populate NYSIIS required information fields. Hospitals located in New York State, outside of New York City, are required to report to NYSIIS all other immunizations administered to children less than 19 years of age while under their care.

(ii) A provider may submit incomplete immunization electronic files or may manually enter incomplete immunization information into the statewide system in fulfillment of requirements for submission of historical immunization information. Required information for immunizations administered after January 1, 2008, which is missing shall be entered when it becomes available to the provider.

(4) Timeliness of Reporting. Providers ordering immunizations must submit immunization information to NYSIIS or the CIR within 14 days of administration of the immunization. Providers must also submit information regarding immunizations not previously reported for each registrant.

For NYSIIS only:

(i) Providers must submit any missing information requested by NYSIIS within 14 days of the issuance of the request.

(ii) For individuals exempt from administration of vaccines, providers must submit patient information, including the reason that such immunization may be detrimental to the child’s health, as defined in subdivision (l) of section 66-1.1 of this Subpart, to the statewide immunization information system within 14 days following the in-person clinical interaction that occurs at or after what would normally have been the due date for administration of an age-appropriate immunization to that child, according to current national immunization recommendations.

(d) Allowable access levels and permitted uses of NYSIIS and/or CIR data by authorized users specific to the organization they are representing.

(1) Allowable access levels.

(i) Read/write access. Only health care providers providing services to the registrant and State and local Department of Health staff may compile reports, read immunization information, enter immunization information and change immunization information, with limitations as specified below. Health care providers who have been granted a time-limited deferral on electronic data submission to NYSIIS may access the information by phone or via written request.

(ii) Read-only access. Authorized users not listed in subparagraph (i) of this paragraph such as schools are permitted read-only access to NYSIIS and/or the CIR. Read-only access allows the user to view records of only those children under their administrative responsibility and to compile reports based on data aggregated from those records.

(2) Permitted uses of NYSIIS or CIR data. All requests for use of NYSIIS information by an authorized user which are not included in the allowable uses for that person as noted in subparagraphs (i) - (x) of this paragraph are prohibited without the approval of the Commissioner of the State Department of Health; or, for requests for CIR information, without the approval of the Commissioner of the New York City Department of Health and Mental Hygiene or his or her designee. Approval is contingent on ongoing adherence to the terms and conditions of the user agreements. Allowable uses of the data for particular categories of users include:

(i) Health care providers or their designees may access NYSIIS or CIR data for the provision of care and treatment, either temporary or longer term, to a particular registrant. The information can be used either on a patient-specific basis or to generate reports specific to their practice to determine immunizations received by a specific groups of registrants, review of practice coverage, generation of reminder and recall notices, quality improvement, vaccine inventory and accountability inclusive of Vaccines for Children (VFC) Program inventory and accountability, vaccine ordering, VFC re-enrollment, and printing a copy of the immunization record for the registrant or the registrant's parent or guardian, as appropriate.

(a) If other child health status or test results information becomes available through NYSIIS or the CIR that may be useful in determining the course of treatment for the child, such information will be made available on an as-needed and authorized basis to health care providers.

(ii) Schools may access NYSIIS or CIR data for verifying immunization history for students entering or registered in that school or school system or may run school-specific reports that aggregate available data. Access will be limited to data for registrants enrolling or already enrolled in a particular school or school system.

(iii) Commissioners of local social services districts and their designees may access NYSIIS or CIR data with regard to children in their legal custody. Such information may be used for quality assurance and accountability by local social services districts.

(iv) The Commissioner of the Office of Children and Family Services and his/her designees may access NYSIIS or CIR data with regard to children in his/her legal custody. Such information may be used for ensuring appropriate care and treatment of children for whom the Office of Children and Family Services maintains custody and responsibility.

(v) Local health departments may access immunization data in NYSIIS and the CIR for purposes of outreach, quality improvement and vaccine accountability, epidemiological studies and disease control within their own county. Local health department staff may be granted access to immunization information in NYSIIS and the CIR for registrants whose immunizations were administered within their own county and for registrants residing in the county whose immunizations were administered outside of the county.

(vi) Third party payers may access NYSIIS or CIR data for the purpose of performing quality assurance, accountability and outreach relating to enrollees covered by their plan. Third party payers must request information from the appropriate registries.

(vii) The Commissioner of Health and the Commissioner of the New York City Department of Health and Mental Hygiene and their designated staffs will have full read/write access to their respective systems/registries in order to fulfill file maintenance and improvement functions and may use the data in both NYSIIS and the CIR for purposes of outreach, quality improvement and vaccine accountability, research, epidemiological studies and disease control.

(a) The Commissioner of Health or the Commissioner of the New York City Department of Health and Mental Hygiene or his or her designee may provide, on request, registrant-specific information to other state or city immunization systems and systems maintained by the Indian Health Service and tribal nations recognized by the state or the United States on a routine basis pursuant to a written agreement with each system requiring such system to conform to national standards for maintaining the integrity of the data, protecting the confidentiality of personal information and using the data only for purposes permitted in this section.

(b) The Commissioner of Health or the Commissioner of the New York City Department of Health and Mental Hygiene may provide registrant-specific information to federal health officials, state or city immunization systems and systems maintained by the Indian Health Service and tribal nations recognized by the state or the United States and others identified by the Commissioner of each respective immunization information system, for activities necessary to protect public health, in accordance with any written agreement required by such Commissioner.

(c) The Commissioner of Health or the Commissioner of the New York City Department of Health and Mental Hygiene may provide institutes of higher education, medical research centers or other institutions engaged in epidemiological research or other public health research access to de-identified registrant information in NYSIIS or the CIR for research purposes if approved by the Commissioner of Health or the Commissioner of the New York City Department of Health and Mental Hygiene, as appropriate.

(viii) WIC programs for the purposes of verifying immunization and lead testing status for those seeking or receiving services, as well as referral for immunizations or lead tests as needed.

(ix) Colleges may access NYSIIS or CIR data for verifying immunization history for students entering or registered in that college or college system or may run college-specific reports that aggregate available data. Access shall be limited to data for registrants enrolling or already enrolled in a particular college or college system.

(x) Professional and technical schools may access NYSIIS or CIR data for verifying immunization history for students entering or registered in that professional or technical school or may run college-specific reports that aggregate available data. Access shall be limited to data for registrants enrolling or already enrolled in a particular professional or technical school.

(xi) Children’s overnight camps and summer day camps may access NYSIIS or CIR data for verifying immunization history for children attending that overnight camp or summer day camp or may run camp-specific reports that aggregate available data. Access shall be limited to data for registrants attending a particular overnight or summer day camp.

(xii) Any parent or guardian of a registrant less than 18 years of age or the registrant himself/herself if 18 years or older or an emancipated minor, may receive a copy of an immunization record at no cost from their local health department, the CIR or NYSIIS.

(e) Methods of Accessing Immunization Data.

Each person seeking access to NYSIIS and/or the CIR must submit a completed application for access.

(f) Maintenance of Security and Confidentiality.

(1) Each person accessing the statewide system must have a distinct password and system ID that conform to industry standards, and with level and type of access tied to the type of user, as defined in subsection (d).

(2) Each person must understand and agree to adhere to the confidentiality protocol developed by the Department or the NYCDOHMH prior to either submitting or obtaining data from NYSIIS or the CIR.

(g) Provision of NYSIIS information to registrant's family/guardian.

(1) Mandated reporters to NYSIIS must provide the parent or legal guardian of each registrant with a copy of an informational brochure or letter from the Department at the time of each registrant's initial entry into the statewide system by that provider.

(2) If the parent/guardian speaks a primary language other than English, mandated reporters to NYSIIS must make every attempt to provide statewide system-related information comparable to the Department's brochure in the primary language of the parent or guardian.

Effective Date: 
Tuesday, December 31, 2019
Doc Status: 
Complete
Statutory Authority: 
Public Health Law, Section 2168

Section 66-1.3 - Requirements for school admission

66-1.3 Requirements for school admission.

A principal or person in charge of a school shall not admit a child to school unless a person in parental relation to the child has furnished the school with one of the following:

(a) A certificate of immunization, as described in section 66-1.6 of this Subpart, from a health care practitioner or from NYSIIS or the CIR, documenting that the child has been fully immunized according to the requirements of section 66-1.1 (f) of this Subpart.

(b) Documentation that the child is in process of receiving immunizations as defined in section 66-1.1(j) of this Subpart. A principal or person in charge of a school shall not refuse to admit a child to school, based on immunization requirements, if that child is in process.

(c) A signed, completed medical exemption form approved by the NYSDOH or NYC Department of Education from a physician licensed to practice medicine in New York State certifying that immunization may be detrimental to the child's health, containing sufficient information to identify a medical contraindication to a specific immunization and specifying the length of time the immunization is medically contraindicated. The medical exemption must be reissued annually. The principal or person in charge of the school may require additional information supporting the exemption.

 

Effective Date: 
Tuesday, December 31, 2019
Doc Status: 
Complete
Statutory Authority: 
Public Health Law Sections 2164 and 2168

Section 66-1.4 - Requirements for continued school attendance

66-1.4 Requirements for continued school attendance. A principal or person in charge of a school shall not permit a child to continue to attend such a school for more than 14 days unless a person in parental relation to the child has furnished the school with one of the documents specified in section 66-1.3 of this Subpart. Such 14 calendar day period may be extended to not more than 30 calendar days for an individual student who is transferring from out-of-state or from another country and can show a good faith effort to get the necessary evidence of immunization.
 

Effective Date: 
Tuesday, July 1, 2014
Doc Status: 
Complete

Section 66-1.5 - Immunization records from previous school

66-1.5 Immunization records from previous school. An immunization record forwarded from the child's previous school, which contains all of the information specified in subdivision (a) of section 66-1.3 of this Subpart may be accepted by the principal or person in charge of the school in lieu of a certificate of immunization.
 

Effective Date: 
Wednesday, September 26, 1990
Doc Status: 
Complete

Section 66-1.6 - Certificate of immunization

Section 66-1.6 – Certificate of Immunization

66-1.6 The certificate of immunization required in section 66-1.3(a) of this Subpart shall be prepared and signed by a health practitioner licensed in New York State and shall specify the products administered and the dates of administration. It may also show physician, nurse practitioner, or physician assistant-verified history of varicella disease and/or positive serologic tests for measles, mumps, rubella, varicella, and/or Hepatitis B and/or laboratory confirmation of disease for measles, mumps, rubella and/or varicella. Certificates of immunization issued prior to September 1, 2019 may also show positive serologic tests for all 3 serotypes of poliomyelitis contained in the polio vaccines. A record issued by NYSIIS, the CIR, an official immunization registry from another state, an electronic health record, and/or an official record from a foreign nation may be accepted as a certificate of immunization without a health practitioner’s signature.

Effective Date: 
Tuesday, December 31, 2019
Doc Status: 
Complete
Statutory Authority: 
Public Health Law Sections 2164 and 2168

Section 66-1.7 - School Survey

Section 66-1.7 School Survey

66-1.7 Every school, shall annually provide the Commissioner of Health, or in the city of New York the New York City Commissioner of Health, by a date determined by the applicable Commissioner, a summary regarding compliance with the provisions of this section. For all schools, excluding public schools within New York City, the summary will be provided in the form of the yearly school survey conducted by the Department of Health.

Effective Date: 
Tuesday, July 1, 2014
Doc Status: 
Complete

Section 66-1.8 - Immunization for children excluded from school

66-1.8 Immunization for children excluded from school. Whenever a child has been refused admission to, or continued attendance at, a school for lack of acceptable evidence of immunization, immunity or exemption as specified in section 66-1.3 of this Subpart, the principal, teacher, owner or person in charge of the school shall:

(a) notify the person in parental relation to the child of his/her responsibility to have the child immunized and of the public resources available for doing so;

(b) notify the local health authority of the name and address of the excluded child and of the immunization or immunizations which the child lacks; and

(c) provide, with the cooperation of the local health authority, for a time and place at which the required immunization or immunizations may be administered.
 

Effective Date: 
Tuesday, July 1, 2014
Doc Status: 
Complete

Section 66-1.9 - Obligation of local health authority

66-1.9 Obligation of local health authority. Upon being notified by a principal or person in charge of a school of the exclusion from school of one or more children for lack of acceptable evidence of immunization, it shall be the responsibility of the local health authority to either:

(a) cooperate with the school authorities to provide a time and place, within two weeks of the exclusion, at which the appropriate immunization or immunizations may be administered, by a health practitioner as defined in section 66-1.1(e); or

(b) notify the commissioner that the required immunizations will not be administered either by local health authority or school, and that the cost of doing so by the agents of the commissioner may be recovered from the amount of State aid to which the local health authority would otherwise be entitled.
 

Effective Date: 
Tuesday, July 1, 2014
Doc Status: 
Complete

Section 66-1.10 - Exclusion in event of disease outbreak

66-1.10 Exclusion in event of disease outbreak.

(a) For those diseases listed in PHL section 2164 only, in the event of an outbreak, as defined in section 2.2(d) of this Title, of a vaccine-preventable disease in a school, the commissioner, or his or her designee, or in the City of New York, the Commissioner of Health of the New York City Department of Health and Mental Hygiene, may order the appropriate school officials to exclude from attendance all students who either have been exempted from immunization under section 66-1.3(c) of this Subpart, or are in the process of receiving required immunizations pursuant to section 66-1.3(b) of this Subpart.

(b) The exclusion shall continue until the commissioner or his or her designee, or in the City of New York, the Commissioner of Health of the New York City Department of Health and Mental Hygiene, determines that the danger of transmission has passed.

(c) Schools must maintain a list of susceptible students who should be excluded from attendance in the event of an outbreak of vaccine preventable disease. This list must include all students who have been excused from immunization under section 66-1.3(c) of this Subpart and students who are in the process of completing immunization series or awaiting the results of serologic testing for any vaccine preventable disease specified under section 66-1.3(b) of this Subpart. The list shall be updated each time a new student enrolls in the school or a student's immunization status changes.
 

Effective Date: 
Tuesday, December 31, 2019
Doc Status: 
Complete
Statutory Authority: 
Public Health Law Sections 2164 and 2168

SubPart 66-2 - Immunization against measles, mumps and rubella for post secondary students

Effective Date: 
Wednesday, September 26, 1990
Doc Status: 
Complete
Statutory Authority: 
Public Health Law, Section 2165

Section 66-2.1 - Definitions

Section 66-2.1 Definitions.

(a) "Institution" means a college, university or other institution for higher education authorized to confer degrees.

(b) "Student" means any person born on or after January 1, 1957, who is registered to attend or attends classes at an institution whether full-time or part-time. "Part-time student" means a student enrolled for at least six, but less than twelve semester hours, or the equivalent, per semester or at least four but less than eight semester hours per quarter in an approved degree or registered certificate program in a degree- granting institution. "Full-time student" means a student enrolled for twelve or more semester hours, or the equivalent, per semester or eight or more semester hours per quarter.

(c) "Immunization" means an adequate dose or doses of an immunizing agent against measles, mumps and rubella which meets standards approved by the United States public health service for such biological products and which is approved by the state department of health under such conditions as may be specified by the public health council.

(d) "Health Practitioner" means any person authorized by law to administer an immunization.

(e) "Attendance" means the physical presence of the student at the institution and shall begin on the first scheduled day of classes for a student each semester.

(f) "School" means a public, private or parochial elementary, intermediate or secondary school building.

(g) "Certificate of Immunization" means that document, prepared by the health practitioner who administers an immunization, which specifies the products administered and the dates of administration (See Public Health Law 2165(5).) It may also show physician-verified history of disease and/or laboratory evidence of immunity. "Certificate of Immunization" shall also mean an immunization record submitted by the institution or school which the student previously attended, which specifies the products administered and the dates of administration and whose source was a certificate of immunization from a health practitioner.
 

Effective Date: 
Wednesday, September 23, 1992
Doc Status: 
Complete

Section 66-2.2 - Requirements for attendance at an institution

66-2.2 Requirements for attendance at an institution.

(a) No institution shall permit any student to attend such institution unless the student has furnished to the institution the documentation in subdivision (b), (c), (d), or (e).

(b) A certificate of immunization that shows the student has:

(1) either:

(i) received two doses of live measles virus vaccine, the first dose administered after the age of 12 months and the second dose administered more than 30 days after the first dose but after 15 months of age; or

(ii) been diagnosed by a physician as having had measles disease; or

(iii) demonstrated serological evidence of measles antibodies; or

(iv) if the student is unable to provide a certificate of immunization that satisfies the requirements in (i), (ii) or (iii) above, documentation that proves the student attended primary or secondary school in the United States after 1980 will be sufficient proof that the student received one dose of live measles virus vaccine. If such documentation is provided, then the student must also provide a certificate of immunization that documents a dose of measles vaccine was administered within one year prior to attendance at the post-secondary institution; and

(2) either:

(i) received a single dose of live rubella virus vaccine administered after the age of 12 months; or

(ii) demonstrated serological evidence of rubella antibodies; and

(3) either:

(i) received a single dose of live mumps virus vaccine administered after the age of 12 months; or

(ii) been diagnosed by a physician as having had mumps disease; or

(iii) demonstrated serological evidence of mumps antibodies;

(c) A certificate of immunization that shows the student is in the process of completing the requirements of subdivision (b) and:

(1) has received at least one dose of live measles virus vaccine as required in subdivision (b); and

(2) has complied with the requirements in subdivision (b) for mumps and rubella; and

(3) has an appointment to return to a health practitioner for the remainder of the immunizations specified in subdivision (b), if this appointment is scheduled no more than 90 days since administration of the first dose of measles virus vaccine.

(d) If any licensed physician, licensed midwife (caring for a pregnant student), or nurse practitioner certifies in writing that one or more of the required immunizations may be detrimental to the student's health or is otherwise medically contraindicated, the requirements of subdivisions (b) and (c) shall be waived until such immunization is determined no longer to be detrimental to the student's health or otherwise medically contraindicated. This statement must specify those immunizations which may be detrimental and the length of time they may be detrimental.

(e) A written and signed statement from the student or in the event that the student is a minor, from their parent or guardian, that they hold sincere and genuine religious beliefs which prohibit immunization of the student. When a religious exemption is claimed, the institution may require supporting documents.
 

Doc Status: 
Complete

Section 66-2.3 - Time requirements for compliance

66-2.3 Time requirements for compliance. No institution shall permit any student to attend such institution in excess of thirty days without complying with section 66-2.2, except that for a student from out of state or another country who can show a good faith effort to comply with section 66-2.2 may attend the institution for 45 days. Prior to August 1, 1991, the applicable thirty and forty-five day periods shall be extended to sixty and ninety days, respectively.
 

Effective Date: 
Wednesday, September 26, 1990
Doc Status: 
Complete

Section 66-2.4 - Immunization for students not in compliance

66-2.4 Immunization for students not in compliance. In the event that a student registers at an institution and has not provided the documentation listed in section 66-2.2 (b) or (c) the institution shall:

(a) notify the student of the necessity to be immunized, and that such immunizations may be administered by a health practitioner or public health officer in the county where the student resides or in which the institution is located; and

(b) notify the student that immunization is required for attendance at the institution unless the student provides valid reason for lack of immunization due to medical or religious exemption according to section 66-2.2 (d) or (e).
 

Effective Date: 
Wednesday, September 26, 1990
Doc Status: 
Complete

Section 66-2.5 - Obligation of local health officer

66-2.5 Obligation of local health officer. If any student is unable to pay for the services of a private health practitioner, such student may present himself or herself to the health officer of the county in which such student resides, or the county in which the institution is located who shall then administer the immunization without charge.
 

Effective Date: 
Wednesday, September 26, 1990
Doc Status: 
Complete

Section 66-2.6 - Exclusion of susceptibles in the event of a disease outbreak

66-2.6 Exclusion of susceptibles in the event of a disease outbreak.

(a) In the event of an outbreak of measles, mumps or rubella in an institution, the commissioner may order the appropriate officials of the institution to exclude from attendance all students without documentation of immunity as specified in section 66-2.2 (b) or (c) and those who have been excused from immunization under section 66-2.2 (d) or (e).

(b) The exclusion shall continue until the commissioner determines that the danger of transmission has passed or until the documentation specified in section 66-2.2 (b) or (c) has been submitted.
 

Effective Date: 
Wednesday, September 26, 1990
Doc Status: 
Complete

Section 66-2.7 - Annual assessment of the immunization level of students attending the institution

66-2.7 Annual assessment of the immunization level of students attending the institution. The institution shall provide annually to the commissioner, on a form provided by the commissioner, a summary report of the immunization status of students attending the institution to whom this regulation applies. This report must be submitted by December 15 of each year.
 

Effective Date: 
Wednesday, September 26, 1990
Doc Status: 
Complete

Section 66-2.8 - Requirements for continued attendance

66-2.8 Requirements for continued attendance. Prior to August 1, 1991, this subpart shall not apply to part-time students. This Subpart shall also not apply to or any student who attended the institution he or she is attending prior to August 1, 1989.
 

Effective Date: 
Wednesday, September 26, 1990
Doc Status: 
Complete

Section 66-2.9 - Penalties

66-2.9 Penalties. A penalty for violation or failure to comply with any provision of this subpart may be assessed. (See Public Health Law Section 206.)

Effective Date: 
Wednesday, September 26, 1990
Doc Status: 
Complete

SubPart 66-3 - COVID-19 Emergency Regulations

Effective Date: 
Thursday, July 9, 2020
Statutory Authority: 
Public Health Law, Sections 201 & 206 and Executive Order 202.14

Section 66-3.1 - Duration and Applicability

66-3.1 Duration and Applicability

The provision of this Subpart shall apply for the duration of any state disaster emergency declared pursuance to sections 28 and 29-a of the Executive Law related to the outbreak of COVID-19 in New York State.  To the extent any provision of this Subpart becomes inconsistent with any Executive Order, the remainder of the provisions in this Subpart shall remain in effect and shall be interpreted to the maximum extent possible as consistent with such Executive Orders.

Effective Date: 
Thursday, July 9, 2020
Statutory Authority: 
Public Health Law, Sections 201 & 206 and Executive Order 202.14

Section 66-3.2 - Face-Coverings

Section 66-3.2 Face-Coverings

(a)  Any person who is over age two and able to medically tolerate a face-covering shall be required to cover their nose and mouth with a mask or face-covering when in a public place and unable to maintain, or when not maintaining, social distance. 

(b) Any paying passenger of a public or private transportation carrier or other for-hire vehicle, who is over age two and able to medically tolerate a face covering, shall wear a mask or face-covering over the nose and mouth during any such trip; any employee of such public or private transportation carrier who is operating such public or private transport, shall likewise wear a mask or face-covering which covers the nose and mouth while there are any paying passengers in such vehicle.

(c) Any employee who is present in the workplace shall be provided and shall wear a mask or face-covering when in direct contact with customers or members of the public, or when unable to maintain social distance. Businesses must provide, at their expense, such face coverings for their employees.

(d) Business operators and building owners, and those authorized on their behalf shall deny admittance to any person who fails to comply with this section and shall require or compel such persons’ removal. Provided, however, that this regulation shall be applied in a manner consistent with the federal American with Disabilities Act, New York State or New York City Human Rights Law, and any other applicable provision of law.

(e) For purposes of this section:

(i) Face-coverings shall include, but are not limited to, cloth masks (e.g. homemade sewn, quick cut, bandana), surgical masks, N-95 respirators, and face shields.

(ii) A person shall be considered as maintaining social distancing when keeping at least six feet distance between themselves and any other persons, other than members of such persons’ household.

Effective Date: 
Thursday, July 9, 2020
Statutory Authority: 
Public Health Law, Sections 201 & 206 and Executive Order 202.14

Section 66-3.3 - Non-essential gatherings

66-3.3 Non-essential gatherings

(a) There shall be no non-essential gatherings of greater than ten individuals for any reason at any location in the state, including but not limited to parties, celebrations or other social events. This restriction may be modified by any Executive Order issued pursuant to Executive Law Section 28 and 29-A implementing the phased re-opening of New York businesses and the relaxation of social distancing rules by region.

(b) No person, business, or other entity, shall encourage or promote any non-essential gathering on any public property including, but not limited to, streets, sidewalks, parking lots, parks, playgrounds, or beaches, that would violate subdivision (a) of this section.

(c) All non-essential gatherings that are permitted pursuant to this section shall comply with social distancing protocols and cleaning and disinfection guidelines issued by the Department.

(d) Subdivision (a) of this section shall not apply to any essential business, as defined by the New York State Department of Economic Development d/b/a Empire State Development (ESD), pursuant to the authority provided in Executive 202.6, or as further defined in this Subpart.

Effective Date: 
Thursday, July 9, 2020
Statutory Authority: 
Public Health Law, Sections 201 & 206 and Executive Order 202.14

Section 66-3.4 - Business operations

66-3.4 Business operations

(a) All businesses and not-for-profit entities in the state shall utilize, to the maximum extent possible, any telecommuting or work from home procedures that they can safely utilize. Except as may otherwise be permitted by any Executive Order issued pursuant to Executive Law Section 28 and 29-A implementing the phased re-opening of New York businesses and the relaxation of social distancing rules by region, each employer shall reduce the in-person workforce at any work locations by 100%, provided that any essential business or entity providing essential services or functions shall not be subject to such in-person restrictions. An entity providing essential services or functions whether to an essential business or a non-essential business shall not be subjected to the in-person work restriction, but may operate at the level necessary to provide such service or function.

(b) Any business not otherwise described herein may be deemed essential after requesting an opinion from the Empire State Development Corporation, which shall review and grant such request, should it determine that it is in the best interest of the state to have the workforce continue at full capacity in order to properly respond to this disaster.

(c) Essential businesses include, but are not limited to, the following: essential health care operations including but not limited to any entity or individual licensed, certified, registered or otherwise approved pursuant to Articles 5, 28, 30, 35, 36 or 40 of the Public Health Law, or Articles 131, 131-B, 131-C, 137, 139, 140, 153, 154, 163, 164 or 165 of the Education Law, and any other research or laboratory services; essential infrastructure including utilities, telecommunication, airports and transportation infrastructure, and hotels and places of accommodation; essential manufacturing, including food processing and pharmaceuticals; essential retail including grocery stores and pharmacies; essential services including trash collection, mail, and shipping services; news media;  banks and related financial institutions; providers of basic necessities to economically disadvantaged populations; construction; vendors of essential services necessary to maintain the safety, sanitation and essential operations of residences or other essential businesses; vendors that provide essential services or products, including logistics and technology support, child care and services needed to ensure the continuing operation of government agencies and provide for the health, safety and welfare of the public.

(d) Except as may otherwise be permitted by any Executive Order issued pursuant to Executive Law Section 28 and 29-A implementing the phased re-opening of New York businesses and the relaxation of social distancing rules by region, all restaurants and bars shall cease serving patrons food or beverages on premises, and shall only serve food or beverages for off-premises consumption which may include take-out or delivery services.

(e) Except as may otherwise be permitted by any Executive Order issued pursuant to Executive Law Section 28 and 29-A implementing the phased re-opening of New York businesses and the relaxation of social distancing rules by region, all indoor common portions of retail shopping malls with in excess of 100,000 square feet of retail space available for lease shall remain closed. Any stores located within such shopping malls, which have their own external entrances open to the public, separate from the general mall entrance, and which are essential businesses may remain open, provided that any restaurant shall limit itself to take out or delivery food services, and that any interior entrances to common areas of the mall remain closed and locked.

Effective Date: 
Thursday, July 9, 2020
Statutory Authority: 
Public Health Law, Sections 201 & 206 and Executive Order 202.14

Section 66-3.5 - Penalties

66-3.5 Penalties

A violation of any provision of this Subpart is subject to all civil and criminal penalties as provided for by law. Individuals who violate this Subpart are subject to a maximum fine of $1,000 for each violation. For purposes of civil penalties, each day that there is a non-essential gathering or that a business operates in a manner inconsistent with the Subpart shall constitute a separate violation under this Subpart.

Effective Date: 
Thursday, July 9, 2020
Statutory Authority: 
Public Health Law, Sections 201 & 206 and Executive Order 202.14