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Title: Section 66-1.1 - Definitions

Effective Date

08/17/2016

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 Immunization Schedules for Persons Aged 0 through 18 Years, issued by the Advisory Committee on Immunization Practices (ACIP) as set forth in Morbidity and Mortality Weekly Reports (MMWR) February 5, 2016 Volume 65 (No. 4) and posted on the Centers for Disease Control and Prevention website at http://www.cdc.gov/vaccines/schedules. The department will amend this section as necessary to reflect revised ACIP Recommended Immunization Schedules. Any child who completed an immunization series following minimum intervals prescribed in an ACIP Recommended Immunization Schedule pre-dating February 2016 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. 

The Advisory Committee on Immunization Practices Recommended Immunization Schedules for Persons Aged 0 through 18 Years issued by the ACIP as set forth in the MMWR February 5, 2016 Volume 65 (No. 4) is hereby incorporated by reference, with the same force and effect as if fully set forth at length herein. It is available for public inspection and copying at the Regulatory Affairs Unit, New York State Department of Health, Corning Tower, Empire State Plaza, Albany, New York 12237. Copies are also available from the United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia 30333, and from the CDC website at http://www.cdc.gov/vaccines/schedules/. 

(i) For all vaccinations, except as provided in subparagraphs (ii) through (vii) below, 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 ninth through twelfth grade (or comparable age level grade equivalents) in the 2016-2017 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) below, until such child graduates from school; provided, however, that such child shall comply with the meningococcal vaccination requirement set forth in subparagraph (vii) below.  

(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 Immunization Schedules for Persons Aged 0 through 18 Years incorporated by reference herein:  

(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 forty-eight months of age or older, only four adequate doses of vaccine are required. The final dose of vaccine must be received no sooner than forty-eight months of age. Doses given after age seven should start with one dose of Tdap.  

(iv) For poliomyelitis vaccination, beginning on or after July 1, 2014, children shall be assessed upon entry or attendance to kindergarten and sixth grade, and/or their equivalent grades, and must have received four adequate doses of poliomyelitis vaccine. If, however, the third adequate dose of poliomyelitis vaccine was given at forty-eight months of age or older, only three adequate doses of vaccine are required. The final dose of vaccine must be received no sooner than forty-eight months of age. As the students enrolling in kindergarten and sixth grade move up a grade level each year, the students enrolling in those higher grades, or grade equivalent, must be appropriately immunized against poliomyelitis. 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) For varicella vaccination, beginning on and after July 1, 2014, children shall be assessed upon entry or attendance to kindergarten and sixth grade, and/or their equivalent grades, and must have received two adequate doses of vaccine. As the students enrolling in kindergarten and sixth grade move up a grade level each year, the students enrolling in those higher grades, or grade equivalent, must be appropriately immunized against varicella. 

(vi) By entry to sixth grade or a comparable age level grade equivalent, any child eleven 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 sixteen 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 Immunization Schedules for Persons Aged 0 through 18 Years incorporated by reference at Section 66-1.1 (f) of this subpart.

(g) Immunity means that (i) for measles, mumps, rubella, hepatitis B, and all 3 serotypes of poliomyelitis found in the polio vaccines, a child has had a positive serologic test, as defined in section 66-1.1 (h), for those diseases or (ii) for varicella, a child has either had a positive serologic test, as defined in section 66-1.1 (h), or had the disease as verified by a physician, nurse practitioner, or physician's assistant statement.

(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, hepatitis B and all 3 serotypes of poliomyelitis found in the polio vaccines.

(i) Grace period means that vaccine doses administered within 4 calendar days of the recommended minimum age or interval will be considered valid.

(j) In process means that (i) 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 Immunization Schedules for Persons Aged 0 through 18 Years incorporated by reference at Section 66-1.1 (f) of this subpart or (ii) a child is obtaining serologic tests within 30 days of notification of the parent/guardian that such testing is requested or (iii) 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 Immunization Schedules for Persons Aged 0 through 18 Years incorporated by reference at Section 66-1.1 (f) of this subpart.

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 Immunization Schedules for Persons Aged 0 through 18 Years incorporated by reference at Section 66-1.1 (f) of this subpart. 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, if not otherwise exempt in accordance with Section 66-1.3.

Statutory Authority

Public Health Law Sections 2164 and 2168

Volume

VOLUME A-1a (Title 10)

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