SECTION 310:535-1-3. Criteria for immunizations required for child care

(a)   Each child two months of age or older shall present certification that he or she has received or is receiving the immunizations as specified below before he or she is admitted to, and while enrolled in, a child care center or child care home.

(b)   Certification shall include the following:

(1)   5 DTaP/DTP doses at 2, 4, 6, and 12 to 18 months and 4 to 6 years or beginning at 6 weeks of age with minimum intervals of 4 weeks between doses 1 and 2 and doses 2 and 3 and 4 months between doses 3 and 4 and 6 months between doses 4 and 5, with all fifth doses given on or after January 1, 2003 given on or after the fourth birthday; The fifth DTaP/DTP is not required if the fourth DTaP/DTP is administered on or after the fourth birthday;

(2)   4 Polio doses at 2, 4 and 6 to 18 months and 4 to 6 years or beginning at 6 weeks of age with minimum intervals of 4 weeks between all doses; The fourth Polio is not required if the third dose is given on or after the fourth birthday;

(3)   1 to 4 Haemophilus influenzae type B (Hib) doses at 2, 4, 6, and 12 to 15 months of age or older depending upon age at first Hib immunization and type of vaccine used or beginning at 6 weeks of age with minimum intervals of 4 weeks between doses 1, 2, and 3, if a third dose is part of the primary series, and the booster dose no earlier than 12 months of age and at least 8 weeks after the previous dose;

(4)   2 Measles, Mumps, Rubella doses with the first dose on or after the first birthday and the second dose at 4 to 6 years or at anytime after the first dose provided at least 4 weeks have elapsed since the receipt of the first dose;

(5)   1 Varicella dose on or after the first birthday;

(6)   2 Hepatitis A doses with the first dose on or after the first birthday and the second dose six to eighteen months later and for all doses given on or after January 1, 2003, 6 months will be defined as 6 calendar months;

(7)   3 Hepatitis B doses with minimum intervals as follows: 1 month (4 weeks) between doses 1 and 2, two months (8 weeks) between doses 2 and 3, four months (16 weeks) between doses 1 and 3, and dose 3 no earlier than 24 weeks of age;

(8)   1 to 4 doses of pneumococcal conjugate vaccine (PCV) for children 2 months through 59 months of age at 2, 4, 6, and 12 to 15 months of age or older depending upon age at first PCV immunization with minimum intervals between doses as follows: 4 weeks between doses 1, 2, and 3 and 8 weeks between doses 3 and 4 or any dose given as the final dose at age >12 months.

(9)   Vaccine doses administered 4 days or less before the minimum intervals or ages listed in the preceding sections will be counted as valid.

(c)   In the event that the parent, guardian, or responsible adult presenting a child for admission to a child care facility certifies in writing that a family emergency exists, the immunization requirements shall be waived for a period not to exceed thirty days. No such waiver shall be knowingly permitted more than once for any child.

(d)   Immunization records for children attending school-age programs are not required if those records are maintained by the school and are readily available.

(e)   A child, through his parent or guardian, may apply for an exemption from this requirement by submitting a form to theDepartment. The child care center or child care home shall maintain a copy of the approved application in the child's records.

(1)   A request for exemption for medical reasons shall contain a certificate signed by a physician stating that the physical condition of the child is such that the immunization would endanger the life or health of the child and that the child should be exempt for immunization.

(2)   Religious and personal exemptions may be obtained after receiving an approved brief instructional presentation provided by any local county health department regarding the risks associated with not being vaccinated and the benefits vaccinations provide to the individual and the community. To be approved, the completed exemption form along with evidence of completed instruction is required.

(f)   The Department may grant exemptions or substitutions in the immunization schedule based on a medical history of a physical condition such that the immunization would endanger the life or health of the child or a medical history stating the child is likely to be immune as a result of having had a vaccine-preventable disease if the following are met:

(1)   A history of having had diphtheria and/or tetanus is not acceptable as proof of immunity since infection with diphtheria or tetanus may not render an individual immune to either of these diseases;

(2)   A history of having had polio, pertussis, rubella, mumps, or hepatitis A must be supported by laboratory evidence to be acceptable as proof of immunity to these diseases;

(3)   A history of having had measles must be accompanied by a statement from a physician, public health authority, or laboratory evidence to be acceptable as proof of immunity to measles;

(4)   A parental history of having had varicella is acceptable evidence of immunity to varicella.

(5)   A history of having had Hib before age two years is not acceptable as proof of immunity since infection with Hib prior to age two years may not render an individual immune.

[Source: Amended at 16 Ok Reg 1400, eff 5-27-99; Amended at 19 Ok Reg 2919, eff 7-26-02 (emergency); Amended at 20 Ok Reg 1661, eff 6-12-03; Amended at 22 Ok Reg 1132, eff 5-26-05; Amended at 23 Ok Reg 1344, eff 5-25-06; Amended at 24 Ok Reg 1987, eff 6-25-07; Amended at 37 Ok Reg 1413, eff 9-11-20]