Day Care

Regulation of the Department of Public Health concerning immunization requirements for family day care homes, child day care centers, and group day care homes.

Section 1. Section 19a-87b-10 Subsection (k) of the regulations of Connecticut State Agencies is amended as follows:

(k) Immunization requirements

(1) A child seeking admission to or attending a family day care home shall be protected as age-appropriate by adequate immunization against diphtheria, pertussis, tetanus, poliomyelitis, measles, mumps, rubella, hemophilus influenzae type b, [and] hepatitis b if such child was born after December 31, 1993, VARICELLA IF SUCH CHILD WAS BORN AFTER DECEMBER 31, 1996, and against any other disease for which vaccination is recommended in the current schedule for active immunization adopted by the Commissioner in accordance with Connecticut General Statutes Section 19a-7f.

(2) The provider shall admit no child to a family day care home unless such child's parent furnishes documentation of age-appropriate immunization, immunization-in-progress or exemption to immunization as specified in subdivision (3) of this subsection.

(3) For each enrolled child, the provider must obtain from the child's parent and keep on file at the family day care home one or more of the following types of documentation for each of the diseases listed in subdivision (1) of this subsection:

(A) a statement signed and dated by a physician, physician assistant, or an advanced practice registered nurse indicating that the child is current or in progress with immunizations according to the schedule adopted by the Commissioner in accordance with Connecticut General Statutes Section 19a-7f and that names the appointment date for the child's next immunization;

(B) a statement signed and dated by a physician, physician assistant, or an advanced practice registered nurse indicating that the child has an appointment that will keep the immunizations current or in progress as required by said schedule and that names the date for the child's next immunization;

(C) a statement signed and dated by a physician, physician assistant, or an advanced practice registered nurse indicating that the child has laboratory confirmed proof of immunity to natural infection, OR, IN THE CASE OF VARICELLA, A STATEMENT SIGNED AND DATED BY A PHYSICIAN, PHYSICIAN ASSISTANT, OR AN ADVANCED PRACTICE REGISTERED NURSE INDICATING THAT THE CHILD HAS ALREADY HAD CHICKENPOX BASED ON FAMILY AND OR MEDICAL HISTORY;

(D) a statement signed and dated by a physician, physician assistant, or an advanced practice registered nurse indicating that the child has a medical contraindication to immunization;

(E) a written statement that immunization is contrary to the religious beliefs and practices of the child or the parent of such child. Such statement shall be signed by the child's parent [and shall include affirmation of church membership by an appropriate church authority].

(4) For each child to whom subparagraph (B) of subdivision (3) of this section applies, continued enrollment in day care for more than thirty days after the named immunization appointment shall be contingent on the provider receiving written documentation from a physician, physician assistant, or an advanced practice registered nurse stating either: that the named appointment was kept and the child received the scheduled immunizations, or that the child was unable to receive the scheduled immunizations for medical reasons and a new appointment date is named.

Section 2. Section 19a-79-6a Subsection (d) of the Regulations of the Connecticut State Agencies is amended as follows:

(d) Immunization requirements

(1) A child seeking admission to or attending a child day care center or group day care home shall be protected as age-appropriate by adequate immunization against diphtheria, pertussis, tetanus, poliomyelitis, measles, mumps, rubella, hemophilus influenzae type b, [and] hepatitis b if such child was born after December 31, 1993,  VARICELLA IF SUCH CHILD WAS BORN AFTER DECEMBER 31, 1996, as of August 1, 2007 pneumococcal disease and against any other disease for which vaccination is recommended in the current schedule for active immunization adopted by the Commissioner in accordance with Connecticut General Statutes Section 19a-7f.

(2) The provider shall admit no child to a child day care center or group day care home unless such child's parent furnishes documentation of age-appropriate immunization, immunization-in-progress or exemption from immunization as specified in subdivision (3) of this subsection. No child shall be permitted to continue to attend a child day care center or group day care home for more than thirty (30) days unless such child continues to meet said requirements of subdivision (3) of this subsection.

(3) For each enrolled child, the operator must obtain from the child's parent and keep on file at the child day care center or group day care home one or more of the following types of documentation for each of the diseases listed in subdivision (1) of this subsection:

(A) a statement signed and dated by a physician, physician assistant, or an advanced practice registered nurse indicating that the child is current or in progress with immunizations according to the schedule adopted by the Commissioner in accordance with Connecticut General Statutes Section 19a-7f and that names the appointment date for the child's next immunization;

(B) a statement signed and dated by a physician, physician assistant, or an advanced practice registered nurse indicating that the child has an appointment that will keep the immunizations current or in progress as required by said schedule and that names the date for the child's next immunization;

(C) a statement signed and dated by a physician, physician assistant, or an advanced practice registered nurse indicating that the child has laboratory confirmed proof of immunity to natural infection, OR, IN THE CASE OF VARICELLA, A STATEMENT SIGNED AND DATED BY A PHYSICIAN, PHYSICIAN ASSISTANT, OR AN ADVANCED PRACTICE REGISTERED NURSE INDICATING THAT THE CHILD HAS ALREADY HAD CHICKENPOX BASED ON FAMILY AND/OR MEDICAL HISTORY;

(D) a statement signed and dated by a physician, physician assistant, or an advanced practice registered nurse indicating that the child has a medical contraindication to immunization;

(E) a written statement that immunization is contrary to the religious beliefs and practices of the child or the parent of such child. Such statement shall be signed by the child's parent [and shall include affirmation of church membership by an appropriate church authority].

(4) For each child to whom subparagraph (B) of subdivision (3) of this section applies, continued enrollment in day care for more than thirty days after the named immunization appointment shall be contingent on the provider receiving written documentation from a physician, physician assistant, or an advanced practice registered nurse stating either: that the named appointment was kept and the child received the scheduled immunizations, or that the child was unable to receive the scheduled immunizations for medical reasons and a new appointment date is named.

STATEMENT OF PURPOSE: To conform with the statutory requirement (Connecticut General Statutes Sections 19a-7f, 19a-79 and 19a-87b(b)) that age-appropriate immunization of children attending family day care homes, child day care centers or group day care homes in Connecticut reflect the current nationally recommended schedule for active immunization of normal infants and children. In 1996, the nationally recommended schedule changed to include vaccination against varicella.

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Infectious Diseases      |      Immunizations