Section I - Requirements

This section discusses requirements for attendance at a post-secondary institution regarding immunization for measles, mumps, rubella and meningococcal disease in accordance with PHL Section 2165 (measles, mumps and rubella), PHL Section 2167 (meningococcal disease), and Title 10 New York Codes, Rules and Regulations Subpart 66-2 (10 NYCRR Subpart 66-2). Also found in this section are definitions of the terms student, certificate of immunization, exclusion, audit, enforcement and medical and religious exemptions in accordance with PHL Section 2165 and NYCRR 66-2.

Requirements for Attendance

Measles

Students born on or after January 1, 1957 must submit proof of immunity to measles. Only one of the following is required:

  • The student must submit proof of two doses of live measles vaccine: the first dose given no more than 4 days prior to the student's first birthday and the second at least 28 days after the first dose; or
  • The student must submit serological proof of immunity to measles. This means the demonstration of measles antibodies through a blood test performed by an approved medical laboratory; or
  • The student must submit a statement from the diagnosing physician, physician assistant or nurse practitioner that the student has had measles disease; or
  • The student must submit proof of honorable discharge from the armed services within 10 years from the date of application to the institution. The proof of honorable discharge shall qualify as a certificate enabling a student to attend the institution pending actual receipt of immunization records from the armed services; or
  • If a student is unable to access his/her immunization record from a health care provider or previous school, 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 vaccine. If this option is used, the second dose of measles vaccine must have been administered within one year of attendance at a post-secondary institution.

Mumps

Students born on or after January 1, 1957 must submit proof of immunity to mumps. Only one of the following is required:

  • The student must submit proof of one dose of live mumps vaccine given no more than 4 days prior to the student's first birthday; or
  • The student must submit serological proof of immunity to mumps. This means the demonstration of mumps antibodies through a blood test performed by an approved medical laboratory; or
  • The student must submit a statement from the diagnosing physician, physician assistant, or nurse practitioner that the student has had mumps disease; or
  • The student must submit proof of honorable discharge from the armed services within 10 years from the date of application to the institution. The proof of honorable discharge shall qualify as a certificate enabling a student to attend the institution pending actual receipt of immunization records from the armed services.

Rubella

Students born on or after January 1, 1957 must submit proof of immunity to rubella. Only one of the following is required:

  • The student must submit proof of one dose of live rubella vaccine given no more than 4 days prior to the student's first birthday; or
  • The student must submit serological proof of immunity to rubella. This means the demonstration of rubella antibodies through a blood test performed by an approved medical laboratory (Since rubella rashes resemble rashes of other diseases, it is impossible to diagnose reliably on clinical grounds alone. Serological evidence is the only permissible alternative to immunization.); or
  • The student must submit proof of honorable discharge from the armed services within 10 years from the date of application to the institution. The proof of honorable discharge shall qualify as a certificate enabling a student to attend the institution pending actual receipt of immunization records from the armed services.

Meningococcal Disease

New York State PHL Section 2167 requires post-secondary institutions to distribute information about meningococcal disease and vaccination to the students, or parents or guardians of students under the age of 18. The institution is required to maintain a record of the following for each student:

  • Certificate of Immunization for meningococcal meningitis disease; or
  • A response to receipt of meningococcal meningitis disease and vaccine information signed by the student or the student's parent or guardian; AND, EITHER
  • Self reported or parent recall of meningococcal meningitis immunization within the past 10 years; or
  • An acknowledgement of meningococcal disease risks and refusal of meningococcal meningitis immunization signed by the student or student's parent or guardian.

Specific Disease Information

For more specific disease information regarding measles, mumps, rubella and meningococcal disease, refer to Appendix "D".

In Process

A student is considered in process and allowed to attend classes if he/she has presented a Certificate of Immunization that shows the student is in the process of completing the immunization requirements of PHL Section 2165.

To be "in process" the student must have received at least one dose of live measles virus vaccine, have complied with the requirements for mumps and rubella, and have an appointment to return to a health practitioner for the second dose of measles if this appointment is scheduled no more than 90 days since administration of the first dose of measles virus vaccine.

A student can be considered in process of complying with PHL Section 2167 regarding meningococcal disease until the maximum 30 day grace period has elapsed. The 30 day grace period may be extended to 60 days if a student can show a good faith effort to comply with PHL Section 2167. If a student is granted the extended grace period, then exclusion begins immediately after the 60 days elapses.

Student

Measles, Mumps and Rubella Requirements

As defined by PHL Section 2165 (1)(b) and 10 NYCRR Subpart 66-2.1(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, in an approved degree or registered certificate program in a degree granting institution. "Part-time student" means a student enrolled for at least six, but less than 12 semester hours, or the equivalent per semester or at least four but less than eight semester hours per quarter. "Full-time student" means a student enrolled for 12 or more semester hours or the equivalent per semester, or 8 or more semester hours per quarter. If a student is registered to attend or attends an institution for less than 6 semester hours or 4 credit hours per quarter, the immunization requirements do not apply to that student. If an enrollee at a post-secondary institution was born before 1957, he/she does not have to comply with PHL Section 2165 immunization requirements.

Meningococcal Disease Requirements

As defined by PHL Section 2167(1)(a) "student" means a person attending an institution and, in the case of a student attending college, "student" means a person who is registered to attend or who attends classes at an institution, who is enrolled for at least 6 semester hours or the equivalent per semester or at least 4 semester hours per quarter. There is no age differentiation regarding meningococcal disease.

Attendance

As defined by 10 NYCRR Subpart 66-2.1 (e), attendance at a post-secondary institution 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.

Certificate of Immunization

The certificate of immunization shall be prepared by a physician, physician assistant or nurse practitioner, and shall specify the vaccines and gives the dates of administration. It may also show physician-verified history of disease, laboratory evidence of immunity or medical exemption. This includes documents such as a certificate from a physician, a copy of the immunization portion of the cumulative health record from a prior school, a migrant health record, a union health record, a community health plan record, a signed immunization transfer card, a military dependent's "shot" record, the immunization portion of a passport, an immunization record card signed by a physician, physician assistant or nurse practitioner, or an immunization registry record.

Exemptions from Immunization Requirements

Medical Exemption

If a licensed physician, physician assistant, or nurse practitioner, or licensed midwife caring for a pregnant student certifies in writing that the student has a health condition which is a valid contraindication to receiving a specific vaccine, then a permanent or temporary (for resolvable conditions such as pregnancy) exemption may be granted. This statement must specify those immunizations which may be detrimental and the length of time they may be detrimental. Provisions need to be made to review records of temporarily exempted persons periodically to see if contraindications still exist. In the event of an outbreak, medically exempt individuals should be protected from exposure. This may include exclusion from classes or campus.

Religious Exemption

A student may be exempt from vaccination if, in the opinion of the institution, that student or student's parent(s) or guardian of those less than 18 years old holds genuine and sincere religious beliefs which are contrary to the practice of immunization. The student requesting exemption may or may not be a member of an established religious organization. Requests for exemptions must be written and signed by the student if 18 years of age or older, or parent(s), or guardian if under the age of 18. The institution may require supporting documents. It is not required that a religious exemption statement be notarized. In the event of an outbreak, religious exempt individuals should be protected from exposure. This may include exclusion from classes or campus.

Exclusion

"Exclusion" is the process whereby noncompliant students are not permitted continued attendance at the institution; where as, "attendance" means the student's physical presence on campus (i.e., exclusion from classes, dorm residence and other curricular and extra-curricular campus activities). Exclusion should begin immediately after a 30 day grace period as stipulated under PHL Section 2165 (measles, mumps and rubella requirements), or after 45 days if a student is from out of state or from another country and can show a good faith effort to comply, or when a disease outbreak occurs.

For institutions to be in compliance with PHL Section 2167 (meningococcal meningitis response form), exclusion of students should begin immediately after the 30 day grace period elapses. The 30 day grace period may be extended to 60 days if a student can show a good faith effort to comply with PHL Section 2167. If a student is granted the extended grace period, then exclusion begins immediately after the 60 days elapse.

Audits

PHL Section 206 (See Appendix A) grants the Commissioner of the New York State Department of Health (NYSDOH) through the Immunization Program the authority to determine compliance with PHL Sections 2165 and 2167. The purpose of immunization record audits is to determine if post-secondary institutions are in compliance with the aforementioned sections of public health law. NYSDOH regional office staff will conduct the audits. Local health department staff may also be utilized to assist with the audit process. A random sampling of the student immunization records and meningococcal response forms will be reviewed at the time of the audit. Selection of an institution for auditing is not necessarily the result of any allegations of violations of PHL Section 2165. A number of institutions are selected across the state annually for routine audits.

Enforcement of Public Health Law

Under PHL Section 206, the NYSDOH Immunization Program has the legal authority to ensure that schools throughout the state comply with PHL Sections 2165 and 2167. PHL Section 2165 requires that:

No institution shall permit any student to attend such institution in excess of thirty days without complying with subdivision two of this section. However, such thirty day period may be extended to not more than forty-five days for a student where such student is from out-of-state or from another country and can show a good faith effort to provide a certificate of immunization.

PHL Section 2167 requires that:

No institution shall permit any student to attend the institution in excess of thirty days without complying with this section: provided, however, that such thirty day period may be extended to not more than sixty days if a student can show a good faith effort to comply with this section.

Findings of violations of PHL Sections 2165 and 2167 may result in the imposition of a civil penalty of up to $2,000 per each student who is permitted to attend school in violation of these requirements.

Disease Control

Disease control is the responsibility of the county health department. Contact your local health department for outbreak control procedures for measles, mumps, rubella and meningococcal disease immediately upon identifying a suspect case. (See Appendix C.)