KRS 194A.050 requires the secretary for the Cabinet for Health and Family Services to promulgate administrative regulations necessary to operate the programs and fulfill the responsibilities vested in the cabinet. KRS 211.190(3) requires the secretary to promulgate administrative regulations necessary to regulate and control all matters set forth in KRS 211.180. KRS 214.034(1) requires the cabinet to promulgate administrative regulations to establish immunization schedules. This administrative regulation establishes the mandatory immunization schedule for attendance at child day care centers, certified family child care homes, other licensed facilities which care for children, preschool programs, and public and private primary and secondary schools.
"Advanced practice registered nurse" or "APRN" means a nurse designated to engage in advanced registered nursing as defined in KRS 314.011.
"Advisory Committee on Immunization Practices" or "ACIP" means the United States Department of Health and Human Services (HHS) Committee that makes national immunization recommendations to the Secretary of the HHS, the Assistant Secretary for Health, and the Director of the Centers for Disease Control and Prevention or CDC.
"Commonwealth of Kentucky Parent or Guardian's Declination on Religious Grounds to Required Immunizations" means an original, written, sworn, and notarized statement of a parent or guardian's objection to medical immunization against disease of a child on religious grounds.
"Dose" means a measured quantity of vaccine, specified in the package insert provided by the manufacturer.
"Healthcare provider" means a person licensed under KRS 311.530 to 311.620, 311.840 to 311.862, and a nurse designated to engage in advanced practice registered nursing as defined in KRS 314.011 and 314.042.
A current Commonwealth of Kentucky Certificate of Immunization Status shall be required for a child that is otherwise homeschooled in order to attend one (1) or more in-school classes or to participate in sports or any school-sponsored extra-curricular activities.
A Commonwealth of Kentucky Certificate of Immunization Status of a child shall be considered current for age-appropriate vaccines if the child is:
Two (2) doses of PCV if the first dose was received when aged seven (7) months through eleven (11) months;
Two (2) doses of Hib if the first dose was received when aged seven (7) months through eleven (11) months;
One (1) dose of Hib if the first dose was received when aged twelve (12) months through fourteen (14) months; or
Three (3) doses of PCV if the first dose was received when aged seven (7) months through eleven (11) months, with at least one (1) dose received when aged twelve (12) months through fifteen (15) months; or
Two (2) doses of PCV if the first dose was received when aged twelve (12) months through fifteen (15) months;
Three (3) doses of Hib if the first dose was received before aged twelve (12) months, and the second dose was received when younger than aged fifteen (15) months;
Two (2) doses of Hib if the first dose was received when aged twelve (12) months through fourteen (14) months; or
One (1) dose of Hib if the first dose was received when aged fifteen (15) months through eighteen (18) months;
Three (3) doses of PCV if the first dose was received when aged seven (7) months through eleven (11) months, with at least one dose when aged twelve (12) months through eighteen (18) months; or
Two (2) doses of PCV if the first dose was received when aged twelve (12) months through eighteen (18) months;
A diagnosis or verification from a healthcare provider that the child has varicella immunity (non-vaccine);
Three (3) doses of Hib if the first dose was received before aged twelve (12) months, and the second dose was received when younger than aged fifteen (15) months;
Two (2) doses of Hib if the first dose was received when aged twelve (12) months through fourteen (14) months; or
One (1) dose of Hib if the first dose was received when aged fifteen (15) months through forty-seven (47) months;
Three (3) doses of PCV if the first dose was received when aged seven (7) months through eleven (11) months, with at least one (1) dose when aged twelve (12) months through forty-seven (47) months;
Two (2) doses of PCV if the first dose was received when aged twelve (12) months through twenty-three (23) months; or
One (1) dose of PCV if the first dose was received when aged twenty-four (24) months through forty-seven (47) months;
A diagnosis or verification from a healthcare provider that the child has varicella immunity (non-vaccine);
Three (3) doses of Hib if the first dose was received before aged twelve (12) months, and the second dose was received when younger than aged fifteen (15) months;
Two (2) doses of Hib if the first dose was received when aged twelve (12) months through fourteen (14) months; or
One (1) dose of Hib if the first dose was received when aged fifteen (15) months through fifty-nine (59) months;
Three (3) doses of PCV if the first dose was received when aged seven (7) months through eleven (11) months, with at least one (1) dose when aged twelve (12) months through fifty-nine (59) months;
Two (2) doses of PCV if the first dose was received when aged twelve (12) months through twenty-three (23) months; or
One (1) dose of PCV if the first dose was received when aged twenty-four (24) months through fifty-nine (59) months;
A diagnosis or verification from a healthcare provider that the child has varicella immunity (non-vaccine);
Four (4) doses of DTaP or DTP or combinations of the two (2) vaccines if the fourth dose was received when aged four (4) years or older and at least six (6) months after the previous dose;
Four (4) doses of IPV or OPV or combinations of the two (2) vaccines with the fourth dose received when aged four (4) years through six (6) years and at least six (6) months after the previous dose;
Four (4) or more doses of IPV or OPV or combinations of the two (2) vaccines received before age four (4) years and an additional dose received when aged four (4) years through six (6) years and at least six (6) months after the previous dose; or
Three (3) doses of IPV or OPV or combinations of the two (2) vaccines if the third dose was received when aged four (4) years or older and at least six (6) months after the previous dose;
A diagnosis or verification from a healthcare provider that the child has varicella immunity (non-vaccine);
Four (4) doses of DTaP or DTP or combinations of the two (2) vaccines if the fourth dose was received when aged four (4) years or older and at least six (6) months after the previous dose; or
A dose of Td that was preceded by two (2) doses of DTaP, DTP, DT, or Td or combinations of the four (4) vaccines;
Four (4) doses of IPV or OPV or combinations of the two (2) vaccines with the fourth dose received when aged four (4) years or older and at least six (6) months after the previous dose;
Four (4) or more doses of IPV or OPV or combinations of the two (2) vaccines received before age four (4) years and an additional dose received when aged four (4) years or older and at least six (6) months after the previous dose;
Four (4) doses of IPV or OPV or combinations of the two (2) vaccines if the fourth dose was received before August 7, 2009, with all doses separated by at least four (4) weeks; or
Three (3) doses of IPV or OPV or combinations of the two (2) vaccines if the third dose was received when aged four (4) years or older and at least six (6) months after the previous dose;
A diagnosis or verification from a healthcare provider that the child has varicella immunity (non-vaccine);
Four (4) doses of DTaP or DTP or combinations of the two (2) vaccines if the fourth dose was received when aged four (4) years or older and at least six (6) months after the previous dose;
A dose of Td that was preceded by two (2) doses of DTaP, DTP, DT, or Td or combinations of the four (4) vaccines; or
Four (4) doses of IPV or OPV or combinations of the two (2) vaccines with the fourth dose received when aged four (4) years and older and at least six (6) months after the previous dose;
Four (4) or more doses of IPV or OPV or combinations of the two (2) vaccines received before age four (4) years and an additional dose received when aged four (4) years or older and at least six (6) months after the previous dose;
Four (4) doses of IPV or OPV or combinations of the two (2) vaccines if the fourth dose was received before August 7, 2009, with all doses separated by at least four (4) weeks; or
Three (3) doses of IPV or OPV or combinations of the two (2) vaccines if the third dose was received when aged four (4) years or older and at least six (6) months after the previous dose;
Two (2) doses of adult HepB approved by the FDA to be used for an alternative schedule for adolescents aged eleven (11) years through fifteen (15) years;
A diagnosis or verification from a healthcare provider that the child has varicella immunity (non-vaccine); and
Four (4) doses of DTaP or DTP or combinations of the two (2) vaccines if the fourth dose was received when aged four (4) years or older and at least six (6) months after the previous dose;
A dose of Td that was preceded by two (2) doses of DTaP, DTP, DT, or Td or combinations of the four (4) vaccines; or
Four (4) doses of IPV or OPV or combinations of the two (2) vaccines with the fourth dose received when aged four (4) years or older and at least six (6) months after the previous dose;
Four (4) or more doses of IPV or OPV or combinations of the two (2) vaccines received before age four (4) years and an additional dose received when aged four (4) years or older and at least six (6) months after the previous dose;
Four (4) doses of IPV or OPV or combinations of the two (2) vaccines if the fourth dose was received before August 7, 2009, with all doses separated by at least four (4) weeks; or
Three (3) doses of IPV or OPV or combinations of the two (2) vaccines if the third dose was received when aged four (4) years or older and at least six (6) months after the previous dose;
Two (2) doses of adult HepB approved by the FDA to be used for an alternative schedule for adolescents aged eleven (11) through fifteen (15) years;
A diagnosis or verification from a healthcare provider that the child has varicella immunity (non-vaccine); and
Four (4) doses of DTaP or DTP or combinations of the two (2) vaccines if the fourth dose was received when aged four (4) years or older and at least six (6) months after the previous dose;
A dose of Td that was preceded by two (2) doses of DTaP, DTP, DT, or Td or combinations of the four (4) vaccines; or
Four (4) doses of IPV or OPV or combinations of the two (2) vaccines with the fourth dose received when aged four (4) years and older and at least six (6) months after the previous dose;
Four (4) or more doses of IPV or OPV or combinations of the two (2) vaccines received before age four (4) years and an additional dose received when aged four (4) years or older and at least six (6) months after the previous dose;
Four (4) doses of IPV or OPV or combinations of the two (2) vaccines if the fourth dose was received before August 7, 2009, with all doses separated by at least four (4) weeks; or
Three (3) doses of IPV or OPV or combinations of the two (2) vaccines if the third dose was received when aged four (4) years or older and at least six (6) months after the previous dose;
Two (2) doses of adult HepB approved by the FDA to be used for an alternative schedule for adolescents aged eleven (11) years through fifteen (15) years;
A diagnosis or verification from a healthcare provider that the child has varicella immunity (non-vaccine); and
Immunizations shall be received in accordance with the minimum ages and intervals between doses recommended by the ACIP. Partial, split, half, or fractionated doses or quantities shall not be administered and shall not be counted as a valid dose.
If the first two (2) doses of Hib vaccine were meningococcal group B outer membrane protein (PRP-OMP) vaccines, the third dose may be omitted.
A child with a medical contraindication to pertussis vaccine may be given DT in lieu of DTaP or Td in lieu of Tdap.
If both IPV and OPV were administered as part of a series, a total of four (4) doses shall be administered.
If only OPV was administered, and all doses were received prior to four (4) years of age, one (1) dose of IPV shall be administered when aged four (4) years or older and at least four (4) weeks after the last OPV dose.
A child aged seven (7) years or older may receive one (1) dose of Tdap in the catch-up series if the child is not fully immunized with DTaP vaccine.
A Commonwealth of Kentucky Certificate of Immunization Status marked to designate a medical exemption shall be issued for a child with a temporary or permanent medical contraindication to receiving a vaccine.
If an immunization is administered but another is objected to on religious grounds, a healthcare provider, pharmacist, local health department, or other licensed healthcare facility administering immunizations:
May request that a parent or guardian complete the Commonwealth of Kentucky Parent or Guardian's Declination on Religious Grounds to Required Immunizations form to be submitted upon enrollment in a child care facility or school;
Shall issue a Commonwealth of Kentucky Certificate of Immunization Status marked to designate "religious objection" to the requirements of Section 2 of this administrative regulation, in compliance with KRS 214.036; and
Shall list administered immunizations on the Commonwealth of Kentucky Certificate of Immunization Status.
An EPID 230A form, Commonwealth of Kentucky Parent or Guardian's Declination on Religious Grounds to Required Immunizations, shall:
List the immunizations that a parent or guardian objects to being administered to a child based on religious grounds;
A Commonwealth of Kentucky Certificate of Immunization Status marked to designate "Provisional Status" shall:
Be issued for a child who is behind in required immunizations listed in Section 2 of this administrative regulation;
Be issued for a child who has received at least one (1) dose of each of the required vaccines but has not completed all the required immunizations;
Permit a child to attend a child day care center, certified family child care home, licensed facility which cares for children, preschool program, or primary or secondary school until the child reaches the appropriate age or upon passage of the time interval between required doses;
Thirty (30) days from the date the next dose is required to be given for use in a day care center, certified family child-care home, or other licensed facility which cares for children; and
A registered nurse or licensed practical nurse designee of a physician, local health department administrator, or other licensed healthcare facility.
A Commonwealth of Kentucky Certificate of Immunization Status printed from the Kentucky Immunization Registry shall not require a signature.
A healthcare provider, pharmacist, local health department, or other licensed healthcare facility administering immunizations may obtain a blank hard copy of the following from the Cabinet for Health and Family Services:
Commonwealth of Kentucky Parent or Guardian's Declination on Religious Grounds to Required Immunizations.
A Kentucky licensed healthcare facility administering immunizations electronic medical record system; or
An electronically produced copy of a Commonwealth of Kentucky Certificate of Immunization Status shall contain at least the following information:
Certification that the child is current for immunizations until a specified date, including a statement that the certificate shall not be valid after the specified date;
The printed name, ink or electronic signature, and date as described in subsection (2) of this section; and
The name, address, and telephone number of the healthcare provider practice, pharmacy, local health department, or licensed health care facility issuing the certificate.
A signed certificate or a certificate printed from the Kentucky Immunization Registry may be faxed from a medical office to a:
All immunizations required by Section 2 of this administrative regulation and received by a child shall be included on the Commonwealth of Kentucky Certificate of Immunization Status.
All ACIP recommended immunizations a child has received in addition to the immunizations required by Section 2 of this administrative regulation may be included on the Commonwealth of Kentucky Certificate of Immunization Status.
Preschool program or a public or private primary or secondary school for all in-school classes or to participate in sports or any school sponsored extra-curricular activities if the child is otherwise homeschooled; and
Available for inspection and review by a representative of the Cabinet for Health and Family Services or a representative of a local health department.
An Out-of-State Certificate of Immunization Status shall be accepted when completed by an out-of-state physician or advanced practice registered nurse.
All age appropriate immunizations required in Kentucky as identified in Section 2(3) of this administrative regulation;
Certification that the child is current for immunizations until a specified date, including a statement that the certificate shall not be valid after the specified date;
A printed name, ink or electronic signature, and date as described in Section 4(2) of this administrative regulation; and
The name, address, and telephone number of the healthcare provider practice, local health department, or licensed health care facility issuing the certificate.
The Out-of-State Certificate of Immunization Status may be in the size, orientation, and format required by another state.
Immunizations documented on an out-of-state certificate shall be transferred to a hard copy of a Commonwealth of Kentucky Certificate of Immunization Status or shall be documented on an electronically produced Commonwealth of Kentucky Certificate of Immunization Status when one (1) or more immunizations are administered in Kentucky.
A current Commonwealth of Kentucky Certificate of Immunization Status or an Out-of-State Certificate of Immunization Status for a child shall be provided by a parent or guardian: