DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
Disease Control and Environmental Epidemiology Division
6 CCR 1009-2
STATE BOARD OF HEALTH
RULES PERTAINING TO THE INFANT IMMUNIZATION PROGRAM,
THE VACCINES FOR CHILDREN PROGRAM, AND
THE IMMUNIZATION OF STUDENTS ATTENDING SCHOOL

Proposed amendments to Section I (H), Table 1 and Table 2:
I.	Definitions
	. . . 
H.	School - A public, private, or parochial nursery school, day care center, child care facility, family care home, Head Start program, kindergarten, or elementary or secondary school through grade twelve, or a college or university. “School” does not include A PUBLIC SERVICES SHORT-TERM CHILD CARE FACILITY AS DEFINED IN SECTION 26-6-102 (6.7), C.R.S., A GUEST CHILDCARE FACILITY AS DEFINED IN SECTION 26-6-102 (5), C.R.S., A SKI SCHOOL AS DEFINED IN SECTION 26-6-103.5 (6), C.R.S., OR college or university courses which are offered off-campus; or are offered to nontraditional adult students, as defined by the governing board of the institution; or are offered at colleges or universities which do not have residence hall facilities.
. . . 

Table 1.	MINIMUM NUMBER OF DOSES REQUIRED FOR CERTIFICATE OF IMMUNIZATION

Vaccine a	Level of School/Age of Student	
	Child
Care
2 to 3
mos	Child
Care
4 to 5
mos	Child
Care
6 to 7
mos	Child
Care
8 to 11
mos	Child
Care
12 to 14
mos	Child
Care
15 to 17
mos	Child
Care
18 to 23
mos	Preschool
2 to 4 
yrs	K Entry
4 to 6
yrs	Grades
K to 5
5 to 10
yrs	Grades
6 to 12
11 to 18
yrs	College	
Pertussis/
Tetanus/
Diphtheria	1	2	3	3	3	4 	4 	4 	5/4 b	5/4 b c	6 c d 		
Polio e	1	2	3	3	3	3	3	3	4/3 f	4/3 f	4/3 f		
Measles/
Mumps/
Rubella g					1	1	1	1	2 h	2 h	2 h	2 h i	
Haemophilus influenzae
type b (Hib) j	1	2	2	3/2	3/2	3/2/1	3/2/1	3/2/1					
Pneumococcal Conjugate  k	1	2	3/2	4/3/2	4/3/2	4/3/2	4/3/2	4/3/2					
Hepatitis B l	1	2	2	2	3	3	3	3	3	3	3 		
Varicella m					1	1	1	1	2n	2  2/1n	2  2/1 n o		
Meningococcal												p	
a	Vaccine doses administered  4 days before the minimum interval or age are to be counted as valid.
b	Five doses of pertussis, tetanus, and diphtheria vaccines are required at school entry in Colorado unless the 4th dose was given at ≥ 48 months (i.e., on or after the 4th birthday) in which case only 4 doses are required.
c	For students ≥ 7 years who have not had the required number of pertussis doses, no new or additional doses are required. Any student ≥ 7 years at school entry in Colorado who has not completed a primary series of 3 appropriately spaced doses of tetanus and diphtheria vaccine may be certified after the 3rd dose of tetanus and diphtheria vaccine (or tetanus, diphtheria, and pertussis vaccine if 10 or 11 years) if it is given > 6 months after the 2nd dose.
d	The student must meet the minimum prior requirement for the 4th or 5th doses of diphtheria, tetanus, and pertussis vaccine and have 1 tetanus, diphtheria, and pertussis vaccine dose.
e	For polio, in lieu of immunization, written evidence of a laboratory test showing immunity is acceptable.
f	Four doses of polio vaccine are required at school entry in Colorado unless the 3rd dose was given ≥ 48 months (i.e., on or after the 4th birthday) in which case only 3 doses are required. Four valid doses are a complete series regardless of age at completion. 
g	For measles, mumps, and rubella, in lieu of immunization, written evidence of a laboratory test showing immunity is acceptable for the specific disease tested. The 1st dose of measles, mumps, and rubella vaccine must have been administered at ≥ 12 months of age (i.e., on or after the 1st birthday) to be acceptable. 
h	The 2nd dose of measles vaccine or measles, mumps, and rubella vaccine must have been administered at least 28 calendar days after the 1st dose. 
i	Measles, mumps, and rubella vaccine is not required for college students born before January 1, 1957.
j	The number of Hib vaccine doses required depends on the student’s current age and the age when the vaccine was administered. If any dose was given ≥ 15 months, the Hib vaccine requirement is met. For students who began the series < 12 months, 3 doses are required of which at least 1 dose must have been administered at ≥ 12 months (i.e., on or after the 1st birthday). If the 1st dose was given at 12 to 14 months, 2 doses are required. If the current age is ≥ 5 years, no new or additional doses are required. 
k	The number of pneumococcal conjugate vaccine doses depends on the student’s current age and the age when the 1st dose was administered. If the 1st dose was administered at: (i) ≤ 6 months, 3 doses are required at 6 to 14 months and 4 doses are required at 15 to 23 months with 1 dose administered on or after the 1st birthday; (ii) 7 to 11 months, 2 doses are required at 6 to 14 months and 3 doses are required at 15 to 23 months with 1 dose on or after the 1st birthday; (iii) 12 to 23 months, 2 doses are required. If the current age is ≥ 2 years, no new or additional doses are required. 
l	For hepatitis B, in lieu of immunization, written evidence of a laboratory test showing immunity is acceptable. 
m	For varicella, written evidence of a laboratory test showing immunity or a documented disease history from a health care provider is acceptable. The 1st dose of varicella vaccine must have been administered at ≥ 12 months of age (i.e., on or after the 1st birthday) to be acceptable. 
n	IF THE SECOND DOSE OF VARICELLA VACCINE WAS ADMINISTERED TO A CHILD< 13 YEARS, THE MINIMUM INTERVAL BETWEEN DOSE 1 AND DOSE 2 IS 3 MONTHS, HOWEVER, IF THE SECOND DOSE IS ADMINISTERED AT LEAST 28 DAYS FOLLOWING THE FIRST DOSE, THE SECOND DOSE DOES NOT NEED TO BE REPEATED. FOR A CHILD WHO IS > 13 YEARS, Tthe second dose of varicella vaccine must have been administered at least 28 calendar days after the 1st dose. SEE TABLE 1 FOR THE SCHOOL YEARS/GRADE LEVELS THAT THE 2ND DOSE OF VARICELLA WILL BE REQUIRED.
o	If the 1st dose of varicella vaccine was administered at ≥ 13 years, 2 doses are required, separated by a minimum of 4 to 8 weeks.   
p	Information concerning meningococcal disease and the meningococcal vaccine shall be provided to each new student or if the student is under 18 years, to the student’s parent or guardian. If the student does not obtain a vaccine, a signature must be obtained from the student or if the student is under 18 years, the student’s parent or guardian indicating that the information was reviewed. 

Table 2.	TIMETABLE FOR IMPLEMENTATION OF REQUIREMENTS FOR SELECTED IMMUNIZATIONS FOR GRADES K TO 12
Refer to Table 1 for the minimum number of doses required for a particular grade level. Table 2 shows the year of implementation for a requirement from Table 1 and is restricted to varicella vaccine dose 1 (VAR1Var1) and dose 2 (VAR2 Var2) and tetanus, diphtheria, and pertussis vaccine (TDAP Tdap). Requirements and effective dates for other vaccines are listed in Table 1. In this table, after a vaccine is required for grades K to 12, it is no longer shown, but the requirements listed in Table 1 continue to apply.

School Year	Grade Level	
	K	1	2	3	4	5	6	7	8	9	10	11	12	
2007-08 	Var2
VAR2	Var1
VAR1	Var1
VAR1	Var1
VAR1	Var1
VAR1	Var1
VAR1	Tdap
Var1
VAR1
TDAP	Var1
VAR1			Tdap
TDAP
			
2008-09	Var2
VAR2	Var2
VAR2	Var1
VAR1	Var1
VAR1	Var1
VAR1	
Var1
VAR1
	Tdap
Var1
VAR1
TDAP	Tdap
Var1
VAR1
TDAP	
Var1
VAR1

		Tdap
TDAP	Tdap
TDAP		
2009-10	Var2
VAR2	
Var2
VAR2
	Var2
VAR2	Var1
VAR1	Var1
VAR1	Var1
VAR1	Tdap
Var1
VAR1
TDAP	Tdap
Var1
VAR1
TDAP	Tdap
Var1
VAR1
TDAP	Var1
VAR1	Tdap
TDAP	Tdap
TDAP	Tdap
TDAP	
2010-11	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var1
VAR1	Var1
VAR1	  Tdap
Var1
VAR1
TDAP	Tdap
Var1
VAR1
TDAP	Tdap
Var1
VAR1
TDAP	Tdap
Var1
VAR1
TDAP	Tdap
Var1
VAR1
TDAP	Tdap
TDAP	Tdap
TDAP	
2011-12	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var1
VAR1	Var1
VAR1	Var1
VAR1	Var1
VAR1	Var1
VAR1	Var1
VAR1	Var1
VAR1		
2012-13 (VAR1 Var1 required for K to 12)	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var1
VAR1	Var1
VAR1	Var1
VAR1	Var1
VAR1	Var1
VAR1	Var1
VAR1	Var1
VAR1	
2013-14	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2							
2014-15	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2						
2015-16	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2					
2016-17	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2				
2017-18	Var2
VAR2	Var2
 VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2			
2018-19	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2		
2019-20 (VAR2 Var2 required for K to 12)	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2	Var2
VAR2