No. 31100 (Amendment): R396-100-3. Required Immunizations

DAR File No.: 31100
Filed: 04/01/2008, 12:46
Received by: NL

RULE ANALYSIS

Purpose of the rule or reason for the change:

This change recognizes that the vaccinations for Hepatitis A, Hepatitis B, Varicella, and Pneumococcal disease are already recommended by the Center for Disease Control's (CDC) Advisory Committee on Immunization Practices (ACIP) and the American Academy of Pediatrics. As such, medical providers routinely provide these vaccinations. This change will match the rule to current practice.

Summary of the rule or change:

The change adds requirements for Hepatitis A, Hepatitis B, Varicella, and Pneumococcal vaccinations for early child care entry effective 07/01/2008. This changed brings the Utah immunizations requirements in line with the CDC ACIP. It also updates the incorporated materials on immunization guidelines.

State statutory or constitutional authorization for this rule:

Section 53A-11-301

This rule or change incorporates by reference the following material:

Preventing Pneumococcal Disease Among Infants and Young Children: October 6, 2000/Vol. 49/No. RR-9

Anticipated cost or savings to:

the state budget:

State vaccine funds already cover underinsured children for all of the newly required immunizations. These immunizations are already routinely given to children who receive immunizations under state programs. The department does not anticipate any additional costs if the vaccinations for Hepatitis A, Hepatitis B, Varicella, and Pneumococcal vaccines are mandatory for enrollment into child care programs.

local governments:

Publicly funded vaccines are currently provided to local health departments at no cost through the federal Vaccines for Children (VFC) program to cover children on Medicaid and the Children's Health Insurance Program (CHIP), those without insurance, or who are American Indian/Alaskan Native and those who are underinsured. Local health departments choosing to serve children with private health insurance with vaccines as a covered cost are reimbursed by contracts with insurance providers. However, the department does not anticipate that there will be a change in the number of vaccinations provided by local governments as a result of this rule change. Therefore, the department estimates that there will be no cost or savings impact because of this change.

small businesses and persons other than businesses:

Physicians' offices, clinics, community health centers are all small businesses. The administration of Hepatitis A, Hepatitis B, Varicella, and Pneumococcal vaccines is recommended by ACIP and is in standard practice in medical provider offices. Most insurance plans in Utah cover all ACIP recommended vaccines. Vaccinations for underinsured children are covered by state programs. Vaccinations for uninsured children are covered by the federal VFC program. Because the department does not anticipate that the number of vaccinations will increase because of this change, the department estimates that there will be no cost or savings.

Compliance costs for affected persons:

If an individual were to pay for the immunization out-of-pocket, the vaccine costs are: $24.50 for a two dose Hepatitis A series, $28.50 for a three dose Hepatitis B series, $59.15 for a single dose Varicella, and $248.56 for a four dose Pneumococcal series. There could be additional administrative fees assessed which could be at a maximum $14.52 per dose. Most insurance plans in Utah cover the cost of these vaccines. Costs for individuals covered by private insurance are dependent upon co-pay or deductibles charged by the insurer. If the cost of a child's vaccination is not covered by insurance, the cost is covered either by Medicaid, CHIP, or the federal VFC program.

Comments by the department head on the fiscal impact the rule may have on businesses:

Some vaccines may be given on an earlier schedule consistent with medical recommendations to allow entry into day care, but the overall number of vaccines is not expected to increase as a result of this rule. Day care providers already document certain immunizations and no significant new expense is expected by the addition of these additional immunizations. David N. Sundwall, MD, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Health
Community and Family Health Services, Immunization
CANNON HEALTH BLDG
288 N 1460 W
SALT LAKE CITY UT 84116-3231

Direct questions regarding this rule to:

Martee Hawkins at the above address, by phone at 801-538-6298, by FAX at 801-538-9440, or by Internet E-mail at [e-mail]

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

05/15/2008

This rule may become effective on:

05/22/2008

Authorized by:

David N. Sundwall, Executive Director

RULE TEXT

R396. Health, Community and Family Health Services, Immunization.

R396-100. Immunization Rule for Students.

R396-100-3. Required Immunizations.

(1) A student born before July 1, 1993 must meet the minimum immunization requirements of the ACIP prior to school entry for the following antigens: Diphtheria, Tetanus, Pertussis, Polio, Measles, Mumps, and Rubella.

(2) A student born after July 1, 1993 must meet the minimum immunization requirements of the ACIP prior to school entry for the following antigens: Diphtheria, Tetanus, Pertussis, Polio, Measles, Mumps, Rubella, and Hepatitis B.

(3) A student born after July 1, 1993, must also meet the minimum immunization requirements of the ACIP prior to entry into the seventh grade for the following antigens: Tetanus, Diphtheria, Pertussis and Varicella.

(4) A student born after July 1, 1996 must meet the minimum immunization requirements of the ACIP prior to school entry for the following antigens: Diphtheria, Tetanus, Pertussis, Polio, Measles, Mumps, Rubella, Hepatitis B, Hepatitis A, and Varicella.

(5) To attend a Utah early childhood program, a student must meet the minimum immunization requirements of the ACIP for the following antigens: Diphtheria, Tetanus, Pertussis, Polio, Measles, Mumps, Rubella, [and ]Haemophilus Influenza Type b, Hepatitis A, Hepatitis B, Pneumococcal, and Varicella vaccines prior to school entry.

(6) The vaccinations must be administered according to the recommendations of the United States Public Health Service's Advisory Committee on Immunization Practices (ACIP) as listed below which are incorporated by reference into this rule:

(a) General Recommendations on Immunization: December 1, 2006/Vol. 55/No. RR-15;

(b) Immunization of Adolescents: November 22, 1996/Vol. 45/No. RR-13;

(c) Combination Vaccines for Childhood Immunization: May 14, 1999/Vol. 48/No.RR-5;

(d) Diphtheria, Tetanus, and Pertussis: Recommendations for Vaccine Use and Other Preventive Measures: August 8, 1991/Vol. 40/No. RR-10;

(e) Pertussis Vaccination: Use of Acellular Pertussis Vaccines Among Infants and Children: March 28, 1997/Vol. 46/No. RR-7;

(f) Use of Diphtheria Toxoid-Tetanus Toxoid-Acellular Pertussis Vaccine as a Five-Dose Series: Supplemental Recommendations of the Advisory Committee on Immunization Practices: November 17, 2000/Vol. 49/No. RR-13;

(g) Preventing Tetanus, Diphtheria, and Pertussis Among Adolescents: Use of Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccines: March 24, 2006/Vol. 55/No. RR-3;

(h) A Comprehensive Strategy to Eliminate Transmission of Hepatitis B Virus Infection in the United States December 23, 2005/Vol. 54/No. RR-6;

(i) Haemophilus b Conjugate Vaccines for Prevention of Haemophilus influenzae Type b Disease Among Infants and Children Two Months of Age and Older: January 11, 1991/Vol. 40/No. RR-1;

(j) Recommendations for Use of Haemophilus b Conjugate Vaccines and a Combined Diphtheria, Tetanus, and Pertussis, and Haemophilus b Vaccine: September 17, 1993/Vol. 42/No. RR-13;

(k) Measles, Mumps, and Rubella-Vaccine Use and Strategies for Elimination of Measles, Rubella, and Congenital Rubella Syndrome and Control of Mumps: May 22, 1998/Vol. 47/No. RR-8;

(l) Updated Recommendations of the Advisory Committee on Immunization Practices (ACIP for the Control and Elimination of Mumps: June 9, 2006/Vol. 55/No. 22;

(m) Poliomyelitis Prevention in the United States: May 19, 2000/Vol. 49/No. RR-5;

(n) Prevention of Varicella: [July 12, 1996/Vol. 45/No. RR-11;]June 22, 2007/Vol. 56/No. RR-4;

(o) [Prevention of Varicella: Updated Recommendations of the Advisory Committee on Immunization Practices: May 28, 1999/Vol. 48/No. RR-6; and

(p) ]Prevention of Hepatitis A Through Active or Passive Immunization: May 29, 2006/Vol. 55/No. RR-7; and

(p) Preventing Pneumococcal Disease Among Infants and Young Children: October 6, 2000/Vol. 49/No. RR-9.

 

KEY: immunizations, rules and procedures

Date of Enactment or Last Substantive Amendment: [May 7, 2007]2008

Notice of Continuation: April 24, 2003

Authorizing, and Implemented or Interpreted Law: 53A-11-303; 53A-11-306