State Immunization Laws for Healthcare
Workers and Patients

Immunization Administration Requirements
For State: CA

** Click on each result to read the abridged text of the state immunization law.

Patient Type	Vaccine	Requirement
Hospital Employees	Hepatitis B[1]	Offer[41]
	Influenza[2]	Offer[505]
	MMR[3]	Offer[553]
	Varicella[4]	Offer[554]
	Pneumococcal[5]	No
	Medical(M),Religious(R), or Philosophical(P) Exemptions[6]	No
Hospital Inpatients	Influenza[7]	Offer[506]
	Pneumococcal[8]	Offer[507]
	Medical(M),Religious(R), or Philosophical(P) Exemptions[9]	No
Individual Providers' Patients	Any Immunization[10]	No
	Medical(M),Religious(R), or Philosophical(P) Exemptions[11]	No
Ambulatory Care Facilities Employees	Any Immunization[12]	Offer[549]
	Medical(M),Religious(R), or Philosophical(P) Exemptions[13]	No
Ambulatory Care Facilities Patients	Any Immunization[14]	Ensure[42]
	Medical(M),Religious(R), or Philosophical(P) Exemptions[15]	Yes – (M)[43]
Correctional Inmates and Residents	Any Immunization[16]	Ensure[44]
	Medical(M),Religious(R), or Philosophical(P) Exemptions[17]	No
Developmentally Disabled Facility Residents	Any Immunization[18]	Ensure[45]
	Medical(M),Religious(R), or Philosophical(P) Exemptions[19]	No
	[]

[1] Does the jurisdiction require that any hospitals offer hepatitis B vaccine to any employees of the hospital, or ensure that any such employees are vaccinated with hepatitis B vaccine?
[2] Does the jurisdiction require that any hospitals offer influenza vaccine to any employees of the hospital, or ensure that any such employees are vaccinated with influenza vaccine?
[3] Does the jurisdiction require that any hospitals offer measles/mumps/rubella (MMR) vaccine (or any component thereof) to any employees of the hospital, or ensure that any such employees are vaccinated with MMR vaccine?
[4] Does the jurisdiction require that any hospitals offer varicella vaccine to any employees of the hospital, or ensure that any such employees are vaccinated with varicella vaccine?
[5] Does the jurisdiction require that any hospitals offer pneumococcal polysaccharide vaccine to any employees of the hospital, or ensure that any such employees are vaccinated with pneumococcal polysaccharide vaccine?	Top of Page
[6] If any hospitals are required to ensure that any hospital employees are vaccinated with hepatitis B, influenza, MMR, varicella or pneumococcal vaccine, does the jurisdiction provide any medical, religious or philosophical exemptions to such administration requirements?
[7] Does the jurisdiction require that any hospitals offer any inpatients of the hospital influenza vaccine, or ensure that any inpatients are vaccinated with influenza vaccine?
[8] Does the jurisdiction require that any hospitals offer any inpatients of the hospital pneumococcal polysaccharide vaccine, or ensure that any inpatients are vaccinated with pneumococcal polysaccharide vaccine?
[9] If any hospitals are required to ensure that any hospital inpatients are vaccinated with influenza or pneumococcal vaccines, does the jurisdiction provide any medical, religious or philosophical exemptions to such administration requirements?	Top of Page
[10] Does the jurisdiction require that any individual healthcare providers offer any vaccinations to any patients, or ensure that any patients are vaccinated with any vaccines?
[11] If any individual providers are required to ensure that any of their patients are vaccinated with any vaccines, does the jurisdiction provide any medical, religious or philosophical exemptions to such administration requirements?
[12] Does the jurisdiction require that any ambulatory care facilities offer any vaccinations to any employees, or ensure that any employees are vaccinated with any vaccines?
[13] If any ambulatory care facilities are required to ensure that any employees are vaccinated with any vaccines, does the jurisdiction provide any medical, religious or philosophical exemptions to such administration requirements?	Top of Page
[14] Does the jurisdiction require that any ambulatory care facilities offer any vaccinations to any patients, or ensure that any patients are vaccinated with any vaccines?
[15] If any ambulatory care facilities are required to ensure that any patients are vaccinated with any vaccines, does the jurisdiction provide for any medical, religious or philosophical exemptions to such administration requirements?
[16] Does the jurisdiction require that any correctional facilities or juvenile detention centers offer any vaccinations to any inmates or juveniles, or ensure that any inmates or juveniles are vaccinated with any vaccines?
[17] If any correctional centers or juvenile detention centers are required to ensure that any inmates or juveniles are vaccinated with any vaccines, does the jurisdiction provide for any medical, religious or philosophical exemptions to such administration requirements?	Top of Page
[18] Does the jurisdiction require that any residential facilities for the developmentally disabled or mentally retarded offer any residents any vaccinations, or ensure that any residents are vaccinated with any vaccines?
[19] If any residential facilities for the developmentally disabled or mentally retarded are required to ensure that any residents are vaccinated with any vaccines, does the jurisdiction provide for any medical, religious or philosophical exemptions to such administration requirements?
[41] For California requirements, see Cal. Code Regs. tit. 8, § 5193, relating to all occupational exposures. Cal. Code Regs. tit. 8, § 5193 requires that for all employees with occupational exposure, hepatitis B vaccination shall be made available after the employee has received the training required in subsection (g)(2)(G)9. and within 10 working days of initial assignment to all employees who have occupational exposure unless the employee has previously received the complete hepatitis B vaccination series, antibody testing has revealed that the employee is immune, or the vaccine is contraindicated for medical reasons. If the employee initially declines vaccine but at a later date while still covered under the standard changes their mind, the employer shall make the hepatitis B vaccine available at that time. If a routine booster dose(s) of hepatitis B vaccine is recommended by the U.S. Public Health Service at a future date, such booster dose(s) shall be made available.
[42] For California requirements, see Cal. Health & Safety Code § 1760.8(b)(3), relating to “pediatric day health care facilities.” Cal. Health & Safety Code § 1760.8(b)(3) requires that children accepted for care must have current immunization records.	Top of Page
[43] For California, for medical exemptions to the immunization administration requirements of Cal. Health & Safety Code § 1760.8(b)(3), see Cal. Health & Safety Code § 1760.8(b)(3), providing that immunization requirements are inapplicable where a certain specified provider states that the vaccine is medically contraindicated. It should also be noted that, while the following is not a medical exemption, immunization requirements are also inapplicable where a certain specified provider states that the child poses no risk to other children in the facility.
[44] For California requirements, see Cal. Code Regs. tit. 15, § 1432(a)(1), relating to “juvenile detention centers.” Cal. Code Regs. tit. 15, § 1432(a)(1) requires the health administrator/responsible physician to develop policies and procedures for a health appraisal/medical examination of minors, and shall include a health evaluation. Immunizations shall be verified and a program shall be started to bring minors up to date within 2 weeks of the evaluation in accordance with current public health guidelines.
[45] For California requirements, see Cal. Code Regs., tit. 22, § 51343.2(1), relating to “intermediate care facilities for the developmentally disabled (nursing),” Cal. Code Regs. tit. 22, § 51343.1(j), relating to “intermediate care facilities for the developmentally disabled (habilitative),” and Cal. Code Regs. tit. 22, § 76341(b) and Cal. Code Regs. tit. 22, § 76874(a), relating to “intermediate care facilities for the developmentally disabled.” Cal. Code Regs. tit. 22, § 51343.2(1) provides that beneficiaries in intermediate care facilities for the developmentally disabled shall receive immunizations, using as a guide the recommendations of the U.S. Public Health Service Advisory Committee on Immunization Practices and the Committee on the Control of Infectious Diseases of the American Academy of Pediatrics. Cal. Code Regs. tit. 22, § 51343.1(j) provides that physician services to residents of intermediate care facilities for the developmentally disabled (habilitative) shall include immunizations in accordance with Cal. Code Regs. tit. 42, 442.477. (Note that 442.477 does not exist.) While the language of this regulation is too vague to accurately characterize as an “ensure” requirement,” such a requirement could be inferred. Cal. Code Regs. tit. 22, § 76341(b) provides that physician services to clients must include immunizations, using a guide the recommendations of the U.S. Public Health Service Advisory Committee on Immunization Practices and the Committee on the Control of Infectious Disease and the American Academy of Pediatrics. While the language of this regulation is too vague to accurately characterize as an “ensure” requirement,” such a requirement could be inferred. Cal. Code Regs. tit. 22, § 76874(a) provides that physician services to clients in intermediate care facilities for the developmentally disabled include immunizations, using as a guide the recommendations of the U.S. Public Health Service Advisory Committee on Immunization Practices and the Committee on the Control of Infectious Disease and the American Academy of Pediatrics. Also, California statutes and regulations do not provide explicitly that any residential facilities for the developmentally disabled and mentally retarded must “offer” immunizations to any resident; however, an “offer” requirement could be inferred from Cal. Code Regs. tit. 22, § 51343.1(j), relating to “intermediate care facilities for the developmentally disabled (habilitative),” and Cal. Code Regs. tit. 22, § 76341(b), relating to “intermediate care facilities for the developmentally disabled.”
[505] For California requirements, see Cal. Health & Safety Code § 1288.7 (2007), providing that by July 1, 2007, the department shall require that each general acute care hospital, in accordance with the Centers for Disease Control guidelines, take all of the following actions: (a) Annually offer onsite influenza vaccinations, if available, to all hospital employees at no cost to the employee. Each general acute care hospital shall require its employees to be vaccinated, or if the employee elects not to be vaccinated, to declare in writing that he or she has declined the vaccination. See also Cal. Code Regs. tit. 8, § 5199, relating to “aerosol transmissible diseases”. Cal. Code Regs. tit. 8, § 5199(h)(10) requires employers to make seasonal influenza vaccine available to all employees with occupational exposure, and to ensure that each employee who declines to accept the seasonal influenza vaccine signs an influenza vaccine declination statement. Cal. Code Regs. tit. 8, § 5199 applies to hospitals, skilled nursing facilities, clinics, medical offices and other outpatient medical facilities, among others. Outpatient medical facilities whose policy is not to diagnose or treat aerosol transmissible diseases are not required to comply with this standard if they meet certain other conditions.	Top of Page
[506] For California requirements, see Cal. Health & Safety Code § 120392.2(a) (2007), providing that each year, commencing October 1 to the following April 1, inclusive, every health care facility, as defined in subdivision (a) of Section 120392, shall offer, pursuant to Section 120392.4, immunizations for influenza and pneumococcal disease to residents, aged 65 years or older, receiving services at the facility, based upon the latest recommendations of the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention, and the latest recommendations of appropriate entities for the prevention, detection, and control of influenza outbreaks in California long-term care facilities. Section 120392.4 provides in part that a resident who receives services at a health care facility during the period of October 1 to April 1 shall have his or her status for influenza and pneumococcal immunization determined by his or her physician or facility medical director, and, if appropriate, the facility shall offer to make the immunizations available, unless the facility, through written policies and procedures and using standardized nursing procedures, offers to make the immunizations available without limitation as to the period when the residents receive services at the facility.
[507] For California requirements, see Cal. Health & Safety Code § 120392.2(b) (2007), providing that each health care facility, as defined in subdivision (a) of Section 120392, shall offer, pursuant to Section 120392.4, pneumococcal vaccine to all new admittees to the health care facility, based on the latest recommendations of the ACIP. Section 120392.4 provides in part that a resident who receives services at a health care facility during the period of October 1 to April 1 shall have his or her status for influenza and pneumococcal immunization determined by his or her physician or facility medical director, and, if appropriate, the facility shall offer to make the immunizations available, unless the facility, through written policies and procedures and using standardized nursing procedures, offers to make the immunizations available without limitation as to the period when the residents receive services at the facility.
[549] For California requirements, see Cal. Code Regs. tit. 8, § 5193, relating to all occupational exposures. Cal. Code Regs. tit. 8, § 5193 requires that for all employees with occupational exposure, hepatitis B vaccination shall be made available after the employee has received the training required in subsection (g)(2)(G)9. and within 10 working days of initial assignment to all employees who have occupational exposure unless the employee has previously received the complete hepatitis B vaccination series, antibody testing has revealed that the employee is immune, or the vaccine is contraindicated for medical reasons. If the employee initially declines vaccine but at a later date while still covered under the standard changes their mind, the employer shall make the hepatitis B vaccine available at that time. If a routine booster dose(s) of hepatitis B vaccine is recommended by the U.S. Public Health Service at a future date, such booster dose(s) shall be made available. See also Cal. Code Regs. tit. 8, § 5199, relating to “aerosol transmissible diseases”. Cal. Code Regs. tit. 8, § 5199(h)(5) requires employers to make available to all susceptible healthcare workers with occupational exposure all vaccine doses listed in Appendix E. Doses listed in Appendix E include seasonal influenza vaccine, measles, mumps, and rubella vaccine, varicella vaccine, and tetanus-diphtheria-acellular pertussis (Tdap) vaccine. Employers are required to ensure that employees who decline to accept a recommended and offered vaccination sign the declination statement in Appendix C1 for each declined vaccine. Cal. Code Regs. tit. 8, § 5199 applies to hospitals, skilled nursing facilities, clinics, medical offices and other outpatient medical facilities, among others. Outpatient medical facilities whose policy is not to diagnose or treat aerosol transmissible diseases are not required to comply with this standard if they meet certain other conditions. The requirements in subsection (h)(5) will become effective on September 1, 2010.
[553] For California requirements, see Cal. Code Regs. tit. 8, § 5199, relating to “aerosol transmissible diseases”. Cal. Code Regs. tit. 8, § 5199(h)(5) requires employers to make available to all susceptible healthcare workers with occupational exposure all vaccine doses listed in Appendix E. Doses listed in Appendix E include seasonal influenza vaccine, measles, mumps, and rubella vaccine, varicella vaccine, and tetanus-diphtheria-acellular pertussis (Tdap) vaccine. Employers are required to ensure that employees who decline to accept a recommended and offered vaccination sign the declination statement in Appendix C1 for each declined vaccine. Cal. Code Regs. tit. 8, § 5199 applies to hospitals, skilled nursing facilities, clinics, medical offices and other outpatient medical facilities, among others. Outpatient medical facilities whose policy is not to diagnose or treat aerosol transmissible diseases are not required to comply with this standard if they meet certain other conditions. The requirements in subsection (h)(5) will become effective on September 1, 2010.	Top of Page
[554] For California requirements, see Cal. Code Regs. tit. 8, § 5199, relating to “aerosol transmissible diseases”. Cal. Code Regs. tit. 8, § 5199(h)(5) requires employers to make available to all susceptible healthcare workers with occupational exposure all vaccine doses listed in Appendix E. Doses listed in Appendix E include seasonal influenza vaccine, measles, mumps, and rubella vaccine, varicella vaccine, and tetanus-diphtheria-acellular pertussis (Tdap) vaccine. Employers are required to ensure that employees who decline to accept a recommended and offered vaccination sign the declination statement in Appendix C1 for each declined vaccine. Cal. Code Regs. tit. 8, § 5199 applies to hospitals, skilled nursing facilities, clinics, medical offices and other outpatient medical facilities, among others. Outpatient medical facilities whose policy is not to diagnose or treat aerosol transmissible diseases are not required to comply with this standard if they meet certain other conditions. The requirements in subsection (h)(5) will become effective on September 1, 2010.

Disclaimer: The purpose of this database is to provide researchers, policymakers, and state and local public health practitioners with descriptive information concerning state immunization-related law. No part of this legal analysis involves providing legal advice or answering specific questions of law on behalf of any person or organization.