State Immunization Laws for Healthcare
Workers and Patients

Immunization Administration Requirements
For State: MD

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

Patient Type	Vaccine	Requirement
Hospital Employees	Hepatitis B[1]	No
	Influenza[2]	Offer[559]
	MMR[3]	Ensure[123]
	Varicella[4]	No
	Pneumococcal[5]	No
	Medical(M),Religious(R), or Philosophical(P) Exemptions[6]	Yes – (M)[124] & (R)[125]
Hospital Inpatients	Influenza[7]	No
	Pneumococcal[8]	No
	Medical(M),Religious(R), or Philosophical(P) Exemptions[9]	No
Individual Providers' Patients	Any Immunization[10]	Ensure [126]
	Medical(M),Religious(R), or Philosophical(P) Exemptions[11]	Yes – (M)[127]
Ambulatory Care Facilities Employees	Any Immunization[12]	No
	Medical(M),Religious(R), or Philosophical(P) Exemptions[13]	No
Ambulatory Care Facilities Patients	Any Immunization[14]	No
	Medical(M),Religious(R), or Philosophical(P) Exemptions[15]	No
Correctional Inmates and Residents	Any Immunization[16]	No[128]
	Medical(M),Religious(R), or Philosophical(P) Exemptions[17]	No
Developmentally Disabled Facility Residents	Any Immunization[18]	Ensure[129]
	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?
[123] For Maryland requirements, see MD. Regs. Code tit. 10, § 06.01.12 and MD. Regs. Code tit. 10, § 06.01.15, relating to “hospitals.” MD. Regs. Code tit. 10, § 06.01.12 provides that a worker born after 1956 working at least 20 hours each week who is newly retained as medical staff, a direct or contractual employee, or a volunteer of a hospital classified as a “general hospital” under Health-General Article, § 19-307, Annotated Code of Maryland, shall have documentation of receipt of one dose of live measles virus vaccine after becoming 1 year old or proof of immunity by blood test for antibody to rubeola. MD. Regs. Code tit. 10, § 06.01.15 provides that a worker born after 1956 working at least 20 hours each week who is newly retained as medical staff, a direct or contractual employee, or a volunteer of a hospital classified as a “general hospital” under Health-General Article, § 19-307, Annotated Code of Maryland, shall have documentation of receipt of one dose of live rubella virus vaccination on or after becoming 1 year old or proof of immunity by blood test for antibody to rubella. Md. Health-General Code Ann. § 19-301 defines a hospital as an institution that: (1) has a group of at least 5 physicians who are organized as a medical staff for the institution; (2) maintains facilities to provide, under the supervision of the medical staff, diagnostic and treatment services for 2 or more unrelated individuals; and (3) admits or retains the individuals for overnight care. Md. Health-General Code Ann. § 19-307 provides that a hospital shall be classified as a general hospital if the hospital at least has the facilities and provides the services that are necessary for the general medical and surgical care of patients. Note that this requirement only applies to those facilities falling within Maryland’s definition of “hospital.”
[124] For Maryland, for medical exemptions to the immunization requirements of MD. Regs. Code tit. 10, § 06.01.12 (regarding rubeola) and MD. Regs. Code tit. 10, § 06.01.15 (regarding rubella), see MD. Regs. Code tit. 10, § 06.01.12 and MD. Regs. Code tit. 10, § 06.01.15. MD. Regs. Code tit. 10, § 06.01.12 and MD. Regs. Code tit. 10, § 06.01.15 provide that a hospital shall grant a medical exemption for any worker who presents a written statement from a licensed physician or a health officer indicating that immunization is medically contraindicated or detrimental to the worker’s health. The statement shall indicate whether the exemption should be permanent or temporary. If the exemption is temporary, the statement shall indicate the date on which the worker is to receive the immunization. A hospital shall withdraw a temporary medical exemption on the day following that date.	Top of Page
[125] For Maryland, for religious exemptions to the immunization requirements of MD. Regs. Code tit. 10, § 06.01.12 (regarding rubeola) and MD. Regs. Code tit. 10, § 06.01.15 (regarding rubella), see MD. Regs. Code tit. 10, § 06.01.12 and MD. Regs. Code tit. 10, § 06.01.15. MD. Regs. Code tit. 10, § 06.01.12 and MD. Regs. Code tit. 10, § 06.01.15 provide that if a worker objects to the immunization on the grounds that it conflicts with the worker’s bona fide religious beliefs and practices, the hospital shall grant a religious exemption.
[126] For Maryland requirements, see MD. Regs. Code tit. 10, § 06.01.12-1, relating to physicians. MD. Regs. Code tit. 10, § 06.01.12-1 provides that a physician in attendance on an individual at increased risk of pneumococcal disease shall educate the individual or individual’s legal guardian on the availability of pneumococcal vaccine and administer pneumococcal vaccine to a consenting individual who has no contraindications and who is at increased risk of pneumococcal disease, or refer the individual to a health care provider who has agreed to administer pneumococcal vaccine.
[127] For Maryland, for medical exemptions to the immunization requirements set forth in MD. Regs. Code tit. 10, § 06.01.12-1, see MD. Regs. Code tit. 10, § 06.01.12-1, which limits immunization administration requirements to individuals who have no contraindications.
[128] For Maryland, no statute or regulation requires any correctional centers or juvenile detention centers to offer any vaccines to any inmates/juveniles or to ensure that any inmates/juveniles are vaccinated with any vaccines. Note MD. Regs. Code tit. 01, § 04.07.13, relating to “residential child care programs”, requires the licensee to, within 30 days after admission and subject to the provisions of State law, provide for the immunization of any child who has not been immunized in accordance with the immunization schedules of the American Academy of Pediatrics, and maintain a record of immunizations in the child’s individual case record. However, Md. Regs. Code tit. 14. § 31.06.02, which replaced tit. 01, §04.07.02, does not list juvenile detention centers as covered entities. Juvenile detention centers are exempt from the requirements of this chapter, and it is incorrect to assume that definitional language indicates that a juvenile detention center is a residential child care program. The program running juvenile detention centers in Maryland states there are no immunization requirements for juvenile detention centers. Communication from Jenny Bowlus, July 21, 2005.	Top of Page
[129] For Maryland requirements, see MD. Regs. Code tit. 01, § 04.07.13, relating to “residential child care programs.” MD. Regs. Code tit. 01, § 04.07.13 requires the licensee to, within 30 days after admission and subject to the provisions of State law, provide for the immunization of any child who has not been immunized in accordance with the immunization schedules of the American Academy of Pediatrics, and maintain a record of immunizations in the child’s individual case record. MD. Regs. Code tit. 01, § 04.02.03 defines a “residential child care program” as a program of care provided in a residential setting by a provider on a 24-hour basis for longer than 24 hours to a child or children unless otherwise provided by state law. Based on a plain reading of the definitional language, this chart assumes that the definition of “residential child care programs” covers residential facilities for the developmentally disabled or mentally retarded.
[559] For Maryland requirements, see MD. Regs. Code tit. 10, § 07.01.34 relating to “infection prevention and control program”. MD. Regs. Code tit. 10, § 07.01.34 provides that hospitals shall establish processes and programs to prevent the spread of communicable diseases and infections. Immunizations for influenza shall be offered to staff and licensed independent practitioners, and reasons for refusal of the influenza vaccine by an employee shall be documented by the infection control or employee health program.

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.