State Immunization Laws for Healthcare
Workers and Patients

Immunization Administration Requirements
For State: NC

** 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]	No
	MMR[3]	No
	Varicella[4]	No
	Pneumococcal[5]	No
	Medical(M),Religious(R), or Philosophical(P) Exemptions[6]	No
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[202]
	Medical(M),Religious(R), or Philosophical(P) Exemptions[11]	No
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]	Ensure[203]
	Medical(M),Religious(R), or Philosophical(P) Exemptions[17]	Yes – (M)[204] & (R)[205]
Developmentally Disabled Facility Residents	Any Immunization[18]	Ensure[206]
	Medical(M),Religious(R), or Philosophical(P) Exemptions[19]	Yes – (M)[207] & (R)[208]
	[]

[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?
[202] For North Carolina requirements, see N.C. Admin. Code tit. 10A, r. 41A.0203 relating to attending physicians. N.C. Admin. Code tit. 10A, r. 41A.0203 provides that infants born to HBsAg-positive mothers shall be given hepatitis B vaccination and hepatitis B immune globulin within 12 hours of birth or as soon as possible after the infant is stabilized. Additional doses of hepatitis B shall be given in accordance with the current published Control of Communicable Diseases Manual (Manual) and Centers for Disease Control and Prevention Guidelines (Guidelines). The infant shall be tested for the presence of HBsAg and anti-HBsAg within 3 to 9 months after the last dose of the regular series of the vaccine; if required because of failure to develop immunity after the regular series, additional doses shall be given in accordance with the Guidelines and the Manual. Infants born to mothers who hepatitis B status is unknown shall be given hepatitis B vaccine within 12 hours of birth, and the mother tested. If the tested mother is found to be HBsAg-positive, the infant shall be given hepatitis B immune globulin as soon as possible and not later than 7 days after birth. When an acutely infected person is the primary caregiver of a susceptible infant less than 12 months of age, the infant shall receive an appropriate dose of hepatitis B immune globulin and hepatitis B vaccinations in accordance with the Manual and the Guidelines.
[203] For North Carolina requirements, see N.C. Gen. Stat. § 130A-152, relating to all agencies having legal custody of any child in North Carolina. N.C. Gen. Stat. § 130A-152 provides that every child shall be immunized against diphtheria, tetanus, whooping cough, poliomyelitis, rubeola, and rubella. In addition, every child shall be immunized against any other disease upon a determination by the Commission that the immunization is in the interest of the public health. Every agency, whether governmental or private, with legal custody of a child is responsible for ensuring that the child has received the required immunizations. If the child has not received the required immunizations at the specified age, the responsible party shall obtain the required immunizations as soon as possible after the lack of immunization is determined.	Top of Page
[204] For North Carolina, for medical exemptions to the immunization requirements of N.C. Gen. Stat. § 130A-152, see N.C. Gen. Stat. § 130A-156 and N.C. Admin. Code tit. 10A, r. 41A.0404. N.C. Gen. Stat. § 130A-156 provides that the Commission for Health Services shall adopt by rule medical contraindication to immunizations required by N.C. Gen. Stat. § 130A-152. If a physician licensed to practice medicine in North Carolina certifies that a required immunization is or may be detrimental to a person’s health due to one of the contraindications adopted by the Commissioner, the person is not required to receive the specified immunization as long as the contraindication persists. The State Health Director may, upon request by a physician licensed to practice medicine in North Carolina, grant a medical exemption to a required immunization for a contraindication not on the list adopted by the Commissioner. N.C. Admin. Code tit. 10A, r. 41A.0404 provides that certificate of a medical exemption from a physician pursuant to N.C. Gen. Stat. § 130A-156 shall be in writing and shall state the basis of the exemption, the specific vaccine(s) the individual should not receive, and the length of time the exemption will apply for the individual. Medical contraindications for which medical exemptions may be certified by a physician are included in the most recent General Recommendations of the Advisory Committee on Immunization Practices, Public Health Service, U.S. Department of Health and Human Services, published by the Morbidity and Mortality Weekly Report.
[205] For North Carolina, for religious exemptions to the immunization requirements of N.C. Gen. Stat. § 130A-152, see N.C. Gen. Stat. § 130A-157, providing that if the bona fide religious beliefs of an adult or the parent, guardian or person in loco parentis of a child are contrary to the immunization requirements of N.C. Gen. Stat. § 130A-152, the adult or child shall be exempt from requirements.
[206] For North Carolina requirements, see N.C. Admin. Code tit. 10A, r. 27H.0303 and N.C. Admin. Code tit. 10A, r. 27H.0304, relating to “group homes for developmentally disabled persons,” and N.C. Gen. Stat. § 130A-152, relating to all state agencies giving legal custody of children. N.C. Admin. Code tit. 10A, r. 27H.0303 provides that all group home residents shall be screened for hepatitis B virus. If screening indicates any resident or employee is a hepatitis B carrier, the following procedures shall be followed: (1) current residents and direct care employees without antibodies (who are not immune) shall be vaccinated with hepatitis B vaccine as required by 10A NCAC 41A.0203(b)(2); (2) written informed consent or refusal to be vaccinated shall be obtained from the employee and shall be documented in the employee’s personnel record; (3) the hepatitis B vaccination series shall be started within 10 working days following receipt of the screening results for non-immune direct care employees; and (4) during the 3 dose, 6 month immunization process, if a non-immune resident is exposed to the blood or other potentially infectious bodily fluids of a hepatitis B carrier, the procedure as outlined in 10A NCAC 41A.0203 B shall be followed. Note that 10A NCAC 41A.0203(b)(2) requires that, after testing, when a susceptible person has had sexual intercourse exposure to hepatitis B infection, the person shall be given a dose appropriate for their body weight of hepatitis B immune globulin and hepatitis B vaccination as soon as possible; hepatitis B immune globulin shall be given no later than 2 weeks after the last exposure. More generally, Rule .0203 provides for the administration of hepatitis B vaccine and/or hepatitis B globulin to exposed persons. Different procedures apply, depending on the identity of the exposed person and the nature of the contact. N.C. Admin. Code tit. 10A, r. 27H.0304 provides that the group home shall screen prospective residents who have been accepted for admission for hepatitis B infection prior to admission; and screen and offer hepatitis B vaccine to all persons accepted for employment within the first 10 days of employment. If a new resident or a new employee is determined to be a hepatitis B carrier and no hepatitis B carriers have previously been placed in, or are employed by, the group home, the procedure in Rule .0303 of this Section shall be followed. If a current resident or employee is a hepatitis B carrier, new residents and new employees without antibodies (who are not immune) shall begin the hepatitis B vaccine series before entering the home. N.C. Gen. Stat. § 130A-152 provides that every child shall be immunized against diphtheria, tetanus, whooping cough, poliomyelitis, rubeola, and rubella. In addition, every child shall be immunized against any other disease upon a determination by the Commission that the immunization is in the interest of the public health. Every agency, whether governmental or private, with legal custody of a child is responsible for ensuring that the child has received the required immunizations. If the child has not received the required immunizations at the specified age, the responsible party shall obtain the required immunizations as soon as possible after the lack of immunization is determined.
[207] For North Carolina, for medical exemptions to the immunization requirements of N.C. Gen. Stat. § 130A-152, see N.C. Gen. Stat. § 130A-156 and N.C. Admin. Code tit. 10A, r. 41A.0404. N.C. Gen. Stat. § 130A-156 provides that the Commission for Health Services shall adopt by rule medical contraindication to immunizations required by N.C. Gen. Stat. § 130A-152. If a physician licensed to practice medicine in North Carolina certifies that a required immunization is or may be detrimental to a person’s health due to one of the contraindications adopted by the Commissioner, the person is not required to receive the specified immunization as long as the contraindication persists. The State Health Director may, upon request by a physician licensed to practice medicine in North Carolina, grant a medical exemption to a required immunization for a contraindication not on the list adopted by the Commissioner. N.C. Admin. Code tit. 10A, r. 41A.0404 provides that certificate of a medical exemption from a physician pursuant to N.C. Gen. Stat. § 130A-156 shall be in writing and shall state the basis of the exemption, the specific vaccine(s) the individual should not receive, and the length of time the exemption will apply for the individual. Medical contraindications for which medical exemptions may be certified by a physician are included in the most recent General Recommendations of the Advisory Committee on Immunization Practices, Public Health Service, U.S. Department of Health and Human Services, published by the Morbidity and Mortality Weekly Report.	Top of Page
[208] For North Carolina, for religious exemptions to the immunization requirements of N.C. Gen. Stat. § 130A-152, see N.C. Gen. Stat. § 130A-157, providing that if the bona fide religious beliefs of an adult, or the parent, guardian or person in loco parentis of a child are contrary to the immunization requirements of N.C. Gen. Stat. § 130A-152, the adult or child shall be exempt from requirements.

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.