State Immunization Laws for Healthcare
Workers and Patients

Immunization Administration Requirements For
Hospital Employees

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

States	Hepatitis B[1]	Influenza[2]	MMR[3]	Varicella[4]	Pneumococcal[5]	Medical(M),Religious(R), or Philosophical(P) Exemptions[6]
AL	No[20]	Ensure[21]	No[22]	No[23]	No[24]	No
AK	Ensure[510]	No	Ensure[26]	No	No	Yes – (M)[27]
AZ	Offer[30]	No	No	No	No	No
AR	Offer[34]	No	No	No	No	No
CA	Offer[41]	Offer[505]	Offer[553]	Offer[554]	No	No
CO	No	Ensure[565]	No	No	No	Yes – (M)[567]
CT	Offer[50]	No	No	No	No	No
DC	No[62]	No[63]	No[64]	No[65]	No[66]	No
DE	No	No	No	No	No	No
FL	No	No	No	No	No	No
GA	No[78]	Offer[569]	No	No	No	No
HI	Offer[82]	No	No	No	No	No
ID	No	No	No	No	No	No
IL	Offer[84]	Offer[85]	Ensure[86]	No[87]	No[88]	No
IN	No	No	No	No	No	No
IA	No	No	No	No	No	No
KS	No	No	No	No	No	No
KY	No	No	No	No	No	No
LA	No	No	No	No	No	No
ME	Ensure[115]	Offer[116]	Ensure[117]	Ensure[118]	No	Yes – (M)[119], (R)[120] & (P)[121]
MD	No	Offer[559]	Ensure[123]	No	No	Yes – (M)[124] & (R)[125]
MA	No	Offer[555]	Ensure[130]	No	No	No
MI	Offer[134]	No	No	No	No	No
MN	Offer[138]	No	No	No	No	No
MS	No	No	No	No	No	No
MO	Offer[139]	No	No	No	No	No
MT	No	No	No	No	No	No
NE	No	Offer[560]	No	No	No	No
NH	No	Ensure[146]	No[147]	No	No	Yes – (M)[148] & (R)[149]
NJ	No	No	Offer[160]	No	No	No
NM	No	No	Ensure[172]	No	No	No
NY	Offer[175]	No	Ensure[176]	No	No	Yes – (M)[177]
NV	No[189]	No[190]	No[191]	No[192]	No[193]	No
NC	No	No	No	No	No	No
ND	No	No	No	No	No	No
OH	No	No	No	No	No	No
OK	Offer[557]	Offer[558]	Ensure[215]	Ensure[216]	No	No
OR	Offer[220]	No[221]	No[222]	No[223]	No[224]	No
PA	No	No	No	No	No	No
RI	Offer[234]	Offer[235]	Ensure[236]	Ensure[511]	No	Yes – (M)[237]
SC	No	No	No	No	No	No
SD	Offer[246]	No[573]	No	No	No	No
TN	No	Offer[512]	No	No	No	No
TX	Offer[256]	No[574]	No[575]	No[576]	No[577]	No
UT	No	No	No	No	No	No
VT	Offer[282]	No	No	No	No	No
VA	No[285]	No[286]	No[287]	No[288]	No[289]	No
WA	Offer[290]	No	No	No	No	No
WV	No	No	No	No	No	No
WI	No	No	Ensure[295]	No	No	No
WY	No	No	No	No	No	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?
[20] For Alabama, no regulation or statute specifically refers to vaccination against hepatitis B for hospital employees. However, note Ala. Admin. Code r. 420-5-7-.04, requiring each hospital to establish vaccination requirements for employees that are consistent with current recommendations from the Federal Centers for Disease Control and Prevention and the Federal Occupational Safety and Health Administration. These requirements apply only to those facilities covered by Alabama’s definition of a hospital, defined in Ala. Admin. Code r. 420-5-7-.04 as a health institution planned, organized, and maintained for offering to the public generally facilities and beds for use in the diagnosis and/or treatment of illness, disease, injury, deformity, abnormality or pregnancy, when the institution offers such care or service for not less than 24 consecutive hours in any week to 2 or more individuals not related by blood or marriage to the owner and/or chief executive officer/administrator.
[21] For Alabama requirements, see Ala. Admin. Code r. 420-5-7-.04, requiring each hospital to establish vaccination requirements for employees that are consistent with current recommendations from the Federal Centers for Disease Control and Prevention and the Federal Occupational Safety and Health Administration (at a minimum to require annual influenza vaccinations). These requirements apply only to those facilities covered by Alabama’s definition of a hospital, defined in Ala. Admin. Code r. 420-5-7-.04 as a health institution planned, organized, and maintained for offering to the public generally facilities and beds for use in the diagnosis and/or treatment of illness, disease, injury, deformity, abnormality or pregnancy, when the institution offers such care or service for not less than 24 consecutive hours in any week to 2 or more individuals not related by blood or marriage to the owner and/or chief executive officer/administrator.
[22] For Alabama, no regulation or statute specifically refers to vaccination against measles, mumps, or rubella for hospital employees. However, note Ala. Admin. Code r. 420-5-7-.04, requiring each hospital to establish vaccination requirements for employees that are consistent with current recommendations from the Federal Centers for Disease Control and Prevention and the Federal Occupational Safety and Health Administration. These requirements apply only to those facilities covered by Alabama’s definition of a hospital, defined in Ala. Admin. Code r. 420-5-7-.04 as a health institution planned, organized, and maintained for offering to the public generally facilities and beds for use in the diagnosis and/or treatment of illness, disease, injury, deformity, abnormality or pregnancy, when the institution offers such care or service for not less than 24 consecutive hours in any week to 2 or more individuals not related by blood or marriage to the owner and/or chief executive officer/administrator.	Top of Page
[23] For Alabama, no regulation or statute specifically refers to vaccination against varicella for hospital employees. However, note Ala. Admin. Code r. 420-5-7-.04, requiring each hospital to establish vaccination requirements for employees that are consistent with current recommendations from the Federal Centers for Disease Control and Prevention and the Federal Occupational Safety and Health Administration. These requirements apply only to those facilities covered by Alabama’s definition of a hospital, defined in Ala. Admin. Code r. 420-5-7-.04 as a health institution planned, organized, and maintained for offering to the public generally facilities and beds for use in the diagnosis and/or treatment of illness, disease, injury, deformity, abnormality or pregnancy, when the institution offers such care or service for not less than 24 consecutive hours in any week to 2 or more individuals not related by blood or marriage to the owner and/or chief executive officer/administrator.
[24] For Alabama, no regulation or statute specifically refers to vaccination against pneumococcal disease for hospital employees. However, note Ala. Admin. Code r. 420-5-7-.04, requiring each hospital to establish vaccination requirements for employees that are consistent with current recommendations from the Federal Centers for Disease Control and Prevention and the Federal Occupational Safety and Health Administration. These requirements apply only to those facilities covered by Alabama’s definition of a hospital, defined in Ala. Admin. Code r. 420-5-7-.04 as a health institution planned, organized, and maintained for offering to the public generally facilities and beds for use in the diagnosis and/or treatment of illness, disease, injury, deformity, abnormality or pregnancy, when the institution offers such care or service for not less than 24 consecutive hours in any week to 2 or more individuals not related by blood or marriage to the owner and/or chief executive officer/administrator.
[26] For Alaska requirements, see Alaska Admin. Code tit. 7 § 12.650, relating to “facilities and local units of health and social services.” Alaska Admin. Code tit. 7 § 12.650 requires each facility to have an employee health program that requires evidence of immunization against rubella. Note that these requirements apply only to those facilities identified in the regulation, and not all settings covered by the chart’s definition of hospital. “Facilities and local units” are defined in Alaska Admin. Code tit. 7 § 12.990 as including (among others) the following facilities: general acute care and rural primary care hospitals, critical access hospitals, and specialized hospitals.
[27] For Alaska requirements, see Alaska Admin. Code tit. 7 § 12.650 for medical exemptions to rubella administration requirements set forth in Alaska Admin. Code tit. 7 § 12.650. Alaska Admin. Code tit. 7 § 12.650 provides that immunization requirements may be waived if a physician signs a certificate that there are medical reasons which dictate that an employee should not be vaccinated against rubella.	Top of Page
[30] For Arizona requirements, see Ariz. Admin. Code R20-5-602 and Ariz. Admin. Code R9-6-331, relating to all occupational exposures. Ariz. Admin. Code R20-5-602 and Ariz. Admin. Code R9-6-331 incorporate the requirements of 29 CFR § 1910.1030. 29 CFR § 1910.1030 provides that employers must make available the hepatitis B vaccine and vaccine series to all employees who have occupational exposure. If the employee initially declines vaccination but changes their mind while still covered under the standard, the employer shall make the hepatitis B vaccine available. If a routine booster dose(s) is recommended by the U.S. Public Health Service, the dose(s) shall be made available to the employee free of charge.
[34] For Arkansas requirements, see 007 05 CARR 002.18, relating to “hospitals and related facilities.” 007 05 CARR 002.18 provides that there shall be a plan for ensuring that all health care workers who are frequently exposed to blood and other potentially infectious bodily fluids are offered hepatitis B immunization. Note that this requirement applies to those facilities defined as a “hospital or related facility,” as set forth in Ark. Admin. Code § 20-9-201 including (among other facilities) a general, tuberculosis or chronic disease hospital, as well as a related facility, including (among other facilities) central facilities
[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.
[50] For Connecticut requirements, see Regs., Conn. State Agencies § 31-372-101-1910, relating to all occupational exposure to bloodborne pathogens or other potentially infectious materials. Regs., Conn. State Agencies § 31-372-101-1910 adopts by reference Subpart Z of 29 CFR § 1910. Subpart Z requires all employers to make available the hepatitis B vaccine and vaccine series to all employees who have occupational exposure. If the employee initially declines vaccination but changes their mind while still covered under the standard, the employer shall make the hepatitis B vaccine available. If a routine booster dose(s) is recommended by the U.S. Public Health Service, the dose(s) shall be made available to the employee free of charge.	Top of Page
[62] For D.C., no regulation or statute specifically refers to vaccination against hepatitis B for hospital employees. However, note 22 DCMR § B2017.10, requiring that immunization against communicable disease shall be required of all employees and all other persons who routinely come into contact with patients or patient areas. This regulation only applies to those institutions meeting the definition of “hospital” set forth in 22 DCMR § 2099.
[63] For D.C., no regulation or statute specifically refers to vaccination against influenza for hospital employees. However, note 22 DCMR § B2017.10, requiring that immunization against communicable disease shall be required of all employees and all other persons who routinely come into contact with patients or patient areas. This regulation only applies to those institutions meeting the definition of “hospital” set forth in 22 DCMR § 2099.
[64] For D.C., no regulation or statute specifically refers to vaccination against measles, mumps, or rubella for hospital employees. However, note 22 DCMR § B2017.10, requiring that immunization against communicable disease shall be required of all employees and all other persons who routinely come into contact with patients or patient areas. This regulation only applies to those institutions meeting the definition of “hospital” set forth in 22 DCMR § 2099.
[65] For D.C., no regulation or statute specifically refers to vaccination against varicella for hospital employees. However, note 22 DCMR § B2017.10, requiring that immunization against communicable disease shall be required of all employees and all other persons who routinely come into contact with patients or patient areas. This regulation only applies to those institutions meeting the definition of “hospital” set forth in 22 DCMR § 2099.	Top of Page
[66] For D.C., no regulation or statute specifically refers to vaccination against pneumococcal disease for hospital employees. However, note 22 DCMR § B2017.10, requiring that immunization against communicable disease shall be required of all employees and all other persons who routinely come into contact with patients or patient areas. This regulation only applies to those institutions meeting the definition of “hospital” set forth in 22 DCMR § 2099.
[78] For Georgia, no statute or regulation requires any hospitals to offer hepatitis B immunization to employees, or ensure that any employees are vaccinated against hepatitis B. However, note Ga. Code Ann. § 31-35-10, requiring that any active emergency medical technician who may be exposed to the hepatitis B virus during a period while such person is engaged in the performance of his/her duties shall, at such person’s request, be vaccinated against hepatitis B. However, this is not an “offer” requirement as immunizations must only be administered upon request. Note also that this requirement does not specify whether the employer must administer immunizations directly.
[82] For Hawaii requirements, see Weil’s Code of Hawaii Rules § 12-205.1, incorporating 29 CFR § 1910.1030 into the Code of Hawaii Rules. 29 CFR § 1910.1030 provides that employers must make available the hepatitis B vaccine and vaccine series to all employees who have occupational exposure. The employer shall ensure that the hepatitis B vaccine and vaccination series is made available at no cost to the employee. Additional time, place and manner requirements apply to vaccine administration. If the employee initially declines immunization but changes their mind while still covered under the standard, the employer shall make the hepatitis B vaccine available. If routine booster dose(s) are recommended by the U.S. Public Health Service, the dose(s) shall be made available to the employee free of charge.
[84] For Illinois requirements, see Ill. Admin. Code tit. 56, § 350.280, incorporating the requirements of 29 CFR § 1910.1030 (relating to all occupational exposure to bloodborne pathogens). 29 CFR § 1910.1030 requires employers to make available the hepatitis B vaccine and vaccine series to all employees who have occupational exposure. The employer must ensure that the hepatitis B vaccine and vaccination series and follow-up is made available at no cost to the employee. Additional time, place and manner requirements apply to vaccine administration. If the employee initially declines vaccination but changes their mind while still covered under the standard, the employer shall make the hepatitis B vaccine available. If a routine booster dose(s) is recommended by the U.S. Public Health Service, the dose(s) shall be made available to the employee free of charge. Note that these requirements only apply to those institutions covered under the Illinois definition of hospital, as set forth in 210 Ill. Comp. Stat. Ann. § 85/3. 210 Ill. Comp. Stat. Ann. § 85/3 defines a “hospital” as any institution, place, building, or agency, public or private, whether organized for profit or not, devoted primarily to the maintenance and operation of facilities for the diagnosis and treatment or care of 2 or more unrelated persons admitted for overnight stay or longer in order to obtain medical, including obstetric, psychiatric, and nursing, care of illness, disease, injury, infirmity, or deformity. Also, note Ill. Admin. Code tit. 77, § 250.450. While this regulation does not specifically relate to hepatitis B vaccine, it does require more broadly each hospital to establish an employee health program that includes required immunizations. This regulation only applies to those institutions covered by the Illinois definition of hospital set forth in 210 Ill. Comp. Stat. Ann. § 85/3.	Top of Page
[85] For Illinois requirements, see Ill. Admin. Code tit. 77, § 956.30 relating to “influenza vaccination”. Ill. Admin. Code tit. 77, § 956.30 provides that beginning with the 2010 to 2011 influenza season, each health care setting shall ensure that all health care employees are offered the opportunity to receive seasonal, novel, and pandemic influenza vaccine during the influenza seasons (between September 1 and March 1 of each year), unless the vaccine is unavailable. Healthcare employees who decline vaccination for any reason shall sign a statement declining vaccination and certifying that he or she received education about the benefits of influenza vaccine. Ill. Admin. Code tit. 77, § 956.10 defines a “health care setting” as including, among others, hospitals as defined in the Hospital Licensing Act.
[86] For Illinois requirements, see Ill. Admin. Code tit. 77, § 250.1820, relating to nursery personnel. Ill. Admin. Code tit. 77, § 250.1820 provides that evidence of prior rubella infection or rubella vaccination shall be required of nursery personnel. This regulation only applies to those institutions covered by the Illinois definition of hospital set forth in 210 Ill. Comp. Stat. Ann. § 85/3. 210 Ill. Comp. Stat. Ann. § 85/3 defines hospitals as any institution, place, building, or agency, public or private, whether organized for profit or not, devoted primarily to the maintenance and operation of facilities for the diagnosis and treatment or care of 2 or more unrelated persons admitted for overnight stay or longer in order to obtain medical, including obstetric, psychiatric, and nursing, care of illness, disease, injury, infirmity, or deformity. Also note Ill. Admin. Code tit. 77, § 250.450. While this regulation does not specifically relate to MMR vaccine, it does require more broadly each hospital to establish an employee health program that includes required immunizations. This regulation only applies to those institutions covered by the Illinois definition of hospital set forth in 210 Ill. Comp. Stat. Ann. § 85/3.
[87] For Illinois, while no statute or regulation requires hospitals to ensure that any employees are vaccinated with varicella vaccine, note Ill. Admin. Code tit. 77, § 250.450. While this regulation does not specifically relate to varicella vaccine, it does require more broadly each hospital to establish an employee health program that includes required immunizations. This regulation only applies to those institutions covered by the Illinois definition of hospital set forth in 210 Ill. Comp. Stat. Ann. § 85/3, which defines hospitals as any institution, place, building, or agency, public or private, whether organized for profit or not, devoted primarily to the maintenance and operation of facilities for the diagnosis and treatment or care of 2 or more unrelated persons admitted for overnight stay or longer in order to obtain medical, including obstetric, psychiatric, and nursing, care of illness, disease, injury, infirmity, or deformity.
[88] For Illinois, while no statute or regulation requires hospitals to ensure that any employees are vaccinated with pneumococcal vaccine, note Ill. Admin. Code tit. 77, § 250.450. While this regulation does not specifically relate to pneumococcal vaccine, it does require more broadly each hospital to establish an employee health program that includes required immunizations. This regulation only applies to those institutions covered by the Illinois definition of hospital set forth in 210 Ill. Comp. Stat. Ann. § 85/3, which defines hospitals as any institution, place, building, or agency, public or private, whether organized for profit or not, devoted primarily to the maintenance and operation of facilities for the diagnosis and treatment or care of 2 or more unrelated persons admitted for overnight stay or longer in order to obtain medical, including obstetric, psychiatric, and nursing, care of illness, disease, injury, infirmity, or deformity.	Top of Page
[115] For Maine requirements, see Code Me. R. § 10-144-264(2), relating to “Designated Healthcare Facilities.” Code Me. R. § 10-144-264(2) provides that Designated Healthcare Facilities shall require of all employees proof of immunization or documented immunity against rubeola, mumps, rubella, varicella, and hepatitis B. Employees shall present the Designated Healthcare Facility with a Certificate of Immunization from a specified healthcare provider, and which contains certain specified information. Code Me. R. § 10-144-264(2) also provides that, in accordance with 29 CFR § 1910.1030 (effective July 6, 1992), Designated Healthcare Facilities shall make available the hepatitis B vaccine to all healthcare workers who have occupational exposure, at no cost to the employees. No chief administrative officer may permit any employee to be in attendance at work without a certificate of immunization for each disease or other acceptable evidence of immunity to each disease, or documentation of exemption or declination.“Designated Healthcare Facilities” are defined in Code Me. R. § 10-144-264(1) as a licensed nursing facility, residential care facility, intermediate care facility for the mentally retarded, multi-level health care facility, hospital, or home health agency.
[116] For Maine requirements, see Code Me. R. § 10-144-264(2), relating to “Designated Healthcare Facilities.” Code Me. R. § 10-144-264(2) provides that Designated Healthcare Facilities shall adopt a policy that recommends and offers annual immunizations against influenza to all personnel who provide direct care for residents of the facility. No chief administrative officer may permit any employee to be in attendance at work without a certificate of immunization for each disease or other acceptable evidence of immunity to each disease, or documentation of exemption or declination. “Designated Healthcare Facilities” are defined in Code Me. R. § 10-144-264(1) as a licensed nursing facility, residential care facility, intermediate care facility for the mentally retarded, multi-level health care facility, hospital, or home health agency.
[117] For Maine requirements, see Code Me. R. § 10-144-264(2), relating to “Designated Healthcare Facilities.” Code Me. R. § 10-144-264(2) provides that Designated Healthcare Facilities shall require of all employees proof of immunization or documented immunity against rubeola, mumps, rubella, varicella, and hepatitis B. Employees shall present the Designated Healthcare Facility with a Certificate of Immunization from a specified healthcare provider, and which contains certain specified information. No chief administrative officer may permit any employee to be in attendance at work without a certificate of immunization for each disease or other acceptable evidence of immunity to each disease, or documentation of exemption or declination. “Designated Healthcare Facilities” are defined in Code Me. R. § 10-144-264(1) as a licensed nursing facility, residential care facility, intermediate care facility for the mentally retarded, multi-level health care facility, hospital, or home health agency.
[118] For Maine requirements, see Code Me. R. § 10-144-264(2), relating to “Designated Healthcare Facilities.” Code Me. R. § 10-144-264(2) provides that Designated Healthcare Facilities shall require of all employees proof of immunization or documented immunity against rubeola, mumps, rubella, varicella, and hepatitis B. Employees shall present the Designated Healthcare Facility with a Certificate of Immunization from a specified healthcare provider, and which contains certain specified information. No chief administrative officer may permit any employee to be in attendance at work without a certificate of immunization for each disease or other acceptable evidence of immunity to each disease, or documentation of exemption or declination. “Designated Healthcare Facilities” are defined in Code Me. R. § 10-144-264(1) as a licensed nursing facility, residential care facility, intermediate care facility for the mentally retarded, multi-level health care facility, hospital, or home health agency.	Top of Page
[119] For Maine, for medical exemptions to the immunization requirements of Code Me. R. § 10-144-264(2), see Code Me. R. § 10-144-264(3), providing that an employee who does not meet the immunization/immunity requirement may be permitted to attend work where the employee presents to the Designated Healthcare Facility a physician’s written statement that immunization against one or more of these diseases is medically inadvisable. If the statement does not include all the diseases, the employee must meet the immunization/immunity requirements for any diseases not covered by the statement
[120] For Maine, for religious exemptions to the immunization requirements of Code Me. R. § 10-144-264(2), see Code Me. R § 10-144-264(3), providing that an employee who does not meet the immunization/immunity requirement may be permitted to attend work where the employee states in writing an opposition to immunization because of a sincere religious belief or for philosophical reasons.
[121] For Maine, for philosophical exemptions to the immunization requirements of Code Me. R. § 10-144-264(2), see Code Me. R. § 10-144-264(3), providing that an employee who does not meet the immunization/immunity requirement may be permitted to attend work where the employee states in writing an opposition to immunization because of a sincere religious belief or for philosophical reasons.
[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.”	Top of Page
[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.
[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.
[130] For Massachusetts requirements, see Mass. Regs. Code tit. 105, § 130.626, relating to hospital personnel assigned to maternal-newborn areas. Mass. Regs. Code tit. 105, § 130.626 requires that personnel assigned to maternal-newborn areas shall have: (1) demonstrated immunity to rubeola either via measles titer, physician-diagnosed disease or physician-documented live measles vaccine received on or after 12 months of age; and (2) demonstrated immunity to rubella either via rubella titer or physician-documented rubella vaccine received on or after 12 months of age. This requirement only applies to those institutions covered by the Massachusetts definition of “hospital.” “Hospital” is defined in Mass. Regs. Code tit. 105, § 130.020 as any institution in the Commonwealth of Massachusetts, however named, whether conducted for charity or for profit, which is advertised, announced, established, or maintained for the purpose of caring for persons admitted thereto for diagnosis or medical, surgical or restorative treatment which is rendered within said institution. This definition shall not include any hospital operated by the Commonwealth of Massachusetts or by the United States.
[134] For Michigan requirements, see Mich. Admin. Code r. 325.70013, requiring that, within a specified time frame, an employer shall make available hepatitis B vaccine to category A employees. If an employee initially declines vaccination, but at a later date, while still covered under these rules, decides to accept hepatitis B vaccine, the employer shall provide the vaccine at the later date. If booster dose(s) are recommended by the United States Public Health Service, they shall be made available. However, if an employee has previously received the complete hepatitis B vaccine series, is found to be immune to hepatitis B virus by adequate antibody titer, or the vaccine is contraindicated for medical reasons, the employer is not required to offer the vaccine to the employee. Category A is defined in Mich. Admin. Code r. 325.70003 as consisting of occupations that require procedures or other occupation-related tasks that involve exposure or reasonably anticipated exposure to blood or other potentially infectious material, or that involves a likelihood for spills or splashes blood or other potentially infectious material.	Top of Page
[138] For Minnesota requirements, see Minn. R. 5205.0010 (2004), which states that the Minnesota Department of Labor and Industry Occupational Safety and Health Codes and rules are amended by incorporating and adopting by reference, and thereby making a part thereof , Title 29 of the Code of Federal Regulations, “Occupational Exposure to Bloodborne Pathogens; Final Rules.” 29 CFR § 1910.1030 provides that employers must make available the hepatitis B vaccine and vaccine series to all employees who have occupational exposure. The employer shall ensure that the hepatitis B vaccine and vaccination series and follow-up is made available at no cost to the employee. Additional time, place and manner requirements apply to vaccine administration.
[139] For Missouri requirements, see Mo. Code Regs. Ann. tit. 19, § 20-20.092 (relating to all public employees), incorporating the requirements of 29 CFR § 1910.1030. 29 CFR § 1910.1030 requires employers to make available the hepatitis B vaccine and vaccine series to all employees who have occupational exposure. The employer shall ensure that the hepatitis B vaccine and vaccination series and follow-up is made available at no cost to the employee. Additional time, place and manner requirements apply to vaccine administration. The employer shall not make participation in a pre-screening program a prerequisite for receiving hepatitis B vaccination. If the employee initially declines vaccination but changes their mind while still covered under the standard, the employer shall make the hepatitis B vaccine available. If a routine booster dose(s) is recommended by the U.S. Public Health Service, the dose(s) shall be made available to the employee free of charge.
[146] For New Hampshire requirements, see N.H. Rev. Stat. Ann. § 151:9-b, relating to “hospitals.” N.H. Rev. Stat. Ann. § 151:9-b requires that before November 30th of each year, each hospital and residential care facility licensed under Title XI, chapter 151 of the New Hampshire Revised Statutes shall provide to its consenting employees annual immunizations against influenza, in accordance with the Advisory Committee on Immunization Practices of the Centers for Disease Control, and subject to the availability of an adequate supply of the necessary vaccine and subject to exemptions for medical contraindications and religious beliefs. N.H. Rev. Stat. Ann. § 151:C-2 defines a “hospital” as an institution which is engaged in providing to patients, under supervision of physicians, diagnostic and therapeutic services for medical diagnosis, treatment and care of injured, disabled, or sick persons, or rehabilitation services for the rehabilitation of such persons. The term “hospital” includes psychiatric and substance abuse treatment hospitals. N.H. Rev. Stat. Ann. § 151:9-b only applies to those facilities covered by the definition of “hospital” found at N.H. Rev. Stat. Ann. § 151:C-2.
[147] For New Hampshire, no statute or regulation requires any hospital to ensure that any employees are vaccinated with MMR vaccine. However, for New Hampshire, see N.H. Code Admin. R. Ann. He-P 301.05, relating to “health care facilities.” N.H. Code Admin. R. Ann. He-P 301.05 requires that if a case or suspect case of measles occurs in a health care facility, the facility shall ensure that vulnerable employees are given a dose of the measles vaccine. Vulnerable employees are those employees born after 1956, who cannot provide either: (1) documentation of 2 doses of measles vaccine on or after their first birthday, the second dose a minimum of 30 days after the first; or; (2) serologic evidence of immunity. N.H. Code Admin. R. Ann. He-P 301.01 defines “health care facilities” as facilities required to be licensed pursuant to RSA 151:2, I and those facilities exempt from licensing pursuant to RSA 151:2, II. RSA 151:2, I identifies (among other types of facilities) hospitals, as defined in RSA 151-C:2;…facilities or portions of a facility operating as an outpatient rehabilitation clinic, ambulatory surgical center, hospice, emergency medical care center, drop-in or walk-in care center, dialysis center, birthing center, or other entity where health care associated with illness, injury, deformity, infirmity, or other physical disability is provided, whether operated for profit or for free or at a reduced cost, however named, and whether owned by a hospital or hospital holding corporation or operated as part of a hospital's services, as facilities required to be licensed pursuant to RSA 151:2, I.
[148] For New Hampshire, for medical exemptions to the immunization requirements set forth in N.H. Rev. Stat. Ann. § 151:9-b, see N.H. Rev. Stat. Ann. § 151:9-b, providing for exemptions for medical contraindications.
[149] For New Hampshire, for religious exemptions to the immunization requirements set forth in N.H. Rev. Stat. Ann. § 151:9-b, see N.H. Rev. Stat. Ann. § 151:9-b, providing for exemptions for religious beliefs.
[160] For New Jersey requirements, see N.J. Admin. Code tit. 8, § 8:43G-20.2(g), relating to “hospitals.” N.J. Admin. Code tit. 8, § 8:43G-20.2(g) provides that hospitals must offer rubella and rubeola vaccine to all employees. Note this regulation only applies to those facilities covered by the New Jersey definition of hospital. N.J. Admin. Code tit. 8, § 8.43G defines a hospital as an institution which maintains facilities for the diagnosis, treatment and care of 2 or more unrelated individuals suffering from illness, injury or deformity and where emergency, out-patient, surgical, obstetrical, convalescent or other medical and nursing care is rendered for periods exceeding 24 hours.
[172] For New Mexico requirements, see N.M. Admin. Code tit. 7, § 7.7.2.21, relating to “acute care, limited services, and special hospitals.” N.M. Admin. Code tit.7, § 7.7.2.21 provides that vaccination or confirmed immunity against rubella shall be required for everyone having direct contact with rubella patients, pediatric patients, or female patients of childbearing age. No individual without documented vaccination against rubella or immunity to rubella may be placed in a position where he/she has direct contact with rubella patients, pediatric patients or female patients of childbearing age. N.M. Admin. Code tit. 7, § 7.7.2.7 defines “acute care hospitals” as a hospital providing emergency services, in-patient medical and nursing care for acute illness, injury, surgery or obstetrics; ancillary services such as pharmacy, clinical laboratory, radiology, and dietary are required for acute-care hospitals. N.M. Admin. Code tit. 7, § 7.7.2.7 defines “limited services hospitals” as a hospital that limits admissions according to medical or surgical specialty, type of disease or medical condition, or a hospital that limits its inpatient hospital services to surgical services or invasive diagnostic treatment procedures; a limited services hospital must have emergency services, inpatient medical and nursing care for acute illness, injury, and surgery, and must offer ancillary services including pharmacy, clinical laboratory, radiology, and dietary. N.M. Admin. Code tit. 7, § 7.7.2.7 defines “special hospitals” as a hospital that treats patients that have diagnosis-related group classifications for two-thirds of all its patients that fall into no more than two major diagnosis categories, or if at least two-thirds of its patients are classified in a specific diagnosis category; an example of a special hospital is a psychiatric or rehabilitation hospital.
[175] For New York requirements, see N.Y. Comp. Codes R. & Regs. tit. 12, § 800.3, which applies the occupational exposure requirements of 29 CFR § 1910.1030 to employers of public employees. 29 CFR § 1910.1030 requires employers to make available the hepatitis B vaccine and vaccination series to all public employees who have occupational exposure. If the public employee initially declines vaccination but changes their mind while still covered under the standard, the employer shall make available the hepatitis B vaccine. If routine booster dose(s) are recommended by the U.S. Public Health Service, they shall be made available to the employee.
[176] For New York requirements, see N.Y. Comp. Codes R. & Regs. tit. 10, § 405.3, relating to “hospitals.” N.Y. Comp. Codes R. & Regs. tit. 10, § 405.3 requires the hospital to require of all personnel, as a condition of employment, a certificate of immunization against rubella, and a certificate of immunization against measles. This requirement is implemented through personnel policies and practices which the chief executive officer of the hospital shall develop and implement. If one of the practitioners designated at 405.3(10)(iii) certifies that the vaccine is contraindicated, the immunization requirements will be inapplicable until they are no longer found to be detrimental to the employee’s health. This requirement only applies to those facilities falling under New York’s regulatory definition of “hospital,” and not all those facilities identified as a hospital by the chart’s definition. N.Y. Comp. Codes R. & Regs. tit. 10, § 700.2 defines a “hospital” as an institution with beds for one or more inpatients not related to the operator which is primarily engaged in providing services and facilities to inpatients by or under the supervision of a physician, and which meets the following requirements: (1) provides diagnostic and therapeutic services for medical diagnosis, treatment and care of injured and sick persons and has, as a minimum, laboratory and radiology services and organized departments of medicine and surgery; (2) has an organized medical staff which may include, in addition to doctors of medicine, doctors of osteopathy and dentistry; (3) has bylaws, rules and regulations pertaining to standards of medical care and service rendered by its medical staff; (4) maintains medical records for all patients; (5) has a requirement that every patient be under the care of a member of the medical staff; (6) provides 24-hour patient services; and (7) has a written utilization review plan acceptable to the NYSDOH; and (8) has agreements with a home care agency.
[177] For New York, for medical exemptions to the immunization administration requirements set forth in N.Y. Comp. Codes R. & Regs. tit. 10, § 405.3, see N.Y. Comp. Codes R. & Regs. tit. 10, § 405.3, providing that immunization requirements are inapplicable if one of the practitioners designated at 405.3(10)(iii) certifies that the vaccine is contraindicated. The immunization requirements will be inapplicable until they are no longer found to be detrimental to the employee’s health. Certain additional procedural requirements must be met to obtain this exemption. In addition, N.Y. Comp. Codes R. & Regs. tit. 10, § 66-3.6 states that no personnel shall be required to receive an influenza vaccine if the vaccine is medically contraindicated for that individual.
[189] For Nevada, no statute or regulation requires any hospital to ensure that any employees are vaccinated with hepatitis B vaccine. However, note Nev. Admin. Code ch. 441A, § 550, relating to “medical facilities.” Nev. Admin. Code ch. 441A, § 550 provides that if a case having a disease caused by invasive Haemophilus influenzae type b is in a medical facility where there is a contact less than 2 years of age, each employee of the medical facility shall complete a course of antimicrobial prophylaxis. If a case having a disease caused by invasive Haemophilus influenzae type b is in a medical facility where there is a contact who is less than 2 years of age, and where 2 persons have been diagnosed as having a disease caused by invasive Haemophilus influenzae type b within 60 days, each member of the staff in the medical facility shall complete a course of antimicrobial prophylaxis, unless medically contraindicated, regardless of whether the staff member has received an immunization against Haemophilus influenzae type b.
[190] For Nevada, no statute or regulation requires any hospital to ensure that any employees are vaccinated with influenza vaccine. However, note Nev. Admin. Code ch. 441A, § 550, relating to “medical facilities.” Nev. Admin. Code ch. 441A, § 550 provides that if a case having a disease caused by invasive Haemophilus influenzae type b is in a medical facility where there is a contact less than 2 years of age, each employee of the medical facility shall complete a course of antimicrobial prophylaxis. If a case having a disease caused by invasive Haemophilus influenzae type b is in a medical facility where there is a contact who is less than 2 years of age, and where 2 persons have been diagnosed as having a disease caused by invasive Haemophilus influenzae type b within 60 days, each member of the staff in the medical facility shall complete a course of antimicrobial prophylaxis, unless medically contraindicated, regardless of whether the staff member has received an immunization against Haemophilus influenzae type b.
[191] For Nevada, no statute or regulation requires any hospital to ensure that any employees are vaccinated with MMR vaccine. However, note Nev. Admin. Code ch. 441A, § 550, relating to “medical facilities.” Nev. Admin. Code ch. 441A, § 550 provides that if a case having a disease caused by invasive Haemophilus influenzae type b is in a medical facility where there is a contact less than 2 years of age, each employee of the medical facility shall complete a course of antimicrobial prophylaxis. If a case having a disease caused by invasive Haemophilus influenzae type b is in a medical facility where there is a contact who is less than 2 years of age, and where 2 persons have been diagnosed as having a disease caused by invasive Haemophilus influenzae type b within 60 days, each member of the staff in the medical facility shall complete a course of antimicrobial prophylaxis, unless medically contraindicated, regardless of whether the staff member has received an immunization against Haemophilus influenzae type b.
[192] For Nevada, no statute or regulation requires any hospital to ensure that any employees are vaccinated with varicella vaccine. However, note Nev. Admin. Code ch. 441A, § 550, relating to “medical facilities.” Nev. Admin. Code ch. 441A, § 550 provides that if a case having a disease caused by invasive Haemophilus influenzae type b is in a medical facility where there is a contact less than 2 years of age, each employee of the medical facility shall complete a course of antimicrobial prophylaxis. If a case having a disease caused by invasive Haemophilus influenzae type b is in a medical facility where there is a contact who is less than 2 years of age, and where 2 persons have been diagnosed as having a disease caused by invasive Haemophilus influenzae type b within 60 days, each member of the staff in the medical facility shall complete a course of antimicrobial prophylaxis, unless medically contraindicated, regardless of whether the staff member has received an immunization against Haemophilus influenzae type b.
[193] For Nevada, no statute or regulation requires any hospital to ensure that any employees are vaccinated with pneumococcal vaccine. However, note Nev. Admin. Code ch. 441A, § 550, relating to “medical facilities.” Nev. Admin. Code ch. 441A, § 550 provides that if a case having a disease caused by invasive Haemophilus influenzae type b is in a medical facility where there is a contact less than 2 years of age, each employee of the medical facility shall complete a course of antimicrobial prophylaxis. If a case having a disease caused by invasive Haemophilus influenzae type b is in a medical facility where there is a contact who is less than 2 years of age, and where 2 persons have been diagnosed as having a disease caused by invasive Haemophilus influenzae type b within 60 days, each member of the staff in the medical facility shall complete a course of antimicrobial prophylaxis, unless medically contraindicated, regardless of whether the staff member has received an immunization against Haemophilus influenzae type b.
[215] For Oklahoma requirements, see Okla. Admin. Code § 310:667-5-4, relating to “hospitals.” Okla. Admin. Code § 310:667-5-4 provides that an immunization history shall be part of each pre-employment examination. The immunization history shall include documentation of immunity to measles, mumps, rubella, and varicella. Birth before 1957 is considered acceptable evidence of immunity to measles, mumps, and rubella, with the exception that birth before 1957 is not acceptable evidence of immunity to rubella for female employees born before 1957 who can become pregnant. Persons born in 1957 or later can be considered immune to measles, mumps, or rubella only if they have documentation of one of the following: (1) measles or mumps disease diagnosed by a physician or licensed independent practitioner; (2) laboratory evidence of measles, mumps, or rubella immunity; or (3) vaccination on or after the first birthday with 2 doses of live measles vaccine, and at least one dose of live rubella vaccine. Okla. Stat. tit. 63, § 1-701 defines a “hospital” as any institution, place, building or agency, public or private, whether organized for profit or not, devoted primarily to the maintenance and operation of facilities for the diagnosis, treatment, or care of patients admitted for overnight stay or longer in order to obtain medical care, surgical care, obstetrical care, or nursing care for illness, disease, injury, infirmity, or deformity. Subject to certain exceptions, places where pregnant females are admitted and receive care incident to pregnancy, abortion, or delivery shall be considered to be a “hospital” within the meaning of this article, regardless of the number of patients received or the duration of their stay. The term “hospital” includes general medical surgical hospitals, specialized hospitals, critical access and emergency hospitals, and birthing centers.
[216] For Oklahoma requirements, see Okla. Admin. Code § 310:667-5-4, relating to “hospitals.” Okla. Admin. Code § 310:667-5-4 provides that an immunization history shall be part of each pre-employment examination. The immunization history shall include documentation of immunity to measles, mumps, rubella, and varicella. Persons can be considered immune to varicella if they have a reliable history of having varicella or if they have received one dose of varicella vaccine on or after the first birthday prior to the 13th birthday, or 2 doses of varicella vaccine separated by at least 28 days on or after the 13th birthday. Okla. Stat. tit. 63, § 1-701 defines a “hospital” as any institution, place, building or agency, public or private, whether organized for profit or not, devoted primarily to the maintenance and operation of facilities for the diagnosis, treatment, or care of patients admitted for overnight stay or longer in order to obtain medical care, surgical care, obstetrical care, or nursing care for illness, disease, injury, infirmity, or deformity. Subject to certain exceptions, places where pregnant females are admitted and receive care incident to pregnancy, abortion, or delivery shall be considered to be a “hospital” within the meaning of this article, regardless of the number of patients received or the duration of their stay. The term “hospital” includes general medical surgical hospitals, specialized hospitals, critical access and emergency hospitals, and birthing centers.
[220] For Oregon requirements, see Or. Admin. R. 437-002-0360, relating to occupational exposure to bloodborne pathogens. Or. Admin. R. 437-002-0360 adopts by reference the requirements of 29 CFR § 1910.1030, requiring employers to make available the hepatitis B vaccine and vaccine series to all employees who have occupational exposure. The employer shall ensure that the hepatitis B vaccine and vaccination series and follow-up is made available at no cost to the employee. Additional time, place and manner requirements apply to vaccine administration. If the employee initially declines vaccination but changes their mind while still covered under the standard, the employer shall make the hepatitis B vaccine available. If a routine booster dose(s) is recommended by the U.S. Public Health Service, the dose(s) shall be made available to the employee free of charge. Also note Or. Rev. Stat. § 433.416, providing that an employer of a health care worker at risk of contracting an infectious disease in the course of employment shall provide to the worker preventative immunization for infectious disease if such preventative immunization is available and medically appropriate. Such preventative immunization shall be provided by the employer at no cost to the employee. A worker shall not be required as a condition of employment to be immunized under this section, unless such immunization is otherwise required under state or federal law, rule or regulation.
[221] For Oregon, while no statute or regulation requires any hospital to ensure that any employee is vaccinated with influenza vaccine, note Or. Rev. Stat. § 433.416, providing that an employer of a health care worker at risk of contracting an infectious disease in the course of employment shall provide to the worker preventative immunization for infectious disease if such preventative immunization is available and medically appropriate. Such preventative immunization shall be provided by the employer at no cost to the employee. A worker shall not be required as a condition of employment to be immunized under this section, unless such immunization is otherwise required under state or federal law, rule or regulation.
[222] For Oregon, while no statute or regulation requires any hospital to ensure that any employee is vaccinated with MMR vaccine, note Or. Rev. Stat. § 433.416, providing that an employer of a health care worker at risk of contracting an infectious disease in the course of employment shall provide to the worker preventative immunization for infectious disease if such preventative immunization is available and medically appropriate. Such preventative immunization shall be provided by the employer at no cost to the employee. A worker shall not be required as a condition of employment to be immunized under this section, unless such immunization is otherwise required under state or federal law, rule or regulation.
[223] For Oregon, while no statute or regulation requires any hospital to ensure that any employee is vaccinated with varicella vaccine, note Or. Rev. Stat. § 433.416, providing that an employer of a health care worker at risk of contracting an infectious disease in the course of employment shall provide to the worker preventative immunization for infectious disease if such preventative immunization is available and medically appropriate. Such preventative immunization shall be provided by the employer at no cost to the employee. A worker shall not be required as a condition of employment to be immunized under this section, unless such immunization is otherwise required under state or federal law, rule or regulation.
[224] For Oregon, while no statute or regulation requires any hospital to ensure that any employee is vaccinated with pneumococcal vaccine, note Or. Rev. Stat. § 433.416, providing that an employer of a health care worker at risk of contracting an infectious disease in the course of employment shall provide to the worker preventative immunization for infectious disease if such preventative immunization is available and medically appropriate. Such preventative immunization shall be provided by the employer at no cost to the employee. A worker shall not be required as a condition of employment to be immunized under this section, unless such immunization is otherwise required under state or federal law, rule or regulation.
[234] For Rhode Island requirements, see R23-17-HCW, “Rules and Regulations Pertaining to Immunization, Testing, and Health Screening for Health Care Workers”, promulgated pursuant to the authority conferred under Chapters 23-17 and 23-17.7.1 of the General Laws of Rhode Island and revised in October 2012. R23-17-HCW § 3.5.6 requires health care facilities to abide by the OSHA Blood Borne Pathogens Standard (29 CFR § 1910.1030), including the offering of hepatitis B vaccination to those health care workers at risk. R23-17-HCW § 1.6 defines “health care worker” as any person who is temporarily or permanently employed by or at, or who serves as a volunteer in, or has an employment contract with, a health care facility as defined in § 2.1 of the Regulations, and has or may have direct contact with a patient in that health care facility. R23-17-HCW § 2.1 defines “health care facilities” as including but not limited to hospitals, nursing facilities, rehabilitation centers, kidney disease treatment centers, freestanding emergency care facilities, facilities providing surgical treatment to patients not requiring hospitalization, physician ambulatory surgery centers and podiatry ambulatory surgery centers, among others.
[235] For Rhode Island requirements, see R23-17-HCW, “Rules and Regulations Pertaining to Immunization, Testing, and Health Screening for Health Care Workers”, promulgated pursuant to the authority conferred under Chapters 23-17 and 23-17.7.1 of the General Laws of Rhode Island and revised in October 2012. R23-17-HCW § 3.5.4 states that annual influenza vaccination is required for all health care workers as defined in R23-17-HCW § 1.6, subject to vaccine supply, and requires each health care facility to develop a specific plan to require annual influenza vaccination of all healthcare workers at no cost to the health care worker. R23-17-HCW § 5.4 further states that any health care worker may refuse the annual seasonal influenza vaccination requirements described in the Regulations provided that he or she provides proper annual written notice of refusal prior to December 15 each year and wears a surgical face mask during each direct patient contact in the performance of his or her duties during any declared period in which influenza is widespread. R23-17-HCW § 1.6 defines “health care worker” as any person who is temporarily or permanently employed by or at, or who serves as a volunteer in, or has an employment contract with, a health care facility as defined in § 2.1 of the Regulations, and has or may have direct contact with a patient in that health care facility. R23-17-HCW § 2.1 defines “health care facilities” as including but not limited to hospitals, nursing facilities, rehabilitation centers, kidney disease treatment centers, freestanding emergency care facilities, facilities providing surgical treatment to patients not requiring hospitalization, physician ambulatory surgery centers and podiatry ambulatory surgery centers, among others.
[236] For Rhode Island requirements, see R23-17-HCW, “Rules and Regulations Pertaining to Immunization, Testing, and Health Screening for Health Care Workers”, promulgated pursuant to the authority conferred under Chapters 23-17 and 23-17.7.1 of the General Laws of Rhode Island and revised in October 2012. R23-17-HCW § 3.5.1 states that prior to employment, all health care workers (with the exception of health care workers who receive a medical exemption) must provide evidence of immunity to measles, mumps, and rubella via either two doses of MMR vaccine or two doses of live measles-containing vaccine, two doses of live mumps-containing vaccine, and one dose of rubella vaccine, or laboratory evidence of immunity or laboratory confirmation of disease. For current health care workers, unvaccinated health care workers born before 1957 who lack laboratory evidence of measles immunity or laboratory confirmation of disease, two doses of MMR vaccine are recommended. (During an outbreak of measles, two doses of MMR vaccine are required for unvaccinated health care workers born before 1957 who lack laboratory evidence of measles immunity or laboratory confirmation of disease.) R23-17-HCW § 1.6 defines “health care worker” as any person who is temporarily or permanently employed by or at, or who serves as a volunteer in, or has an employment contract with, a health care facility as defined in § 2.1 of the Regulations, and has or may have direct contact with a patient in that health care facility. R23-17-HCW § 2.1 defines “health care facilities” as including but not limited to hospitals, nursing facilities, rehabilitation centers, kidney disease treatment centers, freestanding emergency care facilities, facilities providing surgical treatment to patients not requiring hospitalization, physician ambulatory surgery centers and podiatry ambulatory surgery centers, among others.
[237] For Rhode Island, for exemptions to the immunization requirements of R23-17-HCW, “Rules and Regulations Pertaining to Immunization, Testing, and Health Screening for Health Care Workers”, promulgated pursuant to the authority conferred under Chapters 23-17 and 23-17.7.1 of the General Laws of Rhode Island and revised in October 2012, see R23-17-HCW § 5.1. R23-17-HCW § 5.1 states that a health care worker shall be exempt from the immunization requirements described in the Regulations provided that a physician, physician assistant, or certified registered nurse practitioner signs a medical exemption stating that the health care worker is exempt from a specific vaccine because of medical reasons, in accordance with the Advisory Committee on Immunization Practices (ACIP) guidelines, and determined as acceptable by the facility. R23-17-HCW § 1.6 defines “health care worker” as any person who is temporarily or permanently employed by or at, or who serves as a volunteer in, or has an employment contract with, a health care facility as defined in § 2.1 of the Regulations, and has or may have direct contact with a patient in that health care facility. R23-17-HCW § 2.1 defines “health care facilities” as including but not limited to hospitals, nursing facilities, rehabilitation centers, kidney disease treatment centers, freestanding emergency care facilities, facilities providing surgical treatment to patients not requiring hospitalization, physician ambulatory surgery centers and podiatry ambulatory surgery centers, among others.
[246] For South Dakota requirements, see S.D. Admin. R. 44:04:02:09, relating to “medical facilities.” S.D. Admin. R. 44:04:02:09 provides that pathogen control must include a written exposure control plan, approved by the facility’s medical director or physician responsible for infection control, that addresses the requirements contained in 29 CFR § 1910.1030. 29 CFR § 1910.1030 requires employers to make available the hepatitis B vaccine and vaccine series to all employees who have occupational exposure. The employer shall not make participation in a prescreening program a prerequisite for receiving hepatitis B vaccination. If the employee initially declines vaccination but changes their mind while still covered under the standard, the employer shall make the hepatitis B vaccine available. If a routine booster dose(s) is recommended by the U.S. Public Health Service, the dose(s) shall be made available to the employee free of charge.
[256] For Texas requirements, see 25 Tex. Admin. Code § 96.202, requiring that all publicly owned or financed institutions that provide health services, even if health services are not their primary purpose, shall comply with state and federal laws regarding bloodborne pathogen exposure. The federal OSHA requirement, 29 CFR § 1910.1030, requires that employers make available the hepatitis B vaccine series to all employees who have occupational exposure. If the employee initially declines the vaccine but changes their mind while still covered under the standard, the employer shall make hepatitis B vaccine available. If a routine booster dose(s) is recommended by the U.S. Public Health Service, the dose(s) shall be made available to the employee free of charge.Note also 25 Tex. Admin. Code §1.702, which requires each health care facility to develop, implement, and enforce a policy and procedures to protect its patients from vaccine preventable diseases. The policy must, among other things, require covered individuals to receive vaccines for the vaccine preventable disease specified by the facility based on the level of risk the individual presents to patients by the individuals routine and direct exposure to patients, specify the vaccines a covered individual is required to receive based on the level of risk the individual presents to patients by the individuals routine and direct exposure to patients, and include procedures for verifying whether a covered individual has complied with the policy. The policy must include procedures for covered individuals to be exempt from the required vaccines for medical conditions identified as contraindications or precautions by the federal Centers for Disease Control and Prevention, and may include procedures for exemptions based on reasons of conscience, including a religious belief. 25 Tex. Admin. Code §1.701 defines “health care facility” to include hospitals licensed under Chapter 241 of the Texas Health and Safety Code and hospitals maintained or operated by the state.
[282] For Vermont requirements, see VT. Code R. 13-140-042, relating to occupational exposure. VT. Code R. 13-140-042 incorporates 29 CFR § 1910.1030, providing that employers must make available the hepatitis B vaccine and vaccine series to all employees who have occupational exposure. The employer shall ensure that the hepatitis B vaccine and vaccination series and follow-up is made available at no cost to the employee. If the employee initially declines vaccination but changes their mind while still covered under the standard, the employer shall make the hepatitis B vaccine available. If a routine booster dose(s) is recommended by the U.S. Public Health Service, the dose(s) shall be made available to the employee free of charge.
[285] For Virginia, no statute or regulation requires any hospital to ensure that any employees are vaccinated with hepatitis B vaccine. Note, however, 12 Va. Admin. Code § 5-410-490, providing that hospitals shall have an infection control committee to periodically evaluate, and revise as needed, infection control policies, procedures, and techniques for all appropriate phases of hospital operation and service in order to protect patients, employees, and visitors. These policies shall include, but are not limited to, appropriate employee health screening and immunization, among other things.
[286] For Virginia, no statute or regulation requires any hospital to ensure that any employees are vaccinated with influenza vaccine. Note, however, 12 Va. Admin. Code § 5-410-490, providing that hospitals shall have an infection control committee to periodically evaluate, and revise as needed, infection control policies, procedures, and techniques for all appropriate phases of hospital operation and service in order to protect patients, employees, and visitors. These policies shall include, but are not limited to, appropriate employee health screening and immunization, among other things.
[287] For Virginia, no statute or regulation requires any hospital to ensure that any employees are vaccinated with MMR vaccine. Note, however, 12 Va. Admin. Code § 5-410-490, providing that hospitals shall have an infection control committee to periodically evaluate, and revise as needed, infection control policies, procedures, and techniques for all appropriate phases of hospital operation and service in order to protect patients, employees, and visitors. These policies shall include, but are not limited to, appropriate employee health screening and immunization, among other things.
[288] For Virginia, no statute or regulation requires any hospital to ensure that any employees are vaccinated with varicella vaccine. Note, however, 12 Va. Admin. Code § 5-410-490, providing that hospitals shall have an infection control committee to periodically evaluate, and revise as needed, infection control policies, procedures, and techniques for all appropriate phases of hospital operation and service in order to protect patients, employees, and visitors. These policies shall include, but are not limited to, appropriate employee health screening and immunization, among other things.
[289] For Virginia, no statute or regulation requires any hospital to ensure that any employees are vaccinated with pneumococcal vaccine. Note, however, 12 Va. Admin. Code § 5-410-490, providing that hospitals shall have an infection control committee to periodically evaluate, and revise as needed, infection control policies, procedures, and techniques for all appropriate phases of hospital operation and service in order to protect patients, employees, and visitors. These policies shall include, but are not limited to, appropriate employee health screening and immunization, among other things.
[290] For Washington requirements, see Wash. Admin. Code § 296-823-13005 and Wash. Admin. Code § 296-823-130, relating to occupational exposure. Wash. Admin. Code § 296-823-13005 provides that employers must ensure that the hepatitis B vaccine series is available to all employees who have occupational exposure and that it is made available at no cost to the employee, the vaccine series is provided in accordance with the recommendations of the United States Public Health Service that are current at the time these evaluations and procedures take place, and the vaccine series is made available to any employee who initially declines the vaccination but later decides to accept while still covered under this chapter. Note that the administration requirements are inapplicable under the following circumstances: (1) the employee has previously received the complete hepatitis B vaccination series; (2) an antibody test has revealed that the employee is immune to hepatitis B; or (3) there are medical reasons not to give the vaccine. Moreover, employers are not required to provide the hepatitis B vaccine series to employees assigned to provide first aid only as a secondary duty, when they make hepatitis B vaccine available to all unvaccinated first-aid providers who render their assistance in any situation involving the presence of blood or other potentially infectious materials. Wash. Admin. Code § 296-823-130 provides that employers must make hepatitis B vaccine available to employees.
[295] For Wisconsin requirements, see Wis. Adm. Code § 124.07, relating to “hospitals.” Wis. Adm. Code § 124.07 provides that the hospital's employee health program shall include vaccination or confirmed immunity against rubella for everyone who has direct contact with rubella patients, pediatric patients or female patients of childbearing age. No individual without documented vaccination against or immunity to rubella may be placed in a position in which he or she has direct contact with rubella patients, pediatric patients or female patients of childbearing age, except that individuals placed in these positions before February 1, 1988 shall have one year after February 1, 1988 to comply with this requirement, and that individuals newly placed in these positions on or after February 1, 1988 shall have 30 days after they begin working in these positions to comply with this requirement. Wis. Stat. § 50.33 defines a “hospital” as any building, structure, institution or place devoted primarily to the maintenance and operation of facilities for the diagnosis, treatment of, and medical or surgical care for 3 or more non-related individuals hereinafter designated patients, suffering from illness, disease, injury, or disability, whether physical or mental, and including pregnancy, and regularly making available at least clinical laboratory services, and diagnostic X-ray services and treatment facilities for surgery, or obstetrical care, or other definitive medical treatment. “Hospital” may include, but not in limitation thereof by enumeration, related facilities such as outpatient facilities, nurses’, interns’, and resident’s quarters, training facilities and central service facilities operated in connection with hospitals. “Hospital” includes “special hospitals” or those hospital facilities that provide a limited type of medical or surgical care, including orthopedic hospitals, children’s hospitals, critical access hospitals, mental hospitals, psychiatric hospitals or maternity hospitals.
[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.
[510] For Alaska requirements, see Alaska Admin. Code tit. 7 § 12.650, relating to “facilities and local units of health and social services.” Alaska Admin. Code tit. 7 § 12.650 (2007) requires each facility to have an employee health program that requires evidence of immunization against hepatitis B. Note that these requirements apply only to those facilities identified in the regulation, and not all settings covered by the chart’s definition of hospital. “Facilities and local units” are defined in Alaska Admin. Code tit. 7 § 12.990 as including (among others) the following facilities: general acute care and rural primary care hospitals, critical access hospitals, and specialized hospitals.
[511] For Rhode Island requirements, see R23-17-HCW, “Rules and Regulations Pertaining to Immunization, Testing, and Health Screening for Health Care Workers”, promulgated pursuant to the authority conferred under Chapters 23-17 and 23-17.7.1 of the General Laws of Rhode Island and revised in October 2012. R23-17-HCW § 3.5.2 states that all health care workers (with the exception of health care workers who receive a medical exemption) must provide evidence of immunity to varicella via (a) two doses of varicella vaccine, with the second dose administered at least four weeks after the first dose, (b) laboratory evidence of immunity or laboratory confirmation of disease, (c) a healthcare provider diagnosis of varicella or healthcare provider verification of history of varicella disease, or (d) history of herpes zoster based on healthcare provider diagnosis. R23-17-HCW § 1.6 defines “health care worker” as any person who is temporarily or permanently employed by or at, or who serves as a volunteer in, or has an employment contract with, a health care facility as defined in § 2.1 of the Regulations, and has or may have direct contact with a patient in that health care facility. R23-17-HCW § 2.1 defines “health care facilities” as including but not limited to hospitals, nursing facilities, rehabilitation centers, kidney disease treatment centers, freestanding emergency care facilities, facilities providing surgical treatment to patients not requiring hospitalization, physician ambulatory surgery centers and podiatry ambulatory surgery centers, among others.
[512] For Tennessee requirements, see Tenn. Comp. R. and Regs. 1200-8-1-.06 (2007), relating to standards for hospitals. Tenn. Comp. R. and Regs. 1200-8-1-.06(3)(f) provides that the facility shall have an annual influenza vaccination program which shall include at least the offer of influenza vaccination to all staff and independent practitioners or accept documented evidence of vaccination from another vaccine source or facility.The program shall also include a signed declination statement on record from all who refuse vaccination for other than medical contraindications, education of direct care personnel about influenza transmission and control, and an annual evaluation of the program including reasons for non-participation.
[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.
[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.
[555] For Massachusetts requirements, see Mass. Regs. Code tit. 105, § 130.325, relating to requirements that hospital personnel be vaccinated against influenza. Mass. Regs. Code tit. 105, § 130.325(B) provides that each hospital shall ensure that all personnel are vaccinated with seasonal influenza vaccine unless an individual declines vaccination in accordance with Mass. Regs. Code tit. 105, § 130.325(F). Mass. Regs. Code tit. 105, § 130.325(A) defines personnel as individuals employed by or affiliated with the hospital, whether directly, by contract with another entity, or as an independent contractor, paid or unpaid, including but not limited to employees, members of the medical staff, contract employees or staff, students, and volunteers who either work at or come to the licensed hospital site, whether or not such individual(s) provide direct patient care.
[557] For Oklahoma requirements, see Okla. Admin. Code § 310:667-5-4, relating to “employee and/or worker health examinations.” Okla. Admin. Code § 310:667-5-4 provides that hepatitis B vaccine shall be offered consistent with 29 CFR § 1910.1030 (Occupational Exposure to Bloodborne Pathogens.)
[558] For Oklahoma requirements, see Okla. Admin. Code § 310:667-5-4, relating to “employee and/or worker health examinations.” Okla. Admin. Code § 310:667-5-4 provides that each hospital shall have an annual influenza vaccination program that shall include (1) the offer of influenza vaccination onsite, at no charge to all employees and/or workers in the hospital or acceptance of documented evidence of current season vaccination from another vaccine source or hospital and (2) documentation of vaccination for each employee and/or worker or a signed declination statement on record from each individual who refuses the influenza vaccination for other than medical contraindications.
[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.
[560] For Nebraska requirements, see Neb. Rev. Stat. §71-467, pertaining to “general acute hospital; employees; influenza vaccinations; tetanus-diphtheria-pertussis vaccine; duties; record”. Neb. Rev. Stat. §71-467 states that each general acute hospital shall annually offer onsite influenza vaccination to all hospital employees and shall offer to all employees a single dose of tetanus-diphtheria-pertussis vaccine if they have not previously received such vaccine and regardless of the time since their most recent vaccination with such vaccine. Neb. Rev. Stat. §71-467 further states that each general acute care hospital shall require all hospital employees to be vaccinated against influenza, tetanus, diphtheria, and pertussis, except that an employee may elect not to be vaccinated, and that this section shall not apply in individual cases when contraindicated or if a national shortage of the vaccine exists.
[565] For Colorado requirements, see 6 CCR 1011-1, Chapter 2, Part 10, pertaining to influenza immunization of healthcare workers. 6 CCR 1011-1 Chapter 2, §10.8 provides that each licensed hospital, hospital unit, ambulatory surgical center and long-term care facility shall have a written policy regarding the annual influenza immunization of its healthcare workers that, at a minimum, ensures that each of its healthcare workers has either proof of immunization or a medical exemption signed by a physician, physician’s assistant, advanced practice nurse or nurse midwife licensed in the State of Colorado stating that influenza vaccination for that individual is medically contraindicated as described in the product labeling approved by the United States Food and Drug Administration. 6 CCR 1011-1 Chapter 2, §10.8 additionally provides that such written policy must ensure that each healthcare worker who does not have proof of immunization wears a surgical or procedure mask during influenza season when in direct contact with patients and in common areas as specified by the licensee’s policy. 6 CCR 1011-1 Chapter 2, §10.6 provides for exemptions to the requirements of Sections 10.7 through 10.12 if a licensed healthcare entity demonstrates that it has vaccinated a targeted percentage of its employees in a given year, using its own methodology, and continues to use the same or more stringent methodology. The minimum targets required for the exemption are 60 percent of employees vaccinated by December 31, 2012; 75 percent of employees vaccinated by December 31, 2013, and 90 percent of employees vaccinated by December 31, 2014 and December 31 of each year thereafter. 6 CCR 1011-1 Chapter 2, §10.5 defines a hospital as a facility licensed and regulated pursuant to 6 CCR 1011-1, Chapter IV, General Hospitals and defines a healthcare worker as any person working in a healthcare entity who has the potential for exposure to patients, residents, or consumers of the healthcare entity and/or to infectious materials, including body substances, contaminated medical supplies and equipment, contaminated environmental surfaces, or contaminated air. The definition of healthcare worker does not include volunteers.
[567] For Colorado, for exemptions to the immunization requirements of 6 CCR 1011-1, Chapter 2, Part 10, see 6 CCR 1011-1, Chapter 2 §10.8(A)(2). 6 CCR 1011-1, Chapter 2 §10.8(A)(2) provides that in lieu of proof of immunization, a healthcare worker may have a medical exemption signed by a physician, physician’s assistant, advanced practice nurse or nurse midwife licensed in the State of Colorado stating that influenza vaccination for that individual is medically contraindicated as described in the product labeling approved by the United States Food and Drug Administration. Note also that 6 CCR 1011-1 Chapter 2, §10.6 provides for exemptions to the requirements of Sections 10.7 through 10.12 if a licensed healthcare entity demonstrates that it has vaccinated a targeted percentage of its employees in a given year, using its own methodology, and continues to use the same or more stringent methodology. The minimum targets required for the exemption are 60 percent of employees vaccinated by December 31, 2012; 75 percent of employees vaccinated by December 31, 2013, and 90 percent of employees vaccinated by December 31, 2014 and December 31 of each year thereafter. 6 CCR 1011-1 Chapter 2, §10.5 defines a hospital as a facility licensed and regulated pursuant to 6 CCR 1011-1, Chapter IV, General Hospitals and defines a healthcare worker as any person working in a healthcare entity who has the potential for exposure to patients, residents, or consumers of the healthcare entity and/or to infectious materials, including body substances, contaminated medical supplies and equipment, contaminated environmental surfaces, or contaminated air. The definition of healthcare worker does not include volunteers.
[569] For Georgia requirements, see Ga. Code Ann. § 31-7-18, relating to influenza vaccinations for discharged patients aged 65 and older, vaccinations or other measures for health care workers and other employees in hospitals, immunity from liability, and standing orders. Ga. Code Ann. § 31-7-18(b) provides that a hospital shall annually offer to its health care workers and other employees who have direct contact with patients, at no cost, vaccinations for the influenza virus in accordance with the recommendations of the Centers for Disease Control and Prevention, subject to availability of the vaccine.
[573] For South Dakota, no regulation or statute specifically refers to vaccination against influenza for hospital employees. However, note South Dakota Executive Order 2014-11, which requires all state-employed personnel providing direct health care services in a clinic, office, home, or other setting, or any state-employed personnel whose routine work duties brings them into direct contact with a client or patient in a patient or client care area, and all state-employed personnel entering a licensed healthcare facility on a routine basis as part of their job responsibilities to be vaccinated against influenza by December 1 of each year. Exceptions to the requirement are provided to any person who has a documented medical contraindication to the influenza vaccination or who is adherent to a religious doctrine whose teachings are opposed to immunizations. South Dakota Executive Order 2014-11 applies to state employees working in healthcare facilities rather than all hospital employees and therefore does not constitute a requirement for purposes of this database.
[574] For Texas, no regulation or statute specifically refers to vaccination against influenza for hospital employees. However, note 25 Tex. Admin. Code §1.702, which requires each health care facility to develop, implement, and enforce a policy and procedures to protect its patients from vaccine preventable diseases. The policy must, among other things, require covered individuals to receive vaccines for the vaccine preventable disease specified by the facility based on the level of risk the individual presents to patients by the individuals routine and direct exposure to patients, specify the vaccines a covered individual is required to receive based on the level of risk the individual presents to patients by the individuals routine and direct exposure to patients, and include procedures for verifying whether a covered individual has complied with the policy. The policy must include procedures for covered individuals to be exempt from the required vaccines for medical conditions identified as contraindications or precautions by the federal Centers for Disease Control and Prevention, and may include procedures for exemptions based on reasons of conscience, including a religious belief. 25 Tex. Admin. Code §1.701 defines “health care facility” to include hospitals licensed under Chapter 241 of the Texas Health and Safety Code and hospitals maintained or operated by the state.
[575] For Texas, no regulation or statute specifically refers to vaccination against measles, mumps, or rubella for hospital employees. However, note 25 Tex. Admin. Code §1.702, which requires each health care facility to develop, implement, and enforce a policy and procedures to protect its patients from vaccine preventable diseases. The policy must, among other things, require covered individuals to receive vaccines for the vaccine preventable disease specified by the facility based on the level of risk the individual presents to patients by the individuals routine and direct exposure to patients, specify the vaccines a covered individual is required to receive based on the level of risk the individual presents to patients by the individuals routine and direct exposure to patients, and include procedures for verifying whether a covered individual has complied with the policy. The policy must include procedures for covered individuals to be exempt from the required vaccines for medical conditions identified as contraindications or precautions by the federal Centers for Disease Control and Prevention, and may include procedures for exemptions based on reasons of conscience, including a religious belief. 25 Tex. Admin. Code §1.701 defines “health care facility” to include hospitals licensed under Chapter 241 of the Texas Health and Safety Code and hospitals maintained or operated by the state.
[576] For Texas, no regulation or statute specifically refers to vaccination against varicella for hospital employees. However, note 25 Tex. Admin. Code §1.702, which requires each health care facility to develop, implement, and enforce a policy and procedures to protect its patients from vaccine preventable diseases. The policy must, among other things, require covered individuals to receive vaccines for the vaccine preventable disease specified by the facility based on the level of risk the individual presents to patients by the individuals routine and direct exposure to patients, specify the vaccines a covered individual is required to receive based on the level of risk the individual presents to patients by the individuals routine and direct exposure to patients, and include procedures for verifying whether a covered individual has complied with the policy. The policy must include procedures for covered individuals to be exempt from the required vaccines for medical conditions identified as contraindications or precautions by the federal Centers for Disease Control and Prevention, and may include procedures for exemptions based on reasons of conscience, including a religious belief. 25 Tex. Admin. Code §1.701 defines “health care facility” to include hospitals licensed under Chapter 241 of the Texas Health and Safety Code and hospitals maintained or operated by the state.
[577] For Texas, no regulation or statute specifically refers to vaccination against pneumococcal disease for hospital employees. However, note 25 Tex. Admin. Code §1.702, which requires each health care facility to develop, implement, and enforce a policy and procedures to protect its patients from vaccine preventable diseases. The policy must, among other things, require covered individuals to receive vaccines for the vaccine preventable disease specified by the facility based on the level of risk the individual presents to patients by the individuals routine and direct exposure to patients, specify the vaccines a covered individual is required to receive based on the level of risk the individual presents to patients by the individuals routine and direct exposure to patients, and include procedures for verifying whether a covered individual has complied with the policy. The policy must include procedures for covered individuals to be exempt from the required vaccines for medical conditions identified as contraindications or precautions by the federal Centers for Disease Control and Prevention, and may include procedures for exemptions based on reasons of conscience, including a religious belief. 25 Tex. Admin. Code §1.701 defines “health care facility” to include hospitals licensed under Chapter 241 of the Texas Health and Safety Code and hospitals maintained or operated by the state.

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.