State Immunization Laws for Healthcare
Workers and Patients

Immunization Administration Requirements For
Influenza

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

States	Hospital Employees	Hospital Inpatients
AL	Ensure[21]	No
AK	No	No
AZ	No	No
AR	No	No
CA	Offer[505]	Offer[506]
CO	Ensure[565]	No
CT	No	Ensure[51]
DC	No[63]	No
DE	No	No
FL	No	Offer[75]
GA	Offer[569]	Offer[533]
HI	No	No
ID	No	No
IL	Offer[85]	No[542]
IN	No	No
IA	No	No
KS	No	No
KY	No	No
LA	No	Offer[561]
ME	Offer[116]	No
MD	Offer[559]	No
MA	Offer[555]	No
MI	No	No
MN	No	No
MS	No	Offer[572]
MO	No	No
MT	No	No
NE	Offer[560]	Offer[563]
NH	Ensure[146]	Ensure[150]
NJ	No	Offer[161]
NM	No	No
NY	No	Offer[178]
NV	No[190]	No[194]
NC	No	No
ND	No	No
OH	No	Offer[501]
OK	Offer[558]	No
OR	No[221]	No
PA	No	Offer[519]
RI	Offer[235]	No[238]
SC	No	No
SD	No[573]	No
TN	Offer[512]	Offer[508]
TX	No[574]	Offer[257]
UT	No	No
VT	No	No
VA	No[286]	No
WA	No	No
WV	No	No
WI	No	No
WY	No	No

[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.
[51] For Connecticut requirements, see Regs., Conn. State Agencies § 19-13-D8t, applying to “short term hospitals” and “long term hospitals.” § 19-31-D8t requires that professional services provided to each patient by the facility shall include, but not necessarily be limited to, immunization against influenza in accordance with the recommendations of the Advisory Committee on Immunization Practices. Note, however, that § 19-31-D8t does not make specific reference to an “ensure” requirement; however, this chart construes § 19-31-D8t as imposing an “ensure” requirement because exemptions exist to the immunization administration requirements of § 19-13-D8t, indicating that administration of the vaccine is mandatory. “Short term hospitals” and “long term hospitals” are defined in § 19-31-D1(b)(1) and (2), and are both covered by this chart’s definition of hospital.
[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.
[75] For Florida requirements, see Fla. Stat. § 381.005(2), providing that between October 1, or earlier if the vaccination is available, and February 1 of each year, subject to the availability of an adequate supply of the necessary vaccine, each hospital licensed pursuant to chapter 395 shall implement a program to offer immunizations against the influenza virus and pneumococcal bacteria to all patients age 65 or older, in accordance with the recommendations of the Advisory Committee on Immunization Practices of the United States Centers for Disease Control and Prevention and subject to the clinical judgment of the responsible practitioner. Fla. Stat. § 395.002(12) defines a hospital as any establishment that offers services more intensive than those required for room, board, personal services, and general nursing care, and offers facilities and beds for use beyond 24 hours by individuals requiring diagnosis, treatment, or care for illness, injury, deformity, infirmity, abnormality, disease, or pregnancy; and regularly makes available at least clinical laboratory services, diagnostic X-ray services, and treatment facilities for surgery or obstetrical care, or other definitive medical treatment of similar extent, except that a critical access hospital, as defined in s. 408.07, shall not be required to make available treatment facilities for surgery, obstetrical care, or similar services as long as it maintains its critical access hospital designation and shall be required to make such facilities available only if it ceases to be designated as a critical access hospital. However, the provisions of this chapter do not apply to any institution conducted by or for the adherents of any well-recognized church or religious denomination that depends exclusively upon prayer or spiritual means to heal, care for, or treat any person.
[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.	Top of Page
[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.
[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.
[150] For New Hampshire requirements, see N.H. Rev. Stat. Ann. § 151:9-b, relating to “hospitals.” N.H. Rev. Stat. Ann. § 151:9-b provides that all hospitals and residential care facilities licensed under Title XI, chapter 151 of the New Hampshire Revised Statutes shall document evidence of immunization against influenza, for all consenting patients in accordance with the current recommendations of the Advisory Committee on Immunization Practices for the Centers for Disease Control and Prevention (CDC) with respect to indications such as age, timing, dosage, and administration. Immunization of all consenting patient shall be subject to the availability of an adequate supply of the necessary vaccine and subject to exemptions for medical contraindications and religious beliefs, and conducted in accordance with the guidelines of the CDC Advisory Committee on Immunization Practices. A consenting patient shall be immunized prior to discharge from the hospital.
[161] For New Jersey requirements, see N.J. Admin. Code tit. 8, § 8:43G-14.6, requiring that between Oct. 1 or earlier where the vaccine is available, and Feb. 1, every patient aged 65 years and older shall be provided the opportunity to receive influenza vaccination in accordance with the recommendations of the Advisory Committee on Immunization Practices of the Centers for Disease Control in effect at the time of vaccination, incorporated herein by reference. 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.	Top of Page
[178] For New York requirements, see N.Y. CLS Pub Health §2805-h(2)(a), requiring the person in charge of each hospital to offer each admitted person age sixty-five or older vaccination against influenza virus annually between September first and April first. Such officer or person need not offer the vaccination to persons who have already received such vaccine or for whom it is otherwise inappropriate. Note also that N.Y. CLS Pub Health §2805-h(1) requires the person in charge of each hospital to make available immunizations against poliomyelitis, mumps, measles, diphtheria and rubella for each person in its care under age eighteen who has not been previously vaccinated. This is properly characterized as an “ensure” requirement because, although “makes available” would appear on a plain reading to be voluntary language, certain exemptions to this requirement are provided for, indicating that immunization is mandatory. This requirement only applies to those facilities falling under the definition of hospital set forth in N.Y. CLS Pub Health § 2801(1).
[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.
[194] For Nevada, no statute or regulation requires any hospital to ensure that any inpatients are vaccinated with influenza vaccine. Note, however, 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 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 child in the medical facility shall complete a course of antimicrobial prophylaxis, unless medically contraindicated, regardless of whether the child has received an immunization against Haemophilus influenzae type b.
[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.	Top of Page
[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.
[238] For Rhode Island, no statute or regulation requires any hospital to ensure that any inpatient is vaccinated with influenza vaccine. Note, however, R.I. Code R. 14-090-007, providing that the following risk factors shall be evaluated and appropriate follow-up care plans and/or referrals documented in the medical record prior to discharge. For maternal health, rhogam and/or rubella vaccine given, if required. For infant health and development, hepatitis B vaccine given as required.
[257] For Texas requirements, see Tex. Health & Safety Code § 161.0052(b) providing that the executive commissioner of the Health and Human Services Commission by rule shall require a hospital to inform each elderly person admitted to the hospital for a period of 24 hours or more that the pneumococcal and influenza vaccines are available. If the elderly person requests a vaccine, and if a physician, or an advanced nurse practitioner or physician assistant on behalf of a physician, determines that the vaccine is in the person's best interest, the hospital must make the vaccination available to the person before the person is discharged from the hospital.
[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.	Top of Page
[501] For Ohio requirements, see Ohio Rev. Code § 3727.19(B), relating to hospitals. Ohio Rev. Code § 3727.19(B) requires that each hospital offer to each patient who is admitted to the hospital, in accordance with guidelines issued by the advisory committee, vaccination against influenza, unless a physician has determined that vaccination of the patient is medically inappropriate…A patient may refuse vaccination.
[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.
[506] For California requirements, see Cal. Health & Safety Code § 120392.2(a) (2007), providing that each year, commencing October 1 to the following April 1, inclusive, every health care facility, as defined in subdivision (a) of Section 120392, shall offer, pursuant to Section 120392.4, immunizations for influenza and pneumococcal disease to residents, aged 65 years or older, receiving services at the facility, based upon the latest recommendations of the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention, and the latest recommendations of appropriate entities for the prevention, detection, and control of influenza outbreaks in California long-term care facilities. Section 120392.4 provides in part that a resident who receives services at a health care facility during the period of October 1 to April 1 shall have his or her status for influenza and pneumococcal immunization determined by his or her physician or facility medical director, and, if appropriate, the facility shall offer to make the immunizations available, unless the facility, through written policies and procedures and using standardized nursing procedures, offers to make the immunizations available without limitation as to the period when the residents receive services at the facility.
[508] For Tennessee requirements, see Tenn. Code Ann. § 68-11-266, providing that in accordance with the latest recommendations of the advisory committee on immunization practices of the centers for disease control, and subject to the availability of vaccine, each year from October 1 through March 1, prior to discharging any inpatient who is sixty-five (65) years of age or older, a hospital shall offer the inpatient immunization for influenza and pneumococcal diseases.	Top of Page
[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.
[519] For Pennsylvania requirements, see 35 P.S. § 634.3(a), providing that when an eligible person is admitted to a hospital for a period of more than 24 hours for a condition unrelated to the influenza virus or pneumococcal disease, he or she shall be informed that a vaccination for the influenza virus and pneumococcal disease is available and provided the opportunity to receive vaccination against the influenza virus and pneumococcal disease prior to discharge from the hospital. 35 P.S. § 634.2 defines an eligible person as a person 65 years of age or older, and defines a hospital as an institution licensed as a hospital pursuant to Chapter 8 of the Health Care Facilities Act. Chapter 8 of the Health Care Facilities Act defines a hospital as an institution having an organized medical staff established for the purpose of providing to inpatients, by or under the supervision of physicians, diagnostic and therapeutic services for the care of persons who are injured, disabled, pregnant, diseased, sick or mentally ill, or rehabilitation services for the rehabilitation of persons who are injured, disabled, pregnant, diseased, sick or mentally ill. The term includes facilities for the diagnosis and treatment of disorders within the scope of specific medical specialties, but not facilities caring exclusively for the mentally ill.
[533] For Georgia requirements, see Ga. Code Ann. § 31-7-18, relating to influenza vaccinations for discharged patients aged 65 and older. Ga. Code Ann. § 31-7-18 provides that annually between October 1 through March 1, prior to discharging any inpatient who is 65 years of age or older, a hospital shall offer the inpatient vaccinations for the influenza virus and pneumococcal disease, unless contraindicated and contingent on availability of such vaccines.
[542] For Illinois, no statute or regulation requires any hospital to ensure that any inpatients are vaccinated with influenza vaccine. Note, however, 210 Ill. Comp. Stat. Ann. § 85/6.26 relating to “immunization against influenza virus and pneumococcal disease”. 210 Ill. Comp. Stat. Ann. § 85/6.26 requires every hospital to adopt an influenza and pneumococcal immunization policy that includes, among other things, procedures for offering immunization against influenza virus when available between September 1 and April 1, and against pneumococcal disease upon admission or discharge, in accordance with the recommendations of the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention that are most recent to the time of vaccination, unless contraindicated. 210 Ill. Comp. Stat. Ann. § 85/6.26 does not explicitly require hospitals to institute these procedures once adopted; therefore, this does not constitute an “offer” requirement in the context of this database.	Top of Page
[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.
[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.	Top of Page
[561] For Louisiana requirements, see La. Rev. Stat. Ann. § 40:2023, pertaining to availability of immunizations recommended by the Centers for Disease Control and Prevention. La. Rev. Stat. Ann. § 40:2023 provides that beginning October 1, 2012, and each year thereafter, each general hospital licensed under this chapter shall, in accordance with the latest recommendations of the Advisory Committee on Immunization Practices for the Centers for Disease Control and Prevention, offer the following immunizations to all inpatients sixty-five years of age and older prior to discharge, if not contraindicated and contingent on certain payment specifications: (1) immunization against influenza and (2) immunization against pneumococcal disease if ordered by the patient’s attending physician.
[563] For Nebraska requirements, see Neb. Rev. Stat. §71-468, pertaining to onsite vaccinations for influenza and pneumococcal disease. Neb. Rev. Stat. §71-468 requires that each general acute hospital, intermediate care facility, nursing facility, and skilled nursing facility annually, beginning no later than October 1 and ending on the following April 1, offer onsite vaccinations for influenza and pneumococcal disease to all residents and to all inpatients prior to discharge. Note also Neb. Rev. Stat. §71-469, which requires each general acute hospital to offer onsite vaccinations for diphtheria, tetanus, and pertussis to all inpatients prior to discharge, pursuant to procedures of the facility and in accordance with the recommendations of the advisory committee on immunization practices of the Centers for Disease Control and Prevention of the United States Public Health Services of the United States Department of Health and Human Services as the recommendations existed on January 1, 2013. Nothing in this section shall be construed to require any facility listed in this section to bear the cost of a vaccination provided pursuant to this section. Nebraska law further specifies that Neb. Rev. Stat. §71-468 and Neb. Rev. Stat. §71-469 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.
[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.	Top of Page
[572] For Mississippi requirements, see Miss. Code Ann. §41-9-39, which states that each year from October 1 through March 1 and in accordance with the latest recommendations of the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention, each hospital shall offer, prior to discharge, immunizations against influenza virus to all inpatients sixty-five (65) years of age and older unless contraindicated and contingent upon 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.

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.