Colorado State Vaccine Requirements
Posted Date: September 13, 2016
Quick Facts and Resources for Colorado Residents
NEW Quick Fact: On July 1, 2016 the Colorado Department of Public Health and Environment (CDPHE) began providing a new, optional online system to submit exemptions. NVIC has received reports that many schools have been telling parents they must use this new online system. BE ADVISED: The Colorado Department of Education (CDE) has issued a letter informing school districts that CDPHE’s online system is optional and that parents must submit exemption forms to their schools - see CDE letter. Exemptions for schools and daycare DO NOT have to be filed with CDPHE.
CDE’s letter also states that exemption information filed directly with public schools, as required by Colorado law, are protected under the federal Family Educational Rights and Privacy Act (FERPA). FERPA prohibits schools from sharing exemption information without written parental consent, unless there is a public health emergency, as defined by FERPA. FERPA does not apply to private and parochial schools or daycares unless they accept federal funding.
Any exemption submitted to CDPHE, whether online, mailed or faxed, will be put into Colorado’s vaccine tracking system, the Colorado Immunization Information System (CIIS). Submitting exemptions to CDPHE will result in the loss of federal privacy protections under FERPA. BE ADVISED: CDPHE can use, and disclose, exemption information from CIIS without parental consent.
CDPHE has also created a new nonmedical (religious or personal belief) exemption forms that contain language which may be considered compelled speech and a violation of 1st Amendment rights under the U.S. Constitution. CDPHE's new medical exemption form also requests information over and above what the law states is necessary for a medical exemption. NVIC is advising families to seek legal advice on their exemption rights. For more exemption information, read below.
Other Resources: Many vaccination and exemption information links are date specific. If the links below have expired, click on the state's department of health, or immunization program link provided below, as they are likely to provide links to updated information. The General Information link leads to the overview page provided by the state at the time of this webpage's update and may also be helpful. Please email NVIC with broken link information.
K-12 School Information
Other State Resources
- General Information
- Vaccination Requirements
- Religious & Personal Belief Exemption Information & Waiver - NVIC Note: Exemption forms provided by CDPHE include statements that may be considered compelled speech in violation of the U.S. Constitution’s 1st Amendment by forcing parents to sign a statement that they are putting their child at risk by not vaccinating. NVIC is advising parents to seek legal advice on their vaccine exemption rights. Colorado exemption law, CRS 25-4-903 (2)(b) does not require use of a state form and states:
"By submitting to the student's school a statement of exemption signed by one parent or guardian or the emancipated student or student eighteen years of age or older that the parent, guardian, or student is an adherent to a religious belief whose teachings are opposed to immunizations or that the parent or guardian or the emancipated student or student eighteen years of age or older has a personal belief that is opposed to immunizations.”
- Medical Exemption - NVIC Note: Exemption forms provided by CDPHE appear to ask for information that is not required by state law. NVIC is advising parents to seek legal advice on their vaccine exemption rights. Colorado exemption law, CRS 25-4-903 (2)(a) does not require use of a state form and states:
"By submitting to the student's school certification from a licensed physician or advanced practice nurse that the physical condition of the student is such that one or more specified immunizations would endanger his or her life or health or is medically contraindicated due to other medical conditions;” (Note: Effective Aug. 10, 2016 physician assistants may also provide medical exemptions.)
The information contained on NVIC's web pages is for educational purposes only and is not intended to be medical or legal advice. Those seeking medical or legal advice should obtain the services of a competent attorney, physician or qualified health care professional. Although NVIC continually updates our website, state laws and rules change frequently and consumers are ultimately responsible for verifying their state's vaccination and exemption laws and requirements.
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TITLE 25. HEALTH
ARTICLE 4. DISEASE CONTROL
PART 9. SCHOOL ENTRY IMMUNIZATION
C.R.S. 25-4-901. Definitions
As used in this part 9, unless the context otherwise requires:
(1) "Certificate of immunization" means one of the following forms of documentation that include the dates and types of immunizations administered to a student:
(a) A paper document that includes information transferred from the records of a licensed physician, registered nurse, or public health official; or
(b) An electronic file or a hard copy of an electronic file provided to the school directly from the immunization tracking system, established pursuant to section 25-4-2403.
(1.5) "Child" means any student less than eighteen years of age.
(a) "School" means, except as otherwise provided in paragraph (b) of this subsection (2), a public, private, or parochial nursery school, day care center, child care facility, family child care home, foster care home, head start program, kindergarten, elementary or secondary school through grade twelve, or college or university.
(b) "School" does not include:
(I) A public services short-term child care facility as defined in section 26-6-102 (6.7), C.R.S.;
(I.5) A guest child care facility as defined in section 26-6-102 (5), C.R.S., or a ski school as defined in section 26-6-103.5 (6), C.R.S.; or (II) College or university courses of study that are offered off-campus, or are offered to nontraditional adult students, as defined by the governing board of the institution, or are offered at colleges or universities that do not have residence hall facilities.
(3) "Student" means any person enrolled in a Colorado school as defined in subsection (2) of this section.
C.R.S. 25-4-902. Immunization prior to attending school - standardized immunization information
(1) Except as provided in section 25-4-903, no child shall attend any school in the state of Colorado on or after the dates specified in section 25-4-906 (4) unless he or she has presented the following to the appropriate school official
(a) An up-to-date certificate of immunization from a licensed physician, a licensed advanced practice nurse, or authorized representative of the department of public health and environment or county, district, or municipal public health agency stating that the child has received immunization against communicable diseases as specified by the state board of health, based on recommendations of the advisory committee on immunization practices of the United States department of health and human services or the American academy of pediatrics; or
(b) A written authorization signed by one parent or guardian or an authorization signed by the emancipated child requesting that local health officials administer the immunizations.
(c) (Deleted by amendment, L. 97, p. 408, § 1, effective July 1, 1997.)
(2) If the student's certificate of immunization is not up-to-date according to the requirements of the state board of health, the parent or guardian or the emancipated student or the student eighteen years of age or older shall submit to the school, within fourteen days after receiving direct personal notification that the certificate is not up-to-date, documentation that the next required immunization has been given and a written plan for completion of all required immunizations. The scheduling of immunizations in the written plan shall follow medically recommended minimum intervals approved by the state board of health. If the student begins but does not continue or complete the written plan, he or she shall be suspended or expelled pursuant to this part 9.
(3) Notwithstanding the provisions of subsection (1) of this section, a school shall enroll a student who is in out-of-home placement within five school days after receiving the student's education information and records as required in section 22-32-138, C.R.S., regardless of whether the school has received the items specified in subsection (1) of this section. Upon enrolling the student, the school shall notify the student's legal guardian that, unless the school receives the student's certificate of immunization or a written authorization for administration of immunizations within fourteen days after the student enrolls, the school shall suspend the student until such time as the school receives the certificate of immunization or the authorization.
(4) On or before March 1, 2011, the department of public health and environment shall develop and provide to the department of education a standardized document regarding childhood immunizations. The department of education shall post the standardized immunization document on its web site on or before January 15, 2011, and each year thereafter. The standardized document shall be updated annually and shall include, but need not be limited to:
(a) A list of the immunizations required for enrollment in a school and the age at which the immunization is required; and
(b) A list of immunizations currently recommended for children by the center for disease control advisory committee on immunization practices and the recommended age at which each immunization should be given.
(5) The document created pursuant to subsection (4) of this section shall comply with the provisions of section 25-4-903(4) regarding allowable exemptions from required immunizations.
C.R.S. 25-4-902.5 Immunization prior to attending a college or university - tuberculosis screening process development.
(1) Except as provided in section 25-4-903, no student shall attend any college or university in the state of Colorado on or afr the dates specified in section 25-4-906 (4) unless such student can present to the appropriate official of the school a certificate of immunization from a licensed physician, a licensed advanced practice nurse, or authorized representative of the department of public health and environment or county, district, or municipal public health agency stating that the student has received immunization against communicable diseases as specified by the state board of health or a written authorization signed by one parent or guardian or the emancipated student or the student eighteen years of age or older requesting that local health officials administer the immunizations or a plan signed by one parent or guardian or the emancipated student or the student eighteen years of age or older for receipt by the student of the required inoculation or the first or the next required of a series of inoculations within thirty days.
(2) (Deleted by amendment, L. 94, p. 695, § 2, effective April 19, 1994.)
(3) (a) Each college and university in Colorado may work to create a tuberculosis screening process with the goal of making the process as uniform as possible for all colleges and universities in the state. The department of public health and environment may attend and participate in any meetings held by the universities and colleges regarding the screening process. The screening process may include a tuberculosis risk questionnaire, a tuberculosis education policy, a clinical review process for each completed questionnaire, and follow-up testing procedures for students who are determined to be at risk for tuberculosis. On or before January 1, 2009, the colleges and universities that work to create a tuberculosis screening process pursuant to this subsection (3) shall report to the health and human services committees of the senate and the house of representatives, or their successor committees, regarding any legislative recommendations necessary regarding a tuberculosis screening process.
(b) This subsection (3) shall not apply to a university or college that provides course work solely online.
C.R.S. 25-4-903. Exemptions from immunization
(1) (Deleted by amendment, L. 97, p. 409, § 2, effective July 1, 1997.)
(2) It is the responsibility of the parent or legal guardian to have his or her child immunized unless the child is exempted pursuant to this section. A student shall be exempted from receiving the required immunizations in the following manner:
(a) By submitting to the student's school certification from a licensed physician or advanced practice nurse that the physical condition of the student is such that one or more specified immunizations would endanger his or her life or health or is medically contraindicated due to other medical conditions; or
(b) By submitting to the student's school a statement of exemption signed by one parent or guardian or the emancipated student or student eighteen years of age or older that the parent, guardian, or student is an adherent to a religious belief whose teachings are opposed to immunizations or that the parent or guardian or the emancipated student or student eighteen years of age or older has a personal belief that is opposed to immunizations.
(2.5) The state board of health shall promulgate rules regarding:
(a) Immunization information, including exemption rates, that is available to the public through the department, including evidence-based research, resources and information from credible scientific and public health organizations, peer-reviewed studies, and an on-line learning module; and
(b) The frequency of submission of exemption forms.
(3) The state board of health may provide, by regulation, for further exemptions to immunization based upon sound medical practice.
(4) All information distributed to parents by school districts regarding immunization shall inform them of their rights under subsection (2) of this section.
(5) Each school shall make the immunization and exemption rates of their enrolled student population publicly available upon request.
C.R.S. 25-4-904. Rules and regulations - immunization rules - rule-making authority of state board of health
(1) The state board of health shall establish rules and regulations for administering this part 9. Such rules and regulations shall establish which immunizations shall be required and the manner and frequency of their administration and shall conform to recognized standard medical practices. Such rules and regulations may also require the reporting of statistical information and names of non-compliers by the schools. The department of public health and environment shall administer and enforce the immunization requirements.
(2) All rule-making authority granted to the state board of health under the provisions of this article is granted on the condition that the general assembly reserves the power to delete or rescind any rule of the board. All rules promulgated pursuant to this subsection (2) shall be subject to sections 24-4-103 (8) (c) and (8) (d) and 24-4-108, C.R.S.