Delaware State Vaccine Requirements

• General Information
• Vaccination Requirements and for private schools see section “7.0 Control of Specific Contagious Diseases”
• Exemption Information and for private schools see section “7.0 Control of Specific Contagious Diseases” 

• General Information
• Vaccination Requirements - see section see section “7.0 Control of Specific Contagious Diseases”
• Exemption Information - see section “7.0 Control of Specific Contagious Diseases, 7.1.10-13” 

• General Information
• Vaccination Requirements - see section see section “7.0 Control of Specific Contagious Diseases”
• Exemption Information and for private schools see section “7.0 Control of Specific Contagious Diseases”

• State Healthcare Workers and Patient Vaccination Laws
• State of Delaware Legislature  – see applicable statutes and their hyperlinks below. Visit NVIC’s Advocacy Portal for information on legislation introduced impacting vaccine exemption rights. 
• State of Delaware Department of Health
• State of Delaware Immunization Program
• State of Delaware Vaccine Tracking System – You may also wish to contact your state’s vaccine tracking registry to determine if the ability to opt out is available.
• State of Delaware Proposed Rule-Making – View your state’s registry to learn about proposed rule-making.

TITLE 14. EDUCATION
PART I. FREE PUBLIC SCHOOLS
CHAPTER 1. DEPARTMENT OF EDUCATION
SUBCHAPTER II. POWERS AND DUTIES

14 Del. C. § 131. Public school enrollees' immunization program; exemptions 

(a)The Department shall from time to time, with advice from the Division of Public Health, adopt and promulgate rules and regulations to establish an immunization program to protect pupils enrolled in public schools from certain diseases. Such rules and regulations shall include at least the following:

(1)The designation of a basic series of immunizations to be administered according to these rules;

(2)The requirement that all persons enrolling in the public schools at any age or level as authorized by this title shall have:

a.Been immunized according to the required program prior to the time of enrollment in the Delaware schools;

b.Begun the series of immunizations not later than the time of enrollment to be completed within a reasonable time as prescribed by the Department in relation to the particular immunization involved; or

c.Presented written documentation of any claim of prior immunization in the form of a statement from the immunizing physician or agency or such other form as may from time to time be approved by regulation of the Department;

(3)Provision that persons seeking to be enrollees of the public school who have not been immunized or do not meet the requirements for immunization within the time prescribed shall be denied further attendance in the public schools;

(4)Provision for written notification of the parent, or legal guardian of an enrollee, of a pending exclusion;

(5)Provision for exemption from any or all of the immunization program prescribed for a particular enrollee upon a written statement from a physician, i.e., medical doctor or doctor of osteopathy, stating that the enrollee should not receive the prescribed immunization or immunizations required in the basic series because of the reasonable certainty of a reaction detrimental to that person. The asserted cause of medical exemption may be subject to review and approval by the Division of Public Health. A history of clinical illness of measles or rubella shall not be accepted as cause for exemption. The parents or legal guardian of a child medically exempt from the immunization program shall be informed by schools of the provisions within paragraph (a)(7) of this section;

(6)Provision for exemption from the immunization program for an enrollee whose parents or legal guardian, because of individual religious beliefs, reject the concept of immunization. Such a request for exemption shall be supported by the affidavit herein set forth:

AFFIDAVIT OF RELIGIOUS BELIEF

STATE OF DELAWARE

________ COUNTY;

1.(I) (We) (am) (are) the (parent(s)) (legal guardian(s)) of __________.

Name of Child

2.(I) (We) hereby (swear) (affirm) that (I) (we) subscribe to a belief in a relation to a Supreme Being involving duties superior to those arising from any human relation.

3.(I) (We) further (swear) (affirm) that our belief is sincere and meaningful and occupies a place in (my) (our) life parallel to that filled by the orthodox belief in God.

4.This belief is not a political, sociological or philosophical view of a merely personal moral code.

5.This belief causes (me) (us) to request an exemption from the mandatory school vaccination program for __________.

Name of Child

6.(I) (We) acknowledge that, in the event that the Division of Public Health declares that there is an outbreak of a vaccine preventable disease, or if in the estimation of the Division of Public Health, (my) (our) child has had, or is at risk of having an exposure to a vaccine preventable disease, (my) (our) child shall be temporarily excluded from attendance at the public school, in which case, it will be (my) (our) responsibility, along with the school, to assist (my) (our) child in keeping up with school work, and (my) (our) child shall be authorized to return to school once approved by the Division of Public Health.

7.(I) (We) acknowledge that (I) (we) have been given the opportunity to receive from the school district information regarding the medical benefits and risks in choosing whether to have the child participate in the immunization program, and if (I) (we) have not taken that opportunity, it is hereby waived.

Signature of Parent(s) or Legal Guardian(s)

SWORN TO AND SUBSCRIBED before me, a registered Notary Public, this ____ day of ______, ____

(Seal)

Notary Public:

My commission expires:

(7)Provision that, in the event that the Division of Public Health declares that there is an outbreak of a vaccine preventable disease or if in the estimation of the Division of Public Health any child has had or is at risk of having an exposure to a vaccine preventable disease, any child who is enrolled in a public school and who has been exempt from the immunization program for any of the causes authorized herein shall be temporarily excluded from attendance at the public school. Rules and regulations of the Department shall provide that in the event of such temporary exclusion, it will be the responsibility of the school and the parents or legal guardian of the enrollee to assist the enrollee in keeping up with that enrollee's school work and that no academic penalty shall be suffered by the enrollee upon return to school if the student has maintained that student's relationship with the school through the assignments prescribed. An enrollee so temporarily excluded shall be authorized to return to school once approved by the Division of Public Health;

(8)Provision that in any situation where the parents or legal guardian of the enrollee states that the enrollee has been immunized, but that the record has been lost or destroyed by the provider of the immunizations, the following procedure may be carried out by that responsible person and shall be accepted by the local school district board of education or its designee in lieu of compliance with the immunization requirement:

a.The responsible person, or the school nurse, shall sign a statement that the record of the enrollee's immunization has been lost; and

b.The responsible person shall be responsible for the enrollee obtaining 1 dose of each of the vaccines prescribed in the basic series of immunization;

(9)Provision for an enrollee who has reached the statutory age of majority set by laws for the State to be responsible for that enrollee's immunization program and for execution of the request for religious exemption herein authorized;

(10)Provision that it shall be the responsibility of each Delaware public school district to administer, or prescribe a designee to administer, rules and regulations herein authorized and promulgated by the Department of Education.

(b)Appeals from the decision of the Department rendered pursuant to this section shall be to the Superior Court and shall be made in the same manner as is provided by the Superior Court Civil Rules for appeals from commissions, boards and agencies. Such appeal shall be on the record before the Department.

TITLE 14. EDUCATION
800 HEALTH AND SAFETY
804 IMMUNIZATIONS

14 DE Admin. Code 804

1.0 Purpose

This regulation is promulgated pursuant to Title 14 Del.C. Ch. 1, §131 which states that, “the Department (of Education) shall from time to time, with advice from Division of Public Health (DPH), adopt and promulgate rules and regulations to establish an immunization program to protect pupils enrolled in public schools from certain diseases.”

19 DE Reg. 43 (07/01/15))

 2.0 Definitions

"Affidavit of Religious Belief" means, pursuant to 14 Del.C. Ch. 1, §131(a)(6), the statement to request exemption from immunizations based on individual religious beliefs.

“Approved Vaccine” means a vaccine, vaccine combination, formulation, or schedule which has been reviewed and accepted by the Division of Public Health (DPH) based upon Centers for Disease Control and Prevention (CDC) Recommended Immunization Schedule.

"School Enterer" means any child between birth and twenty (20) years inclusive entering or being admitted to a Delaware public school district or public school for the first time, including but not limited to, foreign exchange students, immigrants, students from other states and territories and children entering from nonpublic schools.

“Secondary School” means, for the purposes of this regulation, a school with a grade or age configuration including any of the following: grade 9, grade 10, grade 11, or grade 12.

10 DE Reg. 1807 (06/01/07)

16 DE Reg. 411 (10/01/12)

19 DE Reg. 43 (07/01/15)

20 DE Reg. 441 (12/01/16)

3.0 Minimum Immunizations Required for All School Enterers

3.1 All School Enterers shall have immunizations given up to four days prior to the minimum interval or age and shall include:

3.1.1 Four or more doses of diphtheria, tetanus, pertussis (DTaP, DTP, or other Approved Vaccine). Notwithstanding this requirement:

3.1.1.1 A child who received a fourth dose prior to his or her fourth birthday shall have a fifth dose;

3.1.1.2 A child who received the first dose of diphtheria and tetanus containing vaccine as adult Td vaccine at or after age seven may meet this requirement with only three doses of Td or Approved Vaccine.

3.1.1.3 A booster dose of Tdap (adult) is strongly recommended by DPH for all students at age 11-12 years (preferred) or through 18 years and required as per subsections 4.1 and 4.1.1 below.

3.1.2 Three or more doses of inactivated polio virus vaccine (IPV), oral polio vaccine (OPV), or an Approved Vaccine. Notwithstanding this requirement:

3.1.2.1 A child who received a third dose prior to his or her fourth birthday shall have a fourth dose.

3.1.3 Two doses of measles, mumps and rubella (MMR) Approved Vaccine. The first dose should be administered on or after the age of 12 months. The second dose should be administered after the fourth birthday.

3.1.3.1 Disease histories for measles, rubella and mumps shall not be accepted unless serologically confirmed.

3.1.4 Three doses of Hepatitis B vaccine.

3.1.4.1 For children 11 to 15 years old age, two doses of an Approved Vaccine may be used.

3.1.4.2 Titers are not acceptable in lieu of completing the vaccine series and a disease history for Hepatitis B shall not be accepted unless serologically confirmed.

3.1.5 Two doses of Varicella Approved Vaccine. Students who entered during or prior to the 2008-2009 school year are required to have one dose. By the 2020-2021 school year all students must have two doses. DPH strongly recommends two doses for all students regardless of date of school entry.

3.1.5.1 The first dose should be administered on or after the age of twelve (12) months and the second at kindergarten entry into a Delaware public school.

3.1.5.2 A written disease history, provided by the health care provider, will be accepted in lieu of the Varicella vaccination.

3.1.6 Two doses of meningococcal vaccine are strongly recommended by DPH, with an initial dose at ages 11-12 and a booster at ages 16-18, and required as per subsections 4.1 and 4.1.2 below.

3.2 Children who enter school prior to age four (4) shall follow current Delaware Division of Public Health recommendations.

10 DE Reg. 1807 (06/01/07)

11 DE Reg. 666 (11/01/07)

16 DE Reg. 411 (10/01/12)

19 DE Reg. 43 (07/01/15)

20 DE Reg. 441 (12/01/16)

4.0 Minimum Immunizations for Secondary School Students

4.1 Beginning in school year 2016-2017 entering grade 9 students shall show proof of immunizations. One Secondary School grade shall be added each year thereafter.

4.1.1 An adolescent booster dose of Tdap or other Approved Vaccine administered at age 11-12 (preferred) or prior to entry to Grade 9.

4.1.2 One dose of meningococcal Approved Vaccine.

4.2 Schools will coordinate with the Division of Public Health to assure services to non-compliant Secondary School students.

(Non-regulatory guidance: Please refer to 14 DE Admin. Code 815 Health Examinations and Screenings for health examinations required for entering grade 9 students.)

19 DE Reg. 43 (07/01/15)

5.0 Documentation of Immunization

5.1 The parent, legal guardian, Relative Caregiver or a School Enterer who has reached the statutory age of majority (18) shall present documentation specifying the month, day, and year that the immunizations were administered by a licensed health care practitioner.

5.2 According to 14 Del.C. §131, a principal or person in charge of a school shall not permit a child to enter into school without acceptable evidence of immunization. The parent, legal guardian, Relative Caregiver, or a School Enterer who has reached the statutory age of majority (18) shall be notified of this requirement in writing. Within 14 calendar days after notification, evidence must be presented to the school that the basic series of immunizations has been initiated or has been completed.

5.3 A School Enterer may be conditionally admitted to a Delaware school district by presenting a statement from a licensed health care practitioner who specifies that the School Enterer has received at least:

5.3.1 One dose of DTaP, or DTP, or DT, or Approved Vaccine; and

5.3.2 One dose of IPV or OPV, or Approved Vaccine; and

5.3.3 One dose of measles, mumps and rubella (MMR) Approved Vaccine; and

5.3.4 The first dose of the Hepatitis B series; and

5.3.5 One dose of Varicella vaccine.

5.3.6 One dose of meningococcal vaccine, if entering a Secondary School according to subsections 4.1 and 4.1.2.

5.4 School districts and charter schools shall ensure that policies concerning immunization, guardianship and birth certificates do not create barriers to the school enrollment of homeless children and youth. To that end, school districts shall assist homeless children and youth in meeting the immunization requirements.

5.5 In accordance with the provisions of 14 Del.C. Ch. 1, Subchapter III-A Interstate Compact on Education For Children of Military Families (MIC3) and its enabling regulation, a School Enterer or Secondary School student who is subject to MIC3 shall be allowed thirty (30) calendar days from the date of enrollment or within such time as is reasonably determined under the rules promulgated by the Interstate Commission, to obtain or to initiate a series of immunizations required by this regulation.

5.6 If the School Enterer or Secondary School student fails to complete the series of required immunizations, the parent, legal guardian, Relative Caregiver, or student who has reached the statutory age of majority (18) shall be notified that the School Enterer or Secondary School student will be excluded according to 14 Del.C. §131.

10 DE Reg. 1807 (06/01/07)

16 DE Reg. 411 (10/01/12)

19 DE Reg. 43 (07/01/15)

20 DE Reg. 441 (12/01/16)

6.0 Lost or Destroyed Immunization Record

When a student’s immunization record has been lost or destroyed by the medical provider who administered the vaccine, the parent, legal guardian, Relative Caregiver, School Enterer who has reached the statutory age of majority (18), or the school nurse shall sign a written statement to this effect and must obtain at least one dose of each of the immunizations as identified in subsection 5.3. Evidence that the vaccines were administered shall be presented to the district superintendent or charter school chief administrative officer or his or her designee.

10 DE Reg. 1807 (06/01/07)

19 DE Reg. 43 (07/01/15)

20 DE Reg. 441 (12/01/16)

7.0 Exemption from Immunization

7.1 Exemption from this requirement may be granted in accordance with 14 Del.C. §131 and this regulation which permits approved medical and notarized religious exemptions.

7.1.1 Medical exemptions shall be considered based on a written statement from a physician, i.e., medical doctor or doctor of osteopathy, stating that immunization is medically contraindicated.

7.1.1.1 The Delaware Division of Public Health shall review and determine approval.

7.1.2 Religious exemptions shall be approved upon receipt of a notarized Affidavit of Religious Belief, and the school shall offer information regarding the benefits of immunization and the risks of not being fully immunized.

7.1.3 Upon approval of a medical or religious exemption, the school shall inform the parent, legal guardian, Relative Caregiver, or a School Enterer who has reached the statutory age of majority (18), that the student shall be temporarily excluded from school in the event the Division of Public Health declares an outbreak of a vaccine preventable disease or determines the student has had or is at risk of having an exposure to a vaccine preventable disease. The Division of Public Health shall determine when the student may return to school.

7.1.3.1 During a temporary exclusion, the school and parent, legal guardian or Relative Caregiver shall assist the student with keeping up with school work. No academic penalty shall be assessed provided the student completes assignments.

7.2 Alternative dosages or immunization schedules may be accepted with the written approval of the Delaware Division of Public Health.

10 DE Reg. 1807 (06/01/07)

19 DE Reg. 43 (07/01/15)

20 DE Reg. 441 (12/01/16)

8.0 Verification of School Records

The Delaware Division of Public Health shall have the right to audit and verify school immunization records to determine compliance with the law.

1 DE Reg. 1808 (05/01/98)

4 DE Reg. 1515 (03/01/01)

5 DE Reg. 2295 (06/01/02)

10 DE Reg. 1807 (06/01/07)

19 DE Reg. 43 (07/01/15)

9.0 Documentation

9.1 School nurses shall record and maintain documentation of each student's immunization status.

9.2 Each student's immunization record shall be included in the Delaware Immunization Registry.

1 DE Reg. 1808 (05/01/98)

4 DE Reg. 1515 (03/01/01)

5 DE Reg. 2295 (06/01/02)

10 DE Reg. 1807 (06/01/07)

11 DE Reg. 666 (11/01/07)

16 DE Reg. 411 (10/01/12)

19 DE Reg. 43 (07/01/15)

20 DE Reg. 441 (12/01/16)

Below  are state statutes relating to minor consent for this state; however, there may be additional statutes NVIC is unaware of, and readers may need to do additional research and/or obtain additional legal advice. NVIC doesn't provide legal advice and provides the below for informational purposes only. NVIC provides additional resource information in our FAQ on Vaccination in School-Based Health Clinics, should readers have concerns about the vaccination of their child without parental knowledge or consent this school setting.

707. Consent to health care of minors.

(a) Definitions. — As used in this section:

(1) “Blood testing” includes Early Periodic Screening, Diagnosis, and Treatment (EPSDT) testing and other blood testing deemed necessary by documented history or symptomatology but excludes HIV/AIDS testing and controlled substance testing or any other testing for which separate court order or informed consent as provided by law is required.

(2) “Medical treatment” means developmental screening, mental health screening and treatment, and ordinary and necessary medical and dental examination and treatment, including blood testing, preventive care including ordinary immunizations, tuberculin testing and well-child care. Medical treatment also means the examination and treatment of any laceration, fracture or other traumatic injury, or any symptom, disease or pathology which may, in the judgment of the treating health care professional, if left untreated, reasonably be expected to threaten health or life.

(3) “Relative caregiver” or “caregiver” means an adult person, who by blood, marriage or adoption, is the great grandparent, grandparent, step grandparent, great aunt, aunt, great uncle, uncle, stepparent, brother, sister, step brother, step sister, half brother, half sister, niece, nephew, first cousin or first cousin once removed of a minor and with whom the minor resides, but who is not the legal custodian or guardian of the minor.

(b) Parties authorized to give consent. — Consent to the performance upon or for any minor by any licensed medical, surgical, dental, psychological or osteopathic practitioner or any nurse practitioner/clinical nurse specialist or any hospital or public clinic or their agents or employees of any lawful medical treatment, and to the furnishing of hospitalization and other reasonably necessary care in connection therewith, may be given by:

(1) A parent or guardian of any minor for such minor;

(2) A married minor for himself or herself or, if such married minor be unable to give consent by reason of disability, then by his or her spouse;

(3) A minor of the age of 18 years or more for himself or herself;

(4) A minor parent for his or her child;

(5) A minor or by any person professing to be serving as temporary custodian of such minor at the request of a parent or guardian of such minor for the examination and treatment of (i) any laceration, fracture or other traumatic injury suffered by such minor, or (ii) any symptom, disease or pathology which may, in the judgment of the attending personnel preparing such treatment, if untreated, reasonably be expected to threaten the health or life of such minor; provided, however, that the consent given shall be effective only after reasonable efforts shall have been made to obtain the consent of the parent or guardian of said minor; or

(6) A relative caregiver acting pursuant to an Affidavit of Establishment of Power to Relative Caregivers to Consent to Medical Treatment of Minors.

(c) Effect of consent. — Any consent given by or for a minor pursuant to the authority of any provision of this chapter shall be valid and effective for all purposes, and, notwithstanding any misrepresentation as to age, status as parent, guardian or custodian or as to marital status, made to any practitioner, hospital or clinic for purposes of inducing the furnishing of health care to such minor, shall bind such minor, his or her parent, spouse, heirs, executors and administrators and shall not be subject to subsequent disaffirmance by reason of minority.

(d) Liability of persons responsible for medical care. — Nothing contained in this section shall be construed to relieve any practitioner, hospital, clinic or their agents or employees from liability for negligence in diagnosis, care and treatment or for the performance of any procedure not reasonably required for the preservation of life or health

710. Minors’ consent to diagnostic and lawful therapeutic procedures relating to care and treatment for pregnancy or contagious diseases.

(a) A minor 12 years of age or over who professes to be either pregnant or afflicted with contagious, infectious or communicable diseases within the meaning of Chapters 5 and 7 of Title 16, or who professes to be exposed to the chance of becoming pregnant, may give written consent, except to abortion, to any licensed physician, hospital or public clinic for any diagnostic, preventive, lawful therapeutic procedures, medical or surgical care and treatment, including X rays, by any physician licensed for the practice of medicine or surgery or osteopathic medicine or surgery in this State and by any hospital or public clinic, their qualified employees or agents while acting within the scope of their employment.

(b) Consent so given by a minor 12 years of age or over shall, notwithstanding his or her minority, be valid and legally effective for all purposes, regardless of whether such minor’s profession of pregnancy or contagious disease is subsequently medically confirmed, and shall be binding upon such minor, his or her parents, legal guardians, spouse, heirs, executors and administrators as effectively as if the minor were of full legal age at the time of giving of the consent. A minor giving the consent shall be deemed to have the same legal capacity to act and the same legal obligations with regard to giving consent as if the minor were of full legal age. Consent so given shall not be subject to later disaffirmance by reason of such minority; and the consent of no other person or court shall be necessary for the performance of the diagnostic and lawful therapeutic procedures, medical or surgical care and treatment rendered such minor.

(c) The physician licensed for the practice of medicine or surgery or hospital to whom such consent shall be given may, in the sole exercise of his, her or its discretion, either provide or withhold from the parents or legal guardian or spouse of such minor such information as to diagnosis, therapeutic procedures, care and treatment rendered or to be rendered the minor as such physician, surgeon or hospital deems to be advisable under the circumstances, having primary regard for the interests of the minor.

(d) The parents, legal guardian or spouse of a consenting minor shall not be liable for payment for diagnostic and lawful therapeutic procedures performed, medical or surgical care or treatment rendered or hospital confinement pursuant to this section.

(e) Notice of intention to perform any operation otherwise permitted under this section shall be given the parents or legal guardian of such minor at their last known address, if available, by telegram sent at time of diagnosis by the surgeon designated to perform such operation; provided, that such operation may proceed forthwith after diagnosis if there is reason to believe that delay would endanger the life of such minor or there is a reasonable probability of irreparable injury.

(f) Nothing contained in this section shall be construed to relieve any licensed physician, hospital or public clinic, their agents or employees, from liability for their negligence in the diagnosis, care and treatment rendered such minor.