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Kentucky State Vaccine Requirements


Posted Date: March 16, 2019
Kentucky State Vaccine Requirements

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medical exemption
religious exemption

Quick Facts and Resources for Kentucky Residents

Quick Fact: Any child whose parents are opposed to medical immunization against disease, and who object by a written sworn statement to the immunization of such child on religious grounds shall be exempt from immunizations.  Medical exemptions are also allowed. 

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  Higher Ed 
  • Higher Ed Vaccination Requirements - Request college/university of choice for their Proof of Immunization Compliance, as each institution may use its own form.
  • Exemption Information - Request college/university of choice for their Proof of Immunization Compliance, as each institution may use its own form. 
Daycare Information Other State Resources
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.

TITLE XIII. EDUCATION
CHAPTER 158. CONDUCT OF SCHOOLS -- SPECIAL PROGRAMS
CONDUCT OF SCHOOLS

KRS § 158.035. Certificate of immunization 

Except as provided in KRS 214.036, no child shall be eligible to enroll as a student in any public or private elementary or secondary school without first presenting a certificate from a medical physician, osteopathic physician, or advanced practice registered nurse licensed in any state. The certificate shall state that the child has been immunized against diphtheria, tetanus, poliomyelitis, rubeola, and rubella in accordance with the provisions of this section and KRS 214.010, 214.020, 214.032 to 214.036, and 214.990 and the administrative regulations of the secretary for health and family services. The governing body of private and public schools shall enforce the provisions of this section. 
 

TITLE XVIII. PUBLIC HEALTH
CHAPTER 214. DISEASES
GENERAL PROVISIONS

KRS § 214.034. Immunization of children -- Testing and treatment of children for tuberculosis -- Requirement for reception and retention of current immunization certificate by schools and child-care facilities. 

Except as otherwise provided in KRS 214.036: 

(1) All parents, guardians, and other persons having care, custody, or control of any child shall have the child immunized against diphtheria, tetanus, poliomyelitis, pertussis, measles, rubella, mumps, hepatitis B, and haemophilis influenzae disease in accordance with testing and immunization schedules established by regulations of the Cabinet for Health and Family Services. Additional immunizations may be required by the Cabinet for Health and Family Services through the promulgation of an administrative regulation pursuant to KRS Chapter 13A if recommended by the United States Public Health Service or the American Academy of Pediatrics. All parents, guardians, and other persons having care, custody, or control of any child shall also have any child found to be infected with tuberculosis examined and treated according to administrative regulations of the Cabinet for Health and Family Services promulgated under KRS Chapter 13A. The persons shall also have booster immunizations administered to the child in accordance with the regulations of the Cabinet for Health and Family Services.
(2) A local health department may, with the approval of the Department of Public Health, require all first-time enrollees in a public or private school within the health department's jurisdiction to be tested for tuberculosis prior to entering school. Following the first year of school, upon an epidemiological determination made by the state or local health officer in accordance with administrative regulations promulgated by the Cabinet for Health and Family Services, all parents, guardians, and other persons having care, custody, or control of any child shall have the child tested for tuberculosis, and shall have any child found to be infected with tuberculosis examined and treated according to administrative regulations of the Cabinet for Health and Family Services. Nothing in this section shall be construed to require the testing for tuberculosis of any child whose parent or guardian is opposed to such testing, and who objects by a written sworn statement to the testing for tuberculosis of the child on religious grounds. However, in a suspected case of tuberculosis, a local health department may require testing of this child.

(3) All public or private primary or secondary schools, and preschool programs shall require a current immunization certificate for any child enrolled as a regular attendee, as provided by administrative regulation of the Cabinet for Health and Family Services, promulgated under KRS Chapter 13A, to be on file within two (2) weeks of the child's attendance.

(4) All public or private primary schools shall require a current immunization certificate for hepatitis B for any child enrolled as a regular attendee in the sixth grade, as provided by administrative regulation of the Cabinet for Health and Family Services, promulgated under KRS Chapter 13A, to be on file within two (2) weeks of the child's attendance.

(5) For each child cared for in a day-care center, certified family child-care home, or any other licensed facility which cares for children, a current immunization certificate, as provided by administrative regulation of the Cabinet for Health and Family Services, promulgated under KRS Chapter 13A, shall be on file in the center, home, or facility within thirty (30) days of entrance into the program or admission to the facility.

(6) Any forms relating to exemption from immunization requirements shall be available at public or private primary or secondary schools, preschool programs, day-care centers, certified family child-care homes, or other licensed facilities which care for children. 

KRS § 214.036 Exceptions to testing or immunization requirement 

Nothing contained in KRS 158.035, 214.010, 214.020, 214.032 to 214.036, and 214.990 shall be construed to require the testing for tuberculosis or the immunization of any child at a time when, in the written opinion of his attending physician, such testing or immunization would be injurious to the child's health. Nor shall KRS 158.035, 214.010, 214.020, 214.032 to 214.036, and 214.990 be construed to require the immunization of any child whose parents are opposed to medical immunization against disease, and who object by a written sworn statement to the immunization of such child on religious grounds. Provided, however, that in the event of an epidemic in a given area, the Cabinet for Health and Family Services may, in an emergency regulation, require the immunization of all persons within the area of the epidemic, against the disease responsible for such epidemic.
 

TITLE 902. CABINET FOR HEALTH AND FAMILY SERVICES
DEPARTMENT FOR PUBLIC HEALTH
CHAPTER 2. COMMUNICABLE DISEASES

902 KAR 2:060

Immunization schedules for attending child day care centers, certified family child care homes, other licensed facilities which care for children, preschool programs, and public and private primary and secondary schools.

Section 1. Definitions.

 (1) "Advanced practice registered nurse" or "APRN" means a nurse designated to engage in advanced registered nursing as defined in KRS 314.011.

 (2) "Advisory Committee on Immunization Practices" or "ACIP" means the United States Department of Health and Human Services (HHS) Committee that makes national immunization recommendations to the Secretary of the HHS, the Assistant Secretary for Health, and the Director of the Centers for Disease Control and Prevention or CDC. 

(3) "Child" means a person less than eighteen (18) years of age. 

(4) "Commonwealth of Kentucky Parent or Guardian’s Declination on Religious Grounds to Required Immunizations" means an original, written, sworn, and notarized statement of a parent or guardian’s objection to medical immunization against disease of a child on religious grounds. 

(5) "Dose" means a measured quantity of vaccine, specified in the package insert provided by the manufacturer. 

(6) "DT" means diphtheria and tetanus toxoids. 

(7) "DTaP" means diphtheria and tetanus toxoids and acellular pertussis vaccine. 

(8) "DTP" means diphtheria and tetanus toxoids and pertussis vaccine. 

(9) "Healthcare provider" means a person licensed under KRS 311.530 to 311.620, 311.840 to 311.862, and a nurse designated to engage in advanced practice registered nursing as defined in KRS 314.011 and 314.042. 

(10) "HepA" means hepatitis A vaccine. 

(11) "HepB" means hepatitis B vaccine. 

(12) "Hib" means Haemophilus influenzae type b conjugate vaccine. 

(13) "IPV" means inactivated poliovirus vaccine. 

(14) "MenACWY" means serogroups A, C, W, and Y meningococcal conjugate vaccine. 

(15) "MMR" means measles, mumps, and rubella virus vaccine.

(16) "OPV" means trivalent oral poliovirus vaccine. 

(17) "PCV" means pneumococcal conjugate vaccine. 

(18) "Pharmacist" means a person licensed under KRS 315.002 to 315.050. 

(19) "Physician assistant" means a person licensed under KRS 311.840 to 311.862. 

(20) "Td" means tetanus and diphtheria toxoids for adult use. 

(21) "Tdap" means tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine. 

(22) "Varicella" means varicella vaccine.

(23) "Varicella immunity (non-vaccine)" means:  (a) Diagnosis of varicella disease by a healthcare provider;  (b) Verification of a history of varicella disease by a healthcare provider;  (c) Diagnosis of herpes zoster by a healthcare provider; or  (d) Verification of a history of herpes zoster by a healthcare provider.

Section 2. Immunization Schedules. Except as provided in Section 3 of this administrative regulation:

(1) A current Commonwealth of Kentucky Certificate of Immunization Status shall be required to attend a: 

(a) Child day care center, beginning at age three (3) months;

(b) Certified family child care home, beginning at age three (3) months; 

(c) Licensed facility that cares for children, beginning at age three (3) months; 

(d) Preschool program; or 

(e) Public or private primary or secondary school. 

(2) A current Commonwealth of Kentucky Certificate of Immunization Status shall be required for a child that is otherwise homeschooled in order to attend one (1) or more in-school classes or to participate in sports or any school-sponsored extra-curricular activities. 

(3) A Commonwealth of Kentucky Certificate of Immunization Status of a child shall be considered current for age-appropriate vaccines if the child is:

(a) At least aged three (3) months and less than five (5) months and has received at least: 

  1. One (1) dose of DTaP or DTP;
  2. One (1) dose of IPV or OPV;
  3. One (1) dose of Hib;
  4. One (1) dose of HepB; and
  5. One (1) dose of PCV;

(b) At least aged five (5) months and less than seven (7) months and has received at least: 

  1. Two (2) doses of DTaP or DTP or combinations of the two (2) vaccines;
  2. Two (2) doses of IPV or OPV or combinations of the two (2) vaccines;
  3. Two (2) doses of Hib;
  4. Two (2) doses of HepB; and
  5. Two (2) doses of PCV;

(c) At least aged seven (7) months and less than twelve (12) months and has received at least:   

  1. Three (3) doses of DTaP or DTP or combinations or the two (2) vaccines;
  2. Two (2) doses of IPV or OPV or combinations of the two (2) vaccines;
  3. Two (2) doses of Hib;
  4. Two (2) doses of HepB; and
  5. a. Three (3) doses of PCV; or  b. Two (2) doses of PCV if the first dose was received when aged seven (7) months through eleven (11) months;

(d) At least aged twelve (12) months and less than sixteen (16) months and has received at least: 

1. Three (3) doses of DTaP or DTP or combinations of the two (2) vaccines;
2. Two (2) doses of IPV or OPV or combinations of the two (2) vaccines;

3.a. Three (3) doses of Hib; 

b. Two (2) doses of Hib if the first dose was received when aged seven (7) months through eleven (11) months;

c. One (1) dose of Hib if the first dose was received when aged twelve (12) months through fourteen (14) months; or

d. One (1) dose of Hib if the first dose was received when aged fifteen (15) months;

e. One (1) dose of HepA;

f. Two (2) doses of HepB; and

4.a. Four (4) doses of PCV with one (1) dose when aged twelve (12) months through fifteen (15) months; 

b. Three (3) doses of PCV if the first dose was received when aged seven (7) months through eleven (11) months, with at least one (1) dose received when aged twelve (12) months through fifteen (15) months; or

c. Two (2) doses of PCV if the first dose was received when aged twelve (12) months through fifteen (15) months;

(e) At least aged sixteen (16) months and less than nineteen (19) months and has received at least:

  1. Four (4) doses of DTaP or DTP or combinations of the two (2) vaccines;
  2. Two (2) doses of IPV or OPV or combinations of the two (2) vaccines;

5.a. Four (4) doses of Hib; 

b. Three (3) doses of Hib if the first dose was received before aged twelve (12) months, and the second dose was received when younger than aged fifteen (15) months;

c. Two (2) doses of Hib if the first dose was received when aged twelve (12) months through fourteen (14) months; or

d. One (1) dose of Hib if the first dose was received when aged fifteen (15) months through eighteen (18) months;

e. One (1) dose of HepA;

f. Two (2) doses of HepB;

6.a. Four (4) doses of PCV with one (1) dose when aged twelve (12) months through eighteen (18) months; 

b. Three (3) doses of PCV if the first dose was received when aged seven (7) months through eleven (11) months, with at least one dose when aged twelve (12) months through eighteen (18) months; or

c. Two (2) doses of PCV if the first dose was received when aged twelve (12) months through eighteen (18) months;

d. One (1) dose of MMR; and

7.a. One (1) dose of Varicella; or

b. A diagnosis or verification from a healthcare provider that the child has varicella immunity (non-vaccine);

(f) At least aged nineteen (19) months and less than forty-eight (48) months and has received at least: 

1. Four (4) doses of DTaP or DTP or combinations of the two (2) vaccines;
2. Three (3) doses of IPV or OPV or combinations of the two (2) vaccines:

3.a. Four (4) doses of Hib;

b. Three (3) doses of Hib if the first dose was received before aged twelve (12) months, and the second dose was received when younger than aged fifteen (15) months;

c. Two (2) doses of Hib if the first dose was received when aged twelve (12) months through fourteen (14) months; or

d. One (1) dose of Hib if the first dose was received when aged fifteen (15) months through forty-seven (47) months;

4. Two (2) doses of HepA;

5. Three (3) doses of HepB;

6.a. Four (4) doses of PCV with one (1) dose when aged twelve (12) months through fifteen (15) months; 

b. Three (3) doses of PCV if the first dose was received when aged seven (7) months through eleven (11) months, with at least one (1) dose when aged twelve (12) months through forty-seven (47) months;

c. Two (2) doses of PCV if the first dose was received when aged twelve (12) months through twenty-three (23) months; or

d. One (1) dose of PCV if the first dose was received when aged twenty-four (24) months through forty-seven (47) months;

7. One (1) dose of MMR; and

8.a. One (1) dose of Varicella; or

b. A diagnosis or verification from a healthcare provider that the child has varicella immunity (non-vaccine);

(g) At least aged forty-eight (48) months and less than five (5) years and has received at least: 

1. Four (4) doses of DTaP or DTP or combinations of the two (2) vaccines;
2. Three (3) doses of IPV or OPV or combinations of the two (2) vaccines;

3.a. Four (4) doses of Hib;

b. Three (3) doses of Hib if the first dose was received before aged twelve (12) months, and the second dose was received when younger than aged fifteen (15) months;

c. Two (2) doses of Hib if the first dose was received when aged twelve (12) months through fourteen (14) months; or

d. One (1) dose of Hib if the first dose was received when aged fifteen (15) months through fifty-nine (59) months;

4.. Two (2) doses of HepA;

5. Three (3) doses of HepB;

6.a. Four (4) doses of PCV with one (1) dose when aged twelve (12) months through fifteen (15) months;

b. Three (3) doses of PCV if the first dose was received when aged seven (7) months through eleven (11) months, with at least one (1) dose when aged twelve (12) months through fifty-nine (59) months;

c. Two (2) doses of PCV if the first dose was received when aged twelve (12) months through twenty-three (23) months; or

d. One (1) dose of PCV if the first dose was received when aged twenty-four (24) months through fifty-nine (59) months;

7. Two (2) doses of MMR; and

8.a. Two (2) doses of Varicella; or

b. A diagnosis or verification from a healthcare provider that the child has varicella immunity (non-vaccine);

(h) At least aged five (5) years and less than seven (7) years and has received at least: 

1.a. Five (5) doses of DTaP or DTP or combinations of the two (2) vaccines; or

b. Four (4) doses of DTaP or DTP or combinations of the two (2) vaccines if the fourth dose was received when aged four (4) years or older and at least six (6) months after the previous dose;

2.a. Four (4) doses of IPV or OPV or combinations of the two (2) vaccines with the fourth dose received when aged four (4) years through six (6) years and at least six (6) months after the previous dose;

b. Four (4) or more doses of IPV or OPV or combinations of the two (2) vaccines received before age four (4) years and an additional dose received when aged four (4) years through six (6) years and at least six (6) months after the previous dose; or

c. Three (3) doses of IPV or OPV or combinations of the two (2) vaccines if the third dose was received when aged four (4) years or older and at least six (6) months after the previous dose;

3. Two (2) doses of HepA;

4. Three (3) doses of HepB;

5. Two (2) doses of MMR; and

6.a. Two (2) doses of Varicella; or

b. A diagnosis or verification from a healthcare provider that the child has varicella immunity (non-vaccine);

(i) At least aged seven (7) years and less than eleven (11) years and has received at least: 

1.a. Five (5) doses of DTaP or DTP or combinations of the two (2) vaccines;

b. Four (4) doses of DTaP or DTP or combinations of the two (2) vaccines if the fourth dose was received when aged four (4) years or older and at least six (6) months after the previous dose; or

c. A dose of Td that was preceded by two (2) doses of DTaP, DTP, DT, or Td or combinations of the four (4) vaccines;

2.a. Four (4) doses of IPV or OPV or combinations of the two (2) vaccines with the fourth dose received when aged four (4) years or older and at least six (6) months after the previous dose;

b. Four (4) or more doses of IPV or OPV or combinations of the two (2) vaccines received before age four (4) years and an additional dose received when aged four (4) years or older and at least six (6) months after the previous dose;

c. Four (4) doses of IPV or OPV or combinations of the two (2) vaccines if the fourth dose was received before August 7, 2009, with all doses separated by at least four (4) weeks; or

d. Three (3) doses of IPV or OPV or combinations of the two (2) vaccines if the third dose was received when aged four (4) years or older and at least six (6) months after the previous dose;

3. Two (2) doses of HepA;

4. Three (3) doses of HepB;

5. Two (2) doses of MMR; and

6a. Two (2) doses of Varicella; or

b. A diagnosis or verification from a healthcare provider that the child has varicella immunity (non-vaccine);

(j) At least aged eleven (11) years and less than thirteen (13) years and has received at least: 

1. One (1) dose of Tdap;

2.a. Five (5) doses of DTaP or DTP or combinations of the two (2) vaccines;

b. Four (4) doses of DTaP or DTP or combinations of the two (2) vaccines if the fourth dose was received when aged four (4) years or older and at least six (6) months after the previous dose;

c. A dose of Td that was preceded by two (2) doses of DTaP, DTP, DT, or Td or combinations of the four (4) vaccines; or

d. Two (2) doses of Td after the dose of Tdap;

3.a. Four (4) doses of IPV or OPV or combinations of the two (2) vaccines with the fourth dose received when aged four (4) years and older and at least six (6) months after the previous dose; 

b. Four (4) or more doses of IPV or OPV or combinations of the two (2) vaccines received before age four (4) years and an additional dose received when aged four (4) years or older and at least six (6) months after the previous dose;

c. Four (4) doses of IPV or OPV or combinations of the two (2) vaccines if the fourth dose was received before August 7, 2009, with all doses separated by at least four (4) weeks; or

d. Three (3) doses of IPV or OPV or combinations of the two (2) vaccines if the third dose was received when aged four (4) years or older and at least six (6) months after the previous dose;

4. Two (2) doses of HepA;

5.a. Three (3) doses of HepB; or

b. Two (2) doses of adult HepB approved by the FDA to be used for an alternative schedule for adolescents aged eleven (11) years through fifteen (15) years;

6. Two (2) doses of MMR;

7.a. Two (2) doses of Varicella; or 

b. A diagnosis or verification from a healthcare provider that the child has varicella immunity (non-vaccine); and

c. One (1) dose of MenACWY;

(k) At least aged thirteen (13) years and less than sixteen (16) years and has received at least: 

1. One (1) dose of Tdap; 

2.a. Five (5) doses of DTaP or DTP or combinations of the two (2) vaccines;

b. Four (4) doses of DTaP or DTP or combinations of the two (2) vaccines if the fourth dose was received when aged four (4) years or older and at least six (6) months after the previous dose;

c. A dose of Td that was preceded by two (2) doses of DTaP, DTP, DT, or Td or combinations of the four (4) vaccines; or

d. Two (2) doses of Td after the dose of Tdap;

3.a. Four (4) doses of IPV or OPV or combinations of the two (2) vaccines with the fourth dose received when aged four (4) years or older and at least six (6) months after the previous dose; 

b. Four (4) or more doses of IPV or OPV or combinations of the two (2) vaccines received before age four (4) years and an additional dose received when aged four (4) years or older and at least six (6) months after the previous dose;

c. Four (4) doses of IPV or OPV or combinations of the two (2) vaccines if the fourth dose was received before August 7, 2009, with all doses separated by at least four (4) weeks; or

d. Three (3) doses of IPV or OPV or combinations of the two (2) vaccines if the third dose was received when aged four (4) years or older and at least six (6) months after the previous dose;

4. Two (2) doses of HepA;

5.a. Three (3) doses of HepB; or 

b. Two (2) doses of adult HepB approved by the FDA to be used for an alternative schedule for adolescents aged eleven (11) through fifteen (15) years;

6. Two (2) doses of MMR;

7.a. Two (2) doses of Varicella; or 

b. A diagnosis or verification from a healthcare provider that the child has varicella immunity (non-vaccine); and

c. One (1) dose of MenACWY;

(l) At least aged sixteen (16) years or older and has received at least:

1. One (1) dose of Tdap;

2.a. Five (5) doses of DTaP or DTP or combinations of the two (2) vaccines; 

b. Four (4) doses of DTaP or DTP or combinations of the two (2) vaccines if the fourth dose was received when aged four (4) years or older and at least six (6) months after the previous dose;

c. A dose of Td that was preceded by two (2) doses of DTaP, DTP, DT, or Td or combinations of the four (4) vaccines; or

d. Two (2) doses of Td after the dose of Tdap;

3.a. Four (4) doses of IPV or OPV or combinations of the two (2) vaccines with the fourth dose received when aged four (4) years and older and at least six (6) months after the previous dose; 

b. Four (4) or more doses of IPV or OPV or combinations of the two (2) vaccines received before age four (4) years and an additional dose received when aged four (4) years or older and at least six (6) months after the previous dose;

c. Four (4) doses of IPV or OPV or combinations of the two (2) vaccines if the fourth dose was received before August 7, 2009, with all doses separated by at least four (4) weeks; or

d. Three (3) doses of IPV or OPV or combinations of the two (2) vaccines if the third dose was received when aged four (4) years or older and at least six (6) months after the previous dose;

4. Two (2) doses of HepA;

5.a. Three (3) doses of HepB; or 

b. Two (2) doses of adult HepB approved by the FDA to be used for an alternative schedule for adolescents aged eleven (11) years through fifteen (15) years;

6. Two (2) doses of MMR;

7.a. Two (2) doses of Varicella; or

b. A diagnosis or verification from a healthcare provider that the child has varicella immunity (non-vaccine); and

8.a. Two (2) doses of MenACWY; or

b. One (1) dose of MenACWY if that dose was received at age sixteen (16) years or older. (4) Immunizations shall be received in accordance with the minimum ages and intervals between doses recommended by the ACIP. Partial, split, half, or fractionated doses or quantities shall not be administered and shall not be counted as a valid dose.

Section 3. Exceptions and Exemptions to the Required Immunization Schedules in Section 2.

(1) If the first two (2) doses of Hib vaccine were meningococcal group B outer membrane protein (PRP-OMP) vaccines, the third dose may be omitted. 

(2) A child with a medical contraindication to pertussis vaccine may be given DT in lieu of DTaP or Td in lieu of Tdap. 

(3)(a) If both IPV and OPV were administered as part of a series, a total of four (4) doses shall be administered.  (b) If only OPV was administered, and all doses were received prior to four (4) years of age, one (1) dose of IPV shall be administered when aged four (4) years or older and at least four (4) weeks after the last OPV dose. 

(4) A child aged seven (7) years or older may receive one (1) dose of Tdap in the catch-up series if the child is not fully immunized with DTaP vaccine. 

(5) A Commonwealth of Kentucky Certificate of Immunization Status marked to designate a medical exemption shall be issued for a child with a temporary or permanent medical contraindication to receiving a vaccine. 

(6)(a) If an immunization is administered but another is objected to on religious grounds, a healthcare provider, pharmacist, local health department, or other licensed healthcare facility administering immunizations:  1. May request that a parent or guardian complete the Commonwealth of Kentucky Parent or Guardian’s Declination on Religious Grounds to Required Immunizations form to be submitted upon enrollment in a child care facility or school;  2. Shall issue a Commonwealth of Kentucky Certificate of Immunization Status marked to designate "religious objection" to the requirements of Section 2 of this administrative regulation, in compliance with KRS 214.036; and  3. Shall list administered immunizations on the Commonwealth of Kentucky Certificate of Immunization Status.  (b) An EPID 230A form, Commonwealth of Kentucky Parent or Guardian’s Declination on Religious Grounds to Required Immunizations, shall:  1. Be valid for the requirements of Section 2 of this administrative regulation;  2. List the immunizations that a parent or guardian objects to being administered to a child based on religious grounds;  3. Be an original document written, sworn, and signed before a notary public; and  4. Be submitted at the time of enrollment in a child care facility or school. 

(7) A Commonwealth of Kentucky Certificate of Immunization Status marked to designate "Provisional Status" shall:  (a) Be issued for a child who is behind in required immunizations listed in Section 2 of this administrative regulation;  (b) Be issued for a child who has received at least one (1) dose of each of the required vaccines but has not completed all the required immunizations;  (c) Permit a child to attend a child day care center, certified family child care home, licensed facility which cares for children, preschool program, or primary or secondary school until the child reaches the appropriate age or upon passage of the time interval between required doses;  (d) Expire:  1. Fourteen (14) days from the date the next dose is required to be given for school use; or  2. Thirty (30) days from the date the next dose is required to be given for use in a day care center, certified family child-care home, or other licensed facility which cares for children; and  (e) Not be valid for more than one (1) year.

Section 4. Commonwealth of Kentucky Certificate of Immunization Status.

(1) A Commonwealth of Kentucky Certificate of Immunization Status shall be issued by:  (a) A physician licensed in any state;  (b) An advanced practice registered nurse licensed in any state;  (c) A physician assistant licensed in Kentucky;  (d) A pharmacist licensed in Kentucky;  (e) A local health department in Kentucky;  (f) A licensed healthcare facility administering immunizations in Kentucky; or  (g) An authorized user of the Kentucky Immunization Registry. 

(2) Signatures on the Commonwealth of Kentucky Certificate of Immunization Status shall:  (a) Contain the printed name;  (b) Be in ink or an electronic signature;  (c) Be dated; and  (d) Be that of:  1. A physician;  2. An advanced practice registered nurse;  3. A physician assistant;  4. A pharmacist;  5. The local health department administrator; or  6. A registered nurse or licensed practical nurse designee of a physician, local health department administrator, or other licensed healthcare facility. 

(3) A Commonwealth of Kentucky Certificate of Immunization Status printed from the Kentucky Immunization Registry shall not require a signature. 

(4) A healthcare provider, pharmacist, local health department, or other licensed healthcare facility administering immunizations may obtain a blank hard copy of the following from the Cabinet for Health and Family Services:  (a) Commonwealth of Kentucky Certificate of Immunization Status; and  (b) Commonwealth of Kentucky Parent or Guardian’s Declination on Religious Grounds to Required Immunizations. 

(5) The Commonwealth of Kentucky Certificate of Immunization Status shall:  (a) Be on a hard copy provided by the Cabinet for Health and Family Services; or  (b) Be a copy electronically produced in the size, orientation, and format printed by:  1. A Kentucky medical provider’s electronic medical record system;  2. A local health department’s electronic medical record system;  3. A Kentucky licensed healthcare facility administering immunizations electronic medical record system; or  4. The Kentucky Immunization Registry. 

(6) An electronically produced copy of a Commonwealth of Kentucky Certificate of Immunization Status shall contain at least the following information:  (a) The name of the child;  (b) The birthdate of the child;  (c) The name of the parent or guardian of the child;  (d) The address of the child, including street, city, state, and ZIP Code;  (e) The type(s) of vaccine(s) administered to the child;  (f) The date that each dose of each vaccine was administered;  (g) Certification that the child is current for immunizations until a specified date, including a statement that the certificate shall not be valid after the specified date;  (h) The printed name, ink or electronic signature, and date as described in subsection (2) of this section; and  (i) The name, address, and telephone number of the healthcare provider practice, pharmacy, local health department, or licensed health care facility issuing the certificate. 

(7) A signed certificate or a certificate printed from the Kentucky Immunization Registry may be faxed from a medical office to a:  (a) Medical office;  (b) Healthcare facility;  (c) Child care facility;  (d) School; or  (e) State or local health department. 

(8) All immunizations required by Section 2 of this administrative regulation and received by a child shall be included on the Commonwealth of Kentucky Certificate of Immunization Status. 

(9) All ACIP recommended immunizations a child has received in addition to the immunizations required by Section 2 of this administrative regulation may be included on the Commonwealth of Kentucky Certificate of Immunization Status. 

(10) A completed Commonwealth of Kentucky Certificate of Immunization Status shall be:  (a) On file for a child:  1. Cared for in a:  a. Child day care center;  b. Certified family child care home; or  c. Licensed facility that cares for children; or 2. Enrolled in a:  a. Preschool program;  b. Public or private primary or secondary school; or  c. Preschool program or a public or private primary or secondary school for all in-school classes or to participate in sports or any school sponsored extra-curricular activities if the child is otherwise homeschooled; and  (b) Available for inspection and review by a representative of the Cabinet for Health and Family Services or a representative of a local health department.

Section 5. Out-of-State Certificate of Immunization Status

(1) An Out-of-State Certificate of Immunization Status shall be accepted when completed by an out-of-state physician or advanced practice registered nurse. 

(2) The out-of-state certificate shall contain at least the following information:  (a) The name of the child;  (b) The birthdate of the child;  (c) The name of the parent or guardian of the child;  (d) The address of the child, including street, city, state, and ZIP Code;  (e) The type(s) of vaccine(s) administered to the child;  (f) The date that each dose of each vaccine was administered;  (g) All age appropriate immunizations required in Kentucky as identified in Section 2(3) of this administrative regulation;  (h) Certification that the child is current for immunizations until a specified date, including a statement that the certificate shall not be valid after the specified date;  (i) A printed name, ink or electronic signature, and date as described in Section 4(2) of this administrative regulation; and  (j) The name, address, and telephone number of the healthcare provider practice, local health department, or licensed health care facility issuing the certificate. 

(3) The Out-of-State Certificate of Immunization Status may be in the size, orientation, and format required by another state. 

(4) Immunizations documented on an out-of-state certificate shall be transferred to a hard copy of a Commonwealth of Kentucky Certificate of Immunization Status or shall be documented on an electronically produced Commonwealth of Kentucky Certificate of Immunization Status when one (1) or more immunizations are administered in Kentucky.

Section 6. Review of Immunization Status.

(1) A current Commonwealth of Kentucky Certificate of Immunization Status or an Out-of-State Certificate of Immunization Status for a child shall be provided by a parent or guardian:  (a) Upon enrollment in a:  1. Child day care center;  2. Certified family child care home;  3. Licensed facility that cares for a child; or  4. School at:  a. Kindergarten entry;  b. Seventh grade entry;  c. Eleventh grade entry;  d. Twelfth grade entry for the first twelve (12) months this administrative regulation is effective; and  e. New enrollment at any grade resulting from a transfer to:  (i) Kentucky from another state; (ii) Kentucky from a country outside the United States; or  (iii) A school from another school within Kentucky;  (b) Upon legal name change; or  (c) At a school required examination pursuant to 702 KAR 1:160. 

(2) Upon review of a Commonwealth of Kentucky Certificate of Immunization Status or an Out-of-State Certificate of Immunization Status:  (a) A child whose certificate has exceeded the date for the certificate to be valid shall be recommended to visit the child’s medical provider or local health department to receive immunizations required by this administrative regulation; and  (b) An updated and current certificate shall be provided to the:  1. Day care center, certified family child care home, or other licensed facility that cares for children by a parent or guardian within thirty (30) days from when the certificate was found be invalid; or  2. School by a parent or guardian within fourteen (14) days from when the certificate was found to be invalid. 

(3) A Commonwealth of Kentucky Certificate of Immunization Status or an Out-of-State Certificate of Immunization Status for a child or group of children shall be reviewed upon request of a local health department as part of controlling an outbreak of a vaccine preventable disease.

Section 7. Effective Date. For all child day cares, certified family child care homes, other licensed facilities which care for children, preschool programs, and public or private primary and secondary schools: 

(1) This administrative regulation, except for Section 2, shall become effective for the school year beginning on or after July 1, 2017; and 

(2) Section 2 of this administrative regulation shall become effective for the school year beginning on or after July 1, 2018.

Section 8. Incorporation by Reference.

(1) The following material is incorporated by reference: 

(a) Form "EPID 230, Commonwealth of Kentucky Certificate of Immunization Status", 1/2017; and 

(b) Form "EPID 230A, Commonwealth of Kentucky Parent or Guardian’s Declination on Religious Grounds to Required Immunizations", 6/2017. 

(2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Department for Public Health, 275 East Main Street, Frankfort Kentucky 40621, Monday through Friday, 8 a.m. to 4:30 p.m.


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