State Law & Vaccine Requirements

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Maryland State Vaccine Requirements

Updated May 27, 2024


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Quick Facts and Resources for Maryland Residents

Quick Fact: A child whose parent or guardian objects to immunization on the grounds that it conflicts with the parent's or guardian’s bona fide religious beliefs and practices may not be required to present a physician's certification of immunization in order to be admitted to school or day care.   Medical exemptions are also allowed. 

Other Resources: Many vaccination and exemption information links provided below are date specific. If the links below have expired, click on the state's department of health, or immunization program link provided in Other State Resources below, as they are likely to provide links to updated information. Please email NVIC with broken link information.

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.

  • General Information 
  • Vaccine Requirements - Click link and scroll down on page for requirements and sample waiver; links provided to forms by State of Maryland higher on the webpage as of this date do not work.   

EDUCATION DIVISION II.
ELEMENTARY AND SECONDARY EDUCATION
TITLE 7. PUBLIC SCHOOLS
SUBTITLE 4. HEALTH AND SAFETY OF STUDENTS

§ 7-403 Immunizations 

(a) Rules and regulations.

(1) In cooperation with the State Board and the Statewide Advisory Commission on Immunizations, the Department of Health and Mental Hygiene shall adopt rules and regulations regarding blood test for lead poisoning  required of children entering schools. 

(2) In cooperation with the State Board and Medical and Chirurgical Faculty of Maryland, the Department of Health and Mental Hygiene shall adopt rules and regulations regarding immunizations of children entering schools. 

(3) These rules and regulations shall:

(i) Be adopted in compliance with the Administrative Procedure Act;

(ii) Provide that any child may have the immunization administered by his personal physician; and

(iii)

1. By September 2003, in areas designated as at risk for lead poisoning, as determined under § 18-106 of the Health-General Article, when a child enters a public pre-kindergarten program, kindergarten program, or first grade, require the parent or legal guardian of the child to provide documentation from a health care provider, on a form developed by the Department of Health and Mental Hygiene, certifying that the child has undergone testing for lead poisoning in accordance with the guidelines of  the Centers for Disease Control and Prevention in the screening of young children for lead poisoning: Guidance for State and Local Public Health Officials (November 1997) and any subsequent guidelines; and

2. By September 2003, require a program or school to report the name, last known address, and telephone number of each child for whom certified documentation  of a lead test is not provided under item 1 of this item, as determined by regulation, to the local health department in the jurisdiction where the child resides.

(4) Any requirement for the administration of pertussis vaccine shall be consistent with § 18-332 (b) of the Health-General Article.

(b) Exception.

(1) Unless the Secretary of Health and Mental Hygiene declares an emergency or an epidemic of disease, a child whose parent or guardian objects to immunization on the ground that it conflicts with the parent's or guardian's bona fide religious beliefs and practices may not be required to present a physician's certification of immunization in order to be admitted to school. (2) The Secretary of Health and Mental Hygiene shall adopt rules and regulations for religious exemptions under this subsection. 


HEALTH - GENERAL  
TITLE 18.  DISEASE PREVENTION  
SUBTITLE 4.  MISCELLANEOUS PROVISIONS
 
§ 18-403. Religious exemption 

(a) In general. -- Unless the Secretary declares an emergency or disease epidemic, the Department may not require the immunization of an individual if:
 
(1) The individual objects to immunization because it conflicts with the individual's bona fide religious beliefs and practices; or

(2) The individual is a minor and the individual's parent or guardian objects to immunization because it conflicts with the parent or guardian's bona fide religious beliefs and practices.

(b) Rules and regulations. -- The Secretary shall adopt rules and regulations for religious exemptions under this section.

(c) Reports. -- Repealed.


HEALTH - GENERAL  
TITLE 18.  DISEASE PREVENTION  
SUBTITLE 4.  MISCELLANEOUS PROVISIONS 

§ 18-404. Immunization against influenza virus and pneumococcal disease 

   (a) Definitions. --
 
(1) In this section the following words have the meanings indicated.

(2) "Employee" means an individual employed full-time or part-time directly, through contract with another entity, or as an independent contractor, by a related institution.

(3) "Related institution" has the meaning provided under § 19-301 of this article.

(4) "Medically contraindicated" means that a medical treatment is potentially detrimental to the health of the individual intended to be treated.

(b) Immunizations generally; consent. --
 
(1) Subject to subsection (e) of this section, each related institution in the State shall immunize residents against the influenza virus and pneumococcal disease.

(2) Subject to subsection (e) of this section, each related institution in the State shall immunize employees against the influenza virus.

(3) Before an immunization under this section is administered, the related institution shall obtain written consent to administer the immunization from:
      (i) The resident or employee receiving the immunization; or

      (ii) The legal guardian of the resident receiving the immunization.

(c) Protocol. -- Each related institution shall conduct the immunizations required under subsection (b) of this section:
 
(1) In accordance with the recommendations established by the Advisory Committee on Immunization Process of the United States Centers for Disease Control and Prevention that are in effect at the time the related institution conducts the immunizations; and

(2) By December 1 of each year that the immunization is required.

(d) New residents or employees. -- A related institution that accepts an individual as a new resident or accepts an individual as a new employee after December 1 but before April 1 shall:

(1) Determine the individual's status for immunization as required under subsection (b) of this section; and

(2) If necessary, provide or arrange for an immunization as required under subsection (b) of this section.
 
 
(e) Circumstances under which vaccine not required. -- A resident or employee is not required to receive a vaccine under this section if:
 
(1) The vaccine is medically contraindicated for the resident or employee;

(2) The vaccine is against the resident's or employee's religious beliefs; or

(3) After being fully informed by the related institution of the health risks associated with not receiving a vaccine, the resident or employee refuses the vaccine.

(f) Documentation. --
 
 
(1)
(i) Each related institution shall document the annual immunization against influenza virus and immunization against pneumococcal disease received by each resident in the resident's medical record.
(ii) Each related institution shall document the annual immunization against influenza virus received by each employee in the employee's personnel file.
 
(2) If a resident or employee refuses to be immunized as required under subsection (b) of this section, the related institution shall document the refusal and the reason for the refusal.

(g) Notification; educational and informational materials. -- Each related institution shall:
 
(1) Notify each prospective resident and each prospective employee of the immunization requirements of this section and request that the resident or employee agree to be immunized in accordance with subsection (b)(3) of this section; and

(2) Make available to all residents and employees of the related institution educational and informational materials relating to immunization against influenza virus and immunization against pneumococcal disease. 
CODE OF MARYLAND REGULATIONS
TITLE 13A. STATE BOARD OF EDUCATION
SUBTITLE 16. CHILD CARE CENTERS
13A.16.03.04 CHILD CARE RECORDS

 .04 CHILD RECORDS

G. There shall be an immunization record showing that:
 
(1) The child has had immunizations appropriate for the child's age which meet the immunization guidelines set by the Maryland Department of Health and Mental Hygiene;
 
(2) The child has had at least one dose of each vaccine appropriate for the child's age before entry and is scheduled to complete the required immunizations;
 
(3) A licensed physician or a health officer has determined that immunization is medically contraindicated according to accepted medical standards; or
 
(4) The parent objects to the child's immunization because it conflicts with the parent's bona fide religious beliefs and practices.

H. If a parent objects to a child's immunization or medical examination, or both, because of the parent's bona fide religious beliefs and practices, an operator shall require the parent to provide a health history of the child and sign a statement indicating that to the best of the parent's knowledge and belief, the child is in satisfactory health and free from any communicable disease.  

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.

§20–102.
 
(a) A minor has the same capacity as an adult to consent to medical or dental treatment if the minor: 

(1)  Is married; 

(2)  Is the parent of a child; or

(3)  (i) Is living separate and apart from the minor’s parent, parents, or guardian, whether with or without consent of the minor’s parent, parents, or guardian; and

(ii) Is self–supporting, regardless of the source of the minor’s income.

(b) A minor has the same capacity as an adult to consent to medical treatment if, in the judgment of the attending physician, the life or health of the minor would be affected adversely by delaying treatment to obtain the consent of another individual.

(c)    A minor has the same capacity as an adult to consent to:

(1)    Treatment for or advice about drug abuse;

(2)    Treatment for or advice about alcoholism;

(3)    Treatment for or advice about venereal disease;

(4)    Treatment for or advice about pregnancy;

(5)    Treatment for or advice about contraception other than sterilization;

(6)    Physical examination and treatment of injuries from an alleged rape or sexual offense;

(7)    Physical examination to obtain evidence of an alleged rape or sexual offense;

(8)    Initial medical screening and physical examination on and after admission of the minor into a detention center; and

(9)    Treatment for the prevention of human immunodeficiency virus (HIV).

(c–1)    The capacity of a minor to consent to treatment for drug abuse or alcoholism under subsection (c)(1) or (2) of this section does not include the capacity to refuse treatment for drug abuse or alcoholism in an inpatient or intensive outpatient alcohol or drug abuse treatment program certified under Title 8 of this article for which a parent or guardian has given consent. 

(d)    A minor has the same capacity as an adult to consent to psychological treatment as specified under subsection(c)(1) and (2) of this section if, in the judgment of the attending physician or a psychologist, the life or health of the minor would be affected adversely by delaying treatment to obtain the consent of another individual. 

(e)    A licensed health care practitioner who treats a minor is not liable for civil damages or subject to any criminal or disciplinary penalty solely because the minor did not have capacity to consent under this section. 

(f)    Without the consent of or over the express objection of a minor, a licensed health care practitioner may, but need not, give a parent, guardian, or custodian of the minor or the spouse of the parent information about treatment needed by the minor or provided to the minor under this section, except information about an abortion.


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