Maryland State Vaccine Requirements
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 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.
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.
- Vaccination Requirements for Healthcare Workers, Patients, Inmates & Developmentally Disabled
- State of Maryland Legislature – see applicable statutes and their hyperlinks below. Visit NVIC’s Advocacy Portal for information on legislation introduced impacting vaccine exemption rights
- State of Maryland Department of Health
- State of Maryland Immunization Program
- State of Maryland 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 Maryland Proposed Rule-Making – View your state’s registry to learn about proposed rule-making.
EDUCATION DIVISION II.
ELEMENTARY AND SECONDARY EDUCATION
TITLE 7. PUBLIC SCHOOLS
SUBTITLE 4. HEALTH AND SAFETY OF STUDENTS
(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
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.
(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
(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.
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.