II 

114TH CONGRESS 

1ST SESSION S. 486 

To amend the Head Start Act to ensure that all children in Head Start 

and Early Head Start programs are vaccinated, and allow exemptions 

only for children with underlying medical conditions, for whom vaccines 

are therefore medically contraindicated. 

IN THE SENATE OF THE UNITED STATES 

FEBRUARY 12, 2015 

Mrs. BOXER (for herself and Mrs. FEINSTEIN) introduced the following bill; 

which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To amend the Head Start Act to ensure that all children 

in Head Start and Early Head Start programs are vaccinated, and allow exemptions only for children with underlying medical conditions, for whom vaccines are therefore medically contraindicated. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Head Start on Vac5 cinations Act’’. 


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1 SEC. 2. VACCINATION REQUIREMENT. 

2 (a) HEAD START PROGRAMS.—The first subsection 

3 of section 645 of the Head Start Act (42 U.S.C. 9840) 

4 is amended by adding at the end the following: 

5 ‘‘(6)(A) In this paragraph: 

6 ‘‘(i) The term ‘complete vaccination informa7 tion’ means such information as the Secretary may 

8 require under subparagraph (G), establishing that a 

9 child is vaccinated in accordance with the pediatric 

10 vaccine list. 

11 ‘‘(ii) The term ‘Federally qualified health cen12 ter’ has the meaning given the term in section 

13 1861(aa)(4) of the Social Security Act (42 U.S.C. 

14 1395x(aa)(4)). 

15 ‘‘(iii) The term ‘pediatric vaccine list’ means 

16 the list, including the schedule, established (and pe17 riodically reviewed and as appropriate revised) by 

18 the Advisory Committee on Immunization Practices 

19 (an advisory committee established by the Secretary, 

20 acting through the Director of the Centers for Dis21 ease Control and Prevention). 

22 ‘‘(iv) The term ‘program-registered provider’ 

23 has the meaning given the term in section 1928(c) 

24 of the Social Security Act (42 U.S.C. 1396s(c)). 

25 ‘‘(B) In order for a child who is enrolled in a Head 

26 Start program (other than an Early Head Start program) 


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1 assisted under this subchapter on the effective date of the 

2 Head Start on Vaccinations Act to remain eligible for par3 ticipation in the program, a parent or guardian of the 

4 child shall submit complete vaccination information to the 

5 program, within 3 months after the effective date of the 

6 Head Start on Vaccinations Act. 

7 ‘‘(C)(i) In order for a child to be enrolled in a pro8 gram covered by subparagraph (B), a parent or guardian 

9 of the child— 

10 ‘‘(I) shall submit complete vaccination informa11 tion to the program, in a timely manner, as required 

12 under regulations issued under subparagraph (G); or 

13 ‘‘(II) shall submit a signed agreement that the 

14 parent or guardian will provide that information as 

15 described in subclause (I), and consents to the ad16 ministration described in subparagraph (D)(i) or the 

17 referral described in subparagraph (D)(ii). 

18 ‘‘(ii) Except for the initial submission of information 

19 for a child described in subparagraph (B), in order for 

20 a child who is enrolled in a program covered by subpara21 graph (B) to remain eligible for participation in the pro22 gram, a parent or guardian of the child shall submit com23 plete vaccination information to the program, in a timely 

24 manner, as required under such regulations. The director 

25 of the Head Start agency involved shall annually require 


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1 the parents or guardians of the children in the program 

2 to make such a submission to maintain that enrollment. 

3 ‘‘(D) To assist a parent or guardian in complying 

4 with subparagraph (B) or (C), the director of a Head 

5 Start agency may use funds made available under this 

6 subchapter to— 

7 ‘‘(i) at the request of the parent or guardian, 

8 have an employee of the agency, who is eligible to 

9 administer vaccines in the State in which the agency 

10 is located, administer any missing vaccines on the 

11 pediatric vaccine list to the child; or 

12 ‘‘(ii) assist the parent or guardian in gaining 

13 access to the vaccines, such as by referring the par14 ent or guardian to a Federally qualified health cen15 ter, a State or county public health clinic, a pro16 gram-registered provider, or a provider or contractor 

17 under title V of the Social Security Act (42 U.S.C. 

18 701 et seq.), that has a health care provider who is 

19 eligible to administer vaccines as described in clause 

20 (i). 

21 ‘‘(E)(i) Subject to clause (ii), the director of a Head 

22 Start agency shall, in a timely manner, remove from the 

23 corresponding Head Start program any child who is not 

24 in compliance with subparagraph (B) or (C). 


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1 ‘‘(ii) The director may exempt a child from subpara2 graph (B) or (C) only if a parent or guardian of the child 

3 submits information from a health care provider, who 

4 (under the State’s law concerning vaccinations) is quali5 fied to determine whether the child has an underlying 

6 medical condition, that the child has an underlying med7 ical condition and that administration of vaccines is, there8 fore, medically contraindicated for the child. 

9 ‘‘(F)(i) Except as provided in clause (ii), in the case 

10 of a child in a Head Start program, this paragraph shall 

11 apply notwithstanding any portion of a State law requiring 

12 vaccines that is inconsistent with the pediatric vaccine list. 

13 ‘‘(ii) Nothing in this paragraph shall be construed to 

14 prevent a State from requiring vaccines in addition to the 

15 vaccines on the pediatric vaccine list. 

16 ‘‘(G)(i) Not later than the effective date of the Head 

17 Start on Vaccinations Act, the Secretary shall issue regu18 lations concerning implementation of this paragraph. The 

19 regulations shall include provisions specifying timeliness 

20 for submission of information under subparagraph (C), 

21 the information required to be submitted as complete vac22 cination information, and timeliness for removal of a child 

23 from a Head Start program under subparagraph (E). 

24 ‘‘(ii) Before issuing the regulations, the Secretary 

25 shall— 


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1 ‘‘(I) consult with Indian tribes about the appli2 cation of this paragraph to children from Indian 

3 tribes; 

4 ‘‘(II) consult with the national migrant and sea5 sonal Head Start collaboration director about the 

6 application of this paragraph to children from mi7 grant and seasonal farmworker families; and 

8 ‘‘(III) consider the application of this para9 graph to homeless children and foster children. 

10 ‘‘(iii) This paragraph takes effect on the date of en11 actment of the Head Start on Vaccinations Act.’’. 

12 (b) EARLY HEAD START PROGRAMS.—Section 645A 

13 of the Head Start Act (42 U.S.C. 9840a) is amended— 

14 (1) in subsection (c), by striking ‘‘Persons’’ and 

15 inserting ‘‘Except as provided in subsection (j), per16 sons’’; and 

17 (2) by adding at the end the following: 

18 ‘‘(j) VACCINATIONS.—The provisions of section 

19 645(a)(6) shall apply to Early Head Start agencies, Early 

20 Head Start programs, and children under age 3, in the 

21 same manner and the same extent as those provisions 

22 apply to Head Start agencies, Head Start programs, and 

23 children.’’. 


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1 SEC. 3. EFFECTIVE DATE. 

2 Except as otherwise provided in the Head Start Act, 

3 this Act, including the amendments made by this Act, 

4 takes effect 3 months after the date of enactment of this 

5 Act. 

Æ 


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