I 
114TH CONGRESS 
1ST SESSION 
H. R. 933 
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 HOUSE OF REPRESENTATIVES 
FEBRUARY 12, 2015 
Ms. ESHOO (for herself, Ms. CHU of California, Mr. SCHIFF, Ms. SPEIER, Ms. 
DEGETTE, Ms. MATSUI, Ms. DELAURO, Mr. HONDA, and Mr. 
HUFFMAN) introduced the following bill; which was referred to the Com-
mittee on Education and the Workforce 
A BILL 
To amend the Head Start Act to ensure that all children 
in Head Start and Early Head Start programs are vac-
cinated, and allow exemptions only for children with un-
derlying medical conditions, for whom vaccines are there-
fore medically contraindicated. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Head Start on Vac-
cinations Act’’. 
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SEC. 2. VACCINATION REQUIREMENT. 
(a) HEAD START PROGRAMS.—The first subsection 
of section 645 of the Head Start Act (42 U.S.C. 9840) 
is amended by adding at the end the following: 
‘‘(6)(A) In this paragraph: 
‘‘(i) The term ‘complete vaccination informa-
tion’ means such information as the Secretary may 
require under subparagraph (G), establishing that a 
child is vaccinated in accordance with the pediatric 
vaccine list. 
‘‘(ii) The term ‘Federally qualified health cen-
ter’ has the meaning given the term in section 
1861(aa)(4) of the Social Security Act (42 U.S.C. 
1395x(aa)(4)). 
‘‘(iii) The term ‘pediatric vaccine list’ means 
the list, including the schedule, established (and pe-
riodically reviewed and as appropriate revised) by 
the Advisory Committee on Immunization Practices 
(an advisory committee established by the Secretary, 
acting through the Director of the Centers for Dis-
ease Control and Prevention). 
‘‘(iv) The term ‘program-registered provider’ 
has the meaning given the term in section 1928(c) 
of the Social Security Act (42 U.S.C. 1396s(c)). 
‘‘(B) In order for a child who is enrolled in a Head 
Start program (other than an Early Head Start program) 
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assisted under this subchapter on the effective date of the 
Head Start on Vaccinations Act to remain eligible for par-
ticipation in the program, a parent or guardian of the 
child shall submit complete vaccination information to the 
program, within 3 months after the effective date of the 
Head Start on Vaccinations Act. 
‘‘(C)(i) In order for a child to be enrolled in a pro-
gram covered by subparagraph (B), a parent or guardian 
of the child— 
‘‘(I) shall submit complete vaccination informa-
tion to the program, in a timely manner, as required 
under regulations issued under subparagraph (G); or 
‘‘(II) shall submit a signed agreement that the 
parent or guardian will provide that information as 
described in subclause (I), and consents to the ad-
ministration described in subparagraph (D)(i) or the 
referral described in subparagraph (D)(ii). 
‘‘(ii) Except for the initial submission of information 
for a child described in subparagraph (B), in order for 
a child who is enrolled in a program covered by subpara-
graph (B) to remain eligible for participation in the pro-
gram, a parent or guardian of the child shall submit com-
plete vaccination information to the program, in a timely 
manner, as required under such regulations. The director 
of the Head Start agency involved shall annually require 
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the parents or guardians of the children in the program 
to make such a submission to maintain that enrollment. 
‘‘(D) To assist a parent or guardian in complying 
with subparagraph (B) or (C), the director of a Head 
Start agency may use funds made available under this 
subchapter to— 
‘‘(i) at the request of the parent or guardian, 
have an employee of the agency, who is eligible to 
administer vaccines in the State in which the agency 
is located, administer any missing vaccines on the 
pediatric vaccine list to the child; or 
‘‘(ii) assist the parent or guardian in gaining 
access to the vaccines, such as by referring the par-
ent or guardian to a Federally qualified health cen-
ter, a State or county public health clinic, a pro-
gram-registered provider, or a provider or contractor 
under title V of the Social Security Act (42 U.S.C. 
701 et seq.), that has a health care provider who is 
eligible to administer vaccines as described in clause 
(i). 
‘‘(E)(i) Subject to clause (ii), the director of a Head 
Start agency shall, in a timely manner, remove from the 
corresponding Head Start program any child who is not 
in compliance with subparagraph (B) or (C). 
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‘‘(ii) The director may exempt a child from subpara-
graph (B) or (C) only if a parent or guardian of the child 
submits information from a health care provider, who 
(under the State’s law concerning vaccinations) is quali-
fied to determine whether the child has an underlying 
medical condition, that the child has an underlying med-
ical condition and that administration of vaccines is, there-
fore, medically contraindicated for the child. 
‘‘(F)(i) Except as provided in clause (ii), in the case 
of a child in a Head Start program, this paragraph shall 
apply notwithstanding any portion of a State law requiring 
vaccines that is inconsistent with the pediatric vaccine list. 
‘‘(ii) Nothing in this paragraph shall be construed to 
prevent a State from requiring vaccines in addition to the 
vaccines on the pediatric vaccine list. 
‘‘(G)(i) Not later than the effective date of the Head 
Start on Vaccinations Act, the Secretary shall issue regu-
lations concerning implementation of this paragraph. The 
regulations shall include provisions specifying timeliness 
for submission of information under subparagraph (C), 
the information required to be submitted as complete vac-
cination information, and timeliness for removal of a child 
from a Head Start program under subparagraph (E). 
‘‘(ii) Before issuing the regulations, the Secretary 
shall— 
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‘‘(I) consult with Indian tribes about the appli-
cation of this paragraph to children from Indian 
tribes; 
‘‘(II) consult with the national migrant and sea-
sonal Head Start collaboration director about the 
application of this paragraph to children from mi-
grant and seasonal farmworker families; and 
‘‘(III) consider the application of this para-
graph to homeless children and foster children. 
‘‘(iii) This paragraph takes effect on the date of en-
actment of the Head Start on Vaccinations Act.’’. 
(b) EARLY HEAD START PROGRAMS.—Section 645A 
of the Head Start Act (42 U.S.C. 9840a) is amended— 
(1) in subsection (c), by striking ‘‘Persons’’ and 
inserting ‘‘Except as provided in subsection (j), per-
sons’’; and 
(2) by adding at the end the following: 
‘‘(j) VACCINATIONS.—The provisions of section 
645(a)(6) shall apply to Early Head Start agencies, Early 
Head Start programs, and children under age 3, in the 
same manner and the same extent as those provisions 
apply to Head Start agencies, Head Start programs, and 
children.’’. 
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SEC. 3. EFFECTIVE DATE. 
Except as otherwise provided in the Head Start Act, 
this Act, including the amendments made by this Act, 
takes effect 3 months after the date of enactment of this 
Act. 
Æ 
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