2023 Colorado Revised Statutes › Title 25 - PUBLIC HEALTH AND ENVIRONMENT (§§ 25-1-101 — 25-59-106) › DISEASE CONTROL (§§ 25-4-101 — 25-4-2504) › Article 4 - DISEASE CONTROL (§§ 25-4-101 — 25-4-2504) › Part 9 - SCHOOL ENTRY IMMUNIZATION (§§ 25-4-901 — 25-4-912) › Section 25-4-903 - Exemptions from immunization - rules

(1)
(Deleted by amendment, L. 97, p. 409, § 2, effective July 1, 1997.)
(2)
A parent or legal guardian shall have his or her student immunized, unless the student is exempted pursuant to this section, or an emancipated student or a student eighteen years of age or older shall have himself or herself immunized, unless the student is exempted pursuant to this section. A student is exempted from receiving the required immunizations in the following manner:
(a)
By submitting to the student's school a completed certificate of medical exemption from a licensed physician, physician assistant authorized pursuant to section
12-240-107 (6)
, or advanced practice registered nurse that the physical condition of the student is such that one or more specified immunizations would endanger his or her life or health or are medically contraindicated due to other medical conditions; or
(b)
(I)
By submitting to the student's school either a completed certificate of completion of the online education module or a completed certificate of nonmedical exemption signed by one parent or legal guardian, an emancipated student, or a student eighteen years of age or older that the parent, legal guardian, or student is an adherent to a religious belief whose teachings are opposed to immunizations or has a personal belief that is opposed to immunizations.
(II)
(A)
A complete certificate of completion of the online education module is acquired upon completing the online education module described in subsection (2.7) of this section.
(B)
A complete certificate of nonmedical exemption must include the signature of a person who is authorized pursuant to title 12 to administer immunizations within his or her scope of practice to the student for whom the certificate of nonmedical exemption is sought. Nothing in this subsection (2)(b)(II)(B) requires a person authorized pursuant to title 12 to administer immunizations within his or her scope of practice to sign a certificate of nonmedical exemption. Notwithstanding any law or rule to the contrary, a body that regulates the professional conduct of a person who is authorized pursuant to title 12 to administer immunizations within his or her scope of practice to the student for whom the certificate is sought shall not order a disciplinary action against the person because the person authorized to sign the certificate signed such certificate pursuant to this subsection (2)(b)(II)(B). It is unlawful for the employer or any professional organization to retaliate against a person because the person authorized to sign a certificate signed such certificate pursuant to this subsection (2)(b)(II)(B).
(2.2)
(a)
(I)
A licensed physician, physician assistant authorized pursuant to section
12-240-107 (6)
, or advanced practice registered nurse shall provide a copy of a completed certificate of medical exemption to the student's parent or legal guardian, the emancipated student, or the student eighteen years of age or older.
(II)
The certificate of completion of the online education module must be immediately available to download or print upon completion of the online education module. The certificate of completion of the online education module developed by the department of public health and environment must include the same information as the certificate of nonmedical exemption pursuant to subsection (2.3) of this section.
(III)
A person authorized pursuant to title 12 to administer immunizations within his or her scope of practice to the student for whom the certificate of nonmedical exemption is sought and who signs the certificate of nonmedical exemption form shall provide a copy of a completed certificate of nonmedical exemption to the student's parent or legal guardian, the emancipated student, or the student eighteen years of age or older.
(b)
(I)
A licensed physician, physician assistant authorized pursuant to section
12-240-107 (6)
, or advanced practice registered nurse shall submit the medical exemption data to the immunization tracking system created in section
25-4-2403
.
(II)
A person authorized pursuant to title 12 to administer immunizations within his or her scope of practice to the student for whom the certificate of nonmedical exemption is sought and who signs the certificate of nonmedical exemption shall submit the nonmedical exemption data to the immunization tracking system created in section
25-4-2403
.
(III)
Notwithstanding subsections (2.2)(b)(I) and (2.2)(b)(II) of this section, a licensed physician, a physician assistant authorized pursuant to section
12-240-107 (6)
, an advanced practice registered nurse, or a person authorized pursuant to title 12 to administer immunizations within his or her scope of practice is not subject to a regulatory sanction for failing to submit medical exemption or nonmedical exemption data to the immunization tracking system.
(2.3)
(a)
On or before January 1, 2021, the department of public health and environment shall develop and post on its website a standardized certificate of medical exemption form and a standardized certificate of nonmedical exemption form. The department of public health and environment shall post any updated form on its website.
(b)
At a minimum, the forms developed by the department of public health and environment must:
(I)
Include a notice that informs the student's parent or legal guardian, the emancipated student, or the student eighteen years of age or older of the option to exclude the student's medical or nonmedical exemption information from the immunization tracking system established in section
25-4-2403
;
(II)
Be limited to requests for information related to collecting data pertaining to a medical or nonmedical exemption, including but not limited to:
(A)
The student's immunization information and the vaccine or vaccines for which the exemption applies; and
(B)
Whether a medical exemption or a nonmedical exemption is claimed;
(III)
Not require the student's parent or legal guardian, the emancipated student, or the student eighteen years of age or older to provide any demographic data except the student's name, date of birth, sex, and school's name and location, and the parent's or legal guardian's name;
(IV)
Include references to scientifically based information regarding the benefits and risks of immunizations; and
(V)
Not require the student's parent or legal guardian, the emancipated student, or the student eighteen years of age or older to provide any information that would identify the religious faith or describe the reasons for the personal belief of the student's parent or legal guardian, the emancipated student, or the student eighteen years of age or older who is claiming a nonmedical exemption. The existing immunization tracking system established in section
25-4-2403
must not receive or store any information that would identify the religious faith or the reasons for the personal belief of the student's parent or legal guardian, the emancipated student, or the student eighteen years of age or older who is claiming the exemption.
(c)
The forms developed by the department of public health and environment must not require a parent or legal guardian, emancipated student, or student eighteen years of age or older to sign or indicate agreement with any language regarding immunizations that may be contrary to a religious belief or personal belief that is opposed to immunizations in order to complete the form.
(2.5)
The state board of health shall promulgate rules regarding:
(a)
Immunization information, including exemption rates, that is available to the public through the department, including evidence-based research, resources and information from credible scientific and public health organizations, peer-reviewed studies, and an online learning module; and
(b)
The frequency of submission of exemption forms.
(2.7)
(a)
The online learning module administered by the department of public health and environment pursuant to subsection (2.5)(a) of this section must:
(I)
Include medical and scientific data that is evidence-based and peer reviewed by credible scientific and public health organizations concerning both the benefits and risks of immunizations and evidence-based practices. The module must fairly present both the benefits and risks of immunizations and include data concerning the risk of immunization injury.
(II)
Be interactive; and
(III)
Include other criteria adopted by the department of public health and environment.
(b)
The online learning module must not require a parent or legal guardian, emancipated student, or student eighteen years of age or older to sign or indicate agreement with any language regarding immunizations that may be contrary to a religious belief or personal belief that is opposed to immunizations in order to complete the online learning module.
(3)
The state board of health may provide, by regulation, for further exemptions to immunization based upon sound medical practice.
(4)
All information distributed to parents by school districts regarding immunization shall inform them of their rights under subsection (2) of this section.
(5)
In addition to the requirements pursuant to section
25-4-902 (4)(b)
, each school shall make the immunization and exemption rates of their enrolled student population publicly available upon request.
Amended by 2020 Ch. 134, § 4, eff. 6/26/2020.
Amended by 2019 Ch. 136, § 158, eff. 10/1/2019.
Amended by 2016 Ch. 204, § 19, eff. 8/10/2016.
Amended by 2014 Ch. 240, § 2, eff. 7/1/2014.
L. 78: Entire part R&RE, p. 428, § 1, effective April 4. L. 91: (1) and (2) amended, p. 932, § 3, effective April 16. L. 93: (1) amended, p. 380, § 3, effective April 12. L. 97: Entire section amended, p. 409, § 2, effective July 1. L. 2008: (2)(a) amended, p. 132, § 17, effective 1/1/2009. L. 2014: (2.5) and (5) added, (HB 14-1288), ch. 887, p. 887, § 2, effective July 1. L. 2016: (2)(a) amended, (SB 16-158), ch. 728, p. 728, § 19, effective August 10. L. 2019: (2)(a) amended, (HB 19-1172), ch. 1702, p. 1702, § 158, effective October 1. L. 2020: (2) and (5) amended and (2.2), (2.3), and (2.7) added, (SB 20-163), ch. 582, p. 582, § 4, effective June 26.
This section is similar to former § 25-4-903 as it existed prior to 1978.
For the legislative declaration in HB 14-1288, see section 1 of chapter 240, Session Laws of Colorado 2014. For the legislative declaration in SB 16-158, see section 1 of chapter 204, Session Laws of Colorado 2016. For the legislative declaration in SB 20-163, see section 1 of chapter 134, Session Laws of Colorado 2020.