Policy to Practice: Child Groups—Immunization Requirements and Risk

Policy to Practice: Child Groups—Immunization Requirements and Risk

There are several communicable diseases preventable by vaccination. Massachusetts allows for exemptions based on sincere religious beliefs or if the immunization is medically contraindicated (other states allow for an exemption based on “personal/philosophical belief” – this exemption is not recognized in Massachusetts).

The EI Standards require programs to maintain the health and immunization records for each child enrolled in the EI program, not just enrolled in a child group. “All children enrolled in Early Intervention are up to date on immunizations according to the recommendations of the Massachusetts Department of Public Health unless the child’s parent has stated in writing that vaccination or immunization conflicts with his/her sincere religious beliefs or if the child’s physician has stated in writing that the vaccination or immunization is medically contraindicated” (EIOS Health and Safety: XI.C.1.e.). Please note, children who are considered homeless under the definition of McKinney-Vento may not be excluded or have their entry delayed from child group for lack of immunization documentation. Service coordinators will work with families to either facilitate attaining the necessary documentation or assist the family to find a health care provider.

DPH recognizes that the EIOS do not currently address the immunization requirements for community children who participate in groups at the EI center (“primary site”) or in community settings (“non-primary site”). DPH strongly encourages programs to maintain consistent requirements of both EI eligible children and community children for immunization records at the “primary sites”.

Programs who participate/co-lead groups at “non-primary sites” may want to discuss with their community collaborators what requirements related to immunization documentation exists.

Given current immunization rates, the risk for exposure and contracting a vaccine preventable disease is low. The risk, however small, may still exist for some. The program, with input from their health care consultant, may wish to review the program’s policies, procedures and materials shared with families related to vaccine preventable diseases as part of the program’s health care policies.

Does the information shared with all parents identify or acknowledge;

The importance of immunizations for vaccine preventable diseases

  • The risk for contracting any vaccine preventable disease is low due to the high rate of vaccinated children and adults, but does exist in the general population and in all settings. The risk varies depending on a number of factors (for example, exposure, the age of the child and immunization status)
  • Some participants in groups (children as well as adults) may not be fully immunized due to religious objection, medical contraindication, or because they have not been fully immunized themselves. The risk applies to the person who has not been fully immunized.
  • The program’s policies related to enrolling EI and/or community children who are not fully vaccinated. If the child group is at the EI program (“primary site”) the program may use discretion in developing policies for enrolling community children.
  • The program’s policies related to excluding children/adults who appear to have a communicable disease.

The Department of Public Health’s Immunization program offers several resources including: