Immunization Requirements for School Children, 10-144 CMR Ch. 261

Pursuant to 20-A M.R.S. § 6358, the Department adopted a routine technical rule jointly with Maine’s Department of Education to mainly clarify vaccine dosage requirements in 10-144 C.M.R. chapter 261/05-071 C.M.R. chapter 126, Maine’s rule governing immunization requirements for any child entering public and private primary and secondary school. 20-A M.R.S. § 6354(2) authorizes and directs the departments to set dosage requirements for all Maine school children. The requirements are intended to effectively protect students from contracting and spreading diphtheria, measles, meningococcal meningitis, mumps, pertussis, poliomyelitis, tetanus, rubella, and varicella,—diseases determined through prior major substantive rulemaking pursuant to 20-A M.R.S § 6358(1)—thereby  helping to assure a safe and healthful school environment.  See 20-A M.R.S. § 6352. The evidence-based amendments by the Department’s Maine CDC clinicians were determined after concluding that the American Academy for Family Physicians, the American Academy of Pediatrics , and National Center for Immunization and Respiratory Disease within the United States Centers for Disease Control and Prevention’s recommended dosage schedules for children and adolescents promoted protected children from contracting and spreading the diseases listed by Section 2 at a dangerous rate. The Department further amended the rule to specify that a documented history of Varicella disease could demonstrate history of immunity. Because AAP’s recommendations are evidence-based in the Department’s professional judgment, and to reduce confusion and maintain consistency in Maine CDC’s recommendations, the Department, in carrying out its statutory duty under 20-A M.R.S. § 6354(2) to specify dosage requirements, cites AAP recommendations. Additionally, by the Department stating dosage requirements in terms of minimum age and time-intervals between doses (rather than age or age range), the amendments ensure that children who missed recommended immunizations do not age out of the opportunity to comply with the immunization requirements; instead, once they “catch up” on all required immunizations at the specified intervals, they may be considered immunized under the rule The adopted rule also refines recordkeeping requirements for school officials, requiring them to maintain certificates of immunization, evidence of immunity, and records of exemptions, as applicable in rule and statute. The records must be accessible to the school officials without undue delay, and school officials must maintain a list of children who are not immunized against diseases in accordance with authorized short-term or medical exemptions, to facilitate rapid and appropriate responses to disease incidents and outbreaks. The departments also deleted Section 8(B)(2), which had required superintendents to report compliance with local or school immunization requirements in their annual reports to the Department. Following the public comment period and review performed by the Office of the Attorney General for form and legality, the departments replaced "Physician Assistant" with "Physician Associate" throughout the rule in accordance with Public Law 2025, chapter 316. The Department also clarified rule language identifying those individuals who are authorized to issue vaccines to issue certificates of immunization, as well as which individuals schools may accept immunity documentation.