Colorado Code § 25-4-903

Exemptions from immunization - rules
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(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.

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