Immunizations for Children and Adolescents - School of Government ...

2 UNC School of Government Health Law Bulletin
Basic Childhood Immunization Requirements
1. Does North Carolina law require children to be immunized?
Yes. A state statute requires “[e]very child present in this state” to be immunized against certain
diseases. The person responsible for ensuring a child is immunized is the child’s parent, guardian,
person standing in loco parentis, or other person or agency with legal custody of the child. 2
A state rule specifies which vaccines are required, how many doses of each are required, and
when a child should receive each dose. 3 For example, the rule requires four doses of polio vaccine:
two before the child reaches the age of five months, a third before the child reaches nineteen
months, and a fourth before the child enters school. Children must be immunized according
to this schedule, which appears in the North Carolina Administrative Code—a multivolume
document that contains rules adopted by administrative agencies. 4 Such rules are effective
statewide and have the force of law.
The rule establishing the schedule identifies some limited circumstances in which a child or
adolescent is not required to have a particular vaccine. For example, the varicella (chickenpox)
vaccine is not required for a child who has a documented history of having had chickenpox. 5
The state health director has the authority to temporarily suspend an immunization requirement
under certain emergency conditions, such as a shortage of the required vaccine. When the
state health director takes this action, the North Carolina Department of Health and Human
Services (DHHS) must give written notice of the suspension to local health departments and
other health care providers who receive state-supplied vaccine. Additionally, DHHS must notify
health departments and providers in writing when the suspension is lifted. When a child misses
an immunization as a result of such a suspension, the required immunization schedule must be
resumed within ninety days after the suspension is lifted. 6
2. How are childhood immunizations documented?
North Carolina law requires health care providers who administer required vaccines to provide
a certificate of immunization for each child the provider immunizes. The certificate must
include specific information, including the child’s name, date of birth, and sex; the number of
doses of vaccine given and the dates given; and the name and address of the health care provider
who administered the vaccine. 7 North Carolina vaccine providers who use the North Carolina
Immunization Registry (NCIR) can produce the certificate of immunization by creating a report
called “Immunization Record-Patient Copy.” 8
2. N.C. Gen. Stat. (hereinafter G.S.) § 130A-152.
3. North Carolina Administrative Code, title 10A, subchapter 41A, section .0401 (typically cited in
state government documents as 10A N.C.A.C. 41A .0401).
4. Immunization rules are adopted by the North Carolina Commission for Public Health. G.S. 130A-
152(c) (authorizing the Commission to adopt rules implementing an immunization program); see also
G.S. 130A-29 (establishing the Commission and giving it rule-making authority).
5. 10A N.C.A.C. 41A .0401(a)(8)(A).
6. 10A N.C.A.C. 41A .0401(c).
7. G.S. 130A-154.
8. NCIR User Manual, Chapter 10: Reports and Forms, at 10.3 (available at www.immunizenc.com/
images/PDFs/Reports_and_Forms.pdf).