25 TAC §97.63
The Texas Department of Health (department) adopts on an
emergency basis an amendment to §97.63, concerning immunization requirements
for children attending Texas child-care facilities and elementary schools
regarding the DTaP requirement.
Pursuant to Government Code, §2001.034, the department finds that
an imminent peril to the public health, safety, and welfare of children attending
child-care facilities and elementary schools exists that requires adoption
of this rule on fewer than 30 days notice. Recent outbreaks of pertussis throughout
Texas have resulted in death and disability of children. There is currently
no requirement for pertussis vaccination in children between the ages of 15
months and 5 years of age due to a publication error that was recently discovered.
The absence of requirements for pertussis vaccination in children presents
an imminent peril to the health and safety of children in Texas and warrants
mandating adoption of the recommendations of the Advisory Committee on Immunization
Practices (ACIP). This rule will also align the DTP/DTaP immunization requirements
for Texas students with the most recent Recommended Childhood and Adolescent
Immunization Schedule issued by the ACIP.
The department finds that the DTP/DTaP immunization requirements are necessary
in order to prevent imminent peril and to protect the public health, safety,
and welfare of children attending child-care facilities and elementary schools.
The department also finds that not requiring the combination of doses of DTP/DTaP
recommended by the Advisory Committee on Immunization Practices (ACIP) places
the children attending child-care facilities and elementary schools in imminent
peril. The department finds that requiring the addition of a fifth dose of
DTP/DTaP to the immunization requirements for children four years of age or
older is necessary to protect the public health, safety, and welfare of children
attending child-care facilities and elementary schools.
The emergency rule is adopted under Health and Safety Code, §81.023,
which requires the Board of Health (board) to develop immunization requirements
for children; the immunization requirements are adopted as a statewide control
measure for communicable disease as defined in Health and Safety Code, §§81.081
and 81.082; Education Code, §38.001, which allows the board to develop
immunization requirements for admission to any elementary or secondary school;
Human Resources Code, §42.043, which requires the department to make
rules regarding the immunization of children admitted to child-care facilities;
and Health and Safety Code, §12.001, which provides the board with the
authority to adopt rules for the performance of every duty imposed by law
on the board, the department, and the commissioner of health.
The emergency rule affects Health and Safety Code, §81.023; Texas
Education Code, §38.001; and Human Resource Code, §42.043.
§97.63.Required Immunizations.
(a) - (b)
(No change.)
(c)
The following immunizations are required in the respective
age groupings. A child or student must meet all the immunizations requirements
specific to an age group upon first entering the age group. Implementation
of requirements for hepatitis B vaccine for adolescents and varicella vaccine
and hepatitis A for all ages is contingent upon the appropriation of funds
to the department for these purposes. By July 1 of each odd-numbered year,
the department will publish a statement on whether or not these vaccines have
been funded and are required as specified.
(1)
Children less than five years of age: polio vaccine; diphtheria-tetanus-pertussis
(DTP) or diphtheria-tetanus-acellular pertussis (DTaP) vaccine; measles, mumps,
and rubella vaccine (MMR); Haemophilus influenzae type b conjugate vaccine
(HibCV), hepatitis A, and varicella vaccine.
(A) - (E)
(No change.)
(F)
Children 15 months of age
through four years of age
, but not yet five years of age [
(15 months through four years
of age)
]:
(i)
(No change.)
(ii)
any combination of DTP/DTaP will meet the following requirement:
(I)
children 17 months of age and
younger are required to have three doses of DTP/DTaP vaccine; and
(II)
children 18 months of age
through three years of age are required to have four doses of DTP/DTaP vaccine.
Pediatric diphtheria-tetanus (DT) vaccine is an acceptable substitute for
DTP/DTaP vaccine if pertussis vaccine is medically contraindicated; and
(III)
children four years of age
are required to have five doses of DTP/DTaP vaccine. The fifth dose is not
necessary if the fourth dose in the series is given on or after the fourth
birthday. Pediatric diphtheria-tetanus (DT) vaccine is an acceptable substitute
for DTP/DTaP vaccine if pertussis vaccine is medically contraindicated.
(iii) - (vi)
(No change.)
(2)
Children and students five years of age or older.
(A)
(No change.)
(B)
Diphtheria/Tetanus/Pertussis
[
Tetanus/Diphtheria
].
(i)
Five doses of a diphtheria-tetanus-pertussis containing
vaccine in any combination are required. The fifth dose is not necessary if
the fourth dose in the series is given on or after the fourth birthday. Pediatric
diphtheria-tetanus (DT) vaccine is an acceptable substitute for DTP/DTaP vaccine
if pertussis vaccine is medically contraindicated
[
Children and
students six years of age and younger: at least four doses of DTP/DTaP, DT,
or Td vaccine are required, provided at least one dose has been received on
or after the fourth birthday. Pertussis vaccine is not required for children/students
who are five years of age and older. Children with a medical contraindication
to pertussis vaccine will need to have had only three doses of any combination
of DTP/DTaP/DT/Td vaccines if their first dose was given on or after the first
birthday and their third dose was given on or after the fourth birthday
].
For further information see §97.77(c) and (d) of this title.
(ii)
(No change.)
(C) - (H)
(No change.)
(3)
(No change.)
This agency hereby certifies that the emergency adoption
has been reviewed by legal counsel and found to be within the agency's legal
authority to adopt.
Filed with the Office of
the Secretary of State on August 7, 2003.
TRD-200304838
Susan K. Steeg
General Counsel
Texas Department of Health
Effective Date: August 7, 2003
Expiration Date: December 5, 2003
For further information, please call: (512) 458-7236