NY State Senate Bill 2015-S509A

Senate Bill S509A

2015-2016 Legislative Session

Provides for the immunization of all children born after January 1, 1996 against the human papillomavirus (HPV)

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Archive: Last Bill Status - In Senate Committee Health Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 15, 2016	print number 509a
Jan 15, 2016	amend and recommit to health
Jan 06, 2016	referred to health
Jan 07, 2015	referred to health

Bill Amendments

Original

A (Active)

2015-S509 - Details

Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Amd §§2164 & 613, Pub Health L
Versions Introduced in Other Legislative Sessions:: 2013-2014: S7315
2017-2018: S132
2019-2020: S298

2015-S509 - Summary

Provides for the immunization of all children born after January 1, 1996 with the human papillomavirus (HPV).

2015-S509 - Sponsor Memo

                                 BILL NUMBER:  S509

 TITLE OF BILL :  An act to amend the public health law, in relation
to requiring immunization against human papillomavirus (HPV)

 PURPOSE OR GENERAL IDEA OF BILL :  To ensure that immunization
against HPV be administered to children in New York State in the same
manner and according to the same time schedule that other
immunizations are currently administered

 SUMMARY OF SPECIFIC PROVISIONS :

Section one amends the section heading and subdivisions 2, 3, 5, and 6
of section 2164 of the public health law, as amended by chapter 169 of
the laws of 2006, subdivision 2 as separately amended by chapter 506
of the laws of 2006, by adding human papillomavirus (HPV) to the list
of required immunizing agents, such as those against poliomyelitis,
mumps and measles, to be administered to children in this state.
Section one also adds the HPV vaccine to the list of vaccines for
which: a booster is required; a person in parental relationship to a
child shall request a vaccine if not previously administered; a health
practitioner who administers such immunizing agents shall give a
certificate of immunization to the person in parental relation to a
child who has been vaccinated; a person in parental relation shall be
notified by a principal, teacher, owner or person in charge of the
school that the school has not received a certificate of immunization

or other acceptable evidence of the child's immunization. A form shall
be provided by the school to a person in parental relationship to a
child not yet vaccinated which allows such person to either state a
valid reason for withholding consent to immunize such child or to give
permission to the school to immunize the child. The law currently
permits a religious exemption to mandated immunizations.

Section two amends paragraph (a) of subdivision 7 of section 2164 of
the public health law, as amended by chapter 189 of the laws of 2006,
by adding HPV to the list of immunizations for which a certificate of
immunization is required by a school in order to allow a child to
attend such school in excess of fourteen days. If a student is
transferring from out-of-state or from another country and can show a
good faith effort to get the certificate or other evidence of
immunization, the time period may be extended to thirty days.

Section three amends the opening paragraph of subdivision 8-a of
section 2164 of the public health law, as amended by chapter 189 of
the laws of 2006, by adding HPV to the list of required immunizing
agents for which a certificate of immunization is required in relation
to preventing a child from attending school.

Section four amends paragraph (a) of subdivision 1 of section 613 of
the public health law, as amended by chapter 36 of the laws of 2010,
by adding HPV to the list of communicable diseases against which the
commissioner of health shall develop and supervise the execution of a
program of immunization, surveillance and testing in order to raise to
the highest reasonable level the immunity of children in the state.

Section five provides the effective date.

 JUSTIFICATION :  Cervical cancer is the second-leading cancer among
women worldwide, affecting an estimated 470,000 worldwide resulting in
233,000 deaths annually. In the United States, the American Cancer
Society (ACS) estimates that approximately 11,150 cases of cervical
cancer will be diagnosed this year and approximately 3,670 women will
die from cervical cancer. The American College of Obstetricians and
Gynecologists estimates that in New York approximately 1,000 women are
newly diagnosed with invasive cervical cancer and approximately 300
women die from the disease.
According to ACS, 99.7% of all cervical cancer cases are linked to
human papillomavirus (HPV). The types of HPV that cause cervical
cancer are sexually transmitted. ACS estimates that at least 80% of
sexually active women in the United States will have HPV by age 50,
with most cases acquired soon after individuals have sex for the first
time. Guttmacher Policy Review, Fall 2006. While the majority of cases
resolve on their own, for women whose body defenses are not sufficient
to clear the virus, cervical cancer can develop later in life (it can
take up to 20 years for an HPV infection to cause cervical cancer).

A vaccine against the types of linked to most cases of cervical
cancer, Gardasil, was approved last year by the United States Food and
Drug Administration. The Centers of Disease Control and Prevention
(CDC) and its Advisory Committee on Immunization Practices (ACIP)
recommended the routine vaccination of girls 11-12 years of age, but
noted that the vaccine can be given to girls as young as 9 up to age
26. When CDC has recommended the vaccination of school-age children,
New York adds such recommended vaccination to the list of vaccinations
required for school entry.

Gardasil is shown to protect against two types of HPV that cause about
70% of cervical cancers and two other types of HPV that cause 90% of
genital warts. The vaccine is given as a series of three shots over a
period of six months. Another vaccine against HPV, Cervarix, was
approved by the FDA in 2009.

Cervical cancer screening, through Pap tests and other detection
technologies, together with the new vaccine now make cervical cancer
one of the most preventable forms of cancers. Further, vaccination
against HPV has the potential to significantly reduce cervical cancer
incidence and mortality within our underserved populations - poor and
rural communities and black and Hispanic communities, which are
disproportionately affected by cervical cancer. In 2006, ACS estimated
that more than half of the women in the United States diagnosed with
cervical cancer had not had a Pap test in the last three years. These
women are disproportionately low income, black and Hispanic who lacked
access to affordable health services.

The vaccine is most effective when given to individuals before they
are infected with HPV through sexual contact. ACIP therefore
recommends that females should be vaccinated before sexual activity.
To significantly reduce cervical cancer deaths in this country and the
world, it is necessary to achieve near-universal vaccination of girls
and young women prior to sexual activity. The most effective way to
achieve rapid and widespread vaccination, as suggested by the
Guttmacher Institute, is by requiring children to be vaccinated prior
to attending school. School-based immunization will also help to close
racial, ethnic and socioeconomic gaps in immunization rates.  Because
many individuals have no health insurance coverage or access to
affordable care, a school vaccination program will facilitate
protecting individuals who are or may potentially become disconnected
from health care services.

By requiring vaccination of girls at an early age, before they have
engaged in sexual activity and before they have left school, we have a
greater chance of preventing cervical cancer. ACS reports that surveys
of teens in the United States show that almost one quarter of them
have had sex by the age of 15 and 7096 have had sex by age 18.  And,
according to the Guttmacher Institute, school dropout rates begin to
increase as early as age 13. Middle school may therefore be viewed as
"the last public health gate that an entire age-group of individuals
pass through together-regardless of race, ethnicity or socio-economic
status." Guttmacher Policy Review, Fall 2006. This bill will leave to
the department of health to determine the age at which girls will be
required to be vaccinated in light of ACIP recommendations.

Currently, the cost of the vaccine is covered by Medicaid and Medicaid
managed care plans, Child Health Plus and Family Health Plus. The
federal Vaccines for Children program covers the vaccination of
eligible girls under age 18.

$1.5 million was included in the governor's budget proposal in 2009 to
promote and expand access to the vaccine for low-income teens and
women. Texas recently became the first state to require vaccination of
school girls ages 11 and 12 against HPV and legislation requiring
vaccination in the schools is currently being considered in 18 other
states and the District of Columbia.

 PRIOR LEGISLATIVE HISTORY :  S.7315 of 2014 (Hoylman): Died in Health
A.2067 of 2013-2014 (Paulin): Died in Health

 FISCAL IMPLICATION :  Minimal to the state, offset by future
healthcare costs related to the treatment of cervical cancer.

 EFFECTIVE DATE :  This act shall take effect on the first of
September next succeeding the date on which it shall have become a
law; provided, however, that sections one, two and three of this act
shall apply only to children born on or after January 1, 1996.

2015-S509 - Bill Text download pdf

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                   509

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                               (PREFILED)

                             January 7, 2015
                               ___________

Introduced  by  Sen. HOYLMAN -- read twice and ordered printed, and when
  printed to be committed to the Committee on Health

AN ACT to amend the public health law, in relation to requiring  immuni-
  zation against human papillomavirus (HPV)

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. The section heading and subdivisions  2,  3,  5  and  6  of
section  2164 of the public health law, as amended by chapter 189 of the
laws of 2006 and subdivision 2 as separately amended by chapter  506  of
the laws of 2006, are amended to read as follows:
  Definitions;   immunization  against  poliomyelitis,  mumps,  measles,
diphtheria, rubella, varicella, HUMAN PAPILLOMAVIRUS (HPV),  Haemophilus
influenzae  type  b (Hib), pertussis, tetanus, pneumococcal disease, and
hepatitis B.
  2. a. Every person in parental relation to a child in this state shall
have administered to such child an adequate dose or doses of an immuniz-
ing agent against poliomyelitis, mumps,  measles,  diphtheria,  rubella,
varicella,  HUMAN  PAPILLOMAVIRUS  (HPV),  Haemophilus influenzae type b
(Hib), pertussis, tetanus, pneumococcal disease, and hepatitis B,  which
meets  the standards approved by the United States public health service
for such biological products, and which is approved  by  the  department
under such conditions as may be specified by the public health council.
  b.  Every person in parental relation to a child in this state born on
or after January first, nineteen hundred ninety-four and entering  sixth
grade  or a comparable age level special education program with an unas-
signed grade on or after September first, two thousand seven, shall have
administered to such child a booster immunization containing  diphtheria
and  tetanus  toxoids, [and] an acellular pertussis vaccine, AND A HUMAN
PAPILLOMAVIRUS (HPV) VACCINE, which meets the standards approved by  the
United  States  public  health service for such biological products, and

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.

                                                           LBD01836-01-5

S. 509                              2

which is approved by the department under  such  conditions  as  may  be
specified by the public health council.
  3.  The  person  in  parental  relation  to any such child who has not
previously received such immunization  shall  present  the  child  to  a
health  practitioner  and request such health practitioner to administer
the  necessary  immunization  against  poliomyelitis,  mumps,   measles,
diphtheria,  Haemophilus  influenzae  type  b (Hib), rubella, varicella,
HUMAN PAPILLOMAVIRUS (HPV), pertussis,  tetanus,  pneumococcal  disease,
and hepatitis B as provided in subdivision two of this section.
  5.  The  health  practitioner  who  administers  such immunizing agent
against poliomyelitis, mumps, measles, diphtheria, Haemophilus  influen-
zae  type  b  (Hib),  rubella,  varicella,  HUMAN  PAPILLOMAVIRUS (HPV),
pertussis, tetanus, pneumococcal disease, and hepatitis B  to  any  such
child  shall  give  a  certificate of such immunization to the person in
parental relation to such child.
  6. In the event that a person in parental relation to  a  child  makes
application  for  admission  of  such  child  to a school or has a child
attending school and there exists no  certificate  or  other  acceptable
evidence  of  the  child's  immunization  against  poliomyelitis, mumps,
measles, diphtheria, rubella,  varicella,  HUMAN  PAPILLOMAVIRUS  (HPV),
hepatitis  B,  pertussis,  tetanus,  and,  where applicable, Haemophilus
influenzae type b (Hib) and pneumococcal disease, the principal,  teach-
er,  owner or person in charge of the school shall inform such person of
the necessity to have the child immunized, that such immunization may be
administered by any health practitioner, or that the child may be immun-
ized without charge by the health officer in the county where the  child
resides,  if  such person executes a consent therefor. In the event that
such person does not wish to select a health practitioner to  administer
the  immunization,  he  or she shall be provided with a form which shall
give notice that as a prerequisite to  processing  the  application  for
admission  to,  or  for  continued attendance at, the school such person
shall state a valid reason for withholding consent or consent  shall  be
given  for  immunization  to  be administered by a health officer in the
public employ, or by a school physician or nurse. The form shall provide
for the execution of a consent by such person and it  shall  also  state
that  such  person need not execute such consent if subdivision eight or
nine of this section apply to such child.
  S 2. Paragraph (a) of subdivision 7 of  section  2164  of  the  public
health law, as amended by chapter 189 of the laws of 2006, is amended to
read as follows:
  (a) No principal, teacher, owner or person in charge of a school shall
permit  any  child  to  be  admitted  to  such school, or to attend such
school, in excess of fourteen days, without the certificate provided for
in subdivision five of this section or some other acceptable evidence of
the child's immunization against poliomyelitis, mumps, measles, diphthe-
ria,  rubella,  varicella,  HUMAN  PAPILLOMAVIRUS  (HPV),  hepatitis  B,
pertussis, tetanus, and, where applicable, Haemophilus influenzae type b
(Hib)  and  pneumococcal  disease;  provided, however, such fourteen day
period may be extended to not more than thirty days  for  an  individual
student  by the appropriate principal, teacher, owner or other person in
charge where such student is  transferring  from  out-of-state  or  from
another  country  and  can show a good faith effort to get the necessary
certification or other evidence of immunization.
  S 3. The opening paragraph of subdivision 8-a of section 2164  of  the
public  health  law,  as  amended by chapter 189 of the laws of 2006, is
amended to read as follows:

S. 509                              3

  Whenever a child has been refused admission to, or  continued  attend-
ance  at,  a school as provided for in subdivision seven of this section
because there exists no certificate provided for in subdivision five  of
this  section  or  other acceptable evidence of the child's immunization
against  poliomyelitis,  mumps, measles, diphtheria, rubella, varicella,
HUMAN PAPILLOMAVIRUS (HPV), hepatitis B, pertussis, tetanus, and,  where
applicable,   Haemophilus  influenzae  type  b  (Hib)  and  pneumococcal
disease, the principal, teacher, owner or person in charge of the school
shall:
  S 4. Paragraph (a) of subdivision 1  of  section  613  of  the  public
health law, as amended by section 24 of part E of chapter 56 of the laws
of 2013, is amended to read as follows:
  (a)  The  commissioner  shall develop and supervise the execution of a
program of immunization, surveillance and testing, to raise to the high-
est reasonable level the immunity of the children of the  state  against
communicable  diseases including, but not limited to, influenza, poliom-
yelitis, measles, mumps, rubella, haemophilus influenzae type  b  (Hib),
diphtheria,  pertussis,  tetanus, varicella, HUMAN PAPILLOMAVIRUS (HPV),
hepatitis B, pneumococcal disease, and the immunity  of  adults  of  the
state against diseases identified by the commissioner, including but not
limited to influenza, smallpox, hepatitis and such other diseases as the
commissioner  may  designate through regulation.   Municipalities in the
state shall maintain local programs of immunization to raise the immuni-
ty of the children and  adults  of  each  municipality  to  the  highest
reasonable  level,  in  accordance  with  an  application  for state aid
submitted by the municipality and approved  by  the  commissioner.  Such
programs  shall  include  assurance of provision of vaccine, serological
testing of individuals and educational efforts  to  inform  health  care
providers  and  target populations or their parents, if they are minors,
of the facts relative to these diseases  and  immunizations  to  prevent
their occurrence.
  S  5.  This  act  shall  take  effect  on  the first of September next
succeeding the date on which it  shall  have  become  a  law;  provided,
however,  that  sections one, two and three of this act shall apply only
to children born on or after January 1, 1996.

2015-S509A (ACTIVE) - Details

Current Committee:: Senate Health
Law Section:: Public Health Law
Laws Affected:: Amd §§2164 & 613, Pub Health L
Versions Introduced in Other Legislative Sessions:: 2013-2014: S7315
2017-2018: S132
2019-2020: S298

2015-S509A (ACTIVE) - Summary

Provides for the immunization of all children born after January 1, 1996 with the human papillomavirus (HPV).

2015-S509A (ACTIVE) - Sponsor Memo

                                 BILL NUMBER:  S509A

 TITLE OF BILL :

An act to amend the public health law, in relation to requiring
immunization against human papillomavirus (HPV)

 PURPOSE OR GENERAL IDEA OF BILL :

To ensure that immunization against HPV be administered to children in
New York State in the same manner and according to the same time
schedule that other immunizations are currently administered

 SUMMARY OF SPECIFIC PROVISIONS :

Section 1 amends section 2164 of the public health law, as amended by
chapter 169 of the laws of 2006.

Section 2 amends paragraph (a) of subdivision 1 of section 613 of the
public health law, as amended by section 24 of part E of chapter 56 of
the laws of 2013.

Section 3 establishes the effective date.

 JUSTIFICATION :

Cervical cancer is the second-leading cancer among women worldwide,
affecting an estimated 470,000 worldwide resulting in 233,000 deaths
annually. In the United States, the American Cancer Society (ACS)
estimates that approximately 11,150 cases of cervical cancer will be
diagnosed this year and approximately 3,670 women will die from
cervical cancer. The American College of Obstetricians and
Gynecologists estimates that in New York approximately 1,000 women are
newly diagnosed with invasive cervical cancer and approximately 300
women die from the disease.

According to ACS, 99.7% of all cervical cancer cases are linked to
human papillomavirus (HPV). The types of HPV that cause cervical
cancer are sexually transmitted. ACS estimates that at least 80% of
sexually active women in the United States will have HPV by age 50,
with most cases acquired soon after individuals have Sex for the first
time. Guttmacher Policy Review, Fall 2006. While the majority of cases
resolve on their own, for women whose body defenses are not sufficient
to clear the virus, cervical cancer can develop later in life (it can
take up to 20 years for an HPV infection to cause cervical cancer).

A vaccine against the types of linked to most cases of cervical
cancer, Gardasil, was approved last year by the United States Food and
Drug Administration. The Centers of Disease Control and Prevention
(CDC) and its Advisory Committee on Immunization Practices (ACIP)
recommended the routine vaccination of girls 11-12 years of age, but
noted that the vaccine can be given to girls as young as 9 up to age
26. When CDC has recommended the vaccination of school-age children,
New York adds such recommended vaccination to the list of vaccinations
required for school entry.

Gardasil is shown to protect against two types of HPV that cause about
70% of cervical cancers and two other types of HPV that cause 90% of
genital warts. The vaccine is given as a series of three shots over a
period of six months. Another vaccine against HPV, Cervarix, was
approved by the FDA in 2009.

Cervical cancer screening, through Pap tests and other detection
technologies, together with the new vaccine now make cervical cancer
one of the most preventable forms of cancers. Further, vaccination
against HPV has the potential to significantly reduce cervical cancer
incidence and mortality within our underserved populations - poor and
rural communities and black and Hispanic communities, which are
disproportionately affected by cervical cancer. In 2006, ACS estimated
that more than half of the women in the United States diagnosed with
cervical cancer had not had a Pap test in the last three years. These
women are disproportionately low income, black and Hispanic who lacked
access to affordable health services.

The vaccine is most effective when given to individuals before they
are infected with HPV through sexual contact. ACIP therefore
recommends that females should be vaccinated before sexual activity.
To significantly reduce cervical cancer deaths in this country and the
world, it is necessary to achieve near-universal vaccination of girls
and young women prior to sexual activity. The most effective way to
achieve rapid and widespread vaccination, as suggested by the
Guttmacher Institute, is by requiring children to be vaccinated prior
to attending school. Schoolbased immunization will also help to close
racial, ethnic and socioeconomic gaps in immunization rates. Because
many individuals have no health insurance coverage or access to
affordable care, a school vaccination program will facilitate
protecting individuals who are or may potentially become disconnected
from health care services.

By requiring vaccination of girls at an early age, before they have
engaged in sexual activity and before they have left school, we have a
greater chance of preventing cervical cancer. ACS reports that surveys
of teens in the United States show that almost one quarter of them
have had sex by the age of 15 and 7096 have had sex by age 18.  And,
according to the Guttmacher Institute, school dropout rates begin to
increase as early as age 13. Middle school may therefore be viewed as
"the last public health gate that an entire age-group of individuals
pass through together-regardless of race, ethnicity or socio-economic
status." Guttmacher Policy Review, Fall 2006. This bill will leave to
the department of health to determine the age at which girls will be
required to be vaccinated in light of ACIP recommendations.

Currently, the cost of the vaccine is covered by Medicaid and Medicaid
managed care plans, Child Health Plus and Family Health Plus. The
federal al Vaccines for Children program covers the vaccination of
eligible girls under age 18.

$1.5 million was included in the governor's budget proposal in 2009 to
promote and expand access to the vaccine for low-income teens and
women.

Texas recently became the first state to require vaccination of school
girls ages 11 and 12 against HPV and legislation requiring vaccination
in the schools is currently being considered in 18 other states and
the District of Columbia.

 PRIOR LEGISLATIVE HISTORY :

S.7315 of 2014 (Hoylman): Died in Health
A.2067 of 2013-2014 (Paulin):  Died in Health

 FISCAL IMPLICATION :

Minimal to the state, offset by future healthcare costs related to the
treatment of cervical cancer.

 EFFECTIVE DATE :
This act shall take effect on the first of September next succeeding
the date on which it shall have become a law; provided, however, that
sections one of this act shall apply only to children born on or after
January 1, 1996.

2015-S509A (ACTIVE) - Bill Text download pdf

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 509--A

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                               (PREFILED)

                             January 7, 2015
                               ___________

Introduced  by  Sen. HOYLMAN -- read twice and ordered printed, and when
  printed to be committed to the Committee on Health --  recommitted  to
  the  Committee  on  Health in accordance with Senate Rule 6, sec. 8 --
  committee discharged, bill amended, ordered reprinted as  amended  and
  recommitted to said committee

AN  ACT to amend the public health law, in relation to requiring immuni-
  zation against human papillomavirus (HPV)

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section  1. Section 2164 of the public health law, as amended by chap-
ter 401 of the laws of 2015, is amended to read as follows:
  S  2164.  Definitions;  immunization  against  poliomyelitis,   mumps,
measles,  diphtheria,  rubella,  varicella,  HUMAN PAPILLOMAVIRUS (HPV),
Haemophilus influenzae type b (Hib),  pertussis,  tetanus,  pneumococcal
disease,  meningococcal  disease,  and  hepatitis  B. 1. As used in this
section, unless the context requires otherwise:
  a. The term "school" means and includes any public, private  or  paro-
chial child caring center, day nursery, day care agency, nursery school,
kindergarten, elementary, intermediate or secondary school.
  b. The term "child" shall mean and include any person between the ages
of two months and eighteen years.
  c.  The  term  "person in parental relation to a child" shall mean and
include his  father  or  mother,  by  birth  or  adoption,  his  legally
appointed  guardian, or his custodian. A person shall be regarded as the
custodian of a child if he has assumed the charge and care of the  child
because  the  parents  or  legally  appointed guardian of the minor have
died, are imprisoned, are mentally ill, or have  been  committed  to  an
institution,  or  because  they have abandoned or deserted such child or
are living outside the state or their whereabouts are unknown,  or  have

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD01836-02-6

S. 509--A                           2

designated the person pursuant to title fifteen-A of article five of the
general obligations law as a person in parental relation to the child.
  d.  The term "health practitioner" shall mean any person authorized by
law to administer an immunization.
  2. a. Every person in parental relation to a child in this state shall
have administered to such child an adequate dose or doses of an immuniz-
ing agent against poliomyelitis, mumps,  measles,  diphtheria,  rubella,
varicella,  HUMAN  PAPILLOMAVIRUS  (HPV),  Haemophilus influenzae type b
(Hib), pertussis, tetanus, pneumococcal disease, and hepatitis B,  which
meets  the standards approved by the United States public health service
for such biological products, and which is approved  by  the  department
under such conditions as may be specified by the public health council.
  b.  Every person in parental relation to a child in this state born on
or after January first, nineteen hundred ninety-four and entering  sixth
grade  or a comparable age level special education program with an unas-
signed grade on or after September first, two thousand seven, shall have
administered to such child a booster immunization containing  diphtheria
and  tetanus  toxoids, [and] an acellular pertussis vaccine, AND A HUMAN
PAPILLOMAVIRUS (HPV) VACCINE, which meets the standards approved by  the
United  States  public  health service for such biological products, and
which is approved by the department under  such  conditions  as  may  be
specified by the public health council.
  c. Every person in parental relation to a child in this state entering
or  having  entered  seventh grade and twelfth grade or a comparable age
level special education program with an unassigned  grade  on  or  after
September  first,  two thousand sixteen, shall have administered to such
child an adequate dose or doses of immunizing agents against meningococ-
cal disease as recommended by the  advisory  committee  on  immunization
practices of the centers for disease control and prevention, which meets
the  standards  approved  by the United States public health service for
such biological products, and which is approved by the department  under
such  conditions  as  may be specified by the public health and planning
council.
  3. The person in parental relation to  any  such  child  who  has  not
previously  received  such  immunization  shall  present  the child to a
health practitioner and request such health practitioner  to  administer
the   necessary  immunization  against  poliomyelitis,  mumps,  measles,
diphtheria, Haemophilus influenzae type  b  (Hib),  rubella,  varicella,
HUMAN  PAPILLOMAVIRUS  (HPV),  pertussis, tetanus, pneumococcal disease,
meningococcal disease, and hepatitis B as provided in subdivision two of
this section.
  4. If any person in parental relation to such child is unable  to  pay
for  the  services  of  a private health practitioner, such person shall
present such child to the health officer of  the  county  in  which  the
child  resides,  who  shall then administer the immunizing agent without
charge.
  5. The health  practitioner  who  administers  such  immunizing  agent
against  poliomyelitis, mumps, measles, diphtheria, Haemophilus influen-
zae type  b  (Hib),  rubella,  varicella,  HUMAN  PAPILLOMAVIRUS  (HPV),
pertussis,  tetanus,  pneumococcal  disease,  meningococcal disease, and
hepatitis B to any such child shall give a certificate of such immuniza-
tion to the person in parental relation to such child.
  6. In the event that a person in parental relation to  a  child  makes
application  for  admission  of  such  child  to a school or has a child
attending school and there exists no  certificate  or  other  acceptable
evidence  of  the  child's  immunization  against  poliomyelitis, mumps,

S. 509--A                           3

measles, diphtheria, rubella,  varicella,  HUMAN  PAPILLOMAVIRUS  (HPV),
hepatitis  B,  pertussis,  tetanus,  and,  where applicable, Haemophilus
influenzae  type  b  (Hib),  meningococcal  disease,  and   pneumococcal
disease, the principal, teacher, owner or person in charge of the school
shall  inform  such person of the necessity to have the child immunized,
that such immunization may be administered by any  health  practitioner,
or  that the child may be immunized without charge by the health officer
in the county where the child resides, if such person executes a consent
therefor. In the event that such person does not wish to select a health
practitioner to administer the immunization, he or she shall be provided
with a form which shall give notice that as a prerequisite to processing
the application for admission to, or for continued  attendance  at,  the
school such person shall state a valid reason for withholding consent or
consent  shall  be given for immunization to be administered by a health
officer in the public employ, or by a school  physician  or  nurse.  The
form  shall provide for the execution of a consent by such person and it
shall also state that such person  need  not  execute  such  consent  if
subdivision eight or nine of this section apply to such child.
  7.  (a)  No  principal, teacher, owner or person in charge of a school
shall permit any child to be admitted to such school, or to attend  such
school, in excess of fourteen days, without the certificate provided for
in subdivision five of this section or some other acceptable evidence of
the child's immunization against poliomyelitis, mumps, measles, diphthe-
ria,  rubella,  varicella,  HUMAN  PAPILLOMAVIRUS  (HPV),  hepatitis  B,
pertussis, tetanus, and, where applicable, Haemophilus influenzae type b
(Hib), meningococcal disease, and pneumococcal disease; provided, howev-
er, such fourteen day period may be extended to  not  more  than  thirty
days  for  an  individual student by the appropriate principal, teacher,
owner or other person in charge where such student is transferring  from
out-of-state or from another country and can show a good faith effort to
get the necessary certification or other evidence of immunization.
  (b)  A parent, a guardian or any other person in parental relationship
to a child denied school entrance or attendance may appeal  by  petition
to  the  commissioner  of education in accordance with the provisions of
section three hundred ten of the education law.
  8. If any physician licensed to practice medicine in this state certi-
fies that such immunization may be detrimental to a child's health,  the
requirements  of this section shall be inapplicable until such immuniza-
tion is found no longer to be detrimental to the child's health.
  8-a. Whenever a child has been  refused  admission  to,  or  continued
attendance  at,  a  school  as provided for in subdivision seven of this
section because there exists no certificate provided for in  subdivision
five of this section or other acceptable evidence of the child's immuni-
zation against poliomyelitis, mumps, measles, diphtheria, rubella, vari-
cella, HUMAN PAPILLOMAVIRUS (HPV), hepatitis B, pertussis, tetanus, and,
where  applicable,  Haemophilus  influenzae  type b (Hib), meningococcal
disease, and pneumococcal disease,  the  principal,  teacher,  owner  or
person in charge of the school shall:
  a. forward a report of such exclusion and the name and address of such
child  to  the  local  health  authority  and  to the person in parental
relation to the child together with a notification of the responsibility
of such person under subdivision two of  this  section  and  a  form  of
consent as prescribed by regulation of the commissioner, and
  b.  provide,  with  the  cooperation  of  the appropriate local health
authority, for a time and place at which an immunizing agent  or  agents
shall  be  administered, as required by subdivision two of this section,

S. 509--A                           4

to a child for whom a consent has been obtained. Upon failure of a local
health authority to cooperate in arranging for a time and place at which
an immunizing agent or agents  shall  be  administered  as  required  by
subdivision two of this section, the commissioner shall arrange for such
administration and may recover the cost thereof from the amount of state
aid to which the local health authority would otherwise be entitled.
  9.  This section shall not apply to children whose parent, parents, or
guardian hold genuine and sincere religious beliefs which  are  contrary
to  the  practices herein required, and no certificate shall be required
as a prerequisite to such  children  being  admitted  or  received  into
school or attending school.
  10.  The  commissioner  may  adopt  and amend rules and regulations to
effectuate the provisions and purposes of this section.
  11. Every school shall annually provide  the  commissioner,  on  forms
provided  by  the  commissioner, a summary regarding compliance with the
provisions of this section.
  S 2. Paragraph (a) of subdivision 1  of  section  613  of  the  public
health law, as amended by section 24 of part E of chapter 56 of the laws
of 2013, is amended to read as follows:
  (a)  The  commissioner  shall develop and supervise the execution of a
program of immunization, surveillance and testing, to raise to the high-
est reasonable level the immunity of the children of the  state  against
communicable  diseases including, but not limited to, influenza, poliom-
yelitis, measles, mumps, rubella, haemophilus influenzae type  b  (Hib),
diphtheria,  pertussis,  tetanus, varicella, HUMAN PAPILLOMAVIRUS (HPV),
hepatitis B, pneumococcal disease, and the immunity  of  adults  of  the
state against diseases identified by the commissioner, including but not
limited to influenza, smallpox, hepatitis and such other diseases as the
commissioner  may  designate through regulation.   Municipalities in the
state shall maintain local programs of immunization to raise the immuni-
ty of the children and  adults  of  each  municipality  to  the  highest
reasonable  level,  in  accordance  with  an  application  for state aid
submitted by the municipality and approved  by  the  commissioner.  Such
programs  shall  include  assurance of provision of vaccine, serological
testing of individuals and educational efforts  to  inform  health  care
providers  and  target populations or their parents, if they are minors,
of the facts relative to these diseases  and  immunizations  to  prevent
their occurrence.
  S  3.  This  act  shall  take  effect  on  the first of September next
succeeding the date on which it  shall  have  become  a  law;  provided,
however,  that section one of this act shall apply only to children born
on or after January 1, 1996.

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