1.1 	A bill for an act
1.2 	relating to health; requiring human papilloma virus vaccination of female 
1.3 	children and education materials developed;amending Minnesota Statutes 2006, 
1.4 	section 121A.15, subdivisions 1, 2, 3a, 4, 10, by adding a subdivision.
1.5 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.6 	Section 1. Minnesota Statutes 2006, section 121A.15, subdivision 1, is amended to 
1.7 	read:
1.8 		Subdivision 1.School and child care facility immunization requirements. Except 
1.9 	as provided in subdivisions 3, 4, and 10, no person over two months old may be allowed 
1.10 	to enroll or remain enrolled in any elementary or secondary school or child care facility in 
1.11 	this state until the person has submitted to the administrator or other person having general 
1.12 	control and supervision of the school or child care facility, one of the following statements:
1.13 	(1) a statement from a physician or a public clinic which provides immunizations 
1.14 	stating that the person has received immunization, consistent with medically acceptable 
1.15 	standards, against measles after having attained the age of 12 months, rubella, diphtheria, 
1.16 	tetanus, pertussis, polio, mumps, haemophilus influenza type b, and hepatitis B, and 
1.17 	human papilloma virus; or
1.18 	(2) a statement from a physician or a public clinic which provides immunizations 
1.19 	stating that the person has received immunizations, consistent with medically acceptable 
1.20 	standards, against measles after having attained the age of 12 months, rubella, mumps, 
1.21 	and haemophilus influenza type b and that the person has commenced a schedule of 
1.22 	immunizations for diphtheria, tetanus, pertussis, polio, and hepatitis B, and human 
1.23 	papilloma virus and which indicates the month and year of each immunization received.

2.1 	Sec. 2. Minnesota Statutes 2006, section 121A.15, subdivision 2, is amended to read:
2.2 		Subd. 2.Schedule of immunizations. No person who has commenced a treatment 
2.3 	schedule of immunization pursuant to subdivision 1, clause (2), may remain enrolled in 
2.4 	any child care facility, elementary, or secondary school in this state after 18 months of 
2.5 	enrollment unless there is submitted to the administrator, or other person having general 
2.6 	control and supervision of the school or child care facility, a statement from a physician or 
2.7 	a public clinic which provides immunizations that the person has completed the primary 
2.8 	schedule of immunizations for diphtheria, tetanus, pertussis, polio, and hepatitis B, and 
2.9 	human papilloma virus. The statement must include the month and year of each additional 
2.10 	immunization received. For a child less than seven years of age, a primary schedule of 
2.11 	immunizations shall consist of four doses of vaccine for diphtheria, tetanus, and pertussis 
2.12 	and three doses of vaccine for poliomyelitis and hepatitis B. For a child seven years of 
2.13 	age or older, a primary schedule of immunizations shall consist of three doses of vaccine 
2.14 	for diphtheria, tetanus, polio, and hepatitis B. For a female child age 12 years or older, a 
2.15 	primary schedule of immunization shall consist of three doses of the vaccine for human 
2.16 	papilloma virus.

2.17 	Sec. 3. Minnesota Statutes 2006, section 121A.15, subdivision 3a, is amended to read:
2.18 		Subd. 3a.Disclosures required. (a) This paragraph applies to any written 
2.19 	information about immunization requirements for enrollment in a school or child care 
2.20 	facility that:
2.21 	(1) is provided to a person to be immunized or enrolling or enrolled in a school or 
2.22 	child care facility, or to the person's parent or guardian if the person is under 18 years 
2.23 	of age and not emancipated; and
2.24 	(2) is provided by the Department of Health; the Department of Education; the 
2.25 	Department of Human Services; an immunization provider; or a school or child care 
2.26 	facility.
2.27 	Such written information must describe the exemptions from immunizations permitted 
2.28 	under subdivision 3, paragraphs (c) and (d). The information on exemptions from 
2.29 	immunizations provided according to this paragraph must be in a font size at least equal to 
2.30 	the font size of the immunization requirements, in the same font style as the immunization 
2.31 	requirements, and on the same page of the written document as the immunization 
2.32 	requirements.
2.33 	(b) Before immunizing a person, an immunization provider must provide the 
2.34 	person, or the person's parent or guardian if the person is under 18 years of age and not 
2.35 	emancipated, with the following information in writing:
3.1 	(1) a list of the immunizations required for enrollment in a school or child care 
3.2 	facility;
3.3 	(2) a description of the exemptions from immunizations permitted under subdivision 
3.4 	3, paragraphs (c) and (d);
3.5 	(3) a list of additional immunizations currently recommended by the commissioner; 
3.6 	and
3.7 	(4) in accordance with federal law, a copy of the vaccine information sheet from the 
3.8 	federal Department of Health and Human Services that lists possible adverse reactions to 
3.9 	the immunization to be provided.
3.10 	(c) The commissioner will continue the educational campaign to providers and 
3.11 	hospitals on vaccine safety including, but not limited to, information on the vaccine 
3.12 	adverse events reporting system (VAERS), the federal vaccine information statements 
3.13 	(VIS), and medical precautions and contraindications to immunizations.
3.14 	(d) The commissioner will encourage providers to provide the vaccine information 
3.15 	statements at multiple visits and in anticipation of subsequent immunizations.
3.16 	(e) The commissioner will encourage providers to use existing screening for 
3.17 	immunization precautions and contraindication materials and make proper use of the 
3.18 	vaccine adverse events reporting system (VAERS).
3.19 	(f) In consultation with groups and people identified in subdivision 12, paragraph 
3.20 	(a), clause (1), the commissioner will continue to develop and make available patient 
3.21 	education materials on immunizations including, but not limited to, contraindications and 
3.22 	precautions regarding vaccines.
3.23 	(g) The commissioner will encourage health care providers to use thimerosal-free 
3.24 	vaccines when available.
3.25 	(h) If a notarized statement signed by a minor child's parent or guardian or by an 
3.26 	emancipated person under subdivision 3, paragraph (d), has been submitted in order 
3.27 	to exempt a person from the human papilloma virus vaccination requirements, the 
3.28 	person receiving the statement must provide the minor child's parent or guardian or the 
3.29 	emancipated person a copy of the materials developed by the commissioner of health 
3.30 	under subdivision 13.

3.31 	Sec. 4. Minnesota Statutes 2006, section 121A.15, subdivision 4, is amended to read:
3.32 		Subd. 4.Substitute immunization statement. (a) A person who is enrolling 
3.33 	or enrolled in an elementary or secondary school or child care facility may substitute 
3.34 	a statement from the emancipated person or a parent or guardian if the person is a 
3.35 	minor child in lieu of the statement from a physician or public clinic which provides 
4.1 	immunizations. If the statement is from a parent or guardian or emancipated person, the 
4.2 	statement must indicate the month and year of each immunization given.
4.3 	(b) In order for the statement to be acceptable for a person who is enrolling in 
4.4 	an elementary school and who is six years of age or younger, it must indicate that 
4.5 	the following was given: no less than one dose of vaccine each for measles, mumps, 
4.6 	and rubella given separately or in combination; no less than four doses of vaccine for 
4.7 	poliomyelitis, unless the third dose was given after the fourth birthday, then three doses 
4.8 	are minimum; no less than five doses of vaccine for diphtheria, tetanus, and pertussis, 
4.9 	unless the fourth dose was given after the fourth birthday, then four doses are minimum; 
4.10 	and no less than three doses of vaccine for hepatitis B.
4.11 	(c) In order for the statement to be consistent with subdivision 10 and acceptable for 
4.12 	a person who is enrolling in an elementary or secondary school and is age seven through 
4.13 	age 19, the statement must indicate that the person has received no less than one dose of 
4.14 	vaccine each for measles, mumps, and rubella given separately or in combination, and no 
4.15 	less than three doses of vaccine for poliomyelitis, diphtheria, tetanus, and hepatitis B.
4.16 	(d) In order for the statement to be acceptable for a person who is enrolling in a 
4.17 	secondary school, and who was born after 1956 and is 20 years of age or older, the 
4.18 	statement must indicate that the person has received no less than one dose of vaccine each 
4.19 	for measles, mumps, and rubella given separately or in combination, and no less than one 
4.20 	dose of vaccine for diphtheria and tetanus within the preceding ten years.
4.21 	(e) In order for the statement to be acceptable for a person who is enrolling in a 
4.22 	child care facility and who is at least 15 months old but who has not reached five years 
4.23 	of age, it must indicate that the following were given: no less than one dose of vaccine 
4.24 	each for measles, mumps, and rubella given separately or in combination; no less than one 
4.25 	dose of vaccine for haemophilus influenza type b; no less than four doses of vaccine for 
4.26 	diphtheria, tetanus, and pertussis; and no less than three doses of vaccine for poliomyelitis.
4.27 	(f) In order for the statement to be acceptable for a person who is enrolling in a child 
4.28 	care facility and who is five or six years of age, it must indicate that the following was 
4.29 	given: no less than one dose of vaccine each for measles, mumps, and rubella given 
4.30 	separately or in combination; no less than four doses of vaccine for diphtheria, tetanus, 
4.31 	and pertussis; and no less than three doses of vaccine for poliomyelitis.
4.32 	(g) In order for the statement to be acceptable for a person who is enrolling in a child 
4.33 	care facility and who is seven years of age or older, the statement must indicate that the 
4.34 	person has received no less than one dose of vaccine each for measles, mumps, and rubella 
4.35 	given separately or in combination and consistent with subdivision 10, and no less than 
4.36 	three doses of vaccine for poliomyelitis, diphtheria, and tetanus.
5.1 	(h) In order for the statement to be consistent with subdivision 10 and acceptable for 
5.2 	a female who is enrolling in an elementary or secondary school and is age 12 through age 
5.3 	19, the statement must indicate that the person has received no less than three doses of 
5.4 	vaccine for human papilloma virus.
5.5 	(i) The commissioner of health, on finding that any of the above requirements are 
5.6 	not necessary to protect the public's health, may suspend for one year that requirement.

5.7 	Sec. 5. Minnesota Statutes 2006, section 121A.15, subdivision 10, is amended to read:
5.8 		Subd. 10.Requirements for immunization statements. (a) A statement required 
5.9 	to be submitted under subdivisions 1, 2, and 4 to document evidence of immunization 
5.10 	shall include month, day, and year for immunizations administered after January 1, 1990.
5.11 	(b) A person who has received at least three doses of tetanus and diphtheria toxoids, 
5.12 	with the most recent dose given after age six and before age 11, is not required to have 
5.13 	additional immunization against diphtheria and tetanus until ten years have elapsed from 
5.14 	the person's most recent dose of tetanus and diphtheria toxoid.
5.15 	(c) The requirement for hepatitis B vaccination shall apply to persons enrolling in 
5.16 	kindergarten beginning with the 2000-2001 school term.
5.17 	(d) The requirement for hepatitis B vaccination shall apply to persons enrolling in 
5.18 	grade 7 beginning with the 2001-2002 school term.
5.19 	(e) The requirement for human papilloma virus vaccination shall apply to females 
5.20 	age 12 beginning with the 2009-2010 school term.

5.21 	Sec. 6. Minnesota Statutes 2006, section 121A.15, is amended by adding a subdivision 
5.22 	to read:
5.23 		Subd. 13.Human papilloma virus materials. (a) The commissioner of health 
5.24 	shall develop education materials in consultation with the Minnesota Immunization 
5.25 	Practices Advisory Committee that contain information regarding the risks associated 
5.26 	with the human papilloma virus and cervical cancer and the availability, effectiveness, 
5.27 	and potential risks of the human papilloma virus vaccine.
5.28 	(b) Once the materials are available, the commissioner shall notify each school in 
5.29 	this state of the availability of the materials described in this subdivision and shall make 
5.30 	those materials available on the department's Web site.

5.31 	Sec. 7. RULES.
 5.32 	The commissioner of health shall adopt rules to comply with the immunization 
5.33 	requirements of this act.