AN ACT CONCERNING THE STANDARD OF CARE FOR IMMUNIZATION.

Senate
sSB450 / File No. 476 1

General Assembly File No. 476
February Session, 2026 Substitute Senate Bill No. 450

Senate, April 7, 2026

The Committee on Public Health reported through SEN.
ANWAR of the 3rd Dist., Chairperson of the Committee on the
part of the Senate, that the substitute bill ought to pass.

AN ACT CONCERNING THE STANDARD OF CARE FOR
IMMUNIZATION.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:

Section 1. Subsection (a) of section 19a -7f of the general statutes is 1
repealed and the following is substituted in lieu thereof ( Effective from 2
passage): 3
(a) The Commissioner of Public Health shall [determine] establish the 4
standard of care for immunization for [the children ] residents of this 5
state. The standard of care for immunization shall (1) be based on a 6
consideration of the recommended schedules for active immunization 7
for [normal] adults, infants and children, including, but not limited to, 8
such recommended schedules published by the National Centers for 9
Disease Control and Prevention Advisory Committee on Immunization 10
Practices, the American Academy of Pediatrics, the American College of 11
Obstetrics and Gynecology and the American Academy of Family 12
Physicians, and (2) include schedules recommended by the 13
commissioner for active immunization and contraindications to 14
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administration of vaccines in accordance with such schedules . The 15
commissioner shall establish, within available appropriations, an 16
immunization program [which] that shall: [(1)] (A) Provide [vaccine] 17
vaccines at no cost to health care providers in Connecticut to administer 18
to children so that cost of [vaccine] vaccines will not be a barrier to age-19
appropriate vaccination in this state; [(2)] (B) with the assistance of 20
hospital maternity programs, provide all parents in this state with the 21
recommended immunization schedule for [normal] infants and 22
children, a booklet to record immunizations at the time of the infant's 23
discharge from the hospital nursery and a list of sites where 24
immunization may be provided; [(3)] (C) inform in a timely manner all 25
health care providers of changes in the recommended immunization 26
schedule; [(4)] (D) assist hospitals, local health providers and local 27
health departments to develop and implement record -keeping and 28
outreach programs to identify and immunize those children who have 29
fallen behind the recommended immunization schedule or who lack 30
access to regular preventative health care and have the authority to 31
gather such data as may be needed to evaluate such efforts; [(5)] (E) 32
assist in the development of a program to assess the vaccination status 33
of children who are clients of state and federal programs serving the 34
health and welfare of children and make provision for vaccination of 35
those who are behind the recommended immunization schedule; [(6)] 36
(F) access available state and federal funds , including, but not limited 37
to, any funds available through the federal Childhood Immunization 38
Reauthorization or any funds available through the Medicaid program; 39
[(7)] (G) solicit, receive and expend funds from any public or private 40
source; and [(8)] (H) develop and make available to parents and health 41
care providers public health educational materials about the benefits of 42
timely immunization. 43
Sec. 2. Subparagraph (B) of subdivision (3) of subsection (b) of section 44
19a-7f of the general statutes is repealed and the following is substituted 45
in lieu thereof (Effective from passage): 46
(B) [Commencing January 1, 2013, (i) any ] Any health care provider 47
who administers vaccines to children (i) under the federal Vaccines For 48
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Children immunization program that is operated by the Department of 49
Public Health under authority of 42 USC 1396s shall utilize, and the 50
department shall provide, any vaccine licensed by the federal Food and 51
Drug Administration, including any combination vaccine and dosage 52
form, that is (I) recommended by the National Centers for Disease 53
Control and Prevention Advisory Committee on Immunization 54
Practices, and (II) made available to the department by the National 55
Centers for Disease Control and Prevention, and (ii) [any health care 56
provider who administers vaccines to children ] shall utilize, and the 57
department shall provide, subject to inclusion in such program due to 58
available appropriations, any vaccine licensed by the federal Food and 59
Drug Administration, including any combination vaccine and dosage 60
form, that is (I) [recommended by the National Centers for Disease 61
Control and Prevention Advisory Committee on Immunization 62
Practices] set forth in the schedules for active immunization included in 63
the standard of care for immunization established pursuant to 64
subsection (a) of this section , (II) made available to the department by 65
the National Centers for Disease Control and Prevention or by other 66
means of procurement, provided such procurement conforms with 67
practices designed to reduce state procurement costs and results in more 68
efficient state procurement , and (III) equivalent, as determined by the 69
commissioner, to the cost for vaccine series completion of comparable 70
available licensed vaccines. 71
Sec. 3. Subsection (a) of section 19a -7j of the general statutes is 72
repealed and the following is substituted in lieu thereof ( Effective from 73
passage): 74
(a) Not later than September first, annually, the Secretary of the Office 75
of Policy and Management, in consultation with the Commissioner of 76
Public Health, shall (1) determine the amount appropriated for the 77
following purposes: (A) To purchase, store and distribute vaccines for 78
routine immunizations [included] for infants and children set forth in 79
the [schedule] schedules for active immunization [required by] included 80
in the standard of care for immunization established pursuant to section 81
19a-7f, as amended by this act ; (B) to purchase, store and distribute (i) 82
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vaccines to prevent hepatitis A and B in persons of all ages, as 83
recommended by the [schedule for immunizations published by the 84
National Advisory Committee for Immunization Practices ] schedules 85
for active immunization included in the standard of care for 86
immunization established pursuant to section 19a -7f, as amended by 87
this act, (ii) antibiotics necessary for the treatment of tuberculosis and 88
biologics and antibiotics necessary for the detection and treatment of 89
tuberculosis infections, and (iii) antibiotics to support treatment of 90
patients in communicable disease control clinics, as defined in section 91
19a-216a; (C) to administer the immunization program for infants and 92
children described in section 19a-7f, as amended by this act ; and (D) to 93
provide services needed to collect up-to-date information on childhood 94
immunizations for all children enrolled in Medicaid who reach two 95
years of age during the year preceding the current fiscal year, to 96
incorporate such information into the immunization information 97
system, established pursuant to section 19a -7h, (2) calculate the 98
difference between the amount expended in the prior fiscal year for the 99
purposes set forth in subdivision (1) of this subsection and the amount 100
of the appropriation used for the purpose of the health and welfare fee 101
established in subparagraph (A) of subdivision (2) of subsection (b) of 102
this section in that same year, and (3) inform the Insurance 103
Commissioner of such amounts. 104
Sec. 4. Section 19a -522 of the general statutes is repealed and the 105
following is substituted in lieu thereof (Effective from passage): 106
(a) The [commissioner] Commissioner of Public Health, in 107
consultation with the Commissioner of Social Services, shall adopt 108
regulations, in accordance with chapter 54, concerning the health, safety 109
and welfare of patients in nursing home facilities, classification of 110
violations relating to such facilities, medical staff qualifications, record-111
keeping, nursing service, dietary service, personnel qualifications and 112
general operational conditions. The regulations shall: (1) [Assure] 113
Ensure that each patient admitted to a nursing home facility is protected 114
by adequate immunization against respiratory viral diseases, including, 115
but not limited to, influenza and pneumococcal disease in accordance 116
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with the [recommendations of the National Advisory Committee on 117
Immunization Practices, established by the Secretary of Health and 118
Human Services ] schedules for active immunization included in the 119
standard of care for immunization established pursuant to section 19a -120
7f, as amended by this act ; (2) specify that each patient be protected 121
annually against influenza and be vaccinated against pneumonia in 122
accordance with the [recommendations of the National Advisory 123
Committee on Immunization ] standard of care for immunization 124
established pursuant to section 19a -7f, as amended by this act ; and (3) 125
provide appropriate exemptions for patients for whom such 126
immunizations are medically contraindicated and for patients who 127
object to such immunization on religious grounds. 128
(b) The Commissioner of Public Health may implement policies and 129
procedures necessary to administer the provisions of this section 130
concerning the protection of patients by adequate immunization against 131
respiratory viral diseases while in the process of adopting such policies 132
and procedures as regulations, provided notice of intent to adopt 133
regulations is published on the eRegulations System not later than 134
twenty days after the date of implementation. Policies and procedures 135
implemented pursuant to this section shall be valid until the time final 136
regulations are adopted. 137
[(b)] (c) Nursing home facilities or residential care homes may not 138
charge the family or estate of a deceased self -pay patient beyond the 139
date on which such patient dies. Nursing home facilities or residential 140
care homes shall reimburse the estate of a deceased self -pay patient, 141
within sixty days after the death of such patient, for any advance 142
payments made by or on behalf of the patient covering any period 143
beyond the date of death. Interest, in accordance with subsection (a) of 144
section 37-1, on such reimbursement shall begin to accrue from the date 145
of such patient's death. 146
Sec. 5. Section 19a -7q of the general statutes is repealed and the 147
following is substituted in lieu thereof (Effective from passage): 148
[On or before October 1, 2021, the ] The Commissioner of Public 149
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Health shall develop and make available on the Internet web site of the 150
Department of Public Health a certificate for use, in a form and manner 151
prescribed by the commissioner, by a licensed physician, licensed 152
physician assistant or licensed advanced practice registered nurse 153
stating that, in the opinion of such physician, physician assistant or 154
advanced practice registered nurse, a vaccination required by the 155
general statutes is medically contraindicated for a person because of the 156
physical condition of such person. The certificate shall include (1) 157
definitions of the terms "contraindication" and "precaution", (2) a list of 158
contraindications and precautions [recognized by the National Centers 159
for Disease Control and Prevention] included in the standard of care for 160
immunization established pursuant to section 19a -7f, as amended by 161
this act, for each of the statutorily required vaccinations, from which the 162
physician, physician assistant or advanced practice registered nurse 163
may select the relevant contraindication or precaution on behalf of such 164
person, (3) a section in which the physician, physician assistant or 165
advanced practice registered nurse may record a contraindication or 166
precaution that is not [recognized by the National Centers for Disease 167
Control and Prevention ] included in the standard of care for 168
immunization established pursuant to section 19a -7f, as amended by 169
this act , but in his or her discretion, results in the vaccination being 170
medically contraindicated, including, but not limited to, any 171
autoimmune disorder, family history of any autoimmune disorder, 172
family history of any reaction to a vaccination, genetic predisposition to 173
any reaction to a vaccination as determined through genetic testing and 174
a previous documented reaction of a person that is correlated to a 175
vaccination, (4) a section in which the physician, physician assistant or 176
advanced practice registered nurse may include a written explanation 177
for the exemption from any statutorily required vaccinations, (5) a 178
section requiring the signature of the physician, physician assistant or 179
advanced practice registered nurse, (6) a requirement that the physician, 180
physician assistant or advanced practice registered nurse attach such 181
person's most current immunization record, and (7) a synopsis of the 182
grounds for any order of quarantine or isolation pursuant to section 19a-183
131b. 184
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Sec. 6. Subsection (e) of section 10 -204a of the general statutes is 185
repealed and the following is substituted in lieu thereof (Effective from 186
passage): 187
(e) The definitions of adequate immunization shall reflect the 188
[schedule] schedules for active immunization [adopted] included in the 189
standard of care for immunization established pursuant to section 19a-190
7f, as amended by this act, and be established by regulation adopted in 191
accordance with the provisions of chapter 54 by the Commissioner of 192
Public Health, who shall also be responsible for providing procedures 193
under which such boards and such similar governing bodies shall 194
collect and report immunization data on each child to the Department 195
of Public Health for (1) compilation and analysis by the department, and 196
(2) release by the department of annual immunization rates for each 197
public and nonpublic school in the state, provided such immunization 198
data may not contain information that identifies a specific individual. 199
Sec. 7. Subsection (a) of section 10a -155 of the general statutes is 200
repealed and the following is substituted in lieu thereof ( Effective from 201
passage): 202
(a) Each institution of higher education shall require each full-time or 203
matriculating student born after December 31, 1956, to provide proof of 204
adequate immunization against measles, rubella, mumps and varicella, 205
as [recommended by the national Advisory Committee for 206
Immunization Practices ] set forth in the schedules for active 207
immunization included in the standard of care for immunization 208
established pursuant to section 19a -7f, as amended by this act, before 209
permitting such student to enroll in such institution. 210
Sec. 8. Subsection (a) of section 19a -131a of the general statutes is 211
repealed and the following is substituted in lieu thereof ( Effective from 212
passage): 213
(a) In the event of a state -wide or regional public health emergency, 214
the Governor shall make a good faith effort to inform the legislative 215
leaders specified in subsection (b) of this section before declaring that 216
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the emergency exists and may do any of the following: (1) Order the 217
commissioner to implement all or a portion of the public health 218
emergency response plan developed pursuant to section 19a -131g; (2) 219
authorize the commissioner to isolate or quarantine persons in 220
accordance with section 19a -131b; (3) order the commissioner to 221
vaccinate persons in accordance with section 19a-131e; (4) apply for and 222
receive federal assistance; [or] (5) order the commissioner to suspend 223
certain license renewal and inspection functions during the period of the 224
emergency and during the six -month period following the date the 225
emergency is declared to be over; or (6) authorize the commissioner, or 226
the commissioner's designee, to issue a standing order to permit medical 227
interventions, including vaccination, necessary to respond to the public 228
health emergency. As used in this subsection, "standing order" means a 229
nonpatient specific regimen applicable state-wide that (A) includes, but 230
is not limited to, a prescription or order that is issued by a physician 231
licensed pursuant to chapter 370 allowing licensed health care providers 232
to dispense or administer a medical intervention to control and prevent 233
the spread of, mitigate or treat any infectious or noninfectious disease 234
or threat to the public health, and (B) does not require any individual to 235
receive or utilize such medical intervention. 236
Sec. 9. (NEW) ( Effective from passage ) (a) As used in this section, 237
"eligible health care provider" means a free clinic, as defined in section 238
19a-630 of the general statutes, municipal health authority established 239
under chapter 368e of the general statutes, district department of health 240
established under chapter 368f of the general statutes and any other 241
health care provider, as determined by the Commissioner of Public 242
Health, who is licensed as a health care provider in the state and 243
provides vaccinations for persons nineteen years of age or older. 244
(b) There is established, within available appropriations, a vaccines 245
for adults program to be administered by the Department of Public 246
Health. The program shall provide for the department to purchase and 247
distribute vaccines to eligible health care providers. The Commissioner 248
of Public Health shall determine the vaccines to be purchased and 249
distributed under the program based on the efficacy of such vaccines in 250
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preventing serious disease and death in the adult population and the 251
eligible health care providers to whom such vaccines shall be 252
distributed. In making such determination regarding the vaccines to be 253
purchased, the commissioner may consult with the advisory committee 254
established pursuant to section 19a -131n of the general statutes. An 255
eligible health care provider may administer a vaccine provided under 256
the program to a patient only if such vaccine is not a covered benefit for 257
the patient under any self-funded employee health benefits plan, health 258
benefit plan, as defined in section 38a -1080 of the general statutes, 259
Medicaid, as defined in section 19a-508c of the general statutes, the State 260
employee plan, as defined in section 3-123aaa of the general statutes, or 261
a payment plan entered into between the health care provider and the 262
patient for health care services provided by such health care provider to 263
such patient. The list of vaccines for purchase and distribution and the 264
eligibility requirements for eligible health care providers determined by 265
the commissioner pursuant to this subsection shall not be considered 266
regulations of Connecticut state agencies, as defined in section 4 -166 of 267
the general statutes. 268
Sec. 10. Subsection (d) of section 4-186 of the 2026 supplement to the 269
general statutes is repealed and the following is substituted in lieu 270
thereof (Effective from passage): 271
(d) The provisions of this chapter shall not apply to: (1) [To 272
procedures] Procedures followed or actions taken concerning the lower 273
Connecticut River conservation zone described in chapter 477a and the 274
upper Connecticut River conservation zone described in chapter 477c, 275
(2) [to] the administrative determinations authorized by section 32 -9r 276
concerning manufacturing facilities in distressed municipalities, (3) [to] 277
the rules made pursuant to section 9 -436 for use of paper ballots , [and] 278
(4) [to] guidelines established under section 22a-227 for development of 279
a municipal solid waste management plan , and (5) the list of vaccines 280
for purchase and distribution and eligibility requirements for health 281
care providers determined by the Commissioner of Public Health 282
pursuant to section 9 of this act. 283
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Sec. 11. Subsection (a) of section 38a -492r of the general statutes is 284
repealed and the following is substituted in lieu thereof (Effective January 285
1, 2027): 286
(a) Each individual health insurance policy providing coverage of the 287
type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 288
delivered, issued for delivery, renewed, amended or continued in this 289
state that provides coverage for prescription drugs shall provide (1) 290
coverage for immunizations recommended by the American Academy 291
of Pediatrics, American Academy of Family Physicians [and] or the 292
American College of Obstetricians and Gynecologists, [and] (2) with 293
respect to immunizations that have in effect a recommendation from the 294
Advisory Committee on Immunization Practices of the Centers for 295
Disease Control and Prevention with respect to the individual involved, 296
coverage for such immunizations and at least a twenty -minute 297
consultation between such individual and a health care provider 298
authorized to administer such immunizations to such individual , and 299
(3) coverage for immunizations within the schedules for active 300
immunization included in the standard of care for immunization 301
established pursuant to section 19a-7f, as amended by this act. 302
Sec. 12. Subsection (a) of section 38a -518r of the general statutes is 303
repealed and the following is substituted in lieu thereof (Effective January 304
1, 2027): 305
(a) Each group health insurance policy providing coverage of the type 306
specified in subdivisions (1), (2), (4), (11) and (12) of section 38a -469 307
delivered, issued for delivery, renewed, amended or continued in this 308
state that provides coverage for prescription drugs shall provide (1) 309
coverage for immunizations recommended by the American Academy 310
of Pediatrics, American Academy of Family Physicians [and] or the 311
American College of Obstetricians and Gynecologists, [and] (2) with 312
respect to immunizations that have in effect a recommendation from the 313
Advisory Committee on Immunization Practices of the Centers for 314
Disease Control and Prevention with respect to the individual involved, 315
coverage for such immunizations and at least a twenty -minute 316
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consultation between such individual and a health care provider 317
authorized to administer such immunizations to such individual , and 318
(3) coverage for immunizations within the schedules for active 319
immunization included in the standard of care for immunization 320
established pursuant to section 19a-7f, as amended by this act. 321
Sec. 13. Subdivision (1) of subsection (a) of section 20 -633 of the 322
general statutes is repealed and the following is substituted in lieu 323
thereof (Effective from passage): 324
(a) (1) Any person licensed as a pharmacist under part II of this 325
chapter may order, prescribe and administer any vaccine approved or 326
authorized by the United States Food and Drug Administration as 327
follows: 328
(A) Any such vaccine [, approved or authorized by the United States 329
Food and Drug Administration ] that is listed [on] in the National 330
Centers for Disease Control and Prevention's age -appropriate 331
immunization schedule or the schedules for immunization included in 332
the standard of care for immunization established pursuant to section 333
19a-7f, as amended by this act, to any patient who is: (i) Eighteen years 334
of age or older; or (ii) at least twelve years of age but younger than 335
eighteen years of age with (I) the consent of such patient's parent, legal 336
guardian or other person having legal custody of such patient, or (II) 337
proof that such patient is an emancipated minor; 338
(B) Any such vaccine that is not [included on] listed in the National 339
Centers for Disease Control and Prevention's Adult Immunization 340
Schedule or in the schedules for immunization included in the standard 341
of care for immunization established pursuant to section 19a -7f, as 342
amended by this act, to any patient who is eighteen years of age or older; 343
[, provided the vaccine administration instructions for such vaccine are 344
available on the National Centers for Disease Control and Prevention's 345
Internet web site;] and 346
(C) Any such vaccine pursuant to a verbal or written prescription of 347
a prescribing practitioner for a specific patient. 348
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Sec. 14. Section 52 -571b of the general statutes is repealed and the 349
following is substituted in lieu thereof ( Effective from passage and 350
applicable to any civil action pending on or filed after said date): 351
(a) The state or any political subdivision of the state shall not burden 352
a person's exercise of religion under section 3 of article first of the 353
Constitution of the state even if the burden results from a rule of general 354
applicability, except as provided in subsection (b) of this section. 355
(b) The state or any political subdivision of the state may burden a 356
person's exercise of religion only if it demonstrates that application of 357
the burden to the person (1) is in furtherance of a compelling 358
governmental interest, and (2) is the least restrictive means of furthering 359
that compelling governmental interest. 360
(c) A person whose exercise of religion has been burdened in 361
violation of the provisions of this section may assert that violation as a 362
claim or defense in a judicial proceeding and obtain appropriate relief 363
against the state or any political subdivision of the state. 364
(d) Nothing in this section shall be construed to authorize the state or 365
any political subdivision of the state to burden any religious belief. 366
(e) Nothing in this section shall be construed to affect, interpret or in 367
any way address that portion of article seventh of the Constitution of 368
the state that prohibits any law giving a preference to any religious 369
society or denomination in the state. The granting of government 370
funding, benefits or exemptions, to the extent permissible under the 371
Constitution of the state, shall not constitute a violation of this section. 372
As used in this subsection, the term "granting" does not include the 373
denial of government funding, benefits or exemptions. 374
(f) The provisions of this section shall not apply to the requirements 375
set forth in sections 10 -204a, as amended by this act, 10a -155, as 376
amended by this act, 10a-155b, 19a-79 and 19a-87b. 377
[(f)] (g) For the purposes of this section, "state or any political 378
subdivision of the state" includes any agency, board, commission, 379
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department, officer or employee of the state or any political subdivision 380
of the state, and "demonstrates" means meets the burdens of going 381
forward with the evidence and of persuasion. 382
This act shall take effect as follows and shall amend the following
sections:

Section 1 from passage 19a-7f(a)
Sec. 2 from passage 19a-7f(b)(3)(B)
Sec. 3 from passage 19a-7j(a)
Sec. 4 from passage 19a-522
Sec. 5 from passage 19a-7q
Sec. 6 from passage 10-204a(e)
Sec. 7 from passage 10a-155(a)
Sec. 8 from passage 19a-131a(a)
Sec. 9 from passage New section
Sec. 10 from passage 4-186(d)
Sec. 11 January 1, 2027 38a-492r(a)
Sec. 12 January 1, 2027 38a-518r(a)
Sec. 13 from passage 20-633(a)(1)
Sec. 14 from passage and
applicable to any civil
action pending on or filed
after said date
52-571b

Statement of Legislative Commissioners:
In Section 5(3), "recognized by the National Centers for Disease Control
and Prevention" was bracketed and "included in the standard of care for
immunization established pursuant to section 19a -7f, as amended by
this act" was inserted after the closing bracket, for consistency.

PH Joint Favorable Subst.

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The following Fiscal Impact Statement and Bill Analysis are prepared for the benefit of the members of
the General Assembly, solely for purposes of information, summarization and explanation and do not
represent the intent of the General Assembly or either chamber thereof for any purpose. In general,
fiscal impacts are based upon a variety of informational sources, including the analyst’s professional
knowledge. Whenever applicable, agency data is consulted as part of the analysis, however final
products do not necessarily reflect an assessment from any specific department.

OFA Fiscal Note

State Impact:
Agency Affected Fund-Effect FY 27 $ FY 28 $
Public Health, Dept. GF - Potential
Savings
See Below See Below
Public Health, Dept. GF - Potential
Cost
See Below See Below
Note: GF=General Fund
Municipal Impact:
Municipalities Effect FY 27 $ FY 28 $
Various Municipalities Potential
Savings
Potential Potential

Explanation
The bill makes various changes to state laws on immunizations
resulting in: (1) a potential cost to the Department of Public Health
(DPH) beginning in FY 27; and (2) potential savings to DPH and various
municipalities also beginning in FY 27, as described below.
Section 2 allows DPH to purchase vaccines for the Connecticut
Vaccine Program (CVP) by means other than through the Centers for
Disease Control and Prevention (CDC) under certain conditions ,
resulting in potential savings beginning in FY 27 subject to available
opportunities where alternative procurement options reduce state costs
and increase efficiency.
Sections 9 and 10 establish a state -funded Vaccines for Adults
Program to provide certain vaccines at no cost to underinsured or
uninsured adults, resulting in a potential cost to DPH beginning in FY
27. The exact cost will depend on funding provided and the number of
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vaccines purchased as determined by the Commissioner. DPH currently
operates a similar, more limited program using federal Section 317
funds from the CDC.
This also results in a potential savings to municipalities beginning in
FY 27 to the extent : (1) DPH distributes vaccines to municipal health
authorities; and (2) in the absence of the bill, municipalities would have
covered this cost. Any savings to municipalities is dependent on which
vaccine costs are covered by DPH.
The Out Years
The annualized ongoing fiscal impact identified above would
continue into the future subject to inflation.

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OLR Bill Analysis
sSB 450

AN ACT CONCERNING THE STANDARD OF CARE FOR
IMMUNIZATION.

SUMMARY
This bill makes various changes to state laws on immunizations.
Principally, it:
1. requires the Department of Public Health (DPH) commissioner
to establish an immunization standard of care for adults, in
addition to children as under current law, and authorizes her to
consider recommended vaccine schedules from additional
organizations when doing so (§§ 1, 3, & 5-7);
2. requires the Connecticut Vaccine Program (CVP) to give all
children’s vaccines included under DPH’s standard of care,
instead of only those recommended by the CDC Advisory
Committee on Immunization Practices (ACIP), and allows DPH
to purchase the vaccines by means other than through the CDC
under certain conditions (§ 2);
3. requires DPH, in consultation with the Department of Social
Services (DSS), to adopt regulations for nursing homes on
immunization requirements for respiratory viral diseases ( such
as flu and pneumonia), according to DPH’s immunization
standard of care instead of the CDC recommendations as under
current law (and allows DPH to adopt related policies and
procedures while in the process of adopting regulations) (§ 4);
4. allows the governor, during a public health emergency, to
authorize the DPH commissioner or her designee to issue a
standing order to allow medical interventions (including
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vaccines) needed to respond to the emergency (§ 8);
5. establishes, within available appropriations, a DPH -
administered Vaccines for Adults Program that purchases and
distributes vaccines to eligible health care providers to
administer to underinsured and uninsured adults ages 19 and
older (§§ 9 & 10);
6. requires health insurance policies that cover prescription drugs
to also cover immunizations for children, adolescents, and adults
included in DPH’s standards of care within the schedules the
standards prescribe (§§ 11 & 12);
7. authorizes licensed pharmacists to order, prescribe, and
administer vaccines listed in DPH’s immunization standards of
care, instead of CDC -recommended vaccines, for adult patients
and patients between ages 12 and 18 (with parental consent or
proof the minor is emancipated) (§ 13); and
8. expressly provides that the state’s Religious Freedom Restoration
Act (RFRA) does not apply to school immunization requirements
for (a) public and private schools, including higher education
institutions, and (b) child care centers and group and family day
care homes (§ 14).
EFFECTIVE DATE: Upon passage, except that provisions on (1)
insurance coverage for vaccines take effect January 1, 2027, and (2)
RFRA take effect upon passage and apply to any civil action pending or
filed after that date.
§ § 1, 3 & 5-7 — EXPANDED IMMUNIZATION STANDARDS OF CARE
Current law requires the DPH commissioner to establish an
immunization standard of care for children based on the recommended
vaccine schedules of ACIP, the American Academy of Pediatrics (AAP),
and the American Academy of Family Physicians (AAFP).
The bill requires the commissioner to also establish an immunization
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standard of care for adults and, when setting any immunization
standards, allows her to consider recommended immunization
schedules from additional organizations, such as the American College
of Obstetrics and Gynecology (ACOG). The standards of care must
include immunization schedules for children and adults the
commissioner recommends as well as any related contraindications.
The bill makes related conforming changes to provisions on (1) the
health and welfare fee assessed against certain insurers to pay for the
CVP (§ 3); (2) medical exemption forms for state immunization
requirements (§ 5); and school immunization requirements, including
for higher education institutions (§§ 6 & 7).
§ 2 — VACCINES FOR CHILDREN PROGRAM
By law, DPH administers the CVP, which gives health care providers
certain vaccines at no cost to administer to children under age 19,
regardless of insurance status. Under current law, the program only
gives ACIP-recommended vaccines that DPH purchases through the
CDC. The bill instead requires the program to give all vaccines included
in DPH’s recommended children’s vaccine schedule set under its
standard of care. It allows DPH to purchase the vaccines by means other
than through the CDC, so long as the purchase conforms with practices
designed to increase efficiency and reduce state costs.
§ 4 — NURSING HOME IMMUNIZATION REGULATIONS
Current law requires the DPH commissioner to adopt nursing home
regulations that generally require, among other things, residents to be
adequately immunized against the flu and pneumonia according to
ACIP recommendations. The bill instead requires DPH to a dopt
immunization requirements for respiratory viral diseases, including the
flu and pneumonia, based on DPH’s immunization standards and
consult with the DSS commissioner when doing so.
Under the bill, the DPH commissioner may adopt policies and
procedures needed to implement these immunization requirements
while in the process of adopting regulations. She must publish notice of
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her intent to adopt regulations on the eRegulations system within 20
days after implementing the policies and procedures, which are valid
until final regulations are adopted.
§ 8 — PUBLIC HEALTH EMERGENCIES
The bill allows the governor, during a statewide or regional public
health emergency, to authorize the DPH commissioner or her designee
to issue a standing order to allow medical interventions (including
vaccines) needed to respond to the emergency.
Under the bill, a standing order is a non -patient-specific statewide
order that (1) includes a prescription or order issued by a physician that
allows licensed health care providers to dispense or administer medical
interventions to treat, or control and prevent the spread of, a disease or
public health threat and (2) does not require a person to receive or use
these interventions.
§§ 9 & 10 — VACCINES FOR ADULTS PROGRAM
The bill establishes, within available appropriations, a DPH -
administered Vaccines for Adults Program. Under the program, DPH
must purchase and distribute vaccines to free clinics, municipal and
district health departments, and other licensed health care p roviders
determined by the commissioner who vaccinate adults ages 19 and
older (“eligible health care providers”).
Under the bill, the commissioner must determine the (1) vaccines the
program purchases and distributes based on their efficacy in preventing
serious disease and death in adults and (2) eligible health care providers
the program distributes the vaccines to. When determining which
vaccines to purchase, the commissioner may consult with DPH’s
Federal Recommendations Advisory Committee (see BACKGROUND).
The bill allows an eligible health care provider to administer a vaccine
provided under the program to a patient only if the vaccine is not
already covered by (1) the patient’s public or private health insurance
plan (if any) or (2) a payment plan the pati ent entered into with the
provider for health care services.
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Under the bill, the program’s vaccines and provider eligibility
requirements the commissioner determines are not considered state
regulations and are exempt from the Uniform Administrative Procedure
Act’s regulatory process.
§§ 11 & 12 — INSURANCE COVERAGE FOR IMMUNIZATIONS
The bill requires health insurance policies that cover prescription
drugs to also cover immunizations for children, adolescents, and adults
included in DPH standards of care based on the schedules the standards
set. Existing law already requires these insu rance policies to cover
immunizations (1) recommended by the AAP, AAFP, or ACOG and (2)
that have, in effect, a recommendation from ACIP for the person
involved. These include, for example, immunizations for influenza,
meningitis, tetanus, HPV, hepatitis A and B, measles, mumps, rubella,
and varicella. For ACIP -recommended immunizations, existing law
requires insurance policies to also cover a 20 -minute immunization
consultation between a patient and a provider authorized to administer
them.
The bill applies to individual and group health insurance policies
delivered, issued, renewed, amended, or continued in Connecticut that
cover (1) basic hospital expenses; (2) basic medical-surgical expenses; (3)
major medical expenses; or (4) hospital or medical services, including
those provided under an HMO plan. Because of the federal Employee
Retirement Income Security Act (ERISA), state insurance benefit
mandates do not apply to self-insured benefit plans.
§ 13 — PHARMACISTS
The bill authorizes licensed pharmacists to order, prescribe, and
administer FDA -approved or authorized vaccines listed in DPH’s
immunization standards of care, instead of only CDC -recommended
vaccines, to adult patients and patients between ages 12 and 18 (with
parental consent or proof the minor is emancipated).
Current law also allows pharmacists to order, prescribe, and
administer to adult patients other vaccines that are (1) not on the
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immunization schedules, but for which there are administration
instructions on CDC’s website, or (2) prescribed (verbally or written) by
a practitioner for a specific patient. The bill specifies that these vaccines
must be FDA-approved or authorized, and for vaccines that are not on
the schedules, it eliminates the condition that there must be instructions
on the website.
§ 14 — RELIGIOUS FREEDOM RESTORATION ACT
The Connecticut Constitution grants people the right to follow their
religion, and a state law commonly referred to as RFRA prohibits the
state or any of its political subdivisions from placing any burden on this
right, unless they can demonstrate that their actions are to further a
compelling governmental interest and are the least restrictive way of
doing so.
The bill expressly provides that RFRA does not apply to school
immunization requirements for (1) public and private schools,
including higher education institutions , and (2) child care centers and
group and family day care homes. (A 2021 law eliminated the religious
exemption from immunization requirements for people attending these
facilities, and grandfathered people enrolled in grades kindergarten or
higher who had already submitted the exemption.)
BACKGROUND
DPH Federal Recommendations Advisory Committee
As authorized by law, the DPH commissioner has created a
committee of experts to advise her on matters relating to CDC and FDA
recommendations, using evidence -based data from peer -reviewed
sources. The committee must serve in a nonbinding advisory capacity,
giving guidance only at the commissioner’s discretion (CGS § 19a-131n).
Related Bill
sHB 5044, favorably reported by the Public Health Committee, has
identical provisions to this bill.
Related Case
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In 2022, parents from a few Connecticut municipalities filed a lawsuit
against the governor and the education and public health
commissioners claiming that the legislature’s 2021 repeal of the religious
exemption for school immunization requirements violat ed state and
federal religious freedom protections. In July 2024, the state Supreme
Court dismissed the parents’ claims under the Connecticut and U.S.
constitutions but allowed their claims made under state statute (RFRA)
to proceed ( Spillane v. Lamont, 350 Conn. 119 (2024)). The case is
currently pending in Connecticut Superior Court.
COMMITTEE ACTION
Public Health Committee
Joint Favorable Substitute
Yea 21 Nay 11 (03/18/2026)