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STATE OF OKLAHOMA
2nd Session of the 60th Legislature (2026)
SENATE BILL 1568 By: Grellner
AS INTRODUCED
An Act relating to public health; creating the
Oklahoma Parental Decision-Making and Hepatitis B
Immunization Act of 2026; providing short title;
providing findings and purposes; providing for
certain interpretation of state law and rules;
specifying certain requirements and restrictions on
administration of hepatitis B vaccine to infants;
prohibiting certain vaccination requirements;
specifying certain parental rights; requiring certain
notice and informed consent; directing certain
promulgation of rules; describing rules; providing
certain construction; limiting effect of act;
providing severability; providing for
noncodification; providing for codification; and
providing an effective date.
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. NEW LAW A new section of law not to be
codified in the Oklahoma Statutes reads as follows:
A. This act shall be known and may be cited as the “Oklahoma
Parental Decision-Making and Hepatitis B Immunization Act of 2026”.
B. The Legislature finds that:
1. The Advisory Committee on Immunization Practices (ACIP) has
updated its recommendations to provide for individual-based, shared
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clinical decision-making between parents and health care providers
regarding administration of the hepatitis B vaccine, including the
so called “birth dose,” for infants born to women who test negative
for hepatitis B;
2. Under these recommendations, infants born to mothers who
test positive for hepatitis B or whose infection status is unknown
remain candidates for prompt post-exposure prophylaxis and
vaccination, while decisions for infants of hepatitis B–negative
mothers may be made on an individual basis, with initiation of the
vaccine series at or after two (2) months of age if parents elect to
vaccinate; and
3. Oklahoma law and regulation currently require birthing
hospitals and licensed midwives to implement procedures to ensure
administration of a universal hepatitis B birth dose to all live
infants within twelve (12) hours of birth, subject to documented
exemptions, which effectively conditions the exercise of parental
choice on affirmatively refusing the hospital-administered dose.
C. The purposes of this act are to:
1. Align state newborn hepatitis B vaccination requirements
with current ACIP guidance;
2. Clarify that hepatitis B immunization for eligible infants
and children may be administered in any lawful clinical setting and
is not required to occur in a hospital or birthing facility; and
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3. Affirm and strengthen the fundamental right of parents and
legal guardians to make informed medical decisions for their
children in consultation with their chosen health care
professionals.
SECTION 2. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1-511.1 of Title 63, unless
there is created a duplication in numbering, reads as follows:
A. Notwithstanding any existing law or administrative rule to
the contrary, no statute, regulation, or policy of this state shall
be interpreted or applied to require that the hepatitis B birth dose
be administered in a hospital, birthing facility, or midwife
practice as a condition of compliance with state immunization
requirements for newborns or children, and hepatitis B vaccine doses
administered in any lawful clinical setting shall be deemed to
satisfy such requirements as provided by subsection D of this
section.
B. For infants born to women who test positive for hepatitis B
surface antigen or whose hepatitis B status is unknown at the time
of birth, birthing facilities shall continue to offer and are
authorized to administer appropriate hepatitis B immunoprophylaxis,
including hepatitis B vaccine, as a medically indicated standard of
care.
C. For infants born to women who test negative for hepatitis B,
the timing and location of initiation of the hepatitis B vaccine
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series shall be determined through shared clinical decision-making
between the parent or legal guardian and the infant’s health care
provider, consistent with current Advisory Committee on Immunization
Practices (ACIP) recommendations.
D. Hepatitis B vaccine doses administered in any lawful
clinical setting including, but not limited to, a pediatric or
family medicine clinic, public health department clinic, tribal
clinic, or other licensed outpatient facility, shall be deemed to
satisfy any state law or regulation requiring hepatitis B
immunization of infants or children.
SECTION 3. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1-511.2 of Title 63, unless
there is created a duplication in numbering, reads as follows:
A. No birthing facility, health care provider, or state or
local agency shall require administration of a hepatitis B birth
dose to an infant as a condition of discharge from a hospital or
birthing setting, or as a condition for the provision of any other
medical service to the mother or child, when the mother has tested
negative for hepatitis B.
B. Parents or legal guardians shall retain the right to decline
or defer administration of the hepatitis B birth dose for their
infant for any reason including, but not limited to, personal,
philosophical, or religious beliefs, without penalty under state law
and without adverse action in child welfare, custody, or other state
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administered proceedings, provided that such decision is documented
in the medical record.
C. Birthing facilities and health care providers shall:
1. Inform parents or legal guardians of the current Advisory
Committee on Immunization Practices (ACIP) recommendations regarding
hepatitis B vaccination, including the options for timing and
setting of administration where the mother is hepatitis B-negative;
and
2. Obtain informed consent prior to administering any hepatitis
B vaccine dose to a newborn or child, except where emergency
treatment is medically necessary to prevent imminent serious harm
and consent cannot reasonably be obtained.
SECTION 4. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1-511.3 of Title 63, unless
there is created a duplication in numbering, reads as follows:
A. The State Commissioner of Health shall, within twelve (12)
months of the effective date of this act, amend rules governing
birthing facilities and licensed midwives to remove any requirement
that all live infants receive a universal hepatitis B birth dose
within twelve (12) hours of birth.
B. Such rules shall:
1. Preserve the obligation of birthing facilities to offer
hepatitis B vaccine and appropriate immunoprophylaxis to infants
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born to mothers who are hepatitis B-positive or whose status is
unknown;
2. Recognize that administration of the hepatitis B vaccine
series may lawfully occur outside the hospital or birthing setting;
and
3. Incorporate parental shared clinical decision-making for
infants born to hepatitis B–negative mothers, consistent with the
most current Advisory Committee on Immunization Practices (ACIP)
recommendations in effect on the effective date of this act.
SECTION 5. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1-511.4 of Title 63, unless
there is created a duplication in numbering, reads as follows:
A. Nothing in this act shall be construed to mandate hepatitis
B vaccination of any infant or child beyond the requirements that
may be established by general Oklahoma school and child care
immunization laws, which remain subject to existing exemptions and
parental rights provisions.
B. In the event of any conflict between state hepatitis B
immunization regulations for newborns and the Advisory Committee on
Immunization Practices (ACIP) recommendations in effect on the
effective date of this act, the provisions of this act shall control
unless subsequently amended by the Legislature.
C. If any provision of this act or its application to any
person or circumstance is held invalid, the invalidity shall not
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affect other provisions or applications of the act that may be given
effect without the invalid provision or application, and to this end
the provisions of this act are declared severable.
SECTION 6. This act shall become effective November 1, 2026.
60-2-3489 DC 1/12/2026 7:46:49 PM