To learn the basics about SB 163, check out our overview here.
Do you have a question about SB 163 that you think we should include in the FAQ? Email us at info@coparents4vax.org and let us know!
List of questions (scroll down to read the answers):
List of questions (scroll down to read the answers):
- Does this bill make any changes to the medical exemption criteria or process?
- Does this bill force people to vaccinate their children, or force them to get specific vaccines?
- Does this bill infringe on religious liberties?
- Will the bill create "two classes of citizens," because immunizing students will retain privacy protections that exempting students don't?
- Does this bill remove legislative authority over the vaccine schedule and/or give the Board of Health new authority to add vaccines to the schedule?
- Does this bill violate HIPAA?
- Does this bill violate FERPA?
- If schools just better enforced existing law, will that raise our immunization rates to safe levels?
- How will the standardized form be written by CDPHE? Will the form contain "compelled speech?"
- What will the online education module look like?
- Will those completing the online education module be required to enter a lot of personal information? Will that information be retained?
- What happens to the hard copies of the non-medical exemption forms?
- What is the impact of this bill on informed consent?
- Will the sharing of school immunization rates with parents result in a loss of student privacy, or "out" specific students who have exemptions?
- Does the bill force parents to submit their child's information to a tracking system?
- What is CIIS (the Colorado Immunization Information System)?
- Will this bill impose significant and unreasonable burdens on families?
- Will this bill create access issues for rural Coloradans?
- Is this bill applicable to homeschoolers?
- Does this bill give Board of Health or CDPHE the authority/ability to eliminate non-medical exemptions?
- How often will parents have to submit a non-medical exemption?
- What if a healthcare provider won't sign a non-medical exemption form?
- Are flu shots required? Will I have to get an exemption every year if I skip the flu shot?
- Will my child be excluded from obtaining an education? (Also: Will I be forced to vaccinate my child?)
Q: Does this bill make any changes to the medical exemption criteria or process?
A: No.
A: No.
Q: Does this bill force people to vaccinate their children, or force them to get specific vaccines?
A: No. This bill fully retains a parent's ability to opt out of any vaccine for medical or non-medical reasons.
A: No. This bill fully retains a parent's ability to opt out of any vaccine for medical or non-medical reasons.
Q: Does this bill infringe on religious liberties?
A: No. The bill explicitly states that non-medical exemptions include both exemptions taken due to a religious belief (any religious belief) or due to a personal belief. In fact, the bill specifies that the non-medical exemption form can NOT, in any way, ask a parent to provide information that would identify their religious faith or describe the reasons for not vaccinating. The language in SB 163 is more respectful of religious liberty and privacy than the current practice, because it doesn't in any way give an indication that a parent is taking an exemption for a religious reason and doesn't make parents file something related to their religious beliefs with the school.
A: No. The bill explicitly states that non-medical exemptions include both exemptions taken due to a religious belief (any religious belief) or due to a personal belief. In fact, the bill specifies that the non-medical exemption form can NOT, in any way, ask a parent to provide information that would identify their religious faith or describe the reasons for not vaccinating. The language in SB 163 is more respectful of religious liberty and privacy than the current practice, because it doesn't in any way give an indication that a parent is taking an exemption for a religious reason and doesn't make parents file something related to their religious beliefs with the school.
Q: Will the bill create "two classes of citizens," because immunizing students will retain privacy protections that exempting students don't?
A: No, it will not. Under this bill, the paths that an immunizing or exempting student's information takes will be the same.
Currently, a student who is immunized must (by definition) visit an immunizing provider. If that provider participates in the immunization registry, that provider sends immunization information to CDPHE daily for entry into the Colorado Immunization Information System (CIIS). If a parent has opted out of CIIS then the student's information is blocked from being entered in CIIS. Parents of immunizing students also have to take an immunization record to the school for their records.
Under this bill, non-medical exemptions will also be submitted to CIIS. If the exempting student's parent has opted them out of CIIS then the student's information hits a wall and is blocked from entering or being retained in CIIS. Non-medical exemption forms will continue to be submitted by parents to their schools.
So, the processes are completely parallel. Both immunizing and exempting students have their records initially sent to CIIS -- and both immunizing and exempting students retain the ability to opt out of CIIS. Both immunizing and exempting students submit a record to the school. Both immunizing and exempting students have identical protections under HIPAA and FERPA.
A: No, it will not. Under this bill, the paths that an immunizing or exempting student's information takes will be the same.
Currently, a student who is immunized must (by definition) visit an immunizing provider. If that provider participates in the immunization registry, that provider sends immunization information to CDPHE daily for entry into the Colorado Immunization Information System (CIIS). If a parent has opted out of CIIS then the student's information is blocked from being entered in CIIS. Parents of immunizing students also have to take an immunization record to the school for their records.
Under this bill, non-medical exemptions will also be submitted to CIIS. If the exempting student's parent has opted them out of CIIS then the student's information hits a wall and is blocked from entering or being retained in CIIS. Non-medical exemption forms will continue to be submitted by parents to their schools.
So, the processes are completely parallel. Both immunizing and exempting students have their records initially sent to CIIS -- and both immunizing and exempting students retain the ability to opt out of CIIS. Both immunizing and exempting students submit a record to the school. Both immunizing and exempting students have identical protections under HIPAA and FERPA.
Q: Does this bill remove legislative authority over the vaccine schedule and/or give the Board of Health new authority to add vaccines to the school-entry schedule?
A: No. The legislature does not currently write the vaccine schedule. Existing statute already delegates authority to the State Board of Health to set the school-entry vaccine schedule. No vaccines are listed in Colorado Revised Statutes -- everything on the school schedule has been put there by the State Board of Health. The bill simply directs the State Board of Health to annually evaluate the current national best practices and consider whether Colorado's schedule needs to be updated in any way. There is nothing in SB 163 that mandates any changes to the vaccine schedule -- the State Board of Health will continue to make decisions about what is and is not on the school-entry schedule.
A: No. The legislature does not currently write the vaccine schedule. Existing statute already delegates authority to the State Board of Health to set the school-entry vaccine schedule. No vaccines are listed in Colorado Revised Statutes -- everything on the school schedule has been put there by the State Board of Health. The bill simply directs the State Board of Health to annually evaluate the current national best practices and consider whether Colorado's schedule needs to be updated in any way. There is nothing in SB 163 that mandates any changes to the vaccine schedule -- the State Board of Health will continue to make decisions about what is and is not on the school-entry schedule.
Q: Does the bill violate HIPAA?
A: No, nothing in the bill violates HIPAA. CDPHE is a public health authority under HIPAA and is authorized to collect medical information for the purpose of preventing/controlling disease. So, in other words, transmitting medical information to CIIS keeps that information contained within the envelope of HIPAA.
A: No, nothing in the bill violates HIPAA. CDPHE is a public health authority under HIPAA and is authorized to collect medical information for the purpose of preventing/controlling disease. So, in other words, transmitting medical information to CIIS keeps that information contained within the envelope of HIPAA.
Q: Does the bill violate FERPA?
A: No, nothing in the bill violates FERPA. FERPA is a privacy law that applies to education records at schools that receive funding from the US Department of Education, not to public health records. CDPHE is not subject to FERPA, and this bill has nothing to do with schools sharing a child’s educational records without a parent’s consent.
A: No, nothing in the bill violates FERPA. FERPA is a privacy law that applies to education records at schools that receive funding from the US Department of Education, not to public health records. CDPHE is not subject to FERPA, and this bill has nothing to do with schools sharing a child’s educational records without a parent’s consent.
Q: If schools just better enforced existing law, will that raise our immunization rates to safe levels?
A: Current law requires schools to collect either an immunization record or an exemption form from every student that enrolls. And, with existing law, Colorado has the lowest MMR vaccination rate in the country. There is no evidence to indicate that existing law will get us from lowest in the country to a consistent vaccination rate that would make schools and child cares safe for all students to attend. That is why we need to modernize our rules to better balance the exemption process. If schools did a better job enforcing current law, it would help give us more accurate data but not necessarily higher immunization rates.
A: Current law requires schools to collect either an immunization record or an exemption form from every student that enrolls. And, with existing law, Colorado has the lowest MMR vaccination rate in the country. There is no evidence to indicate that existing law will get us from lowest in the country to a consistent vaccination rate that would make schools and child cares safe for all students to attend. That is why we need to modernize our rules to better balance the exemption process. If schools did a better job enforcing current law, it would help give us more accurate data but not necessarily higher immunization rates.
Q: How will the non-medical exemption form be written by CDPHE? Will the form contain "compelled speech?"
A: Current law already delegates authority to CDPHE to write a non-medical exemption form, which they have done (link here). SB 163 states that the standardized non-medical exemption form must:
A: Current law already delegates authority to CDPHE to write a non-medical exemption form, which they have done (link here). SB 163 states that the standardized non-medical exemption form must:
- Include a notice that the student has the option to exempt their information from the Colorado Immunization Information System (CIIS)
- Be limited to requests for information related to collecting data pertaining to a non-medical exemption, including:
- Demographic info (not including SSN)
- Name and location of the student's school
- The vaccines for which the exemption applies
- Include references to scientifically based information regarding the benefits and risks of immunization; and
- Not require any information that would identify the religious faith or describe the reasons for the personal belief for the exemption
Q: What will the online education module look like?
A: CDPHE has already created a version of an online vaccine education module (link here). SB 163 includes this criteria for the online module that parents can complete to obtain a non-medical exemption. The module must:
A: CDPHE has already created a version of an online vaccine education module (link here). SB 163 includes this criteria for the online module that parents can complete to obtain a non-medical exemption. The module must:
- Include scientific data that is evidence-based and peer-reviewed from credible scientific and public health organizations to disclose the benefits and risks of immunization and evidence-based practices to prevent the spread of vaccine-preventable diseases;
- Be interactive; and
- Include other criteria adopted by CDPHE
Q: Will those completing the online education module be required to enter a lot of personal information? Will that information be retained?
A: Completion of the online module will create a non-medical exemption form, and so those completing the online module will need to provide the same info as those completing a non-medical exemption form (see "How will the non-medical exemption form be written?" above). Non-medical exemptions will be submitted to the Colorado Immunization Information System (CIIS), but if a parent has opted their child out then the information will not be retained in CIIS. This is identical to the process for immunizing parents. Doctors submit immunization records to CIIS, but if the parent has opted out then the child's information is not retained.
A: Completion of the online module will create a non-medical exemption form, and so those completing the online module will need to provide the same info as those completing a non-medical exemption form (see "How will the non-medical exemption form be written?" above). Non-medical exemptions will be submitted to the Colorado Immunization Information System (CIIS), but if a parent has opted their child out then the information will not be retained in CIIS. This is identical to the process for immunizing parents. Doctors submit immunization records to CIIS, but if the parent has opted out then the child's information is not retained.
Q: What happens to the hard copies of the non-medical exemption forms?
A: Parents will continue to submit a paper copy of their non-medical exemption form to their child's school when enrolling them, just like they currently do.
A: Parents will continue to submit a paper copy of their non-medical exemption form to their child's school when enrolling them, just like they currently do.
Q: What is the impact of this bill on informed consent?
A: Informed consent relates to the private conversations that doctors have with their patients and is therefore outside the purview of this bill. Pursuant to federal law, any health care provider administering a vaccine is already legally required to provide relevant information, including vaccine information statements that contain information about the risks and benefits of vaccines and diseases to the parent or guardian of a child before administering a vaccine.
A: Informed consent relates to the private conversations that doctors have with their patients and is therefore outside the purview of this bill. Pursuant to federal law, any health care provider administering a vaccine is already legally required to provide relevant information, including vaccine information statements that contain information about the risks and benefits of vaccines and diseases to the parent or guardian of a child before administering a vaccine.
Q: Will the sharing of school immunization rates with parents result in a loss of student privacy, or "out" specific students who have exemptions?
A: No. The information shared will be the school's overall vaccination rate, not anything that is particular to an individual student, or even a grade or class. Each school's overall vaccination rate is already publicly available information, since HB 14-1288 requires that schools make that info available upon request. SB 163 simply takes the burden of requesting off of parents, and now will includes a school's immunization rate on the letter with immunization and exemption information that already goes out to parents from their school each year.
A: No. The information shared will be the school's overall vaccination rate, not anything that is particular to an individual student, or even a grade or class. Each school's overall vaccination rate is already publicly available information, since HB 14-1288 requires that schools make that info available upon request. SB 163 simply takes the burden of requesting off of parents, and now will includes a school's immunization rate on the letter with immunization and exemption information that already goes out to parents from their school each year.
Q: Does the bill force parents to submit their child’s information to a tracking system?
A: Parents currently have the right to opt their child out of the Colorado Immunization Information System (CIIS) and they will maintain that right under this bill.
A: Parents currently have the right to opt their child out of the Colorado Immunization Information System (CIIS) and they will maintain that right under this bill.
Q: What is CIIS (the Colorado Immunization Information System)?
A: The Colorado Immunization Information System (CIIS) is a confidential, secure immunization registry like those used in 49 other states. CIIS has been in place for 18 years, and there has never been a security breach. It helps health care providers, schools, child care centers and individuals keep track of the shots they and/or their children have received. CIIS is an opt-out registry, and individuals can exclude their information from the system at any time.
A: The Colorado Immunization Information System (CIIS) is a confidential, secure immunization registry like those used in 49 other states. CIIS has been in place for 18 years, and there has never been a security breach. It helps health care providers, schools, child care centers and individuals keep track of the shots they and/or their children have received. CIIS is an opt-out registry, and individuals can exclude their information from the system at any time.
Q: Will this bill impose significant and unreasonable burdens on families?
A: No, it would not. This bill takes small, modest steps toward addressing the convenience imbalance that currently exists in the exemption process. To put it simply, it should not be easier to get an exemption than it is to get a child vaccinated.
While this bill preserves a path for parents who have a deeply held belief about rejecting vaccines, it does take the process closer to asking for “equal effort” for parents that are vaccinating and parents that are exempting. Vaccinating parents cannot get their child their shots electronically or through the mail – they have to make an appointment and physically take the child to a healthcare provider. Asking an exempting parent to get a form signed by a healthcare provider (or complete an online module) is not unreasonable.
What presents a “significant and unreasonable burden” on families is an outbreak of a preventable deadly disease. It’s important to ensure that children’s right to go to school in a safe environment and their right to the freedom from unnecessary risks is part of the conversation.
A: No, it would not. This bill takes small, modest steps toward addressing the convenience imbalance that currently exists in the exemption process. To put it simply, it should not be easier to get an exemption than it is to get a child vaccinated.
While this bill preserves a path for parents who have a deeply held belief about rejecting vaccines, it does take the process closer to asking for “equal effort” for parents that are vaccinating and parents that are exempting. Vaccinating parents cannot get their child their shots electronically or through the mail – they have to make an appointment and physically take the child to a healthcare provider. Asking an exempting parent to get a form signed by a healthcare provider (or complete an online module) is not unreasonable.
What presents a “significant and unreasonable burden” on families is an outbreak of a preventable deadly disease. It’s important to ensure that children’s right to go to school in a safe environment and their right to the freedom from unnecessary risks is part of the conversation.
Q: Will this bill create access issues for rural Coloradans?
A: No. There are several elements of the bill that work to create access for everyone across our state:
A: No. There are several elements of the bill that work to create access for everyone across our state:
- The bill directs funds to local public health agencies in areas with low vaccination rates to help improve access to vaccines.
- Exempting parents do not need to go to a primary care provider to get a signature for a non-medical exemption. They can go to any provider for whom giving that vaccination is within their scope of practice -- which often includes pharmacists (among many others).
- Exempting parents who do not wish to get a signature for a non-medical exemption can instead complete an online education module which will be available 24 hours a day and and can be viewed on a desktop or tablet. This can be done at a public library -- or even at the child's school.
Q: Is this bill applicable to homeschoolers?
A: Homeschoolers in Colorado are currently required to follow the same rules a public/private school students when it comes to vaccines -- they need to maintain either an updated immunization record or an exemption form. SB 163 explicitly excludes homeschoolers, unless their school district specifically asks for a record.
(22-33-104.5(3(g) https://www.cde.state.co.us/choice/homeschool_law)
A: Homeschoolers in Colorado are currently required to follow the same rules a public/private school students when it comes to vaccines -- they need to maintain either an updated immunization record or an exemption form. SB 163 explicitly excludes homeschoolers, unless their school district specifically asks for a record.
(22-33-104.5(3(g) https://www.cde.state.co.us/choice/homeschool_law)
Q: Does this bill give Board of Health or CDPHE the authority/ability to eliminate non-medical exemptions?
A: No. Non-medical exemptions are explicitly codified within statute. Board of Health/CDPHE can only do what statute gives them the authority to enact in rule (for example, two things BOH already has the authority to do from statute is to determine which vaccines are on the school-entry schedule and how frequently exemptions are submitted). The only way to change the specific parameters around non-medical or medical exemptions is to change them in statute. In other words, non-medical exemptions could not be eliminated without a bill going through the legislature (or a statewide ballot initiative).
A: No. Non-medical exemptions are explicitly codified within statute. Board of Health/CDPHE can only do what statute gives them the authority to enact in rule (for example, two things BOH already has the authority to do from statute is to determine which vaccines are on the school-entry schedule and how frequently exemptions are submitted). The only way to change the specific parameters around non-medical or medical exemptions is to change them in statute. In other words, non-medical exemptions could not be eliminated without a bill going through the legislature (or a statewide ballot initiative).
Q: How often will parents have to submit a non-medical exemption?
A: Current law gives Board of Health the authority to determine how often exemptions have to be submitted. SB 163 does not make any changes to statute with regard to the frequency of submitting exemptions -- that will continue to be determined by Board of Health.
A: Current law gives Board of Health the authority to determine how often exemptions have to be submitted. SB 163 does not make any changes to statute with regard to the frequency of submitting exemptions -- that will continue to be determined by Board of Health.
Q: What if a healthcare provider won't sign a non-medical exemption form?
A: Some non-vaccinating parents are already seeing a healthcare provider that knows they are refusing to vaccinate. Parents can also call ahead to a provider office before booking an appointment to find out if signing non-medical exemption forms is something that provider is willing to do. The bill explicitly allows providers other than primary care doctors to sign non-medical exemption forms, as long as giving immunizations is within that provider's scope of practice. Also, parents also have the option of completing the online education module as a way of securing a non-medical exemption.
A: Some non-vaccinating parents are already seeing a healthcare provider that knows they are refusing to vaccinate. Parents can also call ahead to a provider office before booking an appointment to find out if signing non-medical exemption forms is something that provider is willing to do. The bill explicitly allows providers other than primary care doctors to sign non-medical exemption forms, as long as giving immunizations is within that provider's scope of practice. Also, parents also have the option of completing the online education module as a way of securing a non-medical exemption.
Q: Are flu shots required? Will I have to get an exemption every year if I skip the flu shot?
A: No. Flu shots are not currently on the school-entry vaccine schedule, and so those who do not get a flu shot will not have to get any sort of exemption. The bill does not mandate the addition of flu shots (or any other vaccines) for school entry.
A: No. Flu shots are not currently on the school-entry vaccine schedule, and so those who do not get a flu shot will not have to get any sort of exemption. The bill does not mandate the addition of flu shots (or any other vaccines) for school entry.
Q: Will my children be excluded from obtaining an education? (Will I be forced to vaccinate my child?)
A: No. The bill preserves the ability for parent to exempt their child from school entry vaccine requirements for medical or non-medical reasons.
A: No. The bill preserves the ability for parent to exempt their child from school entry vaccine requirements for medical or non-medical reasons.