One is Governor Abbott's Executive Order GA-40. A sample COVID-19 Vaccine Exemption form is included along with the letter. 7500 Security Boulevard, Baltimore, MD 21244, An official website of the United States government, emergency use authorizations (EUAs) of the updated (bivalent). Employers nationwide are implementing mandatory COVID-19 vaccination policies in light of the September 9, 2021 announcement of President Biden's "Path Out of the Pandemic" COVID-19 Action Plan. UTMB estimates it will achieve the 90% compliance threshold by 11:59 p.m., March 20, 2022. Can Nonprecedential Decisions Be Relied Upon? If facilities participate in and are certified under the Medicare and Medicaid programs and are regulated by the CMS health and safety standards known as the Conditions of Participation (CoPs), Conditions for Coverage (CfCs), and Requirements for Participation, then they are expected to abide by the requirements established in the CMS Rule. Posted: February 17, 2023. On November 5, 2021, the Centers for Medicare and Medicaid Services (CMS) issued an interim final rule establishing COVID-19 vaccination requirements for staff working for certain Medicare- and Medicaid-certified providers and suppliers. STUDY ABROAD STUDENTS COVID-19 VACCINE MANDATE RELIGIOUS ACCOMMODATION REQUEST FORM CMS STUDENT COVID-19 VACCINE MANDATE RELIGIOUS ACCOMMODATION REQUEST FORM Please contact the Affirmative Action Office at aao@psu.edu if you need an alternative format of this form. .gov The U.S. Supreme Court recently lifted the pause on enforcement of the Centers for Medicare and Medicaid (CMS) rule that requires medical facilities to ensure all health care workers are vaccinated against COVID-19 or have a medical or religious exemption from vaccination in alignment with federal requirements. Facilities should review the inclusion criterion for these regulations and comply with all applicable requirements. Under OSHA regulations at 29 CFR Subpart U (86 FR 32376), covered healthcare employers must develop and implement a COVID-19 plan to identify and control COVID-19 hazards in the workplace and implement requirements to reduce transmission of COVID-19 in the workplace related to the following:patient screening and management, standard and transmission-based precautions, personal protective equipment (facemasks, respirators), controls for aerosol-generating procedures, physical distancing of at least six feet when feasible, physical barriers, cleaning and disinfection, ventilation, health screening and medical management, training, anti-retaliation, recordkeeping, and reporting. On Friday, the hockey team announced that fans ages 12 and older will be required to show proof of vaccination against COVID-19 or a recent negative test result for entry into Enterprise Center. This pre-diluted vaccine is effective January 3, 2021. Accordingly, I request exemption from the COVID-19 vaccine requirement imposed pursuant to . Accepting Cryptocurrency and Digital Asset Donations: What Charities Need to Know. Healthcare industry stakeholders are concerned that the mandate will further strain staffing shortages in the field. How does receipt of an intent to terminate notice affect an employees annual performance review? Mandatory Arbitration Agreements Remain Valid in California, Antitrust Practitioners Expect Activity With Climate Issues. Yes, individuals may be considered compliant with the requirements within this regulation if they have received any combination of two doses of a vaccine licensed or authorized by the FDA or listed on the WHO emergency use list as part of a two-dose series. How Modern Manufacturing Plants Can Protect Against Ransomware, FTC Will Host May 23, 2023, Workshop on Recyclable Claims and the Appellate Court Affirmed An Order Denying A Beneficiarys Request For An Overview of Why Class Action Privacy Lawsuits May Have Just Gotten Gold Dome Report Legislative Day 26 (2023). and will not survey for compliance with the CMS vaccine mandate rule. HHS issued a letter reminding the following: If you participate in theCDC COVID-19 Vaccination Program, you must: Report any potential violations of these requirements to the HHS Office of the Inspector General: Providers who have questions about billing or reimbursement of vaccine administration for patients covered by private insurance or Medicaid should contact the respective health plan or state Medicaid agency. Does fully vaccinated include additional doses or booster shots? Does that count toward the vaccination requirement? Federal employees lawsuit. Part 1 training plans. Because the federal government purchased theinitial supply of COVID-19 vaccines, this toolkit primarily focuses on coverage for administering the vaccine. With the changes to the CDC guidance for the vaccine intervals, what will happen if an individual now needs to get a second dose after April 19, 2022? Visas for F and M Students Can Now Be Issued 365 Days Ahead of Program Start Date. However,the Texas Workforce Commission issued a letter to Texas employers that states that employees can report violations of GA-40 to TWC over the phone or via e-mail. For Phase 1, within 30 days (i.e. As EPA continues to move toward identifying PFAS as Hazardous Is an OSHA Workplace Violence Standard for the Healthcare Industry on Yellen Calls on World Bank to Take Decisive Action on Climate Change, To Volunteer or Not: The Role of Community Association Board Members. Templates for documenting the exemptions can be found on AMDA's website, on the COVID-19 Resource Page, under AMDA Guidance, Resources, and Tools. If facilities are not certified under the Medicare and Medicaid programs and therefore not regulated by the CoPs, then the Executive Order on Ensuring Adequate COVID Safety Protocols for Federal Contractors or OSHA COVID-19 Healthcare Emergency Temporary Standard apply. The Order allows for two exemptions: (1) the worker is declining vaccination based on sincerely held religious beliefs or (2) the worker is excused from receiving any COVID-19 vaccine due to Qualifying Medical Reasons. Justice Department Announces Application Form for Marijuana Pardon Certificates, HERE IT IS: The Czars HUGE Breakdown of the FCC NPRM is NOW AVAILABLE to Everyone. Medicare covers the updated COVID-19 vaccine at no cost to you. Per CMS mandate, COVID vaccination required (unless approved for medical or religious exemption) PRN (As Needed) JOB SUMMARY. The federal regulation applies to the following individuals, both current and new, regardless of clinical responsibility or patient contact: The federal regulation applies to all the individuals in these groups, even if they perform duties offsite, as they may enter into a CMS-regulated facility during the course and scope of their employment and/or association with UTMB. CMS expects continue compliance with this requirement. Understaffed hospitals that don't want to lose employees to the Biden administration's Covid-19 vaccine mandate have an out. In addition, Phillip advises mass tort defendants and other entities in negotiating and resolving Medicare Secondary Payerand third party payer liabilities, including Medicare Secondary Payer requirements, MMSEA Section 111 reporting procedures, and You are responsible for reading, understanding and agreeing to the National Law Review's (NLRs) and the National Law Forum LLC's Terms of Use and Privacy Policy before using the National Law Review website. TheDepartment of Labors Occupational Safety and Health Administration (OSHA)developedan Emergency Temporary Standard (ETS) with COVID-19 vaccine requirementsfor employers with at least 100 employees. An example of a temple is The Safer Federal Workforce Task Force's "request for a religious exception to the The cost of waiting: COVID vaccine is now 65% effective, but still prevents major illness When we began this year, the Food and Drug Administration estimated that our COVID-19 vaccines were. In certain circumstances, Federal law may entitle a Federal employee who has a religious objection to the CO-19 VID Exemption forms also should include a time frame for the exemption (even if indefinite or permanent) and a confirmation that the practitioner signing the statement has an ongoing professional relationship with the individual seeking an exemption, and has not been engaged solely for the purpose of providing the exemption, AMDA stated. Under the amended CDC guidance, individuals 12 through 64 years of age and who are not moderately or severely immunocompromised may receive their second mRNA vaccine dose eight weeks after their first dose, instead of after three to four weeks. including forms. You can schedule online at, If you are already vaccinated (or are getting vaccinated between now and 11:59 p.m., April 19, 2022) but received your vaccine at a place other than UTMB Employee Health or UTMB Student Health,please email a scan of your COVID-19 Vaccination Form: GSA19R Request for a Religious Exception to the COVID-19 Vaccination Requirement Form is for GSA employee use only. NHSN allows for, and encourages, weekly submission of COVID-19 vaccination data via the Weekly COVID-19 Vaccination Module. This FAQ from OSHA answers questions about requirements in the COVID-19 vaccination and testing emergency temporary standard(ETS). Individuals should submit a complete exemption request as soon as possible. Theorder would have requiredall federal contractors and subcontractors tocomply with COVID-19 workplace safety guidance from the Safer Federal Workforce Task Force. As a result, UTMB is now required to comply with this federal regulation. What if an individual received a vaccine outside of the United States? This includes during meetings/classroom instruction and in all facility hallways, breakrooms, restrooms, elevators, etc. These requirevaccines or regular COVID-19 testing for many federal workers, federal contractors, and private employees. are not capable of being vaccinated due to religious beliefs, observances or practices may request an exemption. In granting such exemptions or accommodations, employers must ensure that they minimize the risk of transmission of COVID-19 to at-risk individuals, in keeping with their obligation to protect the health and safety of patients. Your patients may know these as updated COVID-19 vaccines: On August 31, 2022, the FDA amended the Pfizer-BioNTech (PDF) and Moderna (PDF) COVID-19 vaccine EUAs to authorize bivalent formulations of the vaccines for use as a single booster dose. Its Here The New National Cybersecurity Strategy. This Executive Order from President Biden requires all federal contractors to be vaccinated against COVID-19. Additionally, accrediting organizations will be required to update their survey processes to assess facilities they accredit for compliance with vaccination regulations. Facilities have the flexibility to establish their own processes that permit staff to request a religious exemption from the COVID-19 vaccination requirements. The vaccine remains available under EUA, including: Patients who are moderately or severely immunocompromised (have a weakened immune system) are at increased risk of severe COVID-19 illness and death. An exempted entity must submit written notice to the Comptroller in order to have the exemption renewed for no more than one additional year. House Bill 5106 fiercely opposed this and wants religious exemptions too. The OSHA ETS encourages vaccination by requiring employers to provide reasonable time and paid leave for employee vaccinations and any side effects. [5]CMS encourages facilities to review the Equal Employment Opportunity Commissions Compliance Manual on Religious Discrimination for more information on religious exemptions. The Department of Health and Aged Care website provides Australian Technical Advisory Group on Immunisation (ATAGI) Expanded Guidance on temporary medical exemptions for COVID-19 vaccines. The intent to terminate notice is a procedural requirement that must be met before UTMB terminates certain employees. [6]While CMS considered requiring daily or weekly testing of unvaccinated individuals, scientific evidence on testing found that vaccination is a more effective infection control measure. Businesses that receive state funds or who are licensed by the state are at risk of losing their contracts or licensureif they require proof of vaccination: (d) Notwithstanding any other law, each appropriate state agency shall ensure that businesses in this state comply with Subsection (c) and may require compliance with that subsection as a condition for a license, permit, or other state authorization necessary for conducting business in this state. How Do Religious Exemptions Work? Attorney Advertising Notice: Prior results do not guarantee a similar outcome. You can decide how often to receive updates. Would a physician with admitting privileges in one of UTMB's hospitals be covered under this regulation? The individual named above is seeking a medical exemption to the requirement for COVID-19 vaccination or a delay because of a temporary condition or medical circumstance. Close more info about AMDA releases COVID-19 vaccine medical exemption request forms, guidance, McKnights Women of Distinction Awards and Forum, Providers pepper CMS with schizophrenia questions; agency cautions on MDS changes, Nursing home beds fell pre-pandemic, even as aged population exploded: researchers, Reach of AI, other tech will help SNFs reach seniors looking to avoid nursing homes: expert. It is now clear under federal employment law that employers can require workers to receive a Covid-19 vaccination. Coverage and Reimbursement of COVID-19 Vaccines, Vaccine Administration and Cost-Sharing under Medicaid, the Children's Health Insurance Program, and Basic Health Program resource toolkit For health & drug plans Billing, Coverage and Patient Information resource toolkit (PDF) UPDATED (4/6/2022) We're just part of the solution. Headvises and represents healthcare clients in a range of regulatory, operational, and licensing matters, including health information privacy and security compliance; fraud and abuse (Stark, AntiKickback, and SelfReferral issues); and healthcare compliance matters. Therefore, in accordance with this federal . For example, a third dose of mRNA vaccines is now recommended for individuals who are immunocompromised, and boosters are recommended or available for individuals who are 65 or older? On September 9, 2021, President Biden issued an executive order requiring all federal workers, a number exceeding 3.5 million, to be vaccinated by November 22, 2021. Under the CMSrule, employees of facilities that participate in Medicare and Medicaid willneed to be vaccinated against COVID-19 by February 28th, 2022. Finally, the regulation applies to physicians who have admitting privileges or are treating patients in-person within such facilities. Well update this toolkit as new information becomes available. H-2B Cap for Fiscal Year 2023 Is Met: A Supplemental Cap Increase As COVID-19 Emergency Waivers End, DEA Proposes to Expand Tele- How Employers Need to Prepare for the End of the COVID Public Health USPTO To Transition To Electronically Granted Patents In April 2023, Reductions in Force: Some High-Level Issues To Consider, CMS Streamlines Stark Law Self-Referral Disclosure Protocol (SRDP), The Alice Eligibility Two-Step Dance Continues, FTC is Talking Trash and Zeroing-in on Recyclable Claims, FTC Hosts Forum on Proposed Rule to Ban Noncompete Clauses. All medical exemption requests must include a completed medical certification from the individual's personal Equal Employment Opportunity Commission on Dec. 16, 2020. The CMS Rule"Medicare and Medicaid Programs: Omnibus COVID-19 Health Care Staff Vaccination" Facilities covered by this regulation must establish a policy ensuring all eligible staff have received the first dose of a two-dose COVID-19 vaccine or a one-dose COVID-19 vaccine prior to providing any care, treatment, or other services by . This news article from Reuters explains the U.S. Supreme Court's rulings on the COVID-19 vaccine requirements for large businesses and certain types of healthcare workers. 2105 to be vaccinated against COVID-19, with exceptions only as required by law. Specifically, staff . Which ASC chain has the most surgery centers? Glenn Youngkin is requesting an exemption to a federal rule requiring many health care workers to be vaccinated against COVID-19. However, it is permissible to receive a COVID-19 vaccine outside of the United States. UTMB has established a Religious Exemption Committee to review all requests for a religious exemption. Examples of these facilities include nursing homes, hospitals, dialysis facilities, ambulatory surgical settings, and home health agencies. 21A240 (Jan. 13, 2022). pay. California Law May Limit Hospitals Ability to Adopt The Joint Ankura CTIX FLASH Update - February 28, 2023, Ankura Cyber Threat Investigations and Expert Services. or authorized by the FDA, or who received a vaccine during their participation in a clinical trial. President Biden also issued Executive Order1404on September 9, 2021. 02/28/2022 04:30 AM EST. Exemptions: The CMS rules does provide limited exemptions to vaccination requirements. The National Law Review is not a law firm nor is www.NatLawReview.com intended to be a referral service for attorneys and/or other professionals. Copyright © 2023 Becker's Healthcare. Individuals whoare not capable of being vaccinated due to religious beliefs, observances or practices may request an exemption. The completion of a primary vaccination series for COVID-19 is defined in the rule as the administration of a single-dose vaccine (such as the Janssen (Johnson & Johnson) COVID-19 Vaccine), or the administration of all required doses of a multi-dose By January 4, 2022, all staff must be fully vaccinated unless they have been granted a lawful exemption. Missouri, the Centers for Medicare & Medicaid Services (CMS) issued guidance in QSO-22-09-ALL ("January 14 Memo") on application of the November 5, 2021, CMS interim final rule regarding COVID-19 vaccine immunization of staff among Medicare- and Medicaid-certified providers and suppliers ("Vaccine Rule") in 24 states that had previously been Mobile Arbeit und regionale Feiertage was gilt? The OSHA COVID-19 Employer Emergency Temporary Standard (for facilities with greater than 100 employees) applies to employers that are not subject to the preceding two regulations. House Energy & Commerce Subcommittee Holds Hearing on U.S. Hunton Andrews Kurths Privacy and Cybersecurity. https:// Copyright 2023 Becker's Healthcare. Licensed practitioners, including community physicians with UTMB privileges, If you are not vaccinated and not requesting an exemption, please get your vaccine as soon as possible. Share sensitive information only on official, secure websites. This documentation must contain all information specifying which of the authorized COVID-19 vaccines are clinically contraindicated for the staff member to receive and the recognized clinical reasons for the contraindications. If you would ike to contact us via email please click here. Questions? CMS Press Release: CMS Announces Relief for Clinicians, Providers, Hospitals and Facilities Participating in Quality Reporting Programs in Response to COVID-19 [PDF - 400 KB] CDC and CMS Issue Joint Reminder on NHSN Reporting Healthcare Facility HAI Reporting Requirements to CMS via NHSN Current and Proposed Requirements January 2019 [PDF - 300 KB] A third dose or booster shot is not required to be considered fully vaccinated. document.addEventListener( 'DOMContentLoaded', function () {const newsletterAsset = new HMIRegistration({ publicationId: 8, pubName: "McKnight's Long-Term Care", view: 'newsletter-asset', bootstrap: document.getElementById('newsletter-asset'), formType : "user-initiated",pubType: "business"});newsletterAsset.mount();}); Please login or register first to view this content. the COVID-19 vaccine mandate for federal contractors has been halted by a ruling from the . Supreme Court Clarifies the Meaning Salary Basis Under Federal OIRA Calls for Feedback on Recommendations to Encourage More FTCs One-Two Punch on Data Tracking and Health Privacy. Expanding Regulatory Reach over Intermediaries That May Constitute How to Value Digital Assets for Donation to Charity. Justice and Commerce Departments Announce Creation of Disruptive United States Department of Justice (DOJ), Biden Executive Order 14091 Strengthens Equity for Federal Agencies. To ensure maximum patient protection, all staff who interact with other staff, patients, residents, clients, or PACE program participants in any location beyond the formal clinical setting (such as homes, clinics, other sites of care, administrative offices, off-site meetings, etc.) NLRB Places New Limitations on Confidentiality and Non-Disparagement Settlement Will Benefit Many Aging-Out Children in the Green Card SEC Commissioner Discusses Reform to Regulation D, Massachusetts AG Settles Enforcement Action Against Auto Lender. You have been given an approved CDC-recommended temporary delay, allowing you the time to be safely vaccinated A medical exemption is allowed when a child has a medical condition that prevents them from receiving a vaccine. Even though vaccines have proven largely impotent in preventing COVID transmission, studies. If you are not fully compliant with the mandate by 11:59 p.m., April 19, 2022, your employment with UTMB will be terminated effective April 20, 2022. [1]CMS has also indicated that the vaccination requirements may under the circumstances apply to non-hospital employees when considering the frequency of presence, services provided, and proximity to patients and staff. What should an employee do if they were vaccinated at UTMB but received an email indicating we do not have a COVID-19 vaccination record on file for them? In a Monday statement, AMDA suggested how medical exemption forms might allow the most accurate determination of a requests validity. CMSs health and safety regulations do not cover providers of Home and Community-based Services. Which vaccines count toward the regulation? White House Requires Removal of TikTok App from FDA Withdraws Proposed Rule on General Principles for Food Standards New FAQs Dramatically Expand Scope of California Labor Contractor Today is the Day Dont Miss the Employer Deadline to Report to OSHA, PTO Seeks Comments on Role of Artificial Intelligence in Inventorship. CMS expects that staff will receive a vaccine licensed or authorized for emergency use by the Food and Drug Administration (FDA), which currently includes the Pfizer-BioNTech COVID-19 Vaccine (interchangeable with the licensed Comirnaty vaccine), Moderna Those requesting a medical exemption must also fill out a Medical Release Form: Medical Exemption Form ( Medical Exemption JAWS Version) This article from a law firm's blog discusses the status of vaccine mandates for various types of workers in the wake of the U.S. Supreme Court's decision. Information in this guide is subject to change at any time. fully compliantby 11:59 p.m., April 19, 2022. v. Missouri, et al., No. Candidate Exemption Request Form. wear a KN95 mask during all interactions with others. The Virginia Commissioner of Health said in August 2020 that he will mandate a COVID-19 vaccine for all Virginians barring only medical exemptions. This FAQ explains how government entities and businesses that receive public funding or licensing are prohibited from requiring customers to provide proof of COVID-19 vaccination status in order to receive service. If you received your first dose of a COVID mRNA vaccine before Jan. 31, 2022, you will need to receive the second dose by 11:59 p.m., April 19, 2022. Please note that the legal status of various vaccine requirements is being decided by the courts and is subject to change quickly. Circuit Court of Appeals. This letter from the TWC to Texas employers states that employers must comply with GA-40 and refrain from imposing COVID-19 vaccine mandates in the workplace. Student Exemption Request Form Telehealth Update: DEA Issues Long-Awaited Proposed Rule on Prescribing Controlled Navigating the FCC's Universal Service Program: Compliance Requirements for Service Providers, Financial Services: Use of Limitation-of-Liability Clauses in Fiduciary Relationships. See above for the appropriate form. Words With Friends, Part 1: Insurance Requirements and Contracts, Legislator Proposes To Expand CFL To Encompass "Commercial CERCLA PFAS Scope May Broaden To Many More PFAS, AI Avatar App is the Latest Target of BIPA Class Action Litigation. CMS emphasized its commitment to working with West Virginia and Virginia after governors of those states called for a limited waiver on the agency's COVID-19 vaccination mandate for healthcare . However, individuals who have completed the primary series for the vaccine Covered Facilities are required to track and securely document the vaccination of each staff member. These facilities are expected to report on the new COVID-19 Vaccination Coverage among Health Care Personnel quality measure from October 1, 2021 to December 31, 2021 as established in the various Fiscal Year 2022 payment rules. She serves as counsel to a broad range of clients, public and private, in both federal and state courts, as well as before administrative agencies, and alternative dispute resolution forums. An official website of the United States government For EEOC guidance regarding Can I be required to show proof of a COVID-19 test? For questions or assistance with submitting an exemption request, email covid_vaccine_exemption@utmb.edu. There are several lawsuits that may affect the status of these orders. Your patients may know these as updated COVID-19 vaccines: FDA-authorized bivalent (updated) booster, Pfizer-BioNTech: all patients 511 years old. Health care employees looking to skirt the federal vaccine mandate and claim a religious exemption need to do little more than submit a short request to human resources . The purpose of this policy is to promote important public health measures and facilitate the health and safety of the Tulane community and those within the broader New Orleans community. The mandate was issued Nov. 5, by CMS, and covers healthcare facilities who participate in the Medicare program. GT's The Performance Review Episode 19: Is the Fight Over AB 51 5 Reasons Community Associations Need an Attorney That Specializes in New York Proposes Regulatory Review and Approval of Material Health CMS Issues Long-Awaiting Medicare Advantage RADV Final Rule, Preventing the Use of Cryptocurrencies to Evade Sanctions. The University of Texas Medical Branch at Galveston, CDC Guidance Regarding Medical Exemptions, EEOC Guidance Regarding Religious Exemptions. The Centers for Disease Control and Prevention (CDC) breaks down the contraindications and precautions for people getting any of the COVID-19 vaccines. CMS expects that vaccine administration will occur within the United States for the majority of individuals and that those will receive a COVID-19 vaccine authorized for emergency use orlicensed by the FDA. Health Care Worker Vaccination FAQs. On August 19, 2022, the FDA amended the Novavax COVID-19 vaccine, AdjuvantedEUA to authorize the use for all patients 1217 years old. It also recommended not including the question of religious exemptions, as that issue is not in the jurisdiction of the medical director, the organization said. COVID-19 Vaccine, and the Janssen (Johnson & Johnson) COVID-19 Vaccine. In addition, the regulation does not apply to Medicaid home care services, such as Home and Community-based Services (HCBS) since these providers receive Medicaid funding but are not regulated as certified facilities. For purposes of this regulation, CMS currently considers individuals fully vaccinated if it has been two weeks or more since they completed a primary vaccination series for COVID-19. Individuals seeking a religious exemption will be notified in writing of the status If the For example, a construction crew working on a project at a facility and whose members share facilities used by staff, patients, and visitors would be subject to these requirements as well. The remedy for non-compliance among hospitals and certain other acute and continuing care providers is termination; however, CMSs goal is to bring healthcare facilities into compliance. Beginning Feb. 21, 2022, all employees, students, volunteers and suppliers/contractors who $12 Hourly. GA-40 (10/11/21), Texas Workforce Commission (TWC) Letter to Employers Regarding Executive Order GA-40, Section 418.173 of the Texas Government Code, Whos required to get vaccinated in Texas? Confidentiality and Non-Disparagement Agreements with Non-Supervisory USCIS Confirms It Will Accept Employment-Based I-485 Applications New Jersey Enacts Bill of Rights for Temporary Workers, DOJ Implements Nationwide Voluntary Self-Disclosure Program. CDC recommends that all people be vaccinated, regardless of their history of symptomatic or asymptomatic SARS-CoV-2 infection. CMS provided additional guidelines to mitigate the spread of COVID-19, and UTMB created a risk reduction plan to comply with this mandate requirement. As for what constitutes adequate documentation of vaccination, the following are acceptable: CDC COVID-19 vaccination record card (or legible photo of the card); documentation of vaccination from a healthcare provider or electronic health record; or state immunization information system record.
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