On or before October 1, 2021, the Commissioner of Public Health shall develop and make available on the Internet web site of the Department of Public Health a certificate for use by a physician, physician assistant or advanced practice registered nurse stating that, in the opinion of such physician, physician assistant or advanced practice registered nurse, a vaccination required by the general statutes is medically contraindicated for a person because of the physical condition of such person. The certificate shall include (1) definitions of the terms “contraindication” and “precaution”, (2) a list of contraindications and precautions recognized by the National Centers for Disease Control and Prevention for each of the statutorily required vaccinations, from which the physician, physician assistant or advanced practice registered nurse may select the relevant contraindication or precaution on behalf of such person, (3) a section in which the physician, physician assistant or advanced practice registered nurse may record a contraindication or precaution that is not recognized by the National Centers for Disease Control and Prevention, but in his or her discretion, results in the vaccination being medically contraindicated, including, but not limited to, any autoimmune disorder, family history of any autoimmune disorder, family history of any reaction to a vaccination, genetic predisposition to any reaction to a vaccination as determined through genetic testing and a previous documented reaction of a person that is correlated to a vaccination, (4) a section in which the physician, physician assistant or advanced practice registered nurse may include a written explanation for the exemption from any statutorily required vaccinations, (5) a section requiring the signature of the physician, physician assistant or advanced practice registered nurse, (6) a requirement that the physician, physician assistant or advanced practice registered nurse attach such person’s most current immunization record, and (7) a synopsis of the grounds for any order of quarantine or isolation pursuant to section 19a-131b.