• Quick Guide
• Detailed Vaccine-Specific Requirements
• Exemptions
• Parent's Responsibility
• School Records

Quick Guide

* Please read below for further information.

Detailed Vaccine-Specific Requirements

The North Carolina General Statutes (G.S. 130-A-152(a)) require immunizations for every child present in this state. Every parent, guardian or person in loco parentis is responsible for ensuring that their child(ren) receive required immunizations. If you have specific questions regarding your child, please contact your child's health care provider or your local health department. North Carolina requires the following immunizations:

Diphtheria, tetanus and pertussis

Five doses. Three doses by age seven months and two booster doses, one by age 19 months and the second dose on or after the fourth birthday and before enrolling in school for the first time. If the fourth dose was administered on or after the fourth birthday, the fifth dose is not required.

A booster dose of tetanus/diphtheria/pertussis vaccine is required for individuals attending public school who are entering the sixth grade on or after August 1, 2008, if five years or more have passed since the last dose of tetanus/diphtheria toxoid. A booster dose of tetanus/diphtheria/pertussis vaccine is required for individuals not attending public schools who are 12 years of age on or after August 1, 2008, if five years or more have passed since the last dose of tetanus/diphtheria toxoid. However, pertussis vaccine is not required for individuals between 7 years of age through the fifth grade for those attending public schools and 7 through 12 years of age for those not attending public schools.

Polio

Four doses. Two doses by age five months, a third dose by 19 months of age and a booster dose before enrolling in school for the first time. If the third dose was administered on or after the fourth birthday, the fourth dose is not required.

Measles

Two doses. One dose on or after 12 months of age and before 16 months of age and a second dose before enrolling in school for the first time. As long as the doses are separated by at least 28 days, the second dose may be given at any time before beginning school. A person who has been diagnosed prior to January 1, 1994 by a physician as having measles or an individual who has documented laboratory results of a protective antibody titer against measles is not required to receive vaccine. Lacking such proof, vaccination is required.

Mumps

Two doses. One dose on or after 12 months of age and before age 16 months and a second dose before enrolling in school for the first time. A physician's diagnosis is not acceptable for mumps disease(s). The person must be immunized or have documented laboratory results of a protective antibody titer against the specific disease.

Rubella

One dose on or after 12 months of age and before 16 months of age. A physician's diagnosis is not acceptable for rubella disease(s). The person must be immunized or have documented laboratory results of a protective antibody titer against the specific disease.

Haemophilus influenzae type b (Hib)

Three doses of HbOC or two doses of PRP-OMP by age seven months and a final dose of any type on or after age 12 months and by age 16 months. Persons who receive the first dose of Hib on or after 12 months of age and before 15 months of age are required to have only two doses. Persons who received the first dose of Hib vaccine on or after 15 months of age are required to have only one dose. Persons who have passed their fifth birthday are not required to be vaccinated against Hib.

Note - Due to the shortage of Hib vaccine caused by manufacturing issues, the requirement for a booster dose of Hib vaccine on or after the age of 12 months has been temporarily suspended, until further notice. (1/18/08)

Hepatitis B

Three doses. One dose by age three months, second dose by age five months and a third dose by age 19 months. Persons born on or after July 1, 1994 are required to receive the hepatitis B vaccine. The last dose of hepatitis B vaccine series shall not be administered prior to 24 weeks of age.

Varicella

One dose. One dose of varicella vaccine - on or after 12 months of age and before age 19 months - is required for children born on or after April 1, 2001. However, an individual with laboratory tests showing immunity or a history of chickenpox documented by a health care provider, parent, guardian or person in loco parentis shall not be required to receive varicella vaccine. Documentation of prior history of chickenpox disease must be on or attached to the lifetime immunization card or certificate of immunization. Ask your health care provider for more information.

Exemptions 

There are two exemptions to required immunizations.

• Medical Exemptions - An exemption is permitted for medical reasons when a physician determines that an immunization is or may be harmful to a student for a specific reason. Valid medical exemptions must be written and signed by a physician licensed to practice medicine in North Carolina. The medical exemption must correspond to those medical contraindications specified in the N.C. Immunization Rules or an approved Rules' exception approved by the State Health Director. These physician statements must be maintained in the student's permanent record and at minimum must indicate the following - basis of the exemption; specific vaccine(s) the child should not receive; and length of time the exemption will apply for the child.
  
• Religious exemptions - Parent(s), guardian or person in loco parentis who have a bona fide religious objection to immunization requirements must place a signed statement on file in the student's permanent record. An objection based upon a "scientific" belief (i.e. a foreign substance or chemical may be harmful) or non-religious personal belief or philosophy (i.e. clean living, fresh air, pure water) is not considered to be a religious exemption and is not allowed under North Carolina law.
  
  A written statement must be maintained in the student's record containing, at a minimum, the following - student's name; parent(s), guardian's or person in loco parentis statement of bona fide religious objection; and parent(s), guardian or person in loco parentis signature and date signed. (If a student is at least 18 years old, his/her statement and signature are required.)

See also the Exemptions from Immunizations page.

Parent's Responsibility

Parents must present a Certificate of Immunization to the school principal for each child attending school - public, private or religious - on the first day of attendance. All children entering kindergarten in public schools are required to present the completed Kindergarten Health Assessment Report on or before the first day of attendance as required by General Statute (G.S.) 130A-440.

School Records

It is important to make every attempt to locate and maintain your child's immunization record. It is a legal document.

If you have been unsuccessful in locating your child's immunization record, the vaccination series must be restarted. An accelerated schedule is available at your local health department or physician's office.

See also the How to Find an Immunization Record page.

Last Updated: March 8, 2010

The purpose of this web site is both educational and informative.
Personal medical advice should be sought from your local health department or physician.

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