| Vaccine Requirements for
School Entry
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, please contact your 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 with one dose being after 15 months of
age. 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 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.
Certificate of Immunization
A physician, health clinic or local health department administering
required vaccines must give a Certificate of Immunization to the
person who presented the child for immunization. The certificate/record
must include the following information:
- name, sex and date of birth;
- name and address of parent or guardian;
- number of vaccine doses given;
- date vaccines were given (month and year
is acceptable for out-of-state transfer students); and
- signature of physician or health department
stamp.
Responsibility for Enforcement
G.S. 130A-155 specifically holds the principal responsible for
enforcing state immunization laws for school entry.
The school must notify the parent(s), guardian or person in loco
parentis that they have 30 calendar days from the first day of
attendance to present the required up-to-date immunization record
for the child. If the child's immunizations are not up-to-date,
the required immunizations must be obtained within the same 30
day period.
At the end of the 30 calendar day period, any child without a
Certificate of Immunization showing that the child has received
the required vaccines shall be prohibited from attending school
until he/she provides a Certificate of Immunization as required
by law or shows that he/she has begun the immunization process.
When Immunizations are "In
Process"
As long as a child is on an accelerated schedule of immunizations,
he/she may remain in school while completing the immunizations.
To support the need for additional time (beyond the 30 day period),
the parent(s), guardian or person in loco parentis must provide
a physician's or health department's written statement which indicates
the date when immunizations will be administered. This documentation
indicates that the child is in process and he/she will be allowed
to remain in school as long as the child receives the required
vaccine(s) as scheduled.
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.
School Records
The school is required to maintain immunization records which
contain information required for a Certificate of Immunization
for all children attending the school. The school should keep
a separate listing of students having medical or religious exemptions.
These children may be excluded from attending school in the event
of an outbreak.
When a record of immunization cannot be provided, the student
must be revaccinated at an age-appropriate, accelerated schedule
to the minimum requirement by law.
G.S. 130-155(b) requires North Carolina schools, upon request,
to send a copy of the child's immunization record at no charge
to the student's new school. The former school shall forward a
child's immunization record regardless of status of fees owed
to the school.
Transfers
- In-state transfer students - A new/transfer
student is not considered "in process" if it takes
more than 30 calendar days from the first day of attendance
to obtain their records from another school.The parent(s),
guardian or person in loco parentis should be informed on
the first day of attendance that they have 30 calendar days
to submit an immunization record for their child.
- Out-of-state transfer students - A person who received immunizations
in a state other than North Carolina must present an official
certificate or record of immunization to the child care facility,
school (K-12) or college or university. This certificate or
record must state the person’s name, address, date of
birth, and sex; the type and number of doses of administered
vaccine, the dates of the first MMR and the last DTP and polio,
the name and address of the local physician or local health
department administering the required immunizations and any
other information required by the North Carolina Immunization
Rules.
See also the How to Find an Immunization
Record page. |
