US school entry immunization requirements summarized across major states

The first time I stood at a school registrar’s counter with a folder of vaccine records, I felt like I was translating a language I sort of knew but had never spoken out loud. Every state seemed to have the same melody—DTaP, polio, MMR, varicella, and friends—yet each sang a slightly different verse about forms, timing, and what counts as proof. I wanted a clear, human summary I could read like a travel guide before a cross-country move. So I started collecting notes the way I do for trips: what’s universal, what’s state-specific, and where to double-check the details when rules change.

The pattern underneath fifty different checklists

Once I zoomed out, a few threads helped the whole thing click. First, school entry requirements come from state law and health department rules, not your pediatrician’s office. Your clinician follows the national schedule, but the school verifies against its state’s entry rules. A good “north star” is the CDC’s SchoolVaxView portal, which keeps tabs on state policies and coverage; I bookmarked it so I always have a bird’s-eye view and a launch point to state pages—see the CDC overview here.

• Universal core set: DTaP/Tdap, polio, MMR, varicella, and hepatitis B are the backbone for K–12. Child care adds Hib and often pneumococcal; some states include hepatitis A at younger ages.
• Grade-triggered checks: Kindergarten entry and the 7th-grade Tdap booster are the two big “gateways” where schools re-verify records.
• Documentation matters as much as doses: States name the form and the source that must sign it. Some require a specific state certificate or an electronic registry printout.

How four major states actually do it

Here’s the practical, parent-level version I wish I had on one page. I’m focusing on California, Texas, New York, and Florida because together they cover a huge share of US students and illustrate the range of approaches. I’ve linked to the official, living pages so you can check what’s current before you register.

• California — The state keeps a very clear public site for schools and families. Personal belief exemptions were eliminated several years ago; new medical exemptions run through the CAIR-ME system and must meet accepted criteria. There’s also a formal “conditional admission” pathway if a child has begun but not completed series, with 30-day reviews until fully up to date. Start with the state hub Shots for School and, for rules on medical exemptions and conditional admission, see the state FAQs Medical Exemptions and Conditional Admission.
• Texas — Requirements apply to public and private schools, with details by grade level. Texas allows medical exemptions and “reasons of conscience” affidavits (which include religious beliefs). There is “provisional enrollment” if the student has started but not finished series, with a 30-day check-in cadence. The state page is a good hub: Texas DSHS School Requirements. For the nitty-gritty on provisional enrollment, Texas cites the administrative code with the 30-day review requirement.
• New York — Since 2019, only medical exemptions are permitted for K–12; religious exemptions were repealed. New York publishes an annual school year requirement chart and plain-language guidance. The go-to starting point is the NYS Department of Health’s page: School Vaccination Requirements, with the current year’s PDF posted there each summer.
• Florida — Florida is very form-specific. Schools expect the DH 680 (Florida Certification of Immunization) for proof, which many clinics can e-certify through Florida SHOTS; religious exemptions use DH 681 and must be issued by the county health department. The state’s immunization requirements and documentation rules are here: Florida School Immunization Requirements and the DH 680 documentation page Documenting Immunizations. For the religious exemption form, see the DH 681 overview on the state site.

What I actually gather before showing up at registration

I think of this like packing cubes for a trip. One cube is the records, one is the forms, and the last is “proof that my proof is allowed.” That last part sounds funny, but it’s the #1 thing that saves me time—making sure the school accepts the exact document I’m planning to hand over.

• A complete shot record with dates (month/day/year) for each dose, preferably printed or signed by the clinic or pulled from a state immunization registry. If moving states, I request a stamped copy from our pediatrician for clarity.
• The specific state certificate if one is required (e.g., Florida’s DH 680). For Florida, the state explains DH 680 and who can issue it on this official page.
• Clinician contact info in case the school nurse needs to verify something quickly.
• Translations if any records are in another language—some schools ask for an English translation; I keep a clean, typed copy with original dates.
• Proof of disease history (varicella) if the state accepts it. Many states accept a provider’s diagnosis or lab proof; self-attestation is often not enough.

Conditional and provisional enrollment without getting stuck

Both California and Texas (and several other states) allow a student to start school if they’ve begun the required series and aren’t currently due for a dose, but there’s a catch: schools must review the record every 30 days and exclude students who fall behind. California spells this out clearly and gives schools a review schedule (see the state’s Conditional Admission guidance). Texas uses the term “provisional enrollment”; the state points to the Texas Administrative Code for the 30-day review requirement and the “exclude if overdue” rule (linked from the DSHS school page).

• Put the review date in your calendar as soon as you register.
• Ask the clinic for the next-dose due date and schedule ahead.
• Bring an updated record (or new state certificate) before the review window closes so there’s no last-minute scramble.

Exemptions, carefully and correctly

I’m not here to argue anyone’s preferences; I’m here to help you follow the rules as they actually exist so your child can enroll without surprises. The big differences:

• California and New York permit medical exemptions only for K–12. California requires new medical exemptions to be issued through its CAIR-ME portal and may review them; New York reaffirmed the repeal of religious exemptions in 2019. You can read California’s exemption logistics on the state page here and New York’s announcement and FAQs via the Department of Health statement.
• Texas permits medical and “reasons of conscience” exemptions (including religious). The affidavit process and acceptable documentation are outlined from the DSHS school page.
• Florida permits religious exemptions using Form DH 681, issued by a county health department; proof of immunization (DH 680) or a valid exemption must be on file. The state explains the DH 681 process on this official page about exemptions, linked from the school immunization hub.

One more practical note: in any state, unvaccinated students may be temporarily excluded during an outbreak of a vaccine-preventable disease, even if they have an allowed exemption. Schools don’t love doing this; they’re required to.

Why the national schedule still matters

States write the school rules, but they lean heavily on the national immunization schedule recommended by the Advisory Committee on Immunization Practices (ACIP). That’s why the language can sound familiar across state lines—“on or after the first birthday,” “Tdap at grade 7,” minimum intervals—because the legal text references those clinical timing rules. I like to sanity-check confusing timing against the CDC’s plain-English materials and then confirm the state’s school-entry version. The CDC’s SchoolVaxView has become my “home button” for that flow.

Real-life friction points I’ve learned to avoid

• Old record, new rules: A dose could “count” clinically but miss a school timing rule (for example, a first MMR given a few days before the first birthday). When in doubt, I compare the dates against the school chart for that state.
• Different names across documents: If your child uses a nickname in one system and a legal name in another, align everything (and bring proof) to make verification quick.
• Varicella by history: If a state allows disease history instead of vaccination, they usually require a provider to document the diagnosis or lab result. I don’t assume a parent note will suffice.
• Mid-year transfers: California explicitly allows a short grace period while records transfer, but you’ll still need to meet the requirements; keep a copy of everything before you move.

A five-minute pre-registration checklist

• Find your state’s official page and skim the K–12 chart (links above).
• Collect a signed, date-complete immunization record—or the state certificate your new school expects.
• Note any grade-specific items (e.g., Tdap at 7th grade) and calendar the due date.
• If you’re using provisional/conditional admission, book the next dose now and set a reminder for the 30-day review.
• If requesting an exemption, use the exact process and forms described by the state (e.g., DH 681 in Florida, CAIR-ME for a medical exemption in California).

State-by-state snapshots in one breath

California: tight alignment to the schedule, no nonmedical exemptions, formal conditional admissions with 30-day reviews, and a dedicated hub for schools and parents. Texas: clear charts by grade, medical and reasons-of-conscience exemptions, provisional enrollment with 30-day follow-ups, and explicit acceptable documentation rules. New York: medical-only exemptions since 2019, yearly requirement charts, close adherence to dose timing. Florida: DH 680 for proof, DH 681 for religious exemption via local health departments, and a strong emphasis on using the statewide registry for e-certified forms. Different flavors, same melody.

What I’m keeping and what I’m letting go

I’m keeping a simple rule: start with the state’s official page, then pack my paperwork to match. That trims the stress better than any hack I’ve tried. I’m also keeping the habit of setting calendar nudges for the next-dose due dates and the school’s review windows. And I’m letting go of the idea that there’s a single “US list”—there isn’t. There’s a common core and a local rulebook, and both deserve a quick read.

FAQ

1) Do states require the COVID-19 vaccine for K–12?
Answer: As of now, most states—including the four summarized here—do not list COVID-19 vaccine among routine K–12 entry requirements, though guidance can evolve. Always verify on your state’s official school immunization page before registering.

2) My child had chickenpox. Do we still need the varicella shot?
Answer: Many states accept provider-documented disease history or lab evidence of immunity instead of vaccination; parent self-report is usually not enough. Check the wording on your state’s chart and ask your clinician to document appropriately if eligible.

3) We just moved from another country. Will our record count?
Answer: Schools accept valid records with dates, and many will ask for an English translation. Doses must match US timing rules (minimum ages/intervals), so a catch-up plan may be needed. Bring the original record, a translation, and your clinician’s contact.

4) What happens during an outbreak if my child has an exemption?
Answer: Schools may temporarily exclude students without proof of immunity (including those with allowable exemptions) during outbreaks of vaccine-preventable diseases. The goal is to limit spread; the exclusion ends when it’s safe to return.

5) Is meningitis vaccine required for older students?
Answer: For K–12, meningococcal ACWY is commonly recommended but not always a K–12 legal requirement. However, many states (for example, Texas) require proof of a recent meningococcal vaccine for college entry. Check your state’s higher-education rules if you have a graduating senior.

Sources & References

• CDC — SchoolVaxView (state policies & coverage)
• California — Shots for School (CDPH)
• Texas — School & Child-Care Vaccine Requirements (DSHS)
• New York — School Vaccination Requirements (NYSDOH)
• Florida — School Immunization Requirements (FL DOH)

This blog is a personal journal and for general information only. It is not a substitute for professional medical advice, diagnosis, or treatment, and it does not create a doctor–patient relationship. Always seek the advice of a licensed clinician for questions about your health. If you may be experiencing an emergency, call your local emergency number immediately (e.g., 911 [US], 119).