Health officials remind parents of vaccine requirements

JACKSON, Tenn. — As we get closer to the upcoming school year, health officials are reminding parents about vaccination requirements for students.

If your child does not have their shots updated in time, they may not be allowed to attend school.

Kindergartners or children enrolling in a Tennessee school for the first time must show proof of immunization records. Some students may qualify for exemptions, such as a medical or religious exemption.

Students with medical exemptions must provide the school with documentation from their medical provider. Religious exemptions require a signed statement by the parent that vaccinations conflict with the family’s religious practices.

Below is a summary of the required immunizations for childcare facilities and schools as listed on the Tennessee Department of Health website.

Children enrolling in child care facilities, pre-school, pre-Kindergarten

Infants entering child care facilities must be up to date at the time of enrollment and are required to provide an updated certificate after completing all of the required vaccines due no later than 18 months of age.

Hepatitis B (HBV)
Diphtheria-Tetanus-Pertussis (DTaP, or DT if appropriate)
Poliomyelitis (IPV or OPV)
Haemophilus influenzae type B (Hib) – age younger than 5 years only
Pneumococcal conjugate vaccine (PCV) – age younger than 5 years only
Measles, Mumps, Rubella – 1 dose of each, normally given together as MMR
Varicella – 1 dose or credible history of disease
Hepatitis A – 1 dose, required by 18 months of age or older
12th Grade Immunization Requirements

Children enrolling in Kindergarten

Hepatitis B (HBV)
Diphtheria-Tetanus-Pertussis (DTaP, or DT if appropriate)
Poliomyelitis (IPV or OPV) – final dose on or after the 4th birthday
Measles, Mumps, Rubella – 2 doses of each, usually given together as MMR
Varicella – 2 doses or credible history of disease
Hepatitis A – total of 2 doses, spaced at least 6 – 18 months apart

All children entering 7th grade (including currently enrolled students)

Tetanus-diphtheria-pertussis booster (Tdap) – evidence of one Tdap dose given any time before 7th grade entry is required regardless of Td history
Varicella – 2 doses or credible history of disease
Update to 7th Grade Chickenpox (Varicella) Immunization Requirements

Children who are new enrollees in a TN school in grades other than Kindergarten

Hepatitis B (HBV)
Diphtheria-Tetanus-Pertussis (DTaP, or DT if appropriate)
Poliomyelitis (IPV or OPV – final dose on or after the 4th birthday
Measles, Mumps, Rubella – 2 doses of each, normally given together as MMR
Varicella – 2 doses or credible history of disease
New students entering grades other than 7th grade are not required to have Tdap

Children with medical or religious exemption to requirements

Medical – Physicians (MD or DO) or Public Health Nurses are authorized to indicate specific vaccines medically exempted (because of risk of harm) on the certificate. Other vaccines remain required. The medical reason for the exemption does not need to be provided.

Religious – This exemption requires a signed statement by the parent/guardian that vaccination conflicts with their religious tenets or practices. If the child needs documentation of a health examination for the school, it must be noted by the healthcare provider on the immunization certificate. In that case, the provider should check the box in section 1a. that the parent has sought a religious exemption to explain why immunization information is absent or incomplete.

Minimum ages or dose intervals – Tennessee follows published CDC guidelines. For vaccines with critical minimum age requirements (e.g., MMR, varicella) or minimum dose intervals, doses are considered valid if given up to 4 days before the minimum age or dose interval. Doses administered more than 4 days early are considered invalid and should be repeated as recommended.

Injectable or nasally administered live vaccines not administered on the same day should be administered at least 4 weeks apart. The 4-day “grace period” should not be applied to the 28-day interval between injectable or nasally administered live vaccines not administered at the same visit. If injectable or nasally administered live vaccines are separated by less than 4 weeks, the second vaccine administered should not be counted as a valid dose and should be repeated. The repeat dose should be administered at least 4 weeks after the last invalid dose.

Alternative proof of immunity for certain diseases – A positive serology (year of test documented) is acceptable as an alternative to immunization for measles, mumps, rubella, hepatitis A, hepatitis B or varicella. For varicella, documentation of provider diagnosed varicella or provider-verified credible history of disease given by a parent or guardian also is acceptable. By documenting a history of disease, the provider is asserting that he or she is convinced that the child has had chickenpox.

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