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Immunizations Required for School Attendance


Public Health Law Section 2164 and New York Codes, Rules and Regulations (NYCRR) Title 10, Subpart 66-1 require every student entering or attending public, private or parochial school in NYS to be immune to diphtheria, tetanus, pertussis (DTP), measles, mumps, rubella (MMR), poliomyelitis (IPV), hepatitis B, and varicella (chickenpox) in accordance with Advisory Committee on Immunization Practices (ACIP) recommendations. 

  • Students in grade 6-12 are also required to be vaccinated against pertussis with one dose of Tdap.

  • Students in grades 7-12 are also required to be vaccinated against meningococcal disease.

  • Students in preschool or prekindergarten are also required to be immune to Haemophilus influenzae type b (Hib) and pneumococcal disease (PCV).

Immunization Requirements for School Entrance/Attendance Chart 

Students may receive immunizations at no cost at the Monroe County Department of Public Health Immunization Clinic.

Students attending school must be up to date on required immunizations within 14 days of starting school or they will be excluded from school until documentation of receiving the delinquent immunizations is submitted to the school nurse.

Students who are not fully immunized must have at least one dose of every required vaccine with appointments scheduled to receive the remaining doses in the series in accordance with ACIP minimum spacing intervals before being permitted to attend school. Alternate schedules are not permitted per State law - see Key Points below.

If parents have any further questions, they may refer to the NYS Immunization Webpage or call the Bureau of Immunization for the NYS Department of Health at 518-474-1944.

Immunizations Certificate

Complete Immunization Certificates must be submitted to the Health Office before students start school and must contain:

  • Signature of health care provider
  • Name of the vaccine and month, day and year of injection
  • Valid doses administered in compliance with ACIP recommendations, in relation to number of doses and minimal interval spacing

Failure to provide proof of compliance with the required immunizations for school attendance will result in the student's exclusion from school until documentation is provided.

Medical Exemptions

Medical exemptions must be renewed annually by a NYS licensed physician and submitted to school nurse yearly. The district physician has final approval of all medical exemption requests.

The Medical Exemption Form must list the immunization exempted, the medical contraindication and the length of time the immunization is contraindicated. The healthcare provider must indicate that the immunization is detrimental to the student's health. The district cannot accept written letters from healthcare providers requesting a medical exemption. The request must be on the Department of Health form. Additional documents may be attached to the form, but the healthcare provider may not write: "see attached form" as the reason. Per the NYSDOH, reasons for medical exemptions cannot be accepted by the district unless they are in compliance with the ACIP Contraindications Guidelines

Serologic proof of immunity can be accepted ONLY for the following diseases: measles, mumps, rubella, varicella, and hepatitis B.  
A health care provider’s signed statement attesting to the diagnosis of varicella is acceptable proof of immunity for varicella.

  • Alternative immunization schedules are NOT acceptable. 
  • After the minimum spacing interval, follow-up doses of the series must be administered within 14 days if the series is required for the student's grade level. 
  • Failure to receive the follow-up doses required for grade level within 14 days of minimal spacing will result in exclusion from school and notification sent to the Monroe County Department of  Public Health.
  • Titers proving positive immunity are only accepted for: MMR, Hep B, and Varicella.  The DOH does not recommend titers after 1st dose.  
  • To be considered "In Process" and permitted to attend school, students must submit proof of both:
  1. Receiving  at least* one dose of all the immunizations required for that grade level before starting school.   AND
  2. Scheduled appointments to receive all of the follow-up doses of the required series within the 14 grace period of the minimal spacing interval.  If the schedule in not in accordance with ACIP guidelines, the student may not attend school until an acceptable schedule is provided.

*If the vaccine is required for grade level, it is due within 14 days of the minimum spacing interval or within 14 days of starting school. 

Students who are not fully vaccinated should contact their school nurse to determine which immunizations are needed based on their age and grade level. Immunizations may be scheduled with the child’s primary healthcare provider. Alternatively, in Monroe County, immunizations may be obtained at The Monroe County Immunization Program, 111 Westfall Road, Rochester, NY 14620; phone (585) 753-5150. There is no out of pocket cost for immunizations for children under the age of 18.

Disease Outbreak Exclusion

In the event that the Monroe County Public Health Department determines an outbreak of diphtheria, polio, measles, rubella or mumps is present in a school, all students in that school without documentation of immunity, including those with medical exemptions, will be excluded from school until the outbreak is deemed resolved by the MCPHD. This exclusion could last as long as 28 days.

Understanding Vaccines

For evidence-based information about vaccines, please refer to the following documents Understanding Vaccines and Vaccine Safety.

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