School Nurse

Tennessee Immunization Requirements for Child Care & School

Tennessee Department of Health Rule Chapter 1200-14-1-29

For the first time in 10 years, the Tennessee Department of Health (TDOH) has changed and updated its immunization requirements for child care, pre-school, and school entry. The effective date of most changes is July 2010. Detailed official guidance, including the immunization schedule and the new Immunization Certificate, will be made available no later than April 1 online at http://health.state.tn.us/twis/ or at the TDOH website: http://health.state.tn.us/CEDS/required.htm

Children in Child Care Facilities (new requirements underlined):

  • Diptheria-Tetanus-Pertussis (DTap, or DT if appropriate)
  • Hepatitis B (HBV)
  • Poliomyelitis (IPV or OPV)
  • Haemophilus influenzae type B (Hib): age younger than 5 years only (this requirement is reseumed following suspension during a national Hib vaccine shortage 2008-2009)
  • Pneumococcal conjugate vaccine (PCV): age younger than 5 years only
  • Measles, Mumps, Rubella (1 dose of each, usually given together as MMR)
  • Varicella (1 dose or history of disease
  • Hepatitis A (1 dose by 18 months of age)

Children entering Kindergarten (new requirements underlined):

  • Diptheria-Tetanus-Pertussis (DTap, or DT if appropriate)
  • Hepatitis B (HBV)
  • Poliomyelitis (IPV or OPV): final dose on or after the 4th birthday now required
  • Measles, Mumps, Rubella (2 doses of each, usually given together as MMR)
  • Varicella (2 doses or history of disease): previously only one dose was required
  • Hepatitis A (2 doses): effective July 1, 2011

Children entering 7th grade (new requirements underlined):

  • Tetanus-diptheria-pertussis booster ("Tdap")
  • Verification of immunity to varicella (2 doses or history of disease)

Children who are new enrollees in a TN school in grades other than K or 7th:

  • Diptheria-Tetanus-Pertussis (DTaP, or DT if appropriate)
  • Hepatitis B (HBV): previously only for Kindergarten, 7th grade entry
  • Poliomyelitis (IPV or OPV): final dose on or after the 4th birthday now required
  • Measles, Mumps, Rubella (2 doses of each, usually given together as MMR)
  • Varicella (2 doses or history of disease): previously only one dose was required

Children with medical or religious exemption to requirements:

  • Medical: Healthcare provider must indicate which specific vaccines are medically exempted (because of risk or harm) on the new form. Other vaccines remain required.
  • Religious: Requires only a signed statement by the parent/guardian that vaccination conflicts with their religious tenets or practices. If documentation of a health examination is required, it must be noted by the health care provider on the immunization certificate. In that case, the provider may explain the absence of the immunization information by checking that the parent has obtained a religious exemption.
 

Last updated February 2, 2010