What to Know About Daycare Vaccine Requirements

Enrolling your child in daycare comes with paperwork, and vaccine requirements are usually part of it. Almost every licensed daycare and preschool in the U.S. requires proof that your child is up to date on certain vaccinations before the first day. Here is what that means for your family, what paperwork you will need, and what to do if your child is not caught up yet.

Why daycares ask about vaccines

In most cases, it is not the daycare's choice. State licensing rules require child care programs to keep immunization records on file for every enrolled child, and programs that skip this can face fines or lose their license. 

The rules exist for a good reason. Child care settings bring lots of young children into close contact, which makes it easy for illnesses to spread. Some children in the classroom may be too young to be fully vaccinated, or they may have medical conditions that prevent vaccination, so requirements help protect the most vulnerable kids in the room.

Which vaccines are usually required

Requirements vary by state, and the exact list depends on your child's age. Most states require documentation for the same core set of childhood vaccines:

• DTaP: protects against diphtheria, tetanus, and pertussis (whooping cough)
• Polio (IPV)
• MMR: measles, mumps, and rubella
• Hib: Haemophilus influenzae type b
• Hepatitis B
• Varicella: chickenpox
• Pneumococcal (PCV)

Some states also require hepatitis A or annual flu shots for child care attendance. 

The paperwork you will need

Before your child's first day, the daycare will need documentation on file. That is usually at least one of the following:

1. An immunization record showing your child is up to date for their age. You can get this from your pediatrician's office, and many states let you print it yourself from the state immunization registry.
2. A catch-up plan signed by your child's health care provider, if your child is in the process of getting caught up on missing doses.
3. An exemption certificate, if your child has an exemption (more on that below).

In most states, a child without the required documentation on file can be turned away until it is provided, so do not leave this for the night before. It is not one-and-done either. You will need to hand over updated records periodically.

What if your child is not fully vaccinated yet?

It happens more often than you might think. Families move, appointments get missed, or a baby starts daycare before finishing the full series. If that is your situation:

• Talk to your pediatrician early, ideally as soon as you start the enrollment process. They can map out a catch-up schedule and give you the documentation the daycare needs.
• Ask the daycare exactly which form they want. Some programs just need the immunization record. Others have their own health form for your pediatrician to fill out.
• Keep a copy for yourself. You will reuse that record for preschool, kindergarten, camps, and sports for years to come.

What about exemptions?

Every state allows medical exemptions when a doctor determines a vaccine is not safe for a particular child. Rules for nonmedical exemptions, such as religious or personal-belief exemptions, vary widely. Some states allow them with a signed form. Others, like California, do not allow personal-belief exemptions for child care entry at all. If this applies to your family, check your state health department for the current rules and the exact paperwork required.

Questions worth asking the daycare

While you are sorting out the paperwork, it is a good moment to ask about the program's health policies overall. If you are still in the touring phase, here are some of the things you can ask:

• What is your illness exclusion policy: when do sick kids need to stay home, and when can they come back? 
• How do you notify families about contagious illnesses going around the classroom?
• Are flu or COVID vaccines required here, or just recommended?

A few practical tips

• Start early. Request the immunization record when you enroll, not the week before your start date.
• Keep records somewhere you can find them. An electronic copy you always have access to is a great idea.
• When in doubt, call your pediatrician's office. They handle these requests every day and can usually turn one around quickly.