Get Immunizations in Order Before School

Because North Carolina mandates up-to-date vaccinations before children start school, the state is among the top 10 nationwide in the percentage of 2-year-olds receiving all age-appropriate immunizations.

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All children who live in North Carolina are required by state law to receive immunizations before starting school, making parents and guardians responsible for ensuring their children receive the required vaccinations.

“According to national statistics, North Carolina is one of the top 10 states leading the nation in the percentage of 2-year-old children who have received all age-appropriate immunizations,” says Amanda Dayton, spokeswoman for the Immunization Branch of the state Department of Health and Human Services.

Students attending child-care centers, schools and colleges or universities – public, private or religious – are required to present an immunization record. There are medical and religious exemptions to the required immunizations, but Dayton says relatively few parents use these exemptions.

For the 2006-07 school year, the state had 120,425 kindergarten students. Statewide, there were 525 religious exemptions and 128 medical exemptions. In the 2005-06 school year, there were 110,764 kindergarten students with 335 religious exemptions and 99 medical exemptions.

An exemption is permitted for medical reasons when a physician determines that an immunization is or may be harmful to a student for a specific reason. The valid medical exemption must be written and signed by a physician.

Parents who have a bona fide religious objection to the immunization requirements must place a signed statement on file in the student’s permanent record. According to the state requirements, an objection based upon a “scientific” belief or a nonreligious personal belief or philosophy isn't considered to be a religious exemption and isn't allowed under North Carolina law.

Before entering kindergarten, North Carolina students are required to receive the following vaccines:

  • Five doses for diphtheria, tetanus and pertussis
  • Four doses for polio
  • Two doses for measles
  • One dose for mumps
  • One dose for rubella
  • Four doses for haemophilus influenzae type B (Hib)
  • Three doses for hepatitis B
  • One dose for varicella (chicken pox)
“While the immunizations are required for all children in the state, the first time the state is able to monitor this is when the child registers for school,” Dayton says.

If the immunizations aren't current, the schools must notify the parents or guardians that they have 30 days from the first day of attendance to present the required immunization record for the child. As long as the child is on an accelerated schedule of immunizations, he may remain in school while completing the process.

Parents who need more than 30 days to catch up with vaccinations must provide a physician’s written statement indicating the date when the immunizations will be given. If the immunizations aren't current within the time period, the child will not be allowed to stay in school, according to state requirements.

A student who received immunizations in another state must present an official immunization record to the child-care facility, school, college or university. If an immunization record cannot be provided, the student must be re-vaccinated at an age-appropriate, accelerated schedule to the minimum requirement.

For more information on North Carolina immunization requirements, visit

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