Immunization Requirements for Child Care and TK/K-12 Schools

Vaccines are safe and effective and help provide immunity before children are exposed to potentially life-threatening diseases. Children attending public or private child care facilities and schools in California are required to have certain vaccines. Visit the links below to learn about vaccine requirements for children, staff, and volunteers in child care and TK/K-12 school settings, as well as information on this page about immunization laws, exemptions and the California Immunization Registry (CAIR2).

On this page: Immunization Laws | Immunization Exemptions | California Immunization Registry

Find Information and Resources For:

Parents and Guardians

Child Care Staff and Volunteers

School Staff Grades TK/K-12

California Child Care and School Immunization Laws

In compliance with the California Health and Safety Code Sections 120325-120375, any child attending a private or public elementary or secondary school, child care center, day nursery, nursery school, family day care home, or development center (pre-kindergarten facility) in California must be fully immunized before entry. Child care providers and school administrators are required to enforce immunization requirements, maintain immunization records and submit reports.

Child care facilities, school districts, and other educational institutions have the authority to require stricter immunization requirements. Parents and guardians should contact their child's school for specific guidance.

For more information about California school immunization requirements:

California Code of Regulations—Reference document about required immunizations for school and child care.
California Department of Public Health (CDPH) Immunization Branch—California School Immunization Law—CDPH website with information on California school immunization requirements, answers to frequently asked questions (FAQs), and other resources.

Child Care and School Immunization Exemptions

Medical Exemptions

Under Senate Bills (SB) 276 and SB 714 (Pan, 2019), all new medical exemptions for school and child care entry must be issued through CAIR-ME beginning January 1, 2021. Medical exemptions can only be issued by MDs or DOs licensed in California and must meet applicable Centers for Disease Control and Prevention (CDC), Advisory Committee on Immunization Practices (ACIP), and American Academy of Pediatrics (AAP) criteria.

If your child needs a medical exemption, follow the CAIR-ME Instructions to Request a Medical Exemption. These instructions provide a step-by-step guide for submitting a medical exemption request.

If a child at your child care or school site has been issued a medical exemption, you can request access to see CAIR-ME issued medical exemptions by e-mailing medicalexemptions@cdph.ca.gov.

MDs and DOs can register to issue and manage medical exemptions through the CAIR-ME website.

For more information about medical exemptions, please see the following Senate Bills:

Senate Bill 276 (SB 276)—As of January 1, 2021, all new medical exemptions for school and child care entry must be issued through the California Immunization Registry (CAIR).
Senate Bill 714 (SB 714)—A child who has a medical exemption issued before January 1, 2020, is allowed to continue enrollment until they start the next grade span (birth to preschool, inclusive; TK/K and 1st-6th grade inclusive; and 7th-12th grades inclusive).

Personal Belief Exemptions

Although children were able to receive immunization exemptions in the past based on personal beliefs, parents or guardians of students in any school or child care facility, whether public or private, are no longer allowed to submit a personal belief exemption to a currently required vaccine. If your child previously qualified for a personal belief exemption and needs to get caught up on vaccines, see the Vaccine Catch-Up for Schools Handout (For Children Age 7+).

For more information about personal belief exemptions, please see the following Senate Bill:

Senate Bill (SB 277)—As of January 1, 2016, personal belief exemptions to immunization requirements for school and child care are no longer accepted. This bill also addresses immunization requirements for students who have an individualized education program (IEP).

For more information about immunization laws and exemptions, including answers to Frequently Asked Questions (FAQs) visit:

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California Immunization Registry (CAIR2) San Diego

Is your school or child care facility participating in the California Immunization Registry (CAIR2) San Diego? The California Immunization Registry (CAIR) is a centralized and confidential database for storing vaccine records. The Registry provides an electronic record of all immunizations given to an individual by participating providers.

This system allows healthcare providers to document vaccines provided and to see patient immunization records, including vaccines received at other locations or from other healthcare providers. The Registry decreases the possibility of duplication of immunizations and identifies immunizations that are needed.

To learn more about CAIR2 or how to participate in the registry, visit our CAIR2 webpage.

For questions or more information, contact the CAIR Help Desk at:
CAIRHelpdesk@cdph.ca.gov or (800) 578-7889.