Page last updated 04/21/2026.
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Child care/preschool providers and school administrators are required to enforce immunization requirements, maintain immunization records and submit reports.
- Child care/preschool facilities, school districts, and other educational institutions have the authority to require stricter immunization requirements.
Medical Exemptions (MEs)
Under Senate Bills (SB) 276 and SB 714 (Pan, 2019), beginning January 1, 2021, all new medical exemptions for school and child care/preschool entry must be issued through the California Immunization Registry – Medical Exemption (CAIR-ME) website.
- 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 a child at your child care/preschool or school site has been issued a CAIR ME, providers must follow the steps to verify the CAIR ME.
Personal Belief Exemptions
Under SB 277 (Pan, 2015), since January 1, 2016, 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.
Child Care/Preschool Sites
Children enrolling in or continuing child care/preschool must meet immunization requirements for polio, DTaP, hepatitis B, Hib, varicella, and MMR before starting and at each age checkpoint.
- SB 792 requires staff and volunteers that work in child care settings to have certain immunizations, including flu, pertussis (whooping cough), and measles before starting work.
TK/K-12 Schools
TK/K-12 students, both classroom based (in-person) and non-classroom-based learning environments, must provide immunization records and meet requirements before starting school.
- These immunizations include DTaP, DTP, Tdap, or TD; polio, hepatitis B; MMR; and varicella.
- Students advancing to 7th grade or students in 7th-12th grade that are newly admitted (including from out of state) must meet immunization requirements for Tdap.
No-cost trainings on immunization requirements at child care/preschool facilities and TK/K-12 are open to all staff that transcribe and review immunization records or want to learn more about immunization requirements. This includes school nurses, school administrators, school registrars, health technicians, health IT staff, school aides, and medical assistants. Health care providers and social service agencies are encouraged to attend.
Click the following link(s) to register for a training.
-
State Law – Required Immunizations: Learn about California
school immunization law and regulations, basic procedures for
reviewing immunization requirements and medical exemptions, process
for admitting or excluding students, and instructions on how to
manually complete the blue card.
- Pre-K: Tuesday, June 9, 2026, 9:00 a.m. – 10:00 a.m.
- TK/K-12: Tuesday, June 10, 2026, 9:00 a.m. – 10:00 a.m.
- California Department of Public Health (CDPH) online module for child cares/preschools and schools.
-
Annual Fall Immunization Report Pre-K and K-12: Receive
guidance on submitting the annual state-mandated fall immunization
report, including information on report categories and unique
situations.
- CDPH online module for child cares/preschools, TK/kindergarten, and 7th grade.
Request a School or Pre-Kindergarten Immunization Law training for your group of 5 or more. Training will cover topics related to California school immunization law, how to complete blue cards, and annual reporting.
Immunization Law
- California Health and Safety Code, Sections 1020325-120375
- California School Law (CDPH)
- Exemptions
- Verifying Medical Exemptions: Guide for School Staff | Spanish
- Frequently asked questions on Medical Exemptions and Personal Belief Exemptions
Vaccine Requirements
- 2026
Recommended Child and Adolescent Immunization Schedule
(American Academy of Pediatrics)
- 2019 Binational Immunization Resource Tool for Children from Birth through 18 Years (Centers for Disease Control and Prevention)
- 2025 California Immunization Handbook: Covers school immunization requirements, staff responsibilities, reviewing records, and reporting.
- Immunizations Required for:
Immunization Records
- California
Immunization Registry (CAIR) Hub: Centralized
applications related to statewide immunization reporting and
information for school and child care sites.
- School Immunization Reporting: Submit annual reports on students’ immunization status.
- School and Child
Care Roster Lookup (SCRL): Determine immunization status
of students for admission and continued attendance.
- Frequently Asked Questions (CDPH)
- California Immunization Registry (CAIR2) San Diego: Centralized and confidential database for storing vaccine records.
- How to Find Immunization Records
- How to Verify Students’ Immunization Records
Other
-
Getting
Your Vaccines (County of San Diego)
- Request school-located vaccine events.
- Request Immunization Materials (County of San Diego)
- School Infectious Disease Prevention and Response Program (County of San Diego)
- Shots for School (CDPH)
- Vaccines for All Ages and Stages of Life (County of San Diego)
Contact the San Diego Immunization Unit via e-mail, or call (866) 358-2966, for more information and resources.
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