Page last updated 04/21/2026.
Schools and pre-kindergarten facilities are
required to enforce immunization requirements, maintain immunization
records of all children enrolled, and submit reports.
Steps to Verify and Document Immunization Status of Children at a School Site
1. Use the Parents' Guide to Immunizations for child care or school to notify parents/guardians of California vaccine requirements.
- Parents/guardians can use this handout to see which vaccines are needed by age or grade.
- Additional languages are available at Resources and Information for Parents and Guardians of Children in Child Care/Preschool or School Grades TK/K-12.
2. Ask parents/guardians to provide a copy of the child's Immunization Record (i.e. yellow card, digital vaccine record print out, or other electronic health record).
- Some children may need to get additional vaccines for continued attendance.
- Other acceptable documentation for immunization records include a valid medical exemption (CAIR-ME) or an Individualized Education Program (IEP) document for review.
- Visit Find Immunization Records for tips on finding immunization records.
3. Use the child's Immunization Record to document (write) the dates for each vaccine received onto the California Pre-Kindergarten and School Immunization Record Card (Blue Card).
- Complete a blue card for each child at your site including demographic information, vaccine information, and status of requirements sections.
- Refer to the back of the blue card for detailed directions.
- Visit Immunization Materials or e-mail IZinfo.HHSA@sdcounty.ca.gov to request blue cards.
4. Use the California School Immunization Requirements Guide (Child Care or School) to compare the dates and doses of vaccines noted on the Blue Card. This will determine if the child meets the California immunization requirements.
- Sometimes, children who are missing one or more required
vaccines can still go to child care or school on a
conditional basis. This gives them time to catch up
on the vaccines they need.
- Children must follow the conditional schedule on the second page of the California School Immunization Requirements Guide. Other physician or parent preferred schedules require a CAIR-ME.
5. Inform parents/guardians if their child is missing vaccines or documentation. Refer them to their child's healthcare provider, pharmacy, or public health clinic to receive vaccines.
- Fill out the Letter to Parents/Guardians: Immunizations Needed template. Then, give the document to parents/guardians to let them know which vaccines/doses their child needs.
- Staff cannot admit children to child care or school if immunization requirements are not met.
6. Keep a completed Blue Card on file for every child enrolled at the school site. This includes children who are home-schooled, in independent study, or with an IEP status.
7. Admit only children who:
- Have all required immunizations, a valid/active IEP, or are enrolled in an independent study or a home-based private school.
- Meet requirements conditionally,
and are not currently due for immunizations.
- Make a note to follow up on children who were not due for any immunizations/doses when admitted (conditionally admitted) but have pending doses due later.
- Have a valid medical exemption through CAIR-ME for required immunizations.
8. Submit Immunization Assessment Reports every year in the fall to California Department of Public Health’s CAIR Hub.
To learn more about annual immunization reporting, visit Trainings and Resources for Child Care/Preschool and School Staff.
See the California Immunization Handbook for more information.
Contact the San Diego Immunization Unit via e-mail, or call (866) 358-2966, for more information and resources.
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