Tips for keeping your child's vaccinations up to date

Vaccination requirements by age and grade

It's that time of year again when registration for school begins. If your child hasn't had a health check in the last 12 months, they should come in for a checkup. And if your child is starting kindergarten, turning 11, or entering grade 7, now is the time to talk about vaccines.

So, to register your child for kindergarten, middle school or high school, you will need to show your child's vaccination record. What vaccinations does my child need? In fact, most vaccinations can be completed before your child turns two years old.

The vaccines required for kindergarten are a tetanus and whooping cough booster, a polio booster, a measles, mumps and rubella booster, and a chickenpox booster. Most of these vaccines have combination vaccines. Now, there are other vaccines, but if your child was born after 1993, you need to prove that they received the Hepatitis B vaccine, and if they were born after 1996, you need to prove that they received the Hepatitis B vaccine after July 1, 1996. In addition to the other vaccines I mentioned, you need to prove that they received two doses of the Hepatitis A vaccine and three doses of the Hepatitis B vaccine.

How to keep your child's vaccination records up to date

How do I know if my child's vaccinations are up to date? When your child is born, they are given a vaccination card. Make sure you bring that card with you to every checkup. This gives you an opportunity to review what vaccines your child has had and should have, and to make sure the card itself is up to date. I have a lot of patients who come in who are told by the school that their child is not up to date because the parents have not given them an up to date vaccination record. So make sure your child's vaccination record matches up with what we have in the clinic. Also, we can always give you a copy of what we have in the system, so you can take that paper copy to the school and have them keep it so your child has a vaccination card.

The school will ask for written proof. This is your vaccination card. The record should include your child's name, date of birth, the type of vaccine they got, when they got it, and the date, which is the month and year. All of these are necessary because there is a schedule for your child to get vaccinated. Even if you follow the traditional schedule, there is a catch-up schedule posted by the Centers for Disease Control and Prevention if you are behind on a vaccine. There is also a specific minimum interval between each vaccine, and if your child gets vaccinated too early, they will have to get the same vaccine repeatedly. So make sure your child gets vaccinated on schedule and not too early.

What to do if you lose your child's vaccination record

So what happens if you don't have a record of your vaccination? In that case, your doctor can help you get the records from your previous doctor. If you need to request the records, we can give you a copy that we have on file. Also, if your child was vaccinated in Utah, we have WebKIDS or USIIS, which allows you to print the vaccines they received in Utah at any participating Utah office. The vaccines must be entered into a statewide database, so if you move clinics, you can still see your vaccine records even if you don't have a copy. Unfortunately, if you can't provide written proof of the dates your child was vaccinated and there is no way to get that record, your child will have to be vaccinated again. Keep that very important piece of paper that you keep with your vaccine records in a safe place.

Are vaccines administered overseas accepted in U.S. schools?

What about vaccines given outside the US? We see many patients from outside the US, and the good news is that vaccines given in other countries are accepted if the schedule is similar to the US schedule. Mexico, Canada, and most countries in Central and South America have the same requirements as the US, but in most countries around the world, you can show at least some vaccination records. Also, if your child received vaccines elsewhere, they will count as long as you have complete information about the dates of vaccination.

Conditional Enrollment: What it is and how it works

So what if your child is not fully vaccinated? Is there a grace period during which your child can be vaccinated and enroll in school? No there isn't. To protect the health of all children, schools cannot enroll your child without proof of vaccination, but they can enroll you under what is called “conditional enrollment.” Conditional enrollment is when a child enrolls in school. This also applies to child care programs, and most licensed child care facilities in Utah follow the same guidelines. So if your child has received at least one dose of the age-appropriate vaccine and is on schedule to complete the remaining doses and your doctor writes you that schedule (again, back to the Centers for Disease Control catch-up schedule), your child can enroll in school. If your child is not vaccinated within one month of the next scheduled vaccination date, the conditional enrollment period ends and your child cannot return to school until he or she is vaccinated.

Exemptions: Under what circumstances is my child exempt from vaccination requirements?

We've been hearing a lot lately about students being exempt from vaccinations, but can I exempt my child from Utah's student vaccination rules? Yes you can. Utah allows three types of exemptions and a copy of the exemption form must be submitted to the school and kept in the student's permanent file. Exemption forms are typically available from the school or health department, but exemption forms are not typically available at our school.

But there is certainly a parental refusal form that comes out of the American Academy of Pediatrics. The parental refusal form says, we met with you and we discussed the vaccines that your child needs, we discussed the risks and benefits of the vaccines and why we recommend them. If you still choose not to vaccinate your child, we have you sign it and we sign it at the same time to attest that we had that discussion. This goes in your child's medical record. You can take the American Academy of Pediatrics form to the school and say, “I have discussed it with my doctor, and for personal philosophical or religious reasons, I choose not to have my child get these particular vaccines.” It actually lists all the vaccines that your child should get, and you can submit that to the school.

Now, as pediatricians, it is our job to continue to have that conversation with you about vaccines. There have been a few times where your child's health has changed, or they've developed diabetes or asthma or some other illness, and it's really important that they get a vaccine that they haven't had. We may need to continue to have that conversation with you that day and have you re-sign a form that says, “It's been a few years since we discussed the vaccine, and we've discussed it again, and the parents still refuse to vaccinate.” And we'll have you sign it again. But that's our job as pediatricians, to be advocates for your child. So don't take it personal. But we need to continue to have that conversation. There are religious exemption forms, some for some religions, but not many. There are forms in the health department for your child who has a religious exemption.

Medical exemptions and how to obtain them

What about medical exemptions? What if your child gets that vaccine and has a bad reaction? This is a problem we can actually address because you're not exempt because you don't want your child to get the vaccine, but because your child had a life-threatening reaction to it. To be honest, we don't see a lot of cases like this. Most children tolerate the vaccine without any complications. It's very rare that I've seen a true medical exemption for a vaccine, and when it is, there's a good reason. There are other medical exemptions. For kids who are having chemotherapy, I had to fill out paperwork for kids who are having chemotherapy.

What happens when a vaccine-preventable disease breaks out?

So what happens if your child falls under one of these exemptions and there is an outbreak? If there is an outbreak of a vaccine-preventable disease at your child's school, your child will not be able to attend school or daycare for the duration of the outbreak. This rule actually helps protect unvaccinated children from catching these diseases. Some of these diseases have an incubation period of several weeks, so if your child is not vaccinated against a disease that is circulating at your school, they may be unable to attend school for several weeks.

Again, you will be asked to show proof of vaccinations when you register your child for school. If you don't have that information, talk to your doctor. They will let you know if your child is up to date on vaccinations and if they need to be vaccinated. They will also address any concerns you may have about exemptions. But at the end of the day, vaccinations are for your protection, and your child should be vaccinated before going to school.

_{Last updated: August 15, 2024
First published on August 11, 2014}