1. How many immunizations does my child need before entering school?

For kindergarten entry, your child needs five doses of DTaP (diphtheria, tetanus, and acellular pertussis), unless the fourth dose was received on or after the fourth birthday in which case only four doses are required, four doses of polio, two doses of a measles-containing vaccine (MMR—combined measles, mumps, and rubella), three doses of hepatitis B, and one dose of varicella vaccine. Additionally, if your child attends school in one of the forty counties designated by the department, one dose of hepatitis A vaccine is required for grades K-3 only.

2. Are booster doses of DTaP and polio vaccines acceptable for compliance if administered more than four days prior to the 4th birthday?

No. The allowance of administering the booster dose of DTaP or polio vaccines in the calendar month prior to or of the 4th birthday is no longer acceptable for compliance. Only a four-day grace period for all vaccines is acceptable.

3. Is there a “grand fathering” clause for students who received a booster dose of DTaP or polio vaccine more than four days before the fourth birthday?

Yes. For school year 2006-07, students in grades 3-12, OR students who received booster doses of DTaP and/or polio vaccine prior to August 1, 2004, may be considered “in compliance” with the school immunization requirement for DTaP and/or polio vaccine given more than four days prior to their fourth birthday.

4. Is a booster dose required if a child/student received five or more doses of DTaP/DTP/DT before the age of 4?

Yes. Students must have a dose of DTaP/DTP/DT on or after the 4 th birthday. However, ACIP recommends that children receive no more than 6 doses of diphtheria and tetanus toxoids before the seventh birthday ( MMWR 1991;40 [RR-10]:6) because of concern about adverse reactions, primarily local reactions. Therefore, if the booster dose required would result in a seventh dose of vaccine, then the dose would become medically contraindicated.

5. What is the requirement for polio?

Four doses of polio vaccines are required including one dose on or after the fourth birthday. If the third dose was administered on or after the fourth birthday only three doses are required.

6. If a student enrolls with four doses of polio vaccine, all before age 4, is a booster required?

This depends on the type of polio vaccine received. If a combination vaccine, including both types of OPV and IPV, was used, then a booster at age four is not required. However, if the series is comprised of all IPV or all OPV, then a booster dose is required.

7. If a student started the DTaP series prior to the age of seven but is now seven years old, is the student required more than three doses of tetanus-diphtheria containing vaccine?

The vaccine requirement for students age seven and older is proof of three doses of a tetanus-diphtheria containing vaccine including one received on or after the fourth birthday.

8. Is a student in compliance if he/she received the measles vaccine no more than four days before the 1st birthday?

Yes. There is a four-day grace period for all vaccines.

9. Is it acceptable to have "at birth" or "in hospital" written on the immunization record for hepatitis B vaccine, or do we have to have the actual date?

Any immunization record created or updated after 9/1/91 must include the month/day/year for each vaccine administered.

10. Is the conscientious exemption valid for two years or five years?

The conscientious exemption is valid for two years. However, initially the exemption was valid for five years. Those students, who filed an affidavit that was valid for five years, get a five-year exemption. A school should honor the exemption according to the validity printed on the top of the form.

11. The child has no immunizations on file. I did receive a faxed copy of a Texas Religious Exemption dated in 1999. Does this child need a new affidavit?

No. Valid religious exemptions dated prior to September 1, 2003 are life-long exemptions.

12. I have a student who is transferring from out of state. Is the personal/philosophical exemption from the other state valid in Texas?

No. Students claiming exclusion for reasons of conscience, including a religious belief, must present an affidavit issued by the Texas Department of State Health Services.

13. Are private schools required to accept the conscientious exemption form?

The Attorney General Opinion GA-0420 states that “A private school that does not accept state tax funds is not required to accept for enrollment a child who has received an exemption from the immunizations required by the Texas Health and Safety Code.”

14. May a student be provisionally enrolled while awaiting the conscientious objection form?

No. Students must present a signed affidavit upon enrolling into school.

15. Are out-of-state immunization records acceptable with only a month and year as a vaccine date?

Only if the immunization record is an official immunization record generated from a state or local health authority, such as a registry.

16. Which counties are required for the hepatitis A vaccine?

Schools:
Students attending grades kindergarten through third grade in the following 40 counties are required to have two doses of hepatitis A vaccine: Bexar, Brewster, Brooks, Cameron, Crockett, Culberson, Dimmitt, Duval, Edwards, El Paso, Frio, Gonzales, Grayson, Hidalgo, Hudspeth, Jeff Davis, Jim Hogg, Kenedy, Kinney, La Salle, Maverick, McMullen, Moore, Nueces, Pecos, Potter, Presidio, Randall, Real, Reeves, Starr, Sutton, Terrell, Terry, Uvalde, Val Verde, Webb, Willacy, Zapata, and Zavala counties.

Child-care Facilities:
All children enrolled in a child-care facility, including early childhood programs and pre-kindergarten statewide are required to have two doses of hepatitis A vaccine statewide.

17. Where are the requirements for Pre-K located?

Pre K requirements are under the child-care section §97.63 (A) in the Texas Administrative Code, Title 25 Health Services.

18. Where can I get a copy of my child's shot record so I can enroll them in school?

Contact either your private physician or the local city/county health clinic where your child received the immunizations. You may contact 2-1-1 for assistance in locating a city/county health clinic in your area. If you have consented to having your child’s immunization information entered into the statewide immunization registry, ImmTrac, you may ask your private physician or the local city/county health clinic to search the ImmTrac Registry. Immunization records are not available online for the general public to lookup.

19. I'm enrolling in college and need to know where I can get a copy of my shot record?

The only immunization records that are kept by the Texas Department of State Health Services are for children under 18 years of age and whose parents and/or legal guardian consented to have entered into the ImmTrac database. If you are an adult you will need to contact the local city/county health department or physician's office where your shots were received.

20. If a child has had chickenpox illness is he/she required to get the vaccine?

No. If a child has had chickenpox at any age, he is not required to get the vaccine. Documenting history of chickenpox illness must include a written statement from a physician, school nurse or the child's parent/guardian containing wording such as: "This is to verify that (name of child) had varicella disease (chickenpox) on or about (month/day/year) and does not need the varicella vaccine."

21. Where can I find information about Tuberculosis (TB)?

You can find more information about TB by calling your local health department, or on the DSHS Tuberculosis Elimination Division website.