Most states require children to be vaccinated against roughly the same set of diseases before enrolling in school, though the exact number of doses and the paperwork process vary by state. The core vaccines protect against measles, mumps, rubella, polio, diphtheria, tetanus, whooping cough, chickenpox, and hepatitis B. Additional doses and new vaccines get added at middle school entry and, for many students, again before college.
Vaccines Required for Kindergarten
By the time a child enters kindergarten (typically age 4 to 6), most states require documentation of the following vaccinations:
- DTaP (diphtheria, tetanus, whooping cough): 4 to 5 doses, with the final dose given at age 4 or older
- Polio (inactivated poliovirus): 3 to 4 doses, with the final dose at age 4 or older
- MMR (measles, mumps, rubella): 2 doses
- Varicella (chickenpox): 2 doses
- Hepatitis B: 3 doses, starting at birth
Some states also require hepatitis A (2 doses) for kindergarten entry. Two additional vaccines, for Hib and pneumococcal disease, are required for younger children in preschool and child care settings but are typically only mandated through age 5.
Your state’s department of health website will have the exact checklist. The specific number of doses can depend on when your child received earlier shots, so the form your pediatrician fills out reflects what your child actually needs rather than a single universal count.
New Requirements at Seventh Grade
Most states add two vaccine requirements when students enter middle school, usually at seventh grade. The first is a Tdap booster, which refreshes protection against tetanus, diphtheria, and whooping cough. This is required as long as at least five years have passed since the child’s last tetanus-containing vaccine. The second is a meningococcal ACWY vaccine, which protects against bacterial meningitis. One dose is required for seventh grade entry in most states.
For students in eighth through twelfth grade who haven’t already received these vaccines, the same requirements apply. States that mandate meningococcal vaccination often require just one dose for this age group, though the CDC recommends a booster at age 16 since protection fades over time.
Vaccines for College Entry
Many colleges and universities require proof of vaccination before enrollment, and the requirements often go beyond what K-12 schools mandate. The meningococcal ACWY booster at age 16 is the most common addition. If your child received the initial dose at 11 or 12 but never got the booster, most colleges will flag that gap.
Meningococcal B vaccination is a separate conversation. The CDC does not universally recommend it for all adolescents. Instead, it falls under what’s called shared clinical decision-making, meaning you and your child’s doctor discuss whether it makes sense based on individual risk. Many colleges recommend it, and some require it, particularly for students living in dormitories. The preferred timing is between ages 16 and 18, and the standard series is two doses spaced six months apart. Students heading to college sooner than that can receive a three-dose series on an accelerated timeline.
Colleges also commonly require up-to-date MMR, varicella, and hepatitis B documentation, plus a recent Tdap if more than ten years have passed since the last dose.
Requirements Vary by State
There is no single federal law requiring school vaccinations. Each state sets its own list of required vaccines, the number of doses, and the deadlines for compliance. In practice, most states follow CDC recommendations closely, so the core list is similar everywhere. The differences tend to show up in details: whether hepatitis A is required for kindergarten, whether HPV is mandated (very few states require it for school entry), and how strictly deadlines are enforced.
Every state allows medical exemptions for children who cannot safely receive a vaccine due to an allergy or immune condition. Beyond that, exemption policies diverge significantly. Twenty-nine states and Washington, D.C., allow religious exemptions. Sixteen states allow personal or philosophical exemptions in addition to religious ones, giving parents the option to decline vaccines based on personal beliefs. Four states (California, Connecticut, Maine, and New York) do not allow any non-medical exemptions. California removed its personal and religious exemptions in 2015, Maine followed in 2019, and Connecticut in 2021.
What to Do If Your Child Is Behind
If your child has missed doses or started vaccinations late, they don’t need to restart any series from the beginning. The CDC’s catch-up schedule lays out the minimum intervals between doses so your child can get back on track as quickly as possible. For example, MMR doses need to be spaced at least four weeks apart, while varicella doses require three months between them for children under 13 (four weeks for those 13 and older). Hepatitis B requires at least four weeks between the first and second doses and at least eight weeks between the second and third, with the final dose no earlier than 24 weeks of age.
Most schools allow a provisional enrollment period, giving families a set window (often 30 days) to show proof of at least the first dose in a catch-up series, with a written plan for completing the remaining doses. Your school’s registrar or health office can tell you exactly what they’ll accept.
How to Find Your Child’s Records
If you’ve lost your child’s vaccination records, start with your pediatrician’s office, since they keep copies of everything they’ve administered. If you’ve changed doctors or moved states, your next best option is your state’s Immunization Information System, a digital registry that most states use to track vaccinations. You can contact your state health department to request records from the IIS directly.
If neither route works, the CDC’s information line (1-800-232-4636) can help you figure out where to look based on where your child received their shots. For children who received vaccines in another country, a doctor can review available documentation and, if needed, order blood tests to check for immunity rather than re-administering the full series.