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Immunization Requirements for School Attendance

North Carolina requires immunizations for every child present in the state (listed below). Every parent, guardian, or person in loco parentis is responsible for ensuring that his or her child receives the required immunizations. Proof (e.g., immunization record) of the immunizations required for entry into pre-K, Kindergarten, and 7th grade must be submitted by the parent/legal guardian to the school within 30 calendar days of the first day of school attendance. Students who do not comply with this regulation will not be allowed to attend school until the designated, age-appropriate immunization requirements are met and the immunization record is properly submitted. (NC G.S. 130A-152)

Requirements for Initial Entry – Kindergarten:

  • Within 30 calendar days of his or her first day of attendance in the school system, each student must show evidence of age-appropriate vaccination in accordance with state law and regulation, including the following vaccines as applicable: DTaP (diphtheria, tetanus, and pertussis); poliomyelitis (polio); measles (rubeola); rubella (German measles); mumps; Haemophilus influenzae, type b (Hib); hepatitis B; varicella (chickenpox); and, any other vaccine as may be required by law or regulation.
  • The current vaccination requirements for school are available from the N.C. Immunization Branch online at: 
  • For immunization schedules and required doses of each vaccine listed below go to: 

Additional Requirements- Students entering 7th Grade (Tdap and MCV):

  • All students entering seventh grade or who have reached age 12, whichever comes first, are required to receive a booster dose of Tdap (tetanus, diphtheria, and pertussis vaccine), if they have not previously received it; and, the meningococcal conjugate vaccine (MCV).

Certificate of Immunization:

  • Evidence of immunizations must be shown in the form of a certificate furnished by a licensed physician or by the health department. A student who received immunizations in a state other than North Carolina must present an official certificate that meets the immunizations requirements of G.S. 130A-154(b).
  • Principals are required to refuse admittance to any child whose parent or guardian does not present a medical certification of proper immunizations within the allotted time. If, following approved medical practice, the administration of a vaccine requires more than 30 calendar days to complete, upon certification of this fact by a physician, additional days may be allowed to obtain the required immunizations.
  • NOTE:  The student’s immunization record will be reviewed by the school nurse for compliance with state requirements. Contact your child’s school nurse, healthcare provider, or the local health department with questions.

When Immunizations are “in process” or on a "catch-up schedule":

  • Children who have begun a series of immunizations, but have not completed the series due to the need to meet minimum intervals between doses, are considered in process or on a catch-up schedule and may attend school.

Immunization Exemptions:

  • Medical Exemption:  An exemption is permitted for medical reasons when a physician determines that an immunization is or may be harmful to a student for a specific reason. Valid medical exemptions must be written and signed by a physician licensed to practice medicine in North Carolina. The medical exemption must correspond to those medical contraindications specified in the N.C. Immunization Rules or an approved Rules' exception approved by the State Health Director. The medical exemption statement must be maintained in the student's permanent record, and include, at minimum, the basis of the exemption; specific vaccine(s)the child should not receive, and length of time exemption is for.  Medical Exemption Statement Form
  • Religious exemption:  A parent, legal guardian, or person in loco parentis who has a bonafide religious objection to immunization requirements must place assigned statement on file in the student's permanent record. An objection based upon a "scientific" belief (i.e. a foreign substance or chemical may be harmful) or non-religious personal belief or philosophy (i.e., clean living, fresh air, and pure water) is not considered to be a religious exemption and is not allowed under North Carolina law. A written statement must be maintained in the student's record containing and include, at minimum, the name of student, date, and bona fide religious objection and signature of parent, legal guardian, or person in loco parentis. For a student age 18 or older, student name, signature, date, and statement of bona fide religious objection are required. Religious Exemption Statement Form