Health

Immunization Requirements

Each child must have a record of their immunizations on a medically verified Certificate of Immunization Status (CIS) or have a completed Certificate of Exemption on file for each of the diseases for which full immunization is required before the first day of attendance. It is the duty of the administrator, by law, to exclude children from school, preschool, or childcare if they do not meet immunization requirements on or before the first day of attendance. All children under the age of 19 can get immunizations at no cost in our state from clinics participating in the Vaccine for Children (VFC) program. Some health care providers’ offices charge an administration fee, but you can ask to have the administration fee waived if you can’t pay. Find VFC clinics by using this vaccine map at https://fortress.wa.gov/doh/vaccinemap.

Washington State Department of Health

School and Child Care Immunization:
www.doh.wa.gov/scci

School Immunization Chart:
https://doh.wa.gov/sites/default/files/2025-12/348295-ParentSchoolChart.pdf

Required Immunizations for School

According to the Washington Administrative Code WAC 246-105-030, any child attending school, preschool, or childcare in Washington state is required by law to be fully immunized against or have an exemption in place for the following diseases (note: scroll through table to view all columns):

	DTaP/Tdap (Diphtheria, Tetanus, Pertussis)	Hepatitis B	Hib (Haemophilus influenzae type B)	MMR (Measles, mumps, rubella)	PCV (Pneumococcal Conjugate	Polio	Varicella (Chickenpox)
Preschool Age 19 months to <4 years on September 1st	4 doses DTaP	3 doses	3 or 4 doses* (depending on vaccine)	1 dose	4 doses*	3 doses	1 dose**
Preschool/Transitional Kindergarten 4 years of age or older on September 1st	5 doses DTaP*	3 doses	3 or 4 doses* (depending on vaccine) (Not required at 5 years of age or older)	2 doses	4 doses* (Not required at 5 years of age or older)	4 doses*	2 doses**
Kindergarten through 6th grade	5 doses DTaP*	3 doses	Not required	2 doses	Not required	4 doses*	2 doses**
Grades 7th through 12th	5 doses DTaP* Plus Tdap at age ≥ 10 years	3 doses	Not required	2 doses	Not required	4 doses*	2 doses**
Vaccine doses may be acceptable with fewer than listed depending on when they were given. *Health care provider verification of history of chickenpox disease is also acceptable. Students must get vaccine doses at the correct timeframes to be in compliance with school requirements.

Immunization Requirements to online school or other alternative programs

Students enrolled at a public or private school participating in alternative school programs must follow the same immunization rules as all other students. They need a completed Certificate of Immunization Status (CIS) and/or Certificate of Exemption (COE) on file at the school or district program.

Life-Threatening Health Conditions

The safety and well-being of students is one of our paramount duties. Washington state law (RCW 28A.210.320 and WAC 392-380) requires that before a student may attend school, a parent must present a medication or treatment order addressing any life-threatening health condition the child has that may require medical services to be performed at school. Parents must also provide any medication or equipment identified in the order that is necessary to carry out the order. A nursing care plan to implement the order must also be in place.

Per RCW 28A.210.320, a "life-threatening condition" shall mean a health condition that will put the child in danger of death during the school day if a medication or treatment order and a nursing plan are not in place.

Life-threatening health conditions include but are not limited to:

Diabetes
Severe allergies requiring epinephrine
Epilepsy/seizure disorder
Asthma requiring an inhaler
Cardiac/heart conditions

For more information regarding life-threatening health condition requirements visit: www.lwsd.org/services/health-services/student-health-forms.

Meningococcal and HPV Disease and Prevention

As a parent, there is nothing more important than safeguarding your child’s health. The Washington State Legislature requires schools to make this information available to families about meningococcal disease and human papillomavirus (HPV).

Know the facts about these diseases and the vaccines available to protect your student.

Meningococcal Disease and Prevention
Human Papillomavirus (HPV) and Prevention

Meningococcal Disease and Prevention

What is meningococcal disease?

Meningococcal disease is a serious illness. It spreads through close contact by coughing, kissing, or sharing anything by mouth, such as water bottles, eating utensils, lip balm, or toothbrushes. It can cause pneumonia, blood infections, and meningitis (swelling of the covering of the brain and spinal cord). Severe disease can cause brain damage, loss of hearing or limbs, and death. Fortunately, this life-threatening infection is rare – with only about 20 to 30 reported cases each year in Washington. Adolescents and young adults are more likely to get meningococcal disease, especially if they live in group settings like college dorms.

How can I protect my student from meningococcal disease?

There are three types of vaccines that protect against several kinds of meningococcal disease.

Meningococcal conjugate vaccine (MCV4): The meningococcal conjugate vaccine, or MCV4, prevents against four most common types of bacteria that cause disease. MCV4 is a routine recommendation for all children aged 11 to 12 years, with a booster dose for teens aged 16 to 18. Teens who did not get their first dose at the right time should get it as soon as possible. Teens with high-risk conditions like weak immune systems may need more doses.
Meningococcal B vaccine (MenB): MenB protects against most meningococcal B bacteria. It may be given to teens and adults aged 16 to 23 who have rare health conditions, who are at increased risk during a meningococcal B disease outbreak, or based on shared decision making with your health care provider.
Pentavalent meningococcal vaccine (MenABCWY): MenABCWY vaccine protects against five types of meningococcal disease. It is used when someone can receive both the MenB and MCV4 vaccines at the same visit.

For more information about meningococcal disease and how to prevent it:

Washington State Department of Health: https://doh.wa.gov/you-and-your-family/illness-and-disease-z/meningitis-meningococcal-disease
CDC meningococcal disease and vaccine information: https://www.cdc.gov/meningococcal/vaccines/?CDC_AAref_Val=

Human Papillomavirus (HPV) and Prevention

What is HPV?

HPV is a very common virus that can cause cancers later in life. Nearly 42 million people are currently infected with HPV in the United States. About 13 million people, including teens, become infected with HPV each year. In the U.S., an estimated 36,000 people are affected by a cancer caused by HPV infection each year. While there is screening for cervical cancer that can detect cancer early, there is no recommended screening for the other cancers caused by HPV infection, like cancers of the back of the throat, anus, penis, vagina, or vulva.

How can I protect my student from HPV?

HPV vaccination provides safe, effective, and lasting protection against the HPV infections that most commonly cause cancer. HPV vaccination works extremely well. HPV vaccine has the potential to prevent more than 90% of HPV-attributable cancers. Since HPV vaccination was first recommended in 2006, infections with HPV types that cause most HPV cancers and genital warts have dropped 88% among teen girls and 81% among young adult women.

Who should get the vaccine and when should they get it?

Because the vaccine is more effective when given at younger ages, two doses of HPV vaccine are recommended for all boys and girls starting at age 9. If boys or girls do not get the first dose of HPV vaccine before age 15, they will need three doses. In addition to HPV vaccine, your 11- to 12-year-old should receive Tdap and meningococcal vaccines.

For more information on HPV, the vaccine, and cervical cancer:

Washington State Department of Health: www.doh.wa.gov/hpv
Centers for Disease Control & Prevention: www.cdc.gov/hpv