School and Child Care Immunizations Information for Families

Five children with bandages on their arms showing that they received vaccine shots.

It is important to keep your child up to date on required immunizations for school and child care. Vaccinations can reduce the severity of disease or prevent disease entirely. Vaccinations play an important role in keeping your child healthy.

This web page is designed to help you understand the rules around school and child care immunizations. The page has all the forms families need to meet immunization requirements.

A Statement on Vaccination

We acknowledge the medical system has had a history of racist and discriminatory practices and beliefs.  This history may make it more difficult for families to trust vaccines or medical professionals.

We want to assure you that Washington state school and child care requirements are handled very differently. The Washington State Board of Health is a diverse group that oversees school and child care vaccine requirements. They operate under the goal of improving the health and safety of all people in Washington. Many medical professionals are trained to educate families about vaccination. We encourage you to find a trusted medical professional you can talk to if you have questions about vaccination.

The Basics

Children entering school, child care, or other early learning programs are required to have certain vaccinations before they can start. These requirements are put into place to protect children, families, and communities from vaccine preventable diseases. Immunization requirements apply to all enrolled children, including those learning remotely.

The parent or guardian of a child must provide documentation of vaccination or proof of immunity to specific diseases. This requirement is based on the national Advisory Committee on Immunization Practices (ACIP) Immunization Schedule for school or child care registration and attendance. The specific diseases are listed in the chart below:

  Immunization Charts

The Department of Health has immunization charts for families that show when children should receive specific vaccines. Child care and school have different immunization requirements.

For Child Care

Last revised May 2024

For School


  Required Documents

Certificate of Immunization Status (CIS) Form

Before a child may attend school or child care, the family must provide a Certificate of Immunization Status (CIS) form to staff. This form shows the child’s vaccinations or proof of immunity to disease. 

There are a couple of ways families can submit a valid CIS form:

  • Families can print their child’s CIS by following the instructions on the Access your Family’s Immunization Information web page.
  • Families can ask a health care provider to print out a CIS form for them.
  • Families can ask their school to print out a CIS form for them. Not all schools can do this, so make sure to ask ahead of time.
  • Families can fill out the CIS form themselves and attach medical records showing vaccination.

Download the state’s CIS form:

Certificate of Exemption (COE) Form

State law allows families to exempt their child from school or child care immunization requirements. In most cases, families can claim one of four exemption types.

  • Medical
  • Personal/Philosophical 
  • Religious
  • Religious Membership

Personal/philosophical exemptions cannot be used for measles, mumps, and rubella requirements. For more explanation on each type of exemption, check out the Exemption Quick Reference Guide.

Exemption Quick Reference Guide and Instructions
English (PDF) | Español-Spanish (PDF) | Русский - Russian (PDF) |  Українська - Ukrainian (PDF)

If families want to claim an exemption, they must fill out a Certificate of Exemption (COE) form based on the exemption type. All exemptions except religious membership require a health care practitioner signature and education. The COE form should be attached to the CIS form when it is turned in.

Download the state’s COE form:

Types of health care practitioners licensed in Washington state who can sign the COE form:

  • Medical Doctor (MD)
  • Doctor of Osteopathy (DO)
  • Naturopathic Doctor (ND)
  • Advanced Registered Nurse Practitioner (ARNP)
  • Physician Assistant (PA)

Exclusions and Conditional Status

Children who don’t meet state vaccination requirements may not attend school or child care. Schools and child cares must exclude children who do not provide paperwork showing their child has met the vaccination requirements.

Children who need to catch up on vaccination requirements may stay in school under ‘conditional status.’ To be in conditional status, families must:

  • Get their child vaccinated for all eligible missing vaccines.
  • Turn in required paperwork showing the vaccinations their child has received.
  • Have a parent or guardian sign the conditional status box on the CIS form.

Because some vaccines are given in a series over time, children may have to wait a period of time until they can receive their next vaccination. Families have 30 days from the next vaccine due date to get their child vaccinated. Families must then turn in paperwork showing proof. This process continues until the child is caught up on vaccinations. If a family does not follow up on a required vaccination, their child will lose conditional status and will be excluded from school.

If you think your child might qualify for conditional status, please talk to your school or child care staff.

  Getting Childhood Vaccinations

Children receive different vaccines as they get older. Your pediatrician or health care provider should regularly check to see if your child is due for different vaccines during well-child check-ups.

If your child is behind on childhood vaccinations, they can catch up by visiting their health care provider. In some cases, your child may need to have multiple visits spaced out over time to complete a vaccine series.

In Washington state, children 18 years and younger receive vaccine at no cost as part of the Childhood Vaccine Program. Health care providers participating in the program may charge an administration fee, but the family can ask to have it waived.

Families can find a Childhood Vaccine Program provider near them by using this health provider map (English only) or by visiting (English/Spanish only).

More detailed information about the requirements, including frequently asked questions, is available at (English only).