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School Vaccines and Immunizations

No Shots, No School - Vaccine Requirements, Costs, & Exemptions

Aug 13, 2009 Amy Andersen

Required immunizations can be available free or low cost.. Schools will not allow entry without an up to date shot record. Vaccine access isn't difficult with planning.

Free shot clinics can be found in many locations. Check with the local fire department or health department that may run clinics on certain days and times of the week. Arena style gatherings, which might include backpacks, haircuts, etc., may have a scheduled day for multiple back to school functions on a particular date. Some High Schools and civic centers will list a free shot day.

Low Cost Immunizations

Crowds and long lines at free shot clinics may be discouraging. The time and date of the particular clinic might not be feasible. Most insurance plans and Medicaid cover required school immunizations either completely or by a co-pay. There are also low cost shots available. Investigate Goodwill, nursing and medical schools, and health departments. Call the school office for information on where to find low cost required immunizations.

Required Immunizations versus Recommended Vaccinations

Initial school entry requires:

3 hepatitis B vaccines
5 Dtap
4 Polio
2MMR
Varicella
Hepatitis A is usually given by age 2. Older children in select areas may or may not require this vaccine. HIB (haemophiles influenza type B) and Pneumoccal PCV7 are given up to age 4. A Pneumonia shot thereafter is individually decided, not required.
Some regions require a TB test. Menactra (meningitis) is not given until age 11. Gardisil (HPV) is a recommended vaccine but not required; Influenza vaccine is recommended but not required.

Average Cost of Required Vaccine if Self Paying

Hepatitis B $45-55
MMR $65-70
Tdap $60-75
Polio $80-85
PPD $20

Religious Exemptions to Receiving School Required Vaccination

A written form from the state health department clarifying objection to immunization will exempt the child from the requirement. Most public schools will accept without controversy this statement, regardless of denomination, based on personal beliefs. The language differs in each state but the overall result is the same. For example, NJ needs the objection to the actual administration of the vaccine based on religious grounds. Pennsylvania accepts a simple refusal to the vaccine itself as sufficient. At this time, W.Virginia has no religious exemption. Religious grounds for not vaccinating cannot apply only to one vaccine but to the entirety of the series.

Medical Exemption to Mandatory Vaccination for School Entry

The pediatrician or health department must complete a notarized form. Unless it is a lifelong contraindication, the form must be presented annually each school year. Temporary exemptions are usually given when an injection delay due to illness or timing of immunization is necessary.

Philosophical or Conscientious Exemption to Immunization for School Admission

This is currently available in 19 states. The form is from the state department of health or human services. It allows the exemption of individual vaccines as opposed to all vaccines as is the case in religious exemptions. It is notarized and filed and can be withdrawn as philosophies change.

Parents need to be aware the herd effect of protection for an unvaccinated child isn’t absolute as more parents decide not to vaccinate against a particular disease or against all diseases. This has been evidenced in the past with the resurgence of polio. Individual research is necessary before undertaking decisions to withhold or to vaccinate a child for school.

The copyright of the article School Vaccines and Immunizations in General Medicine is owned by Amy Andersen. Permission to republish School Vaccines and Immunizations in print or online must be granted by the author in writing.