Children in a prekindergarten setting should be age-appropriately immunized. The number of doses depends on the schedule recommended by the Advisory Committee on Immunization Practices (ACIP). Intervals between doses of vaccine should be in accordance with the ACIP-recommended immunization schedule for persons 0 through 18 years of age. Doses received before the minimum age or intervals are not valid and do not count toward the number of doses listed below. See footnotes for specific information for each vaccine. Children who are enrolling in grade-less classes should meet the immunization requirements of the grades for which they are age equivalent.
Dose requirements MUST be read with the footnotes of this schedule
Prekindergarten (Day Care, Head Start, Nursery
Kindergarten and Grades
1, 2, 3, 4 and 5
6, 7, 8, 9, 10 and 11
Diphtheria and Tetanus toxoid-containing vaccine and Pertussis vaccine (DTaP/DTP/Tdap/Td)2
5 doses or 4 doses
if the 4th dose was received at 4 years or older or
if 7 years or older and the series was started at 1 year or older
Tetanus and Diphtheria toxoid-containing vaccine and Pertussis vaccine adolescent booster (Tdap)3
Polio vaccine (IPV/OPV)4
4 doses or 3 doses
if the 3rd dose was received at 4 years or older
Measles, Mumps and
Rubella vaccine (MMR)5
Hepatitis B vaccine6
or 2 doses of adult hepatitis B vaccine (Recombivax) for children who received the doses at least 4 months apart between the ages of 11 through 15 years
Meningococcal conjugate vaccine (MenACWY)8
7, 8, 9, 10 and 11:
2 doses or 1 dose
if the dose was received at 16 years or older
Haemophilus influenzae type b conjugate vaccine (Hib)9
1 to 4 doses
Pneumococcal Conjugate vaccine (PCV)10
1 to 4 doses
Not applicable1. Demonstrated serologic evidence of measles, mumps or rubella antibodies
or laboratory confirmation of these diseases is acceptable proof of immunity to these diseases. Serologic tests for polio are acceptable proof of immunity only if the test was performed before September 1, 2019 and all three serotypes were positive. A positive blood test for hepatitis B surface antibody is acceptable proof of immunity to hepatitis B. Demonstrated serologic evidence of varicella antibodies, laboratory confirmation of varicella disease or diagnosis by a physician, physician assistant or nurse practitioner that a child has had varicella disease is acceptable proof of immunity to varicella.
2. Diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine. (Minimum age: 6 weeks)
a. Children starting the series on time should receive a 5-dose series of DTaP vaccine at 2 months, 4 months, 6 months and at 15 through 18 months and at 4 years or older. The fourth dose may be received as early as age 12 months, provided at least 6 months have elapsed since the third dose. However, the fourth dose of DTaP need not be repeated if it was administered at least 4 months after the third dose of DTaP. The final dose in the series must be received on or after the fourth birthday and at least 6 months after the previous dose.
b. If the fourth dose of DTaP was administered at 4 years or older, and at least 6 months after dose 3, the fifth (booster) dose of DTaP vaccine is not required.
c. For children born before 1/1/2005, only immunity to diphtheria is required and doses of DT and Td can meet this requirement.
d. Children 7 years and older who are not fully immunized with the childhood DTaP vaccine series should receive Tdap vaccine as the first dose in the catch-up series; if additional doses are needed, use Td or Tdap vaccine.
If the first dose was received before their first birthday, then 4 doses are required, as long as the final dose was received at 4 years or older. If the first dose was received on or after the first birthday, then 3 doses are required, as long as the final dose was received at 4 years or older.
3. Tetanus and diphtheria toxoids and acellular pertussis (Tdap) adolescent booster vaccine. (Minimum age for grade 6: 10 years; minimum age for grades 7 through 12: 7 years)
a. Students 11 years or older entering grades 6 through 12 are required to have one dose of Tdap.
b. In addition to the grade 6 through 12 requirement, Tdap may also be given as part of the catch-up series for students 7 years of age and older who are not fully immunized with the childhood DTaP series, as described above. In school year 2020-2021, only doses of Tdap given at age 10 years or older will satisfy the Tdap requirement for students in grade 6; however, doses of Tdap given at age 7 years or older will satisfy the requirement for students in grades 7 through 12.
c. Students who are 10 years old in grade 6 and who have not yet received a Tdap vaccine are in compliance until they turn 11 years old.
4. Inactivated polio vaccine (IPV) or oral polio vaccine (OPV). (Minimum age: 6 weeks)
a. Children starting the series on time should receive a series of IPV at 2 months, 4 months and at 6 through 18 months, and at 4 years or older. The final dose in the series must be received on or after the fourth birthday and at least 6 months after the previous dose.
b. For students who received their fourth dose before age 4 and prior to
August 7, 2010, 4 doses separated by at least 4 weeks is sufficient.
c. If the third dose of polio vaccine was received at 4 years or older and at least 6 months after the previous dose, the fourth dose of polio vaccine is not required.
d. Only trivalent OPV (tOPV) counts toward NYS school polio vaccine requirements. Doses of OPV given before April 1, 2016 should be counted unless specifically noted as monovalent, bivalent or as given during a poliovirus immunization campaign. Doses of OPV given on or after April 1, 2016 should not be counted.
5. Measles, mumps, and rubella (MMR) vaccine. (Minimum age: 12 months)
a. The first dose of MMR vaccine must have been received on or after the first birthday. The second dose must have been received at least 28 days (4 weeks) after the first dose to be considered valid.
b. Measles: One dose is required for prekindergarten. Two doses are required for grades kindergarten through 12.
c. Mumps: One dose is required for prekindergarten. Two doses are required for grades kindergarten through 12.
d. Rubella: At least one dose is required for all grades (prekindergarten through 12).
6. Hepatitis B vaccine
a. Dose 1 may be given at birth or anytime thereafter. Dose 2 must be given at least 4 weeks (28 days) after dose 1. Dose 3 must be at least 8 weeks after dose 2 AND at least 16 weeks after dose 1 AND no earlier than age 24 weeks (when 4 doses are given, substitute “dose 4” for “dose 3” in these calculations).
b. Two doses of adult hepatitis B vaccine (Recombivax) received at least 4 months apart at age 11 through 15 years will meet the requirement.
7. Varicella (chickenpox) vaccine. (Minimum age: 12 months)
a. The first dose of varicella vaccine must have been received on or after the first birthday. The second dose must have been received at least 28 days (4 weeks) after the first dose to be considered valid.
b. For children younger than 13 years, the recommended minimum interval between doses is 3 months (if the second dose was administered
at least 4 weeks after the first dose, it can be accepted as valid); for persons 13 years and older, the minimum interval between doses is 4 weeks.
8. Meningococcal conjugate ACWY vaccine (MenACWY). (Minimum age for grade 7: 10 years; minimum age for grades 8 through 12: 6 weeks).
a. One dose of meningococcal conjugate vaccine (Menactra or Menveo) is required for students entering grades 7, 8, 9, 10 and 11.
b. For students in grade 12, if the first dose of meningococcal conjugate vaccine was received at 16 years or older, the second (booster) dose is not required.
c. The second dose must have been received at 16 years or older. The minimum interval between doses is 8 weeks.
9. Haemophilus influenzae type b (Hib) conjugate vaccine. (Minimum age: 6 weeks)
a. Children starting the series on time should receive Hib vaccine at 2 months, 4 months, 6 months and at 12 through 15 months. Children
older than 15 months must get caught up according to the ACIP catch-up schedule. The final dose must be received on or after 12 months.
b. If 2 doses of vaccine were received before age 12 months, only 3 doses are required with dose 3 at 12 through 15 months and at least 8 weeks after dose 2.
c. If dose 1 was received at age 12 through 14 months, only 2 doses are required with dose 2 at least 8 weeks after dose 1.
d. If dose 1 was received at 15 months or older, only 1 dose is required. e. Hib vaccine is not required for children 5 years or older.
10. Pneumococcal conjugate vaccine (PCV). (Minimum age: 6 weeks)
a. Children starting the series on time should receive PCV vaccine at 2 months, 4 months, 6 months and at 12 through 15 months. Children older than 15 months must get caught up according to the ACIP catch-up schedule. The final dose must be received on or after 12 months.
b. Unvaccinated children ages 7 through 11 months are required to receive 2 doses, at least 4 weeks apart, followed by a third dose at 12 through
c. Unvaccinated children ages 12 through 23 months are required to receive 2 doses of vaccine at least 8 weeks apart.
d. If one dose of vaccine was received at 24 months or older, no further doses are required.
e. PCV is not required for children 5 years or older.
f. For further information, refer to the PCV chart available in the School Survey Instruction Booklet at: www.health.ny.gov/prevention/immunization/schools
NYSCSH Clarification of School Health Examinations in Light of COVID-19 Pandemic
The Center has received additional requests for clarification regarding school health exams related to the recent NYSED Memo: School Health Examinations in Light of COVID-19 Pandemic (5/21/20). Please see the NYSED Health Examination Guidelines for additional information.
Health Examination for School Entry, Mandated Grade Levels, CSE/CPSE, and Working Papers
NYS Commissioners Regulation 136.3 requires:
• Schools to notify parents/guardians of students who did not provide a health certificate in the first 30 days of school that if one is not provided to the school within 30 days of such notice that an examination will be conducted by the medical director.
• Therefore, a health appraisal may not be conducted in the first 60 days of school for mandated grade level health exams.
• The NYS Education Department is encouraging schools to not schedule health appraisals with the medical director until early 2021 to allow parents/guardians more time to obtain a health examination by their healthcare provider.
Please Note: Students cannot be excluded from school if a health examination is not provided.
Additionally, the requirements for working papers and CSE/CPSE have not changed:
• Health examinations for working papers must be within the 12 months prior to the student’s application for working papers per Ed Law §3220. Please see the NYSED Student Support Service webpage for additional information on working papers.
• Health examinations in accordance with Article 19 (the health examination shall not be more than twelve months prior to the first day of school in which the examination is required) are required for initial evaluations by the CSE/CPSE. Please note the CSE/CPSE may request a more recent health examination as needed.
• There is no requirement that a health examination is needed for CSE/CPSE reevaluation. The
CSE/CPSE determines if a health examination is necessary for a student’s reevaluation.
Health Examinations for Fall Sports Participation:
• The Medical Director has the authority to clear students for participation in interscholastic athletics.
• The Medical Director may delegate review of the private provider health exam and a health history to an RN, but should provide written parameters for what information requires personal review by the Medical Director. A Sample School Medical Director Delegation Statement is available on the NYSCSH website.
• Within 30 days prior to the start of each athletic season the parent/guardian must complete a written and signed health history, if a health examination was not conducted within 30 days of the start of the season. A Sample Recommended NYSED Interval Health History For Athletics available on the NYSCSH website. If concerns are noted, the school medical director may ask for additional information.
• For the 2020 fall sports season a student may participate if they had a health examination in the 2018-2019 or 2019-2020 school years and the parent/guardian completes a health history form. Any health examination valid for the 2018-2019 or 2019-2020 school years is acceptable regardless of the date on the exam form.
• The 12-month time frame typically required for health exams for sports participation in the fall season has been waived.
• If the medical director chooses to conduct all health examinations for sports participation they may do so. However, he/she must provide ample opportunities for students to obtain that examination at school so that no student is excluded.
• The Athletic Placement Process (APP) remains unchanged and a current health exam will be needed as part of the APP.
• Students should plan to obtain the required health examination prior to participation in the winter or spring 2020-2021 seasons. This may change depending on the status of COVID-19 in the fall.
Thank you for your attention to these new immunization requirements.
If you have questions or concerns about immunizations, please contact the school health staff.
Registered Nurse, PreK- Grade 6
Phone: 315.626.3439, Extension 1831
Registered Nurse, Grade 7-12
Phone: 315.626.3439, Extension 3831