Immunization Requirements

Download Missouri School/Daycare Immunization Requirements Overview (PDF)
Download Missouri School/Daycare Immunization Requirements FAQ (PDF)

Hepatitis B vaccination is required for students in kindergarten through 12th grade. This vaccine is a series of three injections—the second dose is due one month after the first, and the third dose five months after the second dose.
According to Missouri immunization laws, students are not allowed to attend classes unless all required immunizations have been received or if the student is in the process of obtaining immunizations, in which a Missouri state “immunizations in progress” form (ImmP.14) must be presented to the school nurse. Parents/guardians must provide written proof (an official immunization record) of compliance to the school nurse by the first day of school. Exemption from immunizations is allowed for religious or medical reasons. Please contact your school nurse if you need a Missouri state (ImmP.11A) or (ImmP.12) exemption form.

If you have any questions or concerns regarding the immunization requirements for school attendance, please contact your school nurse or the St. Louis County Department of Health.

SUMMARY OF IMMUNIZATIONS REQUIRED

• DTP/DT/DtaP (diphtheria, tetanus, pertussis)—four doses
• Polio—three doses
• Hepatitis B—three doses
• Hib (Haemophilus influenzae type b)—one dose or more after first birthday depending when the child started the series
• MMR (measles, mumps, rubella)—one dose after first birthday
• Varivax (chicken pox)—one dose or a statement signed by the physician indicating the month and year the child had chicken pox disease.
• PCV (pneumococeal conjugate vaccine) – age appropriate dose depending when the child started the series (1-3 doses).

• DTP/DT/TD/ DtaP—four doses with the last dose on or after fourth birthday and the last dose of pertussis before the seventh birthday (maximum doses: six). A TD booster is recommended if at least 5 years have elapsed since the last dose of tetanus and diphtheria toxoid-containing vaccine. A TD booster is required every 10 years after the last dose for school attendance.• TdaP is required for students enrolled in 8th and 9th grade who have not received a Td booster dose within the past two years - *some exceptions*
• Polio — First through 12th grade, three doses if doses are all IPV or all OPV, or four doses if combination of IPV and OPV is used. All kindergarteners through sixth graders must have the last dose on or after the fourth birthday (maximum doses: four).
• Measles, mumps and rubella (MMR) – two doses required for all students K through eighth grade. For grades 9 through 12, MMRs are highly recommended, but the following are required:
  Measles — two doses on or after first birthday and separated by at least 28 days
  Mumps — one dose on or after the first birthday
  Rubella — one dose on or after the first birthday
• Hepatitis B — three doses (required in grades K–12)
• Varivax — First- through sixth-grade students must have proof of vaccination or proof of chicken pox disease by statement from physician indicating the month and year the child had the chicken pox disease. All kindergarteners and first-grade students must have a second dose of varivax or a written statement by an MD or DO documenting the month and year the child had the disease. A parental statement is no longer accepted for students in kindergarten or first grade, but is allowed for students in grades two through six.