• Immunization (Vaccine) Requirements

• Immunization Exemptions and Partial Exclusion Guide

• Physical Exam Requirements
  

Requirements apply to all students including individuals from another country attending or visiting classes or educational programs as part of an academic visitation or exchange program. Requirements apply to all students, even if over 18 years of age.

Attendees < 2 years should be immunized for their age according to the ACIP Recommended Immunization Schedule. Requirements listed in the table below apply to all attendees ≥ 2 years. These requirements also apply to children in preschool classes called K0 or K1.

Meningococcal vaccine requirements (see Grades 7-10 and 11-12) also apply to residential students in Grades Pre-K through 8 if the school combines these grades in the same school as students in Grades 9-12.

Medical exemptions (statement from a physician stating that a vaccine is medically contraindicated for a student) must be renewed annually at the start of the school year and religious exemptions (statement from a student, or parent/guardian if the student is <18 years of age, stating that a vaccine is against sincerely held religious beliefs) should be renewed annually at the start of the school year.

A reliable history of chickenpox includes a diagnosis of chickenpox, or interpretation of parent/guardian description of chickenpox, by a physician, nurse practitioner, physician assistant, or designee.

In ungraded classrooms, Kindergarten requirements apply to all students ≥ 5 years.

Meningococcal vaccine requirements (see Grades 7-10 and 11-12) also apply to residential students in Grades Pre-K through 8 if the school combines these grades in the same school as students in Grades 9-12.

Medical exemptions (statement from a physician stating that a vaccine is medically contraindicated for a student) must be renewed annually at the start of the school year and religious exemptions (statement from a student, or parent/guardian if the student is <18 years of age, stating that a vaccine is against sincerely held religious beliefs) should be renewed annually at the start of the school year.

A reliable history of chickenpox includes a diagnosis of chickenpox, or interpretation of parent/guardian description of chickenpox, by a physician, nurse practitioner, physician assistant, or designee.

In ungraded classrooms, Grade 7 requirements apply to all students ≥ 12 years.

Medical exemptions (statement from a physician stating that a vaccine is medically contraindicated for a student) must be renewed annually at the start of the school year and religious exemptions (statement from a student, or parent/guardian if the student is <18 years of age, stating that a vaccine is against sincerely held religious beliefs) should be renewed annually at the start of the school year.

A reliable history of chickenpox includes a diagnosis of chickenpox, or interpretation of parent/guardian description of chickenpox, by a physician, nurse practitioner, physician assistant, or designee.

• Meningococcal Disease

Note: Students who are 15 years old in Grade 11 are in compliance until they turn 16 years old.

Massachusetts school immunization requirements are created under authority of 105 CMR 220.000 Immunization of Students Before Admission to School

• Call your child’s doctor to schedule an appointment as soon as possible

• Call your child’s School Based Health Center

• Call the Parent Information Center to make an appointment with the nurse

Worcester Public Schools (WPS) provides free vaccines to students at the the Parent Information Center (PIC). Parents/caregivers must call ahead to make an appointment at 508-799-3194.

Parent Information Center Immunization Clinic

Hours: 9:00 am – 3:00 pm (Hours are subject to change without notice)
Location : 768 Main Street Worcester, MA 01610
Phone number: 508-799-3194

Massachusetts requires all children have lead screening test before they can enter daycare, Kindergarten, or preschool.

Learn about lead screening and reporting requirements

Does your child want to participate on a WPS athletic team? Have you provided the school nurse with an updated physical? The purpose of a sports physical is to ensure the safety of the student and provide guidelines for those with health needs.

Visit the Athletics page or view the Athletics Permission Form.

(see MGL c. 76 §§15, 15C, 15D; 105 CMR 220)

There are three situations in which children not appropriately immunized may be admitted to school:

• A medical exemption is allowed if a physician certifies that immunization is medically contraindicated. This must be renewed annually at the start of the school year.

• A religious exemption is allowed if a parent or guardian provides a written statement that the immunization conflicts with their sincere religious beliefs. This should be renewed annually at the start of the school year.

• Homeless children and children in foster care are protected from exclusion by the Every Student Succeeds Act (an update to the McKinney-Vento Act), which allows school administrators time to secure immunization records from other schools or health systems.

While the statutes and regulations state that unimmunized students who do not meet criteria for medical or religious exemption “shall not be admitted to a school,” the enforcement of exclusion for unimmunized or partially immunized children is discharged by individual schools and school districts.

Please note that unimmunized or partially immunized homeless children and children in foster care cannot be denied entry to public school if they do not have immunization records.

The federal Every Student Succeeds Act states that if a homeless or foster care child or youth arrives lacking immunizations or medical records, the parent/guardian should be referred to the district’s Homeless Education Liaison/foster care point of contact, who has the responsibility to obtain relevant academic records and immunizations or medical records and to ensure that homeless/foster care students are attending school while the records are obtained.

The student must be enrolled and permitted to attend public school in the interim. If you have any questions about the Every Student Succeeds Act, please email the Department of Elementary and Secondary Education (DESE) or call 781-338-3700.

Schools enrolling homeless children and children in foster care may wish to review their obligations under the federal Every Student Succeeds Act of 2015 (ESSA). The National Center for Homeless Education provides information on the Every Student Succeeds Act.

In situations when one or more cases of a vaccine-preventable or any other communicable disease are present in a school, all susceptibles, including those with medical or religious exemptions, are subject to exclusion as described in the Department of Public Health’s Reportable Diseases and Isolation and Quarantine Requirements (105 CMR 300.000).

The Isolation and Quarantine Requirements at 105 CMR 300 establish isolation and quarantine requirements for cases of certain diseases and their contacts in certain high-risk situations, including the school setting. The following table excerpted from 105 CMR 300, outlines several of the more common childhood vaccine-preventable diseases identified in the requirements that may occur in schools and the corresponding exclusion requirements.

Note: This document does not serve as legal or medical advice. To the extent this document conflicts with statutory or regulatory requirements, those requirements shall control. Nothing in this document shall be interpreted to alter or modify requirements set out in the law. Questions about a school’s legal obligations or interpretation of applicable statutes and regulations must be directed to the school’s legal counsel.

Depending on the specific circumstances related to the exposure, case, and contact with any disease or condition listed in 105 CMR 300.200 (A) or (B), additional control measures may be required.

This list is not exhaustive. See 105 CMR 300.000 for the complete Isolation and Quarantine Requirements

Susceptibles includes all those born in or after 1957 without ) written documentation of 2 doses of measles-containing vaccine; or 2) laboratory evidence of immunity or laboratory confirmation of disease. In an outbreak setting, all those with 0 or 1 dose may avoid exclusion if they promptly receive a dose. Those born in the United States before 1957 are considered immune; however, this should not be considered evidence of immunity for health sciences students and health care workers.

Susceptibles includes all those born in or after 1957 without ) written documentation of 2 doses of mumps-containing vaccine; or 2) laboratory evidence of immunity or laboratory confirmation of disease. In an outbreak setting, those with 0 or 1 dose may avoid exclusion if they promptly receive a dose. Those born in the United States before 1957 are considered immune; however, this should not be considered evidence of immunity for health sciences students and health care workers.

Susceptibles includes all those born in or after 1957 without ) written documentation of 2 doses of rubella-containing vaccine; or 2) laboratory evidence of immunity or laboratory confirmation of disease. In an outbreak situation, those with 0 or 1 doses may avoid exclusion if they promptly receive a dose. Those born in the United States before 1957 are considered immune; however, this should not be considered evidence of immunity for health sciences students and health care workers.

Susceptibles include all those exposed, regardless of their age, immunization status, or past history of the disease.

Susceptibles includes all those born in the United States in or after 1980 without 1) written documentation of 2 doses of varicella vaccine; or 2) laboratory evidence of immunity or laboratory confirmation of disease; or 3) a health care provider diagnosis of varicella or health care provider verification of history of varicella disease; or 4) history of herpes zoster based on health care provider diagnosis. In an outbreak situation, those with 0 or 1 doses may avoid exclusion if they promptly receive a dose. Those born in the United States before 1980 are considered immune; however, this should not be considered evidence of immunity for health sciences students or health care workers.

Health care workers and health sciences students should have 2 doses of MMR and varicella, laboratory evidence of immunity, or laboratory confirmation of disease.

Pregnant and immunocompromised persons: It is not recommended to use the year of birth as evidence of immunity for pregnant women and immunocompromised persons. For their protection, these individuals – regardless of their year of birth or other documentation of immunity – should be referred to their health care providers for evaluation.

These are exclusion guidelines for typical school settings only. There are other guidelines for non-school settings. In addition, MDPH may need to implement more rigorous criteria for immunity and other control measures depending on the situation and the individuals exposed, and these recommendations are outlined in other MDPH documents.

Two additional references may that be helpful to school health personnel:

• The Guide to Surveillance and Reporting can be obtained on the MDPH Website

• The Comprehensive School Health Manual

Respiratory Illness Guidance (Includes COVID-19)

CDC COVID-19 Information

Health Documents / Forms

Health & Wellness

Innovative Care Coordination Project

Nursing Department

Free Health Clinics