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Footnotes

¹ A complete Hib series is two doses plus a booster dose on or after 12 months of age (three doses total). If a child receives the first dose of Hib vaccine at 12 - 14 months of age, only one additional dose is required (two doses total). Any child who has received a single dose of Hib vaccine on or after 15 - 59 months of age is in compliance with these specified vaccine requirements. Children 60 months of age and older are not required to receive Hib vaccine.

² If the PCV series is started when a child is seven months of age or older or the child is delinquent in the series, then all four doses may not be required. Please reference the information below to assist with compliance:

• For children seven through 11 months of age, two doses are required.
• For children 12 - 23 months of age: if three doses have been received prior to 12 months of age, then an additional dose is required (total of four doses) on or after 12 months of age. If one or two doses were received prior to 12 months of age, then a total of three doses are required with at least one dose on or after 12 months of age. If zero doses have been received, then two doses are required with both doses on or after 12 months of age.
• Children 24 months through 59 months meet the requirement if they have at least three doses with one dose on or after 12 months of age, or two doses with both doses on or after 12 months of age, or one dose on or after 24 months of age. Otherwise, one additional dose is required. Children 60 months of age and older are not required to receive PCV vaccine.

³ For MMR, Varicella, and Hepatitis A vaccines, the first dose must be given on or after the first birthday.  Vaccine doses administered within 4 days before the first birthday will satisfy the requirement.

Information on exclusions from immunization requirements, provisional enrollment, and acceptable documentation of immunizations may be found in §97.62, §97.66, and §97.68 of the Texas Administrative Code, respectively.

Vaccines:

• DTaP: Diphtheria, tetanus, and acellular pertussis (whooping cough); record may show DT or DTP
• Polio: IPV - inactivated polio vaccine; OPV – oral polio vaccine
• HepB: Hepatitis B vaccine
• Hib: Haemophilus influenzae type b vaccine
• PCV: Pneumococcal conjugate vaccine
• MMR: Measles, mumps, and rubella vaccines combined
• Varicella: Chickenpox vaccine. May be written VAR on record
• HepA: Hepatitis A vaccine

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Footnotes

^1. Receipt of the dose up to (and including) 4 days before the birthday will satisfy the school entry immunization requirement.

^2. Serologic evidence of infection or serologic confirmation of immunity to measles, mumps, rubella, hepatitis B, hepatitis A, or varicella is acceptable in place of vaccine.

^3. Previous illness may be documented with a written statement from a physician, school nurse, or the child’s parent or guardian containing wording such as: “This is to verify that (name of student) had varicella disease (chickenpox) on or about (date) and does not need varicella vaccine.” This written statement will be acceptable in place of any and all varicella vaccine doses required.

Texas Administrative Code Rule:

• §97.61 — Children and Students Included in Vaccine Requirements
• §97.62 — Exclusions From Compliance
• §97.63 — Immunization Requirements in Childcare Facilities, Pre-Kindergarten, Early Childhood Programs and Texas Elementary and Secondary Schools
• §97.64 — Required Vaccinations for Students Enrolled in Health-related and Veterinary Courses on Institutions of Higher Education
• §97.65 — Exceptions to Immunization Requirements (Verification of Immunity/History of Illness)
• §97.66 — Provisional Enrollment for (Non-Higher Education; Non-Veterinary) Students and Children
• §97.67 — School Records
• §97.68 — Acceptable Evidence of Vaccination(s)
• §97.69 — Transfer of Immunization Records
• §97.70 — Review of Records and Providing Assistance
• §97.71 — Annual Report of Immunization Status of Students
• §97.72 — Additional Vaccination Requirements

Students in grades kindergarten through 12th grade are required to have two doses of Hepatitis A with the first dose received on or after the first birthday. To enroll in K-12, the child should already have 2 doses.

However, if the student has 1 dose at time of enrollment in K-12, the child may be provisionally enrolled IF the first dose of hepatitis A was received in the last 6 months. At this time, we would follow CDC’s catch-up recommendation for hepatitis A vaccine. When catching up, the minimal interval between the two hepatitis A doses is 6 months.

Once provisionally enrolled, the child must receive the 2nd dose as rapidly as medically feasible, which in this case is 6 months after the first dose. If more than 6 months have lapsed since the child received the first dose of hepatitis A, the child should not be enrolled (provisionally or otherwise) until the 2nd dose is received.

As for childcare, an 18-month window between dose 1 and dose 2 is built in with the first dose being required by 25 months and the 2nd dose by 43 months.

In the 86th Legislature, HB 3884 required DSHS to create procedures for school districts to provide information relating to bacterial meningitis to students and parents. DSHS shall prescribe the form and content of the information. 

Meningitis is an inflammation of the covering of the brain and spinal cord. It can be caused by viruses, parasites, fungi, and bacteria. Viral meningitis is the most common and the least serious form. Bacterial meningitis is the most likely form to cause serious, long-term complications. It is an uncommon disease but requires urgent treatment with antibiotics to prevent permanent damage or death. 

Multiple organisms can cause bacterial meningitis. Two common types are Streptococcus pneumoniae, with more than 80 serogroups that can cause illness, and Neisseria meningitidis, with five serogroups that most commonly cause meningitis. 

Download bilingual information about bacterial meningitis (PDF)

Learn more about invasive meningococcal disease

Q: Some of my older students received two doses of measles and one dose each of mumps and rubella, which satisfied the old school entry requirements. Will these students need to receive additional doses of MMR?

A: Students that were vaccinated prior to 2009 with two doses of measles and one dose each of mumps and rubella should be considered compliant. All other students must show proof of two doses of MMR vaccine.

Q: What are the polio vaccine requirements for students in Texas schools?

A: As outlined in §97.63 of the Texas Administrative Code, students in kindergarten through 12th grade are required to have four doses of polio vaccine - one of which must have been received on or after the fourth birthday. Or, if the third dose was administered on or after the fourth birthday, only three doses are required. Any combination of oral polio vaccine (OPV) & inactivated poliovirus vaccine (IPV) doses is acceptable, provided age requirements and total number of doses are met.
 

Q: Is polio vaccine required for persons enrolled in school once they turn 18?

A: No, polio vaccine is not required for persons 18 years of age or older.
 

Q: A student received a combination of oral polio vaccine (OPV) and inactivated poliovirus vaccine (IPV). Can this student be enrolled?

A: Yes, the student can enroll as long as they received the required number of doses outlined in §97.63 of the Texas Administrative Code. 
 

Q: A student received oral polio vaccine (OPV) in another country. What are the school entry requirements for students who received only OPV?

A: The requirements are the same for students who received an all IPV series and for those who received an all OPV series: four doses are required, provided one dose was received on or after the fourth birthday. However, three doses meet the requirement if the third dose was received on or after the fourth birthday.

Tetanus and diphtheria toxoids and acellular pertussis (Tdap) vaccine. (Minimum age: 10 years for both Boostrix and Adacel)

Routine Vaccination:

• Administer one dose of Tdap vaccine to all adolescents aged 11 through 12 years

• Tdap may be administered regardless of the interval since the last tetanus and diphtheria toxoid-containing vaccine.

• Administer one dose of Tdap vaccine to pregnant adolescents during each pregnancy (preferably during the early part of gestational weeks 27 through 36), regardless of time since prior Td or Tdap vaccination. 

Catch-up Vaccination:

• Persons aged 7 years and older who are not fully immunized with DTaP vaccine should receive Tdap vaccine as one dose (preferably the first) in the catch-up series; if additional doses are needed, use Td vaccine. For children 7 through 10 years who receive a dose of Tdap as part of the catch-up series, an adolescent Tdap vaccine dose at age 11 through 12 years may be administered.

• Persons aged 11 through 18 years who have not received Tdap vaccine should receive a dose, followed by tetanus and diphtheria toxoids (Td) booster doses every 10 years thereafter.

• Inadvertent doses of DTaP vaccine:

  • If administered inadvertently to a child aged 7 through 10 years, the dose may count as part of the catch-up series. This dose may count as the adolescent Tdap dose, or the child may receive a Tdap booster dose at age 11 through 12 years.

  • If administered inadvertently to an adolescent aged 11 through 18 years, the dose should be counted as the adolescent Tdap booster. 

Texas Administrative Code, Rule 97.63 (III) Tdap:

(-a-) Seventh grade. Students are required to have one booster dose of a tetanus/diphtheria/pertussis-containing vaccine for entry into the seventh grade, if at least five years have passed since the last dose of a tetanus-containing vaccine. If five years have not elapsed since the last dose of a tetanus-containing vaccine at entry into the seventh grade, then this dose will become due as soon as the five-year interval has passed. Td vaccine is an acceptable substitute if Tdap vaccine is medically contraindicated. 

(-b-) Grades 8 - 12. Students who have not already received Tdap vaccine are required to receive one booster dose of Tdap when ten years have passed since the last dose of a tetanus-diphtheria-containing vaccine.

Applying the Rules

To enroll in the seventh grade:

Children with at least three doses of the primary diphtheria/tetanus/pertussis series (DTaP and/or DT):

• Must have one dose of Tdap prior to enrollment.

  • If they have received Tdap, Td, DT, or DTaP in the past five years, no vaccine is needed.

  • If five years pass during seventh grade, the child should receive a Tdap at that time to stay enrolled in school.

Children who do not have at least three doses of diphtheria/tetanus/pertussis vaccine (DTaP and/or DT)

• Must receive one dose of Tdap and/or Td.

  • Three doses of diphtheria/tetanus/pertussis vaccines must be received, at least one of which should be Tdap (unless medically contra-indicated).

Students can be enrolled in school while receiving the additional doses, as long as at least one vaccine has been administered and they receive the doses as soon as it is medically feasible.

To enroll in 8-12th grade:

Children with at least 3 doses of the primary diphtheria/tetanus/pertussis series (DTaP and/or DT):

• Must have one dose of Tdap before enrollment.

  • No vaccine is needed if they have received Tdap, Td, DT, or DTaP in the past ten years.

  • If ten years pass between 8th and 12th grade, the child should receive one dose of Tdap at that time to stay enrolled in school.

Children that do NOT have at least three doses of diphtheria/tetanus/pertussis vaccine (DTaP and/or DT)

• Must receive one dose of Tdap and/or Td.

  • A total of three doses of diphtheria/tetanus/pertussis vaccines must be received, and at least one of which should be Tdap (unless medically contra-indicated).

  • Students can be enrolled in school while receiving the additional doses, as long as at least one vaccine has been administered and they are receiving the doses as soon as is medically feasible.

All entering students at an institution of higher education* are required to show proof of an initial meningococcal vaccination or a booster dose during the five-year period prior to enrolling. They must get the vaccine at least 10 days before the semester begins. View the exemptions section for more information on exemptions from these requirements.

*An "institution of higher education" and "private or independent institution of higher education" per Texas Education Code §51.9192; view Texas Education Code §61.003 for full definitions of these terms.

Students may show proof of vaccination against meningococcal disease by providing their college or university with an immunization record showing they have been vaccinated against it in the last five years. Acceptable proof includes one of the following:

• A form showing the signature or stamp of a physician or his/her designee, or public health personnel that shows the month, day, and year the vaccination dose or booster was administered
• An official immunization record generated from a state or local health authority that shows the month, day, and year the vaccination or booster dose was administered
• An official record received from school officials (includes records from out of state)

Students may get a copy of their immunization records from their private healthcare provider or local health department, depending on where the vaccination(s) were administered. If the student's immunization records are in ImmTrac2, the Texas Immunization Registry, he or she can request a copy by calling the Texas Immunization Information Line at 800-252-9152. Please note that individuals 18-26 must re-consent as adults to stay in the registry.

Which Students Are Required To Receive Meningococcal Vaccine?

• A first-time student of an institution of higher education or private or independent institution of higher education
• A transfer student from another institution
• A returning student who attended college before January 1, 2012, who is enrolling in the same or another institution of higher education following a break in enrollment of at least one fall or spring semester

Which Students Are Not Required To Receive Meningococcal Vaccine?

• Students 22 years of age or older by the first day of the start of the semester
• Students enrolled only in online or other distance education courses
• Students enrolled in a continuing education course or program that is less than 360 contact hours or continuing education corporate training
• Students enrolled in a dual credit course which is taught at a public or private K-12 facility not located on a higher education institution campus
• Students incarcerated in a Texas prison
• Students who are not enrolled in an institution of higher education
• Students submitting an affidavit or a certificate signed by a physician who is duly registered and licensed and in good standing to practice medicine in the United States, stating that, in the physician's opinion, the vaccination required would be injurious to the health and well-being of the student
• Students who submit an affidavit/form signed by the student (or the parent/legal guardian/managing conservator, if applicable) stating the student declines the vaccination for bacterial meningitis for reasons of conscience, including a religious belief
• For students obtaining exemptions from vaccination, these exemptions do not apply during a disaster or public health emergency, terrorist attack, hostile military or paramilitary action, or extraordinary law enforcement emergency declared by an appropriate official or authority from Texas DSHS; and in effect for the location of the institution the student attends

Request an Affidavit for Community College or Public Junior College

Students attending a community college or public junior college may generate and print a conscientious exemption affidavit for the bacterial meningitis vaccine requirement online at the Meningococcal Vaccination Exemption Website.

Request an Affidavit at Other Institutions of Higher Education

A person claiming exclusion for reasons of conscience, including a religious belief, from a required immunization has the option to download and print the blank immunization exemption affidavit form. 

To receive an exemption, a person may download an affidavit form using the methods outlined below.

First, download and print the blank Affidavit Exemption from School or Child-Care Immunizations for Reasons of Conscience form, Stock No. F11-11755.

DSHS suggests you review the How to Complete and File Your Immunization Exemption Affidavit, Stock No. 11-12953 and the Benefits and Risks of Vaccination, Stock No. 11-11846.

To request that DSHS mail you the form, submit a request through the United States Postal Service (USPS), commercial carrier, fax, online, or in person. DSHS does not accept phone and email requests. DSHS uses the USPS to mail requested forms with an estimated delivery within three weeks. 

Use the Request for Exemption from Immunizations for Reasons of Conscience form, Stock No. EF11-13140. The request must include the following information:

• Name of parent, legal guardian, or self (for the mailing label).
• Complete USPS mailing address (for the mailing label).
• Telephone number (to allow DSHS to contact the requestor if the request is not deliverable or returned to DSHS).
• Number of requested affidavit forms.

NOTE: DSHS does not retain this information. DSHS only uses it for the mailing label or to include in the documents sent to the requestor.

You can request an affidavit through one of these methods:

Via Website: Affidavit Request for Exemption from Immunizations for Reasons of Conscience

By Mail:

      Texas Department of State Health Services
      Immunization Section, Mail Code 1946
      P.O. Box 149347
      Austin, Texas 78714-9347

By Fax: 512-776-7544

In Person:

      Texas Department of State Health Services
      1100 West 49th Street
      Austin, Texas 78756

NOTE: No requests will be filled at the time of hand-delivery.
All affidavit forms will be mailed to you via U.S. Postal Service.

Make sure to fill in the student’s name and date of birth, sign the document, and notarize the affidavit form from DSHS.

Submit the completed and notarized form to the institution of higher education, including those offering health-related or veterinary courses. The exemption is valid for two years after the notary date. An institution of higher education, including those offering health-related or veterinary courses, may exclude a child or student not immunized for reasons of conscience, religion, or medical exemption from attending school if there is an official emergency or an outbreak designated by the school or public health department. 

The Department of State Health Services (DSHS) developed immunization toolkits to help universities encourage vaccines beyond mandatory college enrollment requirements. These toolkits include a letter to students, social media posts, a text messaging campaign, and consent form.

Download PDF:

• Topple Meningococcal Toolkit

Students must have all the following vaccinations before they may engage in the course activities which will involve direct patient contact with potential exposure to blood or bodily fluids in educational, medical, or dental care facilities.

Tetanus-Diphtheria Vaccine

Students must show receipt of one dose of tetanus-diphtheria-pertussis vaccine (Tdap). In addition, one dose of a tetanus-containing vaccine must have been received within the last ten years. Td vaccine is an acceptable substitute, if Tdap vaccine is medically contraindicated.

Measles Vaccine

Students born on or after January 1, 1957, must show, prior to patient contact, acceptable evidence of vaccination of two doses of a measles-containing vaccine administered since January 1, 1968 (preferably MMR vaccine).

Mumps Vaccine

Students born on or after January 1, 1957, must show, prior to patient contact, acceptable evidence of vaccination of two doses of a mumps vaccine.

Rubella Vaccine

Students must show, prior to patient contact, acceptable evidence of one dose of rubella vaccine.

Hepatitis B Vaccine

Students are required to receive a complete series of hepatitis B vaccine prior to the start of direct patient care.

Varicella (Chickenpox) Vaccine

Students are required to have received two doses of varicella (chickenpox) vaccine.

Rabies Vaccine

Students enrolled in schools of veterinary medicine whose coursework involves direct contact with animals or animal remains shall receive a complete primary series of rabies vaccine prior to such contact. Serum antibody levels must be checked every two years, with a booster dose of rabies vaccine administered if the titer is inadequate according to current Centers for Disease Control and Prevention (CDC) guidelines.

Tetanus-Diphtheria

One dose of a tetanus-diphtheria toxoid (Td) is required within the last ten years. The booster dose may be in the form of a tetanus-diphtheria-pertussis-containing vaccine (Tdap).

Hepatitis B Vaccine

Students enrolled in schools of veterinary medicine whose coursework involves potential exposure to human or animal blood or bodily fluids shall receive a complete series of hepatitis B vaccine before such contact.

Requirements regarding acceptable evidence of vaccination are found in Texas Administrative Code §97.68.

Provisional Enrollment

Notwithstanding the other requirements in this section, a student may be provisionally enrolled in these courses if the student has received at least one dose of each specified vaccine prior to enrollment and goes on to complete each vaccination series on schedule in accordance with the CDC's Recommended Adult Immunization Schedule as approved by the Advisory Committee on Immunization Practices (ACIP). However, the provisionally enrolled student may not participate in coursework activities involving direct patient contact with potential exposure to blood or bodily fluids in educational, medical, or dental care facilities or direct contact with animals or animal remains until the full vaccination series has been administered.

Serological Confirmation of Immunity

The immunization requirements for health care students (non-veterinary and veterinary) do not apply to individuals who can properly demonstrate proof of laboratory confirmation of immunity or laboratory confirmation of disease. Vaccines for which this may be potentially demonstrated and acceptable methods for demonstration are found in Texas Administrative Code §97.65. Such a student cannot participate in coursework activities involving direct patient contact with potential exposure to blood or bodily fluids in educational, medical, or dental care facilities until such time as proper documentation has been submitted and accepted.

Students who claim to have had the complete series of required vaccinations but have not properly documented them cannot participate in coursework activities involving direct patient contact with potential exposure to blood or bodily fluids in educational, medical, or dental care facilities or direct contact with animals or animal remains, until such time as proper documentation has been submitted and accepted.