Daycare Immunization Requirements Guide 2026: Vaccines and Exemptions
Complete guide to daycare vaccination requirements in 2026. Required vaccines by age, exemption policies, state-by-state differences, and navigating immunization policies.
Immunization requirements are a fundamental aspect of daycare enrollment. Understanding what vaccines are required, when they're needed, and what options exist helps you prepare for enrollment and navigate any concerns. Vaccination policies protect all children in group care settings.
This guide covers everything about daycare immunization requirements in 2026: required vaccines, timing, exemptions, state variations, and what to know before enrollment.
Table of Contents
- Why Daycares Require Vaccines
- Standard Required Vaccines
- Age-Based Requirements
- Exemption Policies
- State Variations
- Preparing for Enrollment
- Questions to Ask
Why Daycares Require Vaccines
Understanding the rationale.
Protecting All Children
Group settings mean:
- Close contact between children
- Higher disease transmission risk
- Some children can't be vaccinated
- Herd immunity matters
- Outbreaks can spread quickly
Legal Requirements
Mandated because:
- State laws require for licensing
- Public health protection
- Consistent with school requirements
- Follows CDC recommendations
- Daycare can't operate without compliance
Who Vaccines Protect
Beyond your child:
- Infants too young for vaccines
- Children with medical exemptions
- Immunocompromised children
- Pregnant staff
- Vulnerable family members
Vaccine-Preventable Disease Risks
Diseases children face:
- Measles (highly contagious)
- Whooping cough (dangerous for infants)
- Chickenpox (complications possible)
- Flu (serious for young children)
- Hepatitis (lifelong impact)
Standard Required Vaccines
What's typically required.
Core Vaccines for Daycare
Typically required: | Vaccine | Protects Against | |---------|-----------------| | DTaP | Diphtheria, tetanus, pertussis | | IPV | Polio | | MMR | Measles, mumps, rubella | | Hib | Haemophilus influenzae type b | | HepB | Hepatitis B | | Varicella | Chickenpox | | PCV | Pneumococcal disease | | Rotavirus | Rotavirus |
CDC Recommended Schedule
Following the schedule:
- Birth: HepB (dose 1)
- 2 months: Multiple vaccines
- 4 months: Continued series
- 6 months: Continued series
- 12-15 months: MMR, varicella, others
- 15-18 months: DTaP booster
Flu Vaccine
Annual requirement:
- Many states require for daycare
- Given annually
- Usually fall timing
- Protects against seasonal flu
- Requirement varies by state
COVID-19 Vaccine
Current status:
- Requirements vary significantly
- Some states require
- Many daycares have policies
- Check individual daycare policy
- Evolving recommendations
Age-Based Requirements
What's needed when.
Infants (Under 12 months)
Required vaccines:
- HepB (at least dose 1)
- DTaP (as age-appropriate)
- Hib (as age-appropriate)
- PCV (as age-appropriate)
- IPV (as age-appropriate)
- Rotavirus (if applicable)
Toddlers (12-24 months)
Additional requirements:
- MMR (usually by 15 months)
- Varicella (usually by 15 months)
- HepA (series starts)
- Continued boosters
Preschool (2-5 years)
Completed series:
- All infant vaccines completed
- Boosters as due
- Annual flu (if required)
- HepA completed
- Kindergarten requirements approaching
"Up to Date" Meaning
Means:
- All vaccines due for age received
- Following CDC schedule
- May not be complete series
- On track for next doses
Exemption Policies
Understanding exceptions.
Types of Exemptions
Categories: | Type | Basis | Availability | |------|-------|-------------| | Medical | Health reasons | All states | | Religious | Sincere religious beliefs | Most states | | Philosophical | Personal beliefs | Some states |
Medical Exemptions
Granted when:
- Documented medical reason
- Physician certification
- Specific conditions apply
- Temporary or permanent
- Accepted in all states
Common reasons:
- Allergic reaction to vaccine
- Immune system disorders
- Certain chronic conditions
- Physician recommendation
Religious Exemptions
Requirements vary:
- Most states allow
- May require documentation
- Sincerity of belief
- No specific religion required
- Process varies by state
Philosophical Exemptions
Personal belief exemptions:
- Available in fewer states
- Declining availability
- May require education
- Documentation required
- Check your state
State Exemption Trends
Recent changes:
- Some states eliminated non-medical
- Stricter documentation required
- Education requirements added
- Outbreak responses
- Varies significantly
State Variations
Differences across states.
Strictest States
States with limited exemptions:
- California (medical only)
- New York (medical only)
- West Virginia (medical only)
- Mississippi (medical only)
- Maine (medical only)
Most Exemptions Allowed
States with all exemption types:
- Texas
- Ohio
- Wisconsin
- Michigan
- Colorado
- (Check current status—laws change)
How to Find Your State's Rules
Resources:
- State health department website
- Immunization coalition
- State childcare licensing
- Your pediatrician
- Your daycare
Required Documentation
Typically need:
- Immunization record
- Physician signature
- Certificate of immunization
- Exemption form (if applicable)
- Updated records
Preparing for Enrollment
Getting ready.
Before Enrollment
Get prepared:
- Check vaccination status
- Schedule any needed vaccines
- Obtain official records
- Complete daycare forms
- Provide required documentation
Getting Records
Where to get:
- Pediatrician's office
- State immunization registry
- Previous providers
- Hospital records (birth doses)
If Behind on Vaccines
Options:
- Catch-up schedule available
- May need accelerated schedule
- Work with pediatrician
- Some flexibility for enrollment
- Provisional enrollment sometimes
Keeping Records Updated
Ongoing:
- Update daycare with new vaccines
- Keep copies of all records
- Use digital records apps
- Track on calendar
- Bring to well-child visits
Questions to Ask
About Requirements
- "What vaccines are required for enrollment?"
- "What documentation do you need?"
- "Are there additional vaccines you recommend?"
- "What's your flu vaccine policy?"
- "What's your COVID vaccine policy?"
About Timing
- "Can my child start if they're not fully up to date?"
- "Is provisional enrollment available?"
- "How much time do we have to catch up?"
- "When do records need to be submitted?"
About Exemptions
- "What exemptions do you accept?"
- "What's the process for exemption?"
- "What happens during an outbreak if exempt?"
- "Do many enrolled children have exemptions?"
About Illness
- "What happens if there's an outbreak?"
- "How do you notify parents of exposure?"
- "What's your policy for vaccine-preventable illness?"
Immunization Checklist
Before Starting Daycare
- [ ] Review child's immunization record
- [ ] Compare to state requirements
- [ ] Schedule any needed vaccines
- [ ] Obtain official documentation
- [ ] Complete daycare health forms
For Infants
- [ ] HepB (doses completed for age)
- [ ] DTaP (doses completed for age)
- [ ] Hib (doses completed for age)
- [ ] PCV (doses completed for age)
- [ ] IPV (doses completed for age)
- [ ] Rotavirus (if due)
For Toddlers/Preschoolers
- [ ] All infant vaccines up to date
- [ ] MMR (at least dose 1)
- [ ] Varicella (at least dose 1)
- [ ] HepA (series started)
- [ ] Flu vaccine (if required)
- [ ] Any needed boosters
Ongoing
- [ ] Track vaccine schedule
- [ ] Provide updates to daycare
- [ ] Keep records accessible
- [ ] Schedule annual flu (if required)
- [ ] Prepare for school requirements
Common Questions
"What if we're behind?"
Most daycares accept children who are catching up, with provisional enrollment while completing needed vaccines. Work with your pediatrician on catch-up schedule.
"Can daycare require vaccines the state doesn't?"
Daycares can have stricter policies than state minimums. Private daycares especially may require additional vaccines or not accept certain exemptions.
"What happens during an outbreak?"
Unvaccinated children may be excluded from care during outbreaks of vaccine-preventable diseases. This protects them and others.
"Where can I get vaccines?"
- Pediatrician's office
- Community health centers
- Pharmacies (older children)
- Health department clinics
- Vaccines for Children program (if eligible)
Resources
- Find Daycare Near You
- Daycare Sick Policy Guide
- Daycare Health Requirements
- Questions to Ask Daycare
Last updated: December 2025