Whatcom County Health Advisory

Immunization Reminder- Students 4 years of age on or before September 1, 2023, must receive additional doses of vaccine to attend school.

Whatcom County Health and Community Services Communicable Disease & Epidemiology Division


In the past, students had 30 days from the first day of attendance to turn in their immunization documentation to the school. The new rule clarifies that students without immunization paperwork should not start school until the required paperwork is turned in to the school. If they are missing vaccine doses, they must get any doses they are eligible to receive before starting school. If more doses are needed in a series that require spacing for dosing purposes, the student is considered in conditional status, and can be in school while completing the vaccine series. Children in conditional status must be making progress toward meeting the immunization requirements. Read details in RCW 28A.210.080.

Transitional kindergarten (TK) was formally recognized by The Office of the Superintendent for Public Instruction (OSPI), in 2018. As a result, school immunization requirements were updated by the Washington Department of Health (DOH).

Requested actions

  • Be aware, Preschool immunization requirements moved from the childcare immunization chart to the school chart.  New requirements were added for students four years of age.
  • Be aware, Students in preschool or kindergarten including TK, who are four years old or older on September 1st, or within 30 days of 4th birthday, whichever is later, are required to have additional dose of DTaP, IPV, MMR and varicella vaccines. This should not be interpreted to mean that all students have a 30-day grace period from the start of school. 
    • A booster dose of DTaP vaccine given at age 4 or older
    • A booster dose of IPV vaccine given at age 4 or older
    • Dose 2 of MMR vaccine
    • Dose 2 of varicella (chickenpox) vaccine
  • Be aware, schools do not need to monitor students who turn four during the school year.
  • Be aware, if a child turns 4 and schools do not receive paperwork showing they meet immunization requirements for school entry, the child will be excluded from school, per Revised Code of Washington RCW 28A.210.120.
  • Review School and Childcare Immunization Webpage for updated requirements for children attending school
  • Use Recall/Reminder functions to send notification to all parents of 4-year olds of this requirement and encourage them to schedule an immunization visit in advance with you so they do not miss any school.
  • Notify your patients of the new webpage, the school and Child Care Immunization page for Families at www.doh.wa.gov/vaxtoschool. The page is designed to help parents understand the rules around school and child care immunizations. The page has all the forms families need to meet the immunization requirements. It is in English and Spanish and DOH is considering translating it into additional languages.

Additional resources

Contacting the Health Department

360-778-6100    Main Call Line – available M-F 8:30am to 4:30pm

360-778-6100    Follow prompts to Afterhours Answering Service – available after 4:30pm and weekends

360-778-6150    Communicable Disease Report Line – 24 hours a day 7 days a week

360-778-6103    Confidential Communicable Disease Fax – 24 hours a day 7 days a week

509 Girard St, Bellingham WA 98225