Health Services

1. What’s DIFFERENT about the new immunization dose requirements for school (TK/K-12)?

Starting in the 2019-2020 school year, school immunization requirements will include:

2 (rather than 1) doses of chickenpox vaccine at

• TK/Kindergarten entry
• 7th grade advancement
• TK/K-12 admission or transfer
• 2 MMR doses and 3 Hepatitis B vaccine doses at admission or transfer for most K-12 students.

As these requirements reflect longstanding national recommendations, many children have already met these requirements.

TK/K Admission —

* New requirements also met by 2 doses measles, 2 doses mumps, and 1 dose rubella vaccine.
** Prior requirements also met by 2 doses measles, 1 dose mumps, and 1 dose rubella vaccine.

1st -12th Grade Admission – 

* New requirements also met by 2 doses measles, 2 doses mumps, and 1 dose rubella vaccine.
** Prior requirements also met by:
Age 7-17 years: 1 dose measles, 0 doses mumps, and 1 dose rubella vaccine.
7th grade: 2 doses measles, 0 doses mumps, and 0 doses rubella vaccine.

7th Grade Advancement 

Complete details in 17 CCR section 6025, Table B.

2. What’s DIFFERENT about the new immunization requirements for pre-kindergarten (child care or preschool)?

Starting July 1, 2019, immunization requirements include:

• Chickenpox vaccine is required at age 15 months and older (rather than age 18 months and older).
• Other required vaccine dose requirements remain the same.
• As children age into requirements, parents have 30 days to submit updated records showing the child has met the requirements. For example, when an already admitted child who is up-to-date on shots turns 18 months old, the parents have 30 days from the day the child turns 18 months old to submit records that the child has received the 4th dose of DTaP and 3rd dose of Hep B.

3. Do students admitted in previous school years have to meet the new requirements in the 2019-2020 school year?

If a child is considered an admission at any school at any date on or after July 1, 2019 (including transfer students), the child will need to meet the newer immunization requirements in effect at the time of admission.

If a child is advancing to 7th grade in the fall of 2019 or later, the child must meet the 7th grade requirements in effect at the time of entry into 7th grade (i.e., 1 dose of Tdap, 2 doses of chickenpox vaccine).

If a child has an expiring personal beliefs exemption prior to attending school on or after July 1, 2019, the child will need to meet all current immunization requirements.

4. For admissions on or after July 1, 2019, what is required for a medical exemption to a required immunization?

Starting July 1, 2019, a parent or guardian must submit a signed, written statement from a physician (MD or DO) licensed in California which states:

• The specific nature of the physical condition or medical circumstance of the child for which a licensed physician does not recommend immunization.
• Each specific required vaccine that is being exempted.
• Whether the medical exemption is permanent or temporary.
• If the exemption is temporary, an expiration date no more than 12 calendar months from the date of signing.

5. Does a medical exemption filed for a child attending before July 1, 2019, need to meet the new requirements?

In some cases. A medical exemption filed previously remains valid until the earliest of:

• When the child is next considered to be an admission at a school or pre-kindergarten facility (applies to both temporary and permanent medical exemptions), at which time staff will need to confirm if the previously filed medical exemption meets the newer requirements, or
• The expiration date specified in the medical exemption (applies to temporary medical exemptions)or
• Advancement to 7th grade, for a medical exemption from varicella vaccine or Tdap.

6. May other practitioners, besides licensed physicians (MDs and DOs), provide a medical exemption to a required immunization?

No. Only a licensed Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO) may provide a medical exemption.

7. To meet the chickenpox requirement for TK/K-12 admission or for advancement into 7th grade, may a school accept an immunization record that indicates a "history of chickenpox disease"?

No, this is not sufficient documentation to meet school requirements.  Medical exemption documentation may be used for a child who had chickenpox disease that was documented by a physician. 

8. What are the requirements for students entering a home-based private school or independent study program and do not receive classroom-based instruction?

Students entering:

• A home-based private school or
• An independent study program and do not receive classroom-based instruction

are not subject to immunization requirements. Parents or guardians must provide records to the respective schools of any required immunizations received by these students.

9. Are students who are homeless or in foster care subject to the immunization requirements?

Yes. However, a student who is homeless or in foster care, when transferring into a new school, may be admitted immediately if the student arrives without immunization records. Schools should utilize their resources to make sure these students have received all required immunizations as soon as possible.

10. Are California schools and child care facilities required to report the immunization status of all pupils at selected ages and grades?

Yes. All California schools and child care facilities, whether public or private, are required to report to the California Department of Public Health and the local health department each year the immunization status of all pupils, without exceptions, admitted at specified ages or grade levels. (Citation: California Health and Safety Code Section 120375 and 17 CCR § 6075)

11. May schools and child care facilities share student immunization information with public health agencies? 

Reporting of student immunization information to public health agencies is allowed by state and federal laws, including but not limited to

California laws:

• Chapters 1 (commencing with section 120325) and 2.5 (commencing with section 120440) of Part 2, of Division 105 of the Health and Safety Code

Federal laws:

• The Health Insurance Portability and Accountability Act of 1996 (HIPAA) (45 CFR Part 160 and Subparts A and E of Part 164), and
• The Family Educational Rights and Privacy Act (FERPA) (20 U.S.C. § 1232g; 34 CFR Part 99), which applies to educational agencies or institutions that receive funds from programs administered by the U.S. Department of Education.

12. Where may I find immunization coverage data for children in schools and child care facilities?

Data are posted at the following sites:

• Kindergarteners: https://www.shotsforschool.org/k-12/reporting-data/
• 7^th Graders: https://www.shotsforschool.org/7th-grade/reporting-data/
• Children attending pre-Kindergarten facilities: https://www.shotsforschool.org/child-care/reporting-data/

Any student who is required to take prescribed medication during the school day may be assisted by a school nurse or designated school personnel if the school receives a completed “Medication Authorization Form” signed by a California licensed health care provider and the student’s parent or guardian (EC 49423).

Upon written parent’s consent and school nurse approval, a student may be allowed to carry and self-administer prescription auto-injectable epinephrine, prescription inhaled asthma medication, or medications and supplies prescribed for the management of diabetes. No other medications, except for emergency use, may be carried.* Students may be allowed to carry and self-administer these prescribed medications if the school receives a completed “Medication Authorization Form” and the “Student/Parent Consent to Carry and Self-Administer Medication” form and after approval by the school nurse.

*For approval to carry and self-administer other medications that are of a confidential nature, need urgent administration, or other reasons, please contact a district nurse. Exceptions to the above rule will be made on a case by case basis in consultation with the district nurse and student's physician.  A district nurse can be contacted at health@pausd.org or (650)833-4240.

Medication forms can be obtained from the school health office or printed from the links below.

No medication, including herbal remedies or other over-the-counter drugs, will be stored or dispensed at school without written authorization from the physician and parent. All medication permits must be renewed at the beginning of the school year before school employees may assist with medication administration. Medication must be supplied by the parent in the original prescription clearly labeled with student’s name, medication, dosage and directions, or original over-the-counter container. Updated forms for the next school year must be signed after the current school year ends.

Your child's school will keep an accurate written record documenting that the medication was administered in the prescribed amount at the prescribed time.

Medication Authorization Forms

• Medication Authorization - General for School Hours, Field Trips, and Disasters (Spanish, Mandarin)
• Medication Authorization - Anaphylaxis (Spanish, Mandarin)
• Medication Authorization - Asthma (Spanish, Mandarin)
• Medication Authorization - Emergency Anti-Seizure (Spanish, Mandarin)
• Seizure Action Plan

If your student has Type 1 Diabetes, Type 2 Diabetes, or a specialized health care procedure (i.e. Catheterization, Gastrostomy Tubes, etc.), please contact Health Services directly at health@pausd.org or 650-833-4240 for information on necessary forms and protocols. 

The District Nurses and other qualified professionals conduct screenings at school sites.

All students are screened at the grade levels listed below:

Vision and Hearing: Grades TK, K, 2nd, 5th, and 8th.

Color Vision: Grade 1

Students may also be screened if the parent, teacher or school nurse suspect a vision or hearing problem and for special education assessments and as needed for district health initiatives. Those who fail the initial screening will be re-tested by the school nurse. Parents will be notified and referred for further follow-up only when a problem is identified (EC 49456, 49452.5).

Parents may submit a written request to the school principal for exemption from any of the above health screenings.

In the event that a case of pertussis, also known as whooping cough, is reported at any PAUSD school, the PAUSD nursing team works very closely with the Santa Clara County Department of Public Health to respond to and prevent cases of pertussis from spreading. The PAUSD nursing team uses the public health department’s protocol to ensure the health and well- being of all PAUSD students. Please use the following resources to learn more about Pertussis and how to prevent it:

California Department of Public Health – Pertussis (whooping cough)

California Department of Public Health – Pertussis Quick Sheet / Spanish

Centers for Disease Control and Prevention – About Pertussis

Centers for Disease Control and Prevention - Diphtheria, Tetanus, and Pertussis Vaccine Recommendations

Centers for Disease Control and Prevention - Tdap Vaccine Information Statement / Spanish / Chinese Traditional / Other Languages