Immunizations Protect Children and Help Schools Remain Healthy

By Kelly Moore, M.D.

Believe it or not, it’s already back to school time in Tennessee. An important part of all parents’ preparation is making sure children’s shot records are up to date. Children entering Kindergarten and 7th grade must get certain immunizations to attend classes, and the shots’ record has to be an official state immunization certificate. Immunization certificates can be completed by a licensed Tennessee physician, advanced practice nurse, physician assistant or the local health department.


In 2010, the Tennessee Department of Health introduced a new immunization certificate and updated requirements for the first time in a decade. These changes brought Tennessee’s requirements current and replaced four different forms with a single, multipurpose certificate usable for childcare, preschool, and school age children.


Why does a child need to be immunized? Vaccines protect the vaccinated child and those who cannot be vaccinated. Students who are not immunized because of certain medical conditions or religious convictions rely on the protection of their classmates to shield them from these serious diseases. Vaccines required for school attendance are selected from among the vaccines recommended for all children to protect against serious diseases a child could encounter in a school or child care center.


When does a child need an immunization certificate? The youngest are children enrolled in child care centers or preschool. Generally, infants and toddlers have to be up to date on immunizations when they enroll. All children 18 months and older must have all the vaccinations needed for child care or preschool. All new Kindergarten students and students new to Tennessee schools in other grades need one to enroll in school for the first time. When students transfer schools in Tennessee, the certificate follows in their student files.


All students about to start 7th grade also need a new immunization certificate because one new vaccine is required for them: Tdap. This tetanus, diphtheria and pertussis booster can prevent the spread of the very contagious cough illness, pertussis, after the vaccines of early childhood have worn off. New 7th graders also need a review of their immunity to chickenpox. These students must have had chickenpox illness or have had two doses of vaccine against it, since we now know some children are not protected by just one dose.


New fulltime college students also must meet state immunization requirements, though they don’t have to use the official state certificate. The requirements are intended to protect young adults from diseases that spread through the air in classrooms or dorms. Those born after 1956 must have had two doses of measles, mumps and rubella vaccine, and those born after 1979 must now provide their school with documentation of immunity to chickenpoxeither a history of the disease or two doses of vaccine.


If your kids need an immunization certificate, consider it a good excuse for scheduling a comprehensive well child exam at the same time. Many older children, especially preteens and teens, miss out on complete annual physicals during those critical years. These exams are covered by TennCare and most insurance programs. In this way, you can give your student a great start toward a healthy and productive school year. You can visit our website at for more information.