Most states require four core vaccines for kindergarten entry: DTaP (diphtheria, tetanus, and whooping cough), polio, MMR (measles, mumps, and rubella), and varicella (chickenpox). Beyond those, many states also require hepatitis B and hepatitis A. Additional boosters kick in around middle school, and colleges often have their own requirements. The exact number of doses and the specific vaccines required vary by state, so checking with your school district or state health department is essential.
Vaccines Required for Kindergarten
Nearly every state requires children to have completed the same set of vaccinations before starting kindergarten. Using Texas as a representative example of typical requirements, here’s what most states ask for:
- DTaP (diphtheria, tetanus, whooping cough): 5 doses, with at least one given on or after the 4th birthday. Four doses can satisfy the requirement if the last one was given after age 4.
- Polio: 4 doses, with at least one given on or after the 4th birthday. Three doses meet the requirement if the final dose came after age 4.
- MMR (measles, mumps, rubella): 2 doses, with the first given on or after the 1st birthday.
- Varicella (chickenpox): 2 doses, with the first given on or after the 1st birthday.
- Hepatitis B: 3 doses (or 2 doses for children aged 11 to 15 who received a specific adult formulation).
- Hepatitis A: 2 doses, with the first given on or after the 1st birthday.
If your child has been following the standard vaccination schedule at their pediatrician’s office, they’ve likely already received most or all of these. The 4-to-6-year-old well-child visit is specifically designed to wrap up the final doses of DTaP, polio, MMR, and varicella before school starts.
What Changes in Middle School
A second wave of requirements hits around 7th grade. Many states require two new vaccines at this point, both recommended by the CDC for 11- to 12-year-olds:
- Tdap: This is a booster for tetanus, diphtheria, and whooping cough, replacing the childhood DTaP series. Most states require one dose before entering 7th grade.
- Meningococcal (MenACWY): One dose of this vaccine, which protects against four types of bacterial meningitis, is typically required on or after a child’s 11th birthday.
The CDC also recommends the HPV vaccine starting at age 11 or 12. While HPV vaccination is not widely mandated by states for school entry, it is part of the standard adolescent schedule and is most effective when given before age 15, when only two doses are needed instead of three.
Boosters for High School and College
The CDC recommends a second dose of the meningococcal (MenACWY) vaccine at age 16 because protection from the first dose fades over time. Teens who received their first dose at 16 or later don’t need a booster. This second dose matters especially for college-bound students, since many colleges require proof of MenACWY vaccination within the past five years.
There’s also a separate meningococcal B (MenB) vaccine that the CDC recommends teens consider, preferably between ages 16 and 18. Serogroup B meningitis is rare, but outbreaks have occurred on several U.S. college campuses in the past decade. MenB is not routinely required for school, though some colleges may ask about it. Teens with certain immune conditions are more strongly encouraged to get it.
The annual flu shot is recommended every year for children ages 4 through 18 but is rarely a school enrollment requirement.
How Requirements Differ by State
There is no single federal vaccination law for schools. Each state sets its own list. The four core kindergarten vaccines (DTaP, polio, MMR, varicella) are required in almost every state, but beyond that, differences emerge. Some states require hepatitis A; others don’t. Some mandate the meningococcal vaccine for 7th graders; a few don’t add it until later.
Your school district will typically send home a list of required vaccines before enrollment, or you can find it on your state health department’s website. If you’re moving between states, check the new state’s requirements early, since your child may need an additional dose or a vaccine that wasn’t required where you lived before.
Exemptions
All 50 states allow medical exemptions for children who can’t safely receive certain vaccines due to allergies, immune conditions, or other health reasons. These require documentation from a healthcare provider.
Beyond medical exemptions, some states also allow religious exemptions, philosophical (personal belief) exemptions, or both. The availability and process for these vary widely. A handful of states, including California and New York, have eliminated non-medical exemptions entirely.
If Your Child Is Behind on Shots
Children who have missed doses don’t need to restart a vaccine series from scratch. The CDC’s catch-up schedule allows kids to pick up where they left off, with specific minimum intervals between doses depending on the vaccine. A pediatrician can map out the fastest path to getting caught up, and many schools will allow conditional enrollment while a child completes a catch-up series on a set timeline.
If you’re unsure which vaccines your child has already received, start by contacting their pediatrician or the health department in the state where they were last vaccinated. Many states maintain immunization information systems, which are digital registries that track vaccination records. The CDC does not hold individual vaccination records, so your state registry or provider’s office is the place to look. You can also call 1-800-CDC-INFO (1-800-232-4636) for help locating the right contact in your state.
Quick Reference by Age
- Age 4 to 6 (kindergarten): Final doses of DTaP, polio, MMR, varicella. Confirm hepatitis A and hepatitis B series are complete.
- Age 11 to 12 (middle school): Tdap booster, first MenACWY dose, HPV vaccine series.
- Age 16 (high school): MenACWY booster. Consider MenB vaccine.
- Age 18 (college): Verify MenACWY was received within the past 5 years. Check your college’s specific requirements.