2022 - 2023 Texas Minimum State Vaccine Requirements for Child

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Rev. 03/2022

2022 - 2023 Texas Minimum State Vaccine Requirements for Child-Care and Pre-K Facilities

This chart summarizes the vaccine requirements incorporated in the Texas Administrative Code (TAC), Title 25 Health Services, §§97.61-97.72. This chart is not

intended as a substitute for consulting the TAC, which has other provisions and details. The Department of State Health Services (DSHS) is granted authority to

set immunization requirements for child-care facilities by the Human Resources Code, Chapter 42.

A c

hild shall show acceptable evidence of vaccination prior to entry, attendance, or transfer to a child-care facility in Texas.

Age at which

child must have

vaccines to be in

compliance:

Minimum Number of Doses Required of Each Vaccine

Diphtheria /

Tetanus /

Pertussis

(DTaP)

Polio

Hepatitis B

(HepB)

Haemophilus

influenzae

type b (Hib)

Pneumococcal

conjugate

vaccine (PCV)

Measles,

Mumps,

& Rubella

(MMR)

1, 4

Varicella

1, 4, 5

Hepatitis A

(HepA)

1, 4

0 through 2 months

By 3 months 1 Dose 1 Dose 1 Dose 1 Dose 1 Dose

By 5 months 2 Doses 2 Doses 2 Doses 2 Doses 2 Doses

By 7 months 3 Doses 2 Doses 2 Doses 2 Doses 3 Doses

By 16 months 3 Doses 2 Doses 2 Doses 3 Doses 4 Doses 1 Dose 1 Dose

By 19 months 4 Doses 3 Doses 3 Doses 3 Doses 4 Doses 1 Dose 1 Dose

By 25 months 4 Doses 3 Doses 3 Doses 3 Doses 4 Doses 1 Dose 1 Dose 1 Dose

By 43 months 4 Doses 3 Doses 3 Doses 3 Doses 4 Doses 1 Dose 1 Dose 2 Doses

Texas Department of State Health Services • Immunizations • MC-1946 • P. O. Box 149347 • Austin, TX 78714-9347 • (800) 252-9152

Stock No. 6-15

Rev. 03/2022

Serologic evidence of infection or serologic confirmation of immunity to measles, mumps, rubella, hepatitis B, hepatitis A, or varicella is acceptable in place of vaccine.

A complete Hib series is two doses plus a booster dose on or after 12 months of age (three doses total). If a child receives the first dose of Hib vaccine at 12 - 14 months of age,

only one additional dose is required (two doses total). Any child who has received a single dose of Hib vaccine on or after 15 - 59 months of age is in compliance with these

specified vaccine requirements. Children 60 months of age and older are not required to receive Hib vaccine.

If the PCV series is started when a child is seven months of age or older or the child is delinquent in the series, then all four doses may not be required. Please reference the

information below to assist with compliance:

• For children seven through 11 months of age, two doses are required.

• For children 12 - 23 months of age: if three doses have been received prior to 12 months of age, then an additional dose is required (total of four doses) on or after 12 months

of age. If one or two doses were received prior to 12 months of age, then a total of three doses are required with at least one dose on or after 12 months of age. If zero doses

have been received, then two doses are required with both doses on or after 12 months of age.

• Children 24 months through 59 months meet the requirement if they have at least three doses with one dose on or after 12 months of age, or two doses with both doses on or

after 12 months of age, or one dose on or after 24 months of age. Otherwise, an additional dose is required. Children 60 months of age and older are not required to receive

PCV vaccine.

For MMR, Varicella, and Hepatitis A vaccines, the first dose must be given on or after the first birthday. Vaccine doses administered within 4 days before the first birthday will

satisfy this requirement.

Previous illness may be documented with a written statement from a physician, school nurse, or the child’s parent or guardian containing wording such as: “This is to verify that

(name of child) had varicella disease (chickenpox) on or about (date) and does not need varicella vaccine.” The written statement will be acceptable in place of any, and all

varicella vaccine doses required.

Information on exclusions from immunization requirements, provisional enrollment, and acceptable documentation of immunizations may be found in §97.62, §97.66, and

97.68 of the Texas Administrative Code, respectively and online at https://www.dshs.texas.gov/immunize/school/default.shtm

Exemptions

Texas law allows (a) physicians to write medical exemption statements which clearly state a medical reason exists that the person cannot receive specific vaccines, and (b)

parents/guardians to choose an exemption from immunization requirements for reasons of conscience, including a religious belief. The law does not allow

parents/guardians to elect an exemption simply because of inconvenience (for example, a record is lost or incomplete and it is too much trouble to go to a physician or

clinic to correct the problem). Schools should maintain an up-to-date list of students with exemptions, so they may be excluded in times of emergency or epidemic

declared by the commissioner of public health.

Instructions for requesting the official exemption affidavit that must be signed by parents/guardians choosing the exemption for reasons of conscience, including a

religious belief, can be found at www.dshs.texas.gov/immunize/school/exemptions.aspx

. The original Exemption Affidavit must be completed and submitted to the

school.

For children claiming medical exemptions, a written statement by the physician must be submitted to the school. Unless it is written in the statement that a lifelong

condition exists, the exemption statement is valid for only one year from the date signed by the physician.

Documentation

Since many types of personal immunization records are in use, any document will be acceptable provided a physician or public health personnel has validated it.

Validation includes a signature, initials, or stamp. An immunization record generated from an electronic health record must include clinic contact information and the

provider’s signature/stamp, along with the vaccine name and vaccination date (month, day, and year). An official record generated from a health authority is acceptable.

An official record received from school officials, including a record from another state is acceptable.