Massachusetts school immunization requirements are created under authority of 105 CMR 220.000 Immunization of Students Before Admission to School
Requirements apply to all students including individuals from another country attending or visiting classes or educational programs as part of an academic visitation or exchange program. Requirements apply to all students, even if over 18 years of age.
Childcare/Preschool†
Attendees <2 years should be immunized for their age according to the ACIP Recommended Immunization Schedule. Requirements listed in the table below apply to all attendees ≥2 years. These requirements also apply to children in preschool classes called K0 or K1.
| Hib | 1-4 doses; the number of doses is determined by vaccine product and age the series begins |
| DTaP | 4 doses |
| Polio | 3 doses |
| Hepatitis B | 3 doses; laboratory evidence of immunity acceptable |
| MMR | 1 dose; must be given on or after the 1st birthday; laboratory evidence of immunity acceptable |
|
Varicella |
1 dose; must be given on or after the 1st birthday; a reliable history of chickenpox* or laboratory evidence of immunity acceptable |
Grades Kindergarten†
In ungraded classrooms, Kindergarten requirements apply to all students ≥ 5 years.
|
DTaP |
5 doses; 4 doses are acceptable if the fourth dose is given on or after the 4th birthday. DT is only acceptable with a letter stating a medical contraindication to DTaP |
|
Polio |
4 doses; fourth dose must be given on or after the 4th birthday and ≥6 months after the previous dose, or a fifth dose is required. 3 doses are acceptable if the third dose is given on or after the 4th birthday and ≥6 months after the previous dose |
| Hepatitis B | 3 doses; laboratory evidence of immunity acceptable |
|
MMR |
2 doses; first dose must be given on or after the 1st birthday and second dose must be given ≥28 days after first dose; laboratory evidence of immunity acceptable |
|
Varicella |
2 doses; first dose must be given on or after the 1st birthday and second dose must be given ≥28 days after first dose; a reliable history of chickenpox* or laboratory evidence of immunity acceptable |
- Address questions about enforcement with your legal counsel.
¶ Meningococcal vaccine requirements (see Grades 7-10 and 11-12) also apply to residential students in Grades Pre-K through 8 if the school combines these grades in the same school as students in Grades 9-12.
†Medical exemptions (statement from a physician stating that a vaccine is medically contraindicated for a student) must be renewed annually at the start of the school year and religious exemptions (statement from a student, or parent/guardian if the student is <18 years of age, stating that a vaccine is against sincerely held religious beliefs) should be renewed annually at the start of the school year.
- A reliable history of chickenpox includes a diagnosis of chickenpox, or interpretation of parent/guardian description of chickenpox, by a physician, nurse practitioner, physician assistant, or
See following pages for Grades 7-10, Grades 11-12, and College (Postsecondary Institutions)
Requirements apply to all students including individuals from another country attending or visiting classes or educational programs as part of an academic visitation or exchange program. Requirements apply to all students, even if over 18 years of age.
Grades 7 – 12†
In ungraded classrooms, Grade 7 requirements apply to all students ≥12 years.
|
Tdap |
1 dose; and history of DTaP primary series or age appropriate catch-up vaccination. Tdap given at ≥7 years may be counted, but a dose at age 11-12 is recommended if Tdap was given earlier as part of a catch-up schedule. Td or Tdap should be given if it has been ≥10 years since last Tdap |
|
Polio |
4 doses; fourth dose must be given on or after the 4th birthday and ≥6 months after the previous dose, or a fifth dose is required. 3 doses are acceptable if the third dose is given on or after the 4th birthday and ≥6 months after the previous dose |
| Hepatitis B | 3 doses; laboratory evidence of immunity acceptable. 2 doses of Heplisav-B given on or after 18 years of age are acceptable |
| MMR | 2 doses; first dose must be given on or after the 1st birthday and second dose must be given ≥28 days after first dose; laboratory evidence of immunity acceptable |
| Varicella | 2 doses; first dose must be given on or after the 1st birthday and second dose must be given ≥28 days after first dose; a reliable history of chickenpox* or laboratory evidence of immunity acceptable |
Meningococcal Requirements
|
Grade 7-9 |
1 dose; 1 dose MenACWY (formerly MCV4) required. Meningococcal B vaccine is not required and does not meet this requirement. |
| Grade 11-12‡ | 2 doses; second dose MenACWY (formerly MCV4) must be given on or after the 16th birthday and ≥ 8 weeks after the previous dose. 1 dose is acceptable if it was given on or after the 16th birthday. Meningococcal B vaccine is not required and does not meet this requirement. |
Meningococcal Vaccine Phase-In Schedule
| 2021-2022 | 2022-2023 | 2023-2024 | |
| 1 Dose MenACWY | Grades 7-8 | Grades 7-9 | Grades 7-10 |
| 2 Doses MenACWY | Grades 11-12 | Grades 11-12 | Grades 11-12 |
- Address questions about enforcement with your legal counsel. School requirements are enforced at the local level.
†Medical exemptions (statement from a physician stating that a vaccine is medically contraindicated for a student) must be renewed annually at the start of the school year and religious exemptions (statement from a student, or parent/guardian if the student is <18 years of age, stating that a vaccine is against sincerely held religious beliefs) should be renewed annually at the start of the school year.
- A reliable history of chickenpox includes a diagnosis of chickenpox, or interpretation of parent/guardian description of chickenpox, by a physician, nurse practitioner, physician assistant, or
‡ Students who are 15 years old in grade 11 are in compliance until they turn 16 years old.