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At least nineteen Illinois cases are now linked to the reports of elevated lead levels in recalled cinnamon applesauce pouches. To learn more about the recall, go to https://www.cdc.gov/nceh/lead/news/lead-poisoning-outbreak-linked-to-cinnamon-applesauce-pouches.html. If you or a family member consumed this product, consult your health care provider.

Minimum Immunization Requirements for Children Enrolling or Entering a Child Care Facility or School in Illinois, 2023-2024

Diphtheria, Pertussis, Tetanus

Vaccine Requirement

Child Care Facility, Preschool, Early Childhood, Pre-Kindergarten Programs

Three doses of Diphtheria, Tetanus, Pertussis (DTP or DTaP) by 1 year of age, and one additional dose by the 2nd birthday.

Minimum intervals:

  • Between the first 3 doses, there must be at least 4 weeks.
  • Between the 3rd and 4th dose, there must be at least 6 calendar months.

Kindergarten through 12th Grade

First Entry into School (Kindergarten or 1st Grade)

Four or more doses of Diphtheria, Tetanus, Pertussis (DTP or DTaP) vaccine with the last dose being a booster and having been received on or after the 4th birthday.

Children ages 7 years and older should receive Td2 instead of DTP or DTaP per the ACIP catch-up schedule.

Minimum ages and intervals:

  • Between the 3 or more primary series doses, there must be at least 4 weeks.
  • Between the primary series and the booster dose, there must be at least 6 calendar months.
  • Booster must be administered on or after the child’s 4th birthday.
Other Grades

Three or more doses of DTP, DTaP, pediatric DT or Td2 with the last dose being a booster and having been received on or after the fourth birthday. 

Minimum intervals:

  • Between the 2 or more primary series doses, there must be at least 4 weeks.
  • Between the last dose in the primary series and the booster dose, there must be at least 6 calendar months. 
  • Booster dose must be administered on or after the child’s 4th birthday.

Entering 6th grade: one dose Tdap vaccine at age ≥11 years, regardless of interval since the last dose of DTP, DTaP, or Td. 

Minimum Intervals Allowed Between Doses and Other Options for Proof of Immunity

See additional footnotes regarding catch-up schedules and inadvertent administration of DTaP and Tdap.5,6

No proof of immunity allowed

Polio

Vaccine Requirement

Child Care Facility, Preschool, Early Childhood, Pre-Kindergarten Programs

Two doses by 1 year of age. One additional dose by 2nd birthday.

Three doses for any child 24 months of age or older appropriately spaced. 

Minimum intervals:

  • Between each of the first 3 doses, there must be at least 4 weeks. 

Kindergarten through 12th Grade

First Entry into School (Kindergarten or 1st Grade)

*Progressive requirement: Starting school year 2017-2018 any child entering Kindergarten shall show proof of 4 dose (booster) series with the last dose on or after the 4th birthday.

Minimum intervals:

  • Between each of the first 3 doses, there must be at least 4 weeks.
  • Between the primary series and the booster dose, there must be at least 6 calendar months.
  • Booster (4th dose) must be administered on or after the child’s 4th birthday.

 

Other Grades

*Progressive requirement applies to grades K-6. See the rules that apply to First Entry into School (Kindergarten or 1st Grade).

Grades 7-12: Three or more doses of polio vaccine with the last dose on or after the 4th birthday.

Minimum intervals:

  • Between each dose, there must be at least 4 weeks.
  • Booster must be administered on or after the child’s 4th birthday.

Minimum Intervals Allowed Between Doses and Other Options for Proof of Immunity

*This is a progressive requirement starting in 2017-2018. For the 2023-2024 school year, the four-dose requirement applies to grades K – 6.

No proof of immunity allowed.

Measles

Vaccine Requirement

Child Care Facility, Preschool, Early Childhood, Pre-Kindergarten Programs

One dose on or after the 1st birthday.

Kindergarten through 12th Grade

Two doses of measles vaccine, the first dose must have been received on or after the 1st birthday and the second dose no less than 4 weeks (28 days) later.

Minimum Intervals Allowed Between Doses and Other Options for Proof of Immunity

Rubella

Vaccine Requirement

Child Care Facility, Preschool, Early Childhood, Pre-Kindergarten Programs

One dose on or after the 1st birthday.

Kindergarten through 12th Grade

Two doses of rubella vaccine, the first dose must have been received on or after the 1st birthday and the second dose no less than 4 weeks (28 days) later.

Minimum Intervals Allowed Between Doses and Other Options for Proof of Immunity

Mumps

Vaccine Requirement

Child Care Facility, Preschool, Early Childhood, Pre-Kindergarten Programs

One dose on or after the 1st birthday

Kindergarten through 12th Grade

Two doses of mumps vaccine, the 1st dose must have been received on or after the first birthday and the second dose no less than 4 weeks (28 days) later.

Minimum Intervals Allowed Between Doses and Other Options for Proof of Immunity

Haemophilus influenzae type b (Hib)

Vaccine Requirement

Child Care Facility, Preschool, Early Childhood, Pre-Kindergarten Programs

Proof of immunization that complies with the ACIP recommendation for Hib vaccination.  Children 24-59 months of age without series shall show proof of one dose of Hib vaccine at 15 months or older.

Refer to ACIP Hib series schedule:

Kindergarten through 12th Grade

Any child five years of age (60 months of age) or older shall not be required to provide proof of immunization with Hib vaccine.

Minimum Intervals Allowed Between Doses and Other Options for Proof of Immunity

No proof of immunity allowed.

Hepatitis B

Vaccine Requirement

Child Care Facility, Preschool, Early Childhood, Pre-Kindergarten Programs

Three doses appropriately spaced.  (see doses in minimum interval column). 

Minimum ages and intervals:

  • Between 1st and 2nd doses must be at least 4 weeks.
  • Between 2nd and 3rd must be at least 8 weeks.
  • Between 1st and 3rd must be at least 16 weeks.
  • Third dose must have been administered on or after 24 weeks of age (168 days).

Kindergarten through 12th Grade

First Entry into School (Kindergarten or 1st Grade)

Kindergarten through 5th grade not a requirement.

Recommendation: Review these records and, if necessary, have student be brought up to date with hepatitis B series.

Other Grades

Students entering 6th thru 12th grade, three doses of hepatitis B vaccine administered at appropriate intervals.

Minimum intervals:

  • Between 1st and 2nd doses must be at least 4 weeks.
  • Between 2nd and 3rd must be at least 8 weeks.
  • Between 1st and 3rd must be at least 16 weeks.

The third dose of hepatitis B vaccine is not required if it can be documented that the child received two doses of adult formulation Recombivax-HB vaccine (10 mcg) and was 11 to 15 years of age at the time of vaccine administration, and that the interval between receipt of the two doses was at least four months.

Minimum Intervals Allowed Between Doses and Other Options for Proof of Immunity

Invasive Pneumococcal Disease (PCV)

Vaccine Requirement

Child Care Facility, Preschool, Early Childhood, Pre-Kindergarten Programs

Proof of immunization that complies with ACIP recommendations for PCV. Children 24 to 59 months of age without primary series of PCV, shall show proof of receiving one dose of PCV after 24 months of age.

Refer to ACIP PCV series schedule:

Kindergarten through 12th Grade

Any child five years of age (60 months of age) or older shall not be required to provide proof of immunization with PCV vaccine.

Minimum Intervals Allowed Between Doses and Other Options for Proof of Immunity

No proof of immunity allowed.

Varicella

Vaccine Requirement

Child Care Facility, Preschool, Early Childhood, Pre-Kindergarten Programs

One dose on or after 1st birthday.

Kindergarten through 12th Grade

Two doses of varicella vaccine are required for all grade levels. The first dose must have been on or after the 1st birthday and the 2nd dose no less than 4 weeks (28) days later.

Minimum Intervals Allowed Between Doses and Other Options for Proof of Immunity

Meningococcal Disease

(MCV4), (MenACWY)

  • For Men ACWY vaccines may be administered simultaneously with Men B vaccines if indicated, but at a different anatomic site, if feasible

Vaccine Requirement

Child Care Facility, Preschool, Early Childhood, Pre-Kindergarten Programs

No Requirement.

Kindergarten through 12th Grade

First Entry into School (Kindergarten or 1st Grade)

No Requirement.

Other Grades

Students entering 6th-11th grades:

One dose of meningococcal conjugate vaccine on or after the child’s 11th birthday.4

Students entering 12th grade:

Two doses of meningococcal conjugate vaccine, with the second dose administered on or after the child’s 16th birthday and at least 8 weeks after the first dose. The second dose is not necessary if the first dose if administered on or after the child’s 16th birthday. 4

Minimum Intervals Allowed Between Doses and Other Options for Proof of Immunity

No proof of immunity allowed.

Notes

Students attending ungraded school programs must comply in accordance with grade equivalent.

Within the Advisory Committee on Immunization Practices (ACIP) recommendations, vaccine doses given up to four days before minimum interval or age can be counted as valid. However, this does not apply to intervals between live vaccines. Live vaccines shall not be given fewer than 28 days after receipt of a prior live vaccine.

Compliance with the School Code

A child shall be considered in compliance with the health examination and immunization requirement in Section 27-8.1 of the School Code if all applicable immunizations that a child can medically receive are given before entering school and a signed statement from a health care provider is presented indicating when the remaining medically indicated immunization will be administered within the current school year. Local school authorities shall monitor immunization schedules to assure their completion. If a child is delinquent for a scheduled appointment for immunization, he or she is no longer considered to be in compliance.

Table 1: Footnotes

1 The chart indicates antigens that may be available in either single-antigen and/or combination-antigen vaccines

2 Td-containing vaccines include tetanus and diphtheria vaccine (Td) or tetanus, diphtheria and acellular pertussis vaccine (Tdap).

3 In accordance with the ACIP catch-up series a fourth dose of Polio is not needed if the third dose was administered at age four or older and at least six months after the previous dose was administered.

4 For Meningococcal Conjugate: if there is an indication for earlier vaccination (between ages 10 and 11) then the provider may submit a letter/statement stating the reasons and provides that with the vaccine records (Section 665.280). Letter/statement should be honored by School Health Authorities and NOT submitted to IDPH for Review

5Catch-Up Immunization Recommendations for DTaP and Tdap

  • Persons aged 7–18 years.
    • If persons aged 7–18 years have never been vaccinated against pertussis, tetanus, or diphtheria, these persons should receive a series of three tetanus and diphtheria toxoid–containing vaccines, which includes at least 1 Tdap dose. The preferred schedule is 1 dose of Tdap, followed by 1 dose of either Td or Tdap ≥4 weeks afterward, and 1 dose of either Td or Tdap 6–12 months later.
    • Persons aged 7–18 years who are not fully immunized against tetanus and diphtheria should receive 1 dose of Tdap, preferably as the first dose in the catch-up series; if additional tetanus toxoid–containing doses are required, either Td or Tdap may be used.
    • The vaccination series does not need to be restarted for those with incomplete DTaP history, regardless of the time that has elapsed between doses. The catch-up schedule and minimum intervals between doses are available at https://www.cdc.gov/vaccines/schedules/hcp/child-adolescent.html.
  • Persons aged ≥19 years.
    • If persons aged ≥19 years have never been vaccinated against pertussis, tetanus, or diphtheria, these persons should receive a series of three tetanus and diphtheria toxoid–containing vaccines, which includes at least 1 Tdap dose. The preferred schedule is 1 dose of Tdap, followed by 1 dose of either Td or Tdap at least 4 weeks afterward, and 1 dose of either Td or Tdap 6–12 months later.
    • Persons aged ≥19 years who are not fully immunized against tetanus and diphtheria should receive 1 dose of Tdap, preferably as the first dose in the catch-up series; if additional tetanus toxoid–containing doses are required, either Td or Tdap may be used.

6Inadvertent Administration of DTaP or Tdap:

  • Persons aged ≥7 years.
    • DTaP is not indicated for persons aged ≥7 years. If DTaP is administered inadvertently to a fully vaccinated child aged 7–9 years, an adolescent Tdap dose should be administered at age 11–12 years.
    • If DTaP is administered inadvertently to an undervaccinated child aged 7–9 years, this dose should count as the Tdap dose of the catch-up series, and the child should receive an adolescent Tdap dose at age 11–12 years.
    • If DTaP is administered inadvertently to a person aged ≥10 years, this dose should count as the adolescent Tdap dose routinely administered at age 11–12 years.
  • Fully vaccinated children aged 7–10 years. 
    • If a fully vaccinated child aged 7–9 years receives Tdap, the Tdap dose should not be counted as valid. The adolescent Tdap dose should be administered as recommended when this child is aged 11–12 years.
    • The preferred age at administration for the adolescent Tdap dose is 11–12 years. However, if Tdap is administered at age 10 years, the Tdap dose may count as the adolescent Tdap dose.

Table 2: Other Options for Proof of Immunity

Vaccine Requirement

Alternative Options for Proof of Immunity

Measles

Proof of prior measles disease shall be verified with date of illness signed by a physician or laboratory evidence of measles immunity.  A diagnosis of measles disease made by a physician on or after July 1, 2002, must be confirmed by laboratory evidence.

Rubella

Laboratory evidence of rubella immunity.

Mumps

Proof of prior mumps disease shall be verified with date of illness signed by a physician or laboratory evidence of mumps immunity.

Hepatitis B

Proof of prior or current infection, if verified by laboratory evidence, may be substituted for proof of vaccination. Laboratory evidence of prior or current hepatitis B infection is acceptable only if one of the following serologic tests indicates positivity:  HBsAg, anti-HBc or anti-HBs.

Varicella

Proof of prior varicella disease shall be verified with one of the following: 

1.       date of illness signed by a physician; or

2.       a health care provider's interpretation that a parent's or legal guardian's description of varicella disease history is indicative of past infection; or

3.       laboratory evidence of varicella immunity.

NOTE: No other options for proof of immunity other than vaccination are allowable for any of the following requirements: Diphtheria, Tetanus, Pertussis, Polio, Haemophilus Influenzae Type B, Invasive Pneumococcal Disease, or Meningococcal disease.

Important Notes:

  • Students attending ungraded school programs must comply in accordance with grade equivalent. Detailed age-based requirements for each vaccine are listed in the PART 665 CHILD AND STUDENT HEALTH EXAMINATION AND IMMUNIZATION CODE, Section 665.240.
  • Students eligible to remain in public schools beyond grade 12 (special education) shall meet the requirements for 12th grade.
  • These requirements also apply to children who transfer into Illinois child care facilities, school programs, and schools from other states, regardless of the age or grade level at which the child transfers.
  • A child shall be considered in compliance with the health examination and immunization requirement in Section 27-8.1 of the School Code if all applicable immunizations that a child can medically receive are given before entering school and a signed statement from a health care provider is presented indicating when the remaining medically indicated immunization will be administered within the current school year.  Local school authorities shall monitor immunization schedules to assure their completion.  If a child is delinquent for a scheduled appointment for immunization, he or she is no longer considered to be in compliance.
  • Within the Advisory Committee on Immunization Practices (ACIP) recommendations, vaccine doses given up to four days before minimum interval or age can be counted as valid.  However, this does not apply to intervals between live vaccines.  Live vaccines shall not be given fewer than 28 days after receipt of a prior live vaccine. 

Resources

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