The Immunization Rules are Changing. Here's What You Need to Know.

Gregory C. Endler | Washington State Department of Health
Mar 04, 2020


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A change is coming in August 2020 that you don’t want to miss. The way schools collect immunization records and comply with immunization rules will be different beginning with the 2020-21 school year. Effective August 1, 2020, a state rule change will affect three areas of immunization compliance:

  • The definition of “conditional status” has been clarified. Students must turn in their immunization paperwork on or before the first day of attendance.
  • All new immunization records from students need to be medically verified.
  • The Tdap vaccine requirement for 6th through 12th graders has been changed to a 7th through 12th grade requirement.

Students without immunization paperwork on the first day of school should not start school until the required paperwork is turned in. These students are not considered in conditional status. These changes were approved by the Washington State Board of Health in 2019

Let’s explore each of these a little bit more.

Conditional Status

In the past, students had 30 days from the first day of attendance to turn in their immunization documentation to the school. The new rule clarifies that students without immunization paperwork should not start school until the required paperwork is turned in to the school. If they are missing vaccine doses, they must get any doses they are eligible to receive before starting school. Once they have provided the required paperwork to the school that they have received all vaccines they are currently eligible to receive, they can start school.  If more doses are needed in a series that require spacing for dosing purposes, the student is considered in conditional status, and can be in school while completing the vaccine series. Children in conditional status must be making progress toward meeting the immunization requirements. 

Knowing the counts occur within the first week of school, it is vitally important that you work with your teams to begin work now, as opposed to waiting.

There are some special situations which override the conditional status rules: 

  • McKinney-Vento and foster students must be immediately enrolled even if lacking documentation of immunization status
  • Additionally McKinney-Vento students cannot be excluded for being out of compliance with the immunization requirements
  • Children of active duty military parents must turn in documentation of immunization a CIS or Certificate of Exemption (COE) on or before the first day of attendance but if they are missing immunizations they have 30 days time to get all of the required immunizations they are eligible to receive.

Medically Verified Records

Starting on August 1, 2020, the revised rule requires medically verified immunization records for school and child care entry. A medically verified record includes one or more of the following:

  • A Certificate of Immunization Status(CIS) printed from the Washington Immunization Information System (IIS)
  • A physical copy of the Certificate of Immunization Status form with a healthcare provider signature
  • A physical copy of the Certificate of Immunization Status with accompanying medical immunization records from a healthcare provider verified and signed by school staff
  • OR, A Certificate of Immunization Status printed from MyIR. MyIR is the state immunization registry that can be accessed by parents to print their child’s Certificate of Immunization Status.

Tdap Requirement Change

The requirement for a Tdap dose is changing from grade 6-12 to grade 7-12. This means all students entering 7th through 12th grades must have one booster dose of Tdap vaccine. 

In the 2020-2021 school year, all students in 7th grade must have received their Tdap dose on or after age 10 years. 

Students in 8th through 12th grades must have received their Tdap dose on or after age 7 years.

It is important to communicate these changes with your staff, including those who register new students, and update your process for the 2020-21 school year

The Department of Health in partnership with the Office of Superintendent of Public Instruction have created a webpage to support the implementation of this change. There you will find information, resources, pre written documents and parent letters as well as frequently asked questions.

This information can help answer many questions you may have about the rule change. If you have any other questions, contact the Department of Health.


  • Immunization
  • Resource
  • Advocacy & Legislation

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