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Immunizations & Health Mandates


K-12 Admission Requirements

  • Polio - 4 doses (3 doses OK if at least one is given on or after the 4th birthday).
  • DTaP - 5 doses (4 doses OK if at least one is given on or after the 4th birthday, 3 doses OK if at least one dose of Tdap, DTaP, or DTP is given on or after the 7th birthday).
  • Hepatitis B - 3 doses.
  • Measles, Mumps, Rubella (MMR) - 2 doses given on or after the 1st birthday (two doses of measles, two doses of mumps, and one dose of rubella meet the requirement, either separately or combined).
  • Varicella - 2 doses.
  • Tdap (Grades 7th-12th) - 1 dose given on or after the 7th birthday.

7th Grade Advancement

  • Tdap - 1 dose given on or after the 7th birthday.
  • Varicella - 2 doses.

Students who had a valid personal beliefs exemption filed before 2016 between Kindergarten and 6th grade need to meet the requirements listed for TK/K-12 as well as requirements for 7th grade.

These students will need documentation for the following immunizations:

  • Diphtheria, Tetanus, and Pertussis containing vaccine (DTaP, DTP, DT, Tdap, or Td) - 3 doses. One dose of Tdap vaccine given on or after the 7th birthday will meet the 7th grade requirement and count as one of the 3 doses required for students TK/K-12.
  • Polio (OPV or IPV) - 4 doses (3 doses ok if one given on or after the 2nd birthday)
  • MMR - 2 doses (or 2 doses of measles-containing vaccine and 1 dose of rubella vaccine)
  • Varicella - 2 doses

Medical Exemptions

All medical exemptions for schools and child care facilities must be submitted through the California Immunization Registry - Medical Exemption website (CAIR-ME) by physicians licensed in California. Schools and child care facilities may only accept new medical exemptions that are issued using CAIR-ME.

This change impacts medical exemptions for:

  • New enrollments as of January 1, 2021.
  • Students who transition to the next grade span (TK/K - 6th grade, 7th-12th grade).
  • Students whose temporary medical exemption have expired.
  • Medical exemptions that were revoked due to the issuing physician being a subject of disciplinary action.

In order to receive a medical exemption, parents must create a CAIR-ME account and log in to submit a request for a medical exemption. Next, the child's physician can complete the medical exemption in CAIR-ME and print a copy for the parents to give to the school or child care facility.

A medical exemption may be issued in CAIR-ME no more than 12 months before a child first enters a grade span (grade spans are birth-preschool, TK/K-6th, and 7th-12th).

Families who have a medical exemption due to a history of disease, for example from Varicella / Chickenpox, must also follow this process.

To request a medical exemption, please visit the CAIR-ME web page.

For Frequently Asked Questions on Medical Exemptions, please visit Shots for School web page.

For additional questions about submitting a request through CAIR-ME, please follow up with your child's physician. For questions about PAUSD Registration, please email Registration Services or call (650) 329-3707.

For information on where to get immunizations for your child in Santa Clara County, click here | Spanish.

Tuberculosis (TB) Requirements

Students newly enrolling into a school in Santa Clara County are required to have their healthcare provider complete a TB Risk Assessment for School Entry form completed by a United States licensed health professional.

  • TB skin or blood testing is only required if their healthcare provider identifies a risk factor for TB exposure on the TB Risk Assessment form.
  • To be valid, documentation must show a TB risk assessment or tests was performed in the United States up to twelve months prior to registration for school.

For information on tuberculosis requirements and where to get a tuberculosis screening for your child in Santa Clara County, click here.

Oral Health Assessment KINDERGARTEN ONLY

A dental check-up is required by May 31st of Kindergarten or 1st grade for students who did not attend a California public school for Kindergarten.

Health Examination (CHDP Report) FIRST GRADE ONLY

California law requires a health assessment 18 months before or up to 90 days after enrolling in first grade.


Immunization or Health Mandate records from your child's physician can be delivered to your child's school site or Health Services:

  • By mail:
    Attn: Health Services
    25 Churchill Ave.
    Palo Alto, 94306
  • By fax: (650) 833-4226
  • Drop-Off:
    District Office Portable A
    25 Churchill Ave.
    Palo Alto, 94306
    Hours: 8 am - 4:45 pm (note - during summer, the District Office is closed on Fridays).

If you have questions please contact Health Services.