School Health Requirements Frequently Asked Questions

What kind of health requirements does Hawaii State Law require for school attendance?

Hawaii State Law requires all students to meet health examination and immunization requirements before they may attend any public or private school in the state. “School” is defined as any group child care home, day nursery, day care center, child care center, Head Start program, preschool, kindergarten, elementary school, middle school, or secondary school.

Post-secondary school, includes adult education school, business school, trade school, community college, college or university.

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What are the school health requirements?

Tuberculosis (TB) clearance must be completed within one year before first entrance into school in Hawaii and must be performed by the State of Hawaii Department of Health or by a U.S. licensed physician, advanced practice registered nurse (APRN), or physician assistant (PA). Infants who first attend school before age 12 months must submit a TB certificate to the school before they reach 14 months of age. The certificate of TB examination must include date of administration, reading and results in millimeters.

A physical examination must be completed within one year before first attending school in Hawaii and must be performed by a U.S. licensed physician, APRN, or PA.



    • Required immunizations for preschool attendance are DTaP/DTP/Td (diphtheria/tetanus/pertussis), Polio, MMR (measles, mumps, rubella), Hepatitis B, Hib (Haemophilus influenzae type b) and Varicella (chickenpox).
    • Required immunizations for grades kindergarten – 12 include DTaP/DTP/Td, Polio, MMR, Hepatitis B, and Varicella.

All immunizations must meet minimum age and interval requirements between vaccine doses.

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Which vaccinations are required and how many shots does my child need?

See the tables for the specific vaccines and number of doses required.

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What is required by the first day of school?

By the first day of school, all students entering school in Hawaii for the first time must have:

    1. Tuberculosis (TB) clearance


  1. A completed student health record that includes:
    • Physical examination (PE)
    • All required immunizations
    • OR, a signed statement or a medical appointment card from your child’s doctor to prove that your child is in the process of completing missing immunizations or the PE

Students who have not completed these requirements by the first day of school will not be allowed to attend school until these requirements are met.

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Are exemptions from immunizations allowed?

Children may be exempt from immunization requirements for medical or religious reasons, if the appropriate documentation is presented to the school. A religious exemption form may be obtained and completed at the school that your child will attend. Medical exemptions must be obtained from your child’s doctor (a U.S. licensed physician). No other exemptions are allowed by the State.

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What if I can’t afford shots for my children?

Your child may qualify to receive vaccines at no charge through Vaccines for Children, a federally-funded program that provides vaccines to eligible children in Hawaii. There may be a charge from the provider to cover the cost of giving the shot. Call your doctor or the Hawaii Immunization Program at 586-8332 for more information and program eligibility requirements.

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What if my child is transferring from another state or territory of the U.S.?

You will need to show proof that the student health requirements have been met prior to school entry. Hawaii schools will accept out-of-state records that meet the State of Hawaii requirements for the physical examination, TB examination, and immunizations.

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Are children who repeat Kindergarten or 7th grade subject to the new entrance requirements?

Yes. All children entering Kindergarten and 7th grade, including first time entrants and repeaters, are subject to these requirements.

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If my child had chickenpox before, will he/she need to get the
chickenpox shot?

A documented history of chickenpox (varicella), signed by a U.S. licensed physician, advanced practice registered nurse (APRN), or physician’s assistant (PA), may be substituted for the chickenpox vaccine requirement.

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May I request a copy of my immunization record from the Department of Health?

Yes. You may request a copy of your immunization record from the Department of Health Immunization Branch by calling 586-8300 (Oahu), 1-800-933-4832 (Neighbor Islands), or e-mailing Persons requesting immunization records should be aware that the information retained by the Immunization Branch may or may not meet their requests. In the event that the Immunization Branch has partial immunization records or no records at all, requestors are advised to contact health care providers that have administered vaccinations to them.

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Where can I get more information about school health requirements?

Contact the Department of Health, Hawaii Immunization Program at 586-8332. Neighbor islands call toll-free at 1-800-933-4832.

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