School Health Requirements

What does Hawai‘i State Law require for school attendance?

Hawai‘i State Law requires all students to meet physical examination, immunization, and tuberculosis clearance requirements before they may attend any public or private school in the State.

School means any:

  • Group childcare home
  • Day nursery
  • Day care center
  • Child care center
  • Head Start program
  • Preschool
  • Kindergarten
  • Elementary school
  • Middle school
  • Secondary school

What are the health requirements?

Physical Examination:

  • Must be completed within one year before first entrance into school in Hawai‘i (preschool or kindergarten through 12th grade)
  • Must be performed by a U.S. licensed MD, DO, ND, APRN or PA.

Immunizations required for school attendance:

  • DTaP/DTP/Td (diphtheria/tetanus/pertussis)
  • Polio
  • MMR (measles, mumps, rubella)
  • Hepatitis B
  • Hib (Haemophilus influenzae type b) (for preschool attendance)
  • Varicella (chickenpox)

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

Tuberculosis (TB) Clearance:

For information regarding TB clearance requirements for school attendance, visit Hawai‘i Department of Health Tuberculosis Control Program or call (808) 832-5731.

Are exemptions allowed?

Children may be exempt from immunization requirements for medical or religious reasons, if the appropriate documentation is presented to the school. Religious exemption forms may be completed at the school that your child will attend. Medical exemptions must be obtained from your child’s doctor. No other exemptions are allowed by the State.





The Hawaii State Department of Health has scheduled hearings to gather public comments on the proposed amendments to Title 11, Chapter 157, “Examination and Immunization,” which include health examination and immunization requirements for school attendance in Hawaii. For more information and to view the proposed rules, visit

HAR 11-157 Current and Proposed Comparison


Last reviewed November 2018