2019-2020 School Health Requirements

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

School Health Requirements for the 2019-2020 School Year

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

VAX to 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.

VAX to school

Frequently Asked Questions (FAQs)

What is required by the first day of school?

By the first day of school, all students entering school in Hawai‘i for the first time must have:
1. A completed health record form to prove that a physical examination was performed within one year before school entrance, and that all immunization requirements have been met.
A signed statement or appointment slip from your doctor to prove that your child has a physical examination scheduled and/or has begun the vaccination series and is waiting for the next dose in the series.
2. A completed TB clearance form.

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

Where do I get the ”Student Health Record” form?

You can get a copy of the “student health record”(Form 14) from the school where your child will be enrolled or from your child’s doctor.

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

You will need to show proof that the health requirements have been met prior to school entry. The school will accept out-of-state records that meet the State of Hawai‘i requirements for physical examination, immunizations, and tuberculosis clearance.

Which immunizations are required and how many doses does my child need?

Immunizations are required for all students entering preschool, kindergarten, and seventh grade, and for those students entering school in Hawai‘i for the first time, regardless of age.

See the table below for the specific vaccines and number of doses required.

Vaccine Doses

a. DTaP=Diphtheria-Tetanus-Acellular Pertussis.  DTP may be used in place of DTaP.

b. Polio=IPV (Inactivated poliovirus vaccine) or OPV (Oral poliovirus vaccine).

c. Hib=Haemophilus influenzae type b.  More than one dose of Hib is recommended for children less than 15 months of age to be fully protected against Haemophilus influenzae type b.  For preschool entry, children must have received at least one dose of Hib on or after 12 months of age.

d. MMR=Measles-Mumps-Rubella.  The first dose of MMR vaccine must have been received on or after 12 months of age.  For grades kindergarten through 12, two doses of measles vaccine are required, with at least one of the two doses being MMR vaccine.

e. Hep B=Hepatitis B vaccine.  Required for all students born after December 31, 1992 and for 7th grade attendance.

f. Effective July 1, 2002.  A documented history of varicella (chickenpox), signed by a U.S. licensed MD, DO, ND, APRN or PA, may be substituted for the varicella vaccine requirement. The first dose of varicella vaccine must have been received on or after 12 months of age.

g. Two (2) doses of varicella vaccine are required if the first dose is administered on or after the 13th birthday.

h. In addition to meeting the kindergarten through grade 12 immunization requirements upon first school attendance listed in the table above, all students must show evidence of having received these immunizations prior to 7th grade attendance. Students who received these vaccines in infancy or childhood do not need to receive them again, as long as all doses meet the minimum age and interval requirements.

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.

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.

Hawaii Immunization Exemptions – medical and religious exemption data submitted by each school for students in kindergarten through grade 12

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 Department of Health Immunization Branch at 586-8300 (Oahu), 1-800-933-4832 (Neighbor Islands) for more information and program eligibility requirements.

How can I obtain a copy of my immunization record?

You should contact the health care provider or clinic where you received your immunizations. You may also contact the Hawaii Department of Health Immunization Branch at (808) 586-8300 or 1-800-933-4832 to determine if your vaccinations are recorded in the Hawaii Immunization Registry (HIR). However, please note that HIR may not have all of the vaccinations that you have received.


Brochures & Supporting Materials

Childcare Facility, Preschool, and Kindergarten – Grade 12: Important Notice to Parents

Post-Secondary School Health Requirements

School Assessment Reports


Contact Us

Hawai‘i Department of Health Immunization Branch

E-mail: [email protected]
Phone: (808) 586-8332 or 1(800) 933-4832

Hawai‘i Department of Health Tuberculosis Control Branch

Website: health.hawaii.gov/tb
Phone: (808) 832-5731


Last reviewed August 2019