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Immunization Program
     Day Care
Nebraska Day Care Immunization Laws
Each licensed day care program in Nebraska is required to keep the immunization
history of each child enrolled in its program on file (Neb. Rev. Stat.  §§ 71-1913.01 through 71-1913.03). In addition, licensed programs are required to report information
 on student’s immunization status annually, due on November 1st, to the Nebraska Immunization Program. 
Due to a clerical error, you may have received the daycare reporting mailer addressed to another day care facility.  Please disregard the discrepancy and proceed as usual with completing the reporting for your day care facility.
  • This report is done online through a secure state survey system
  • Every licensed childcare facility must complete the report even if no children are being cared for at this time.
  • Do not report school age children or your own children
  • All vaccine exemptions must be reported
  • Non-compliant facilities will be reported to the Nebraska Child Care Licensing Unit

To complete the online reporting survey, click below link:

If you have 25 or more children to report, you may use the below template link.  Open the link and then save to your desktop. 

Report Template for 25 or more children

Once you have completed the template, please send to:


  •  If you are not able to complete the online survey, you must contact the 
    Immunization Program to obtain the hardcopy survey using either our e-mail address or toll free 800 phone number at: or
or you can download at:
2018 Daycare Immunization Report Section 1 and 2.pdf2018 Daycare Immunization Report Section 1 and 2

To view regulations, please refer to Title 173 of the Nebraska Administrative
 Code, Chapter 4.
Immunization Documentation
Parents or guardians must present an immunization record showing the child is
protected by age-appropriate immunization against:

• Measles, mumps, rubella
• Polio
• Diphtheria, tetanus, pertussis
• Haemophilus influenza type b (Hib)
• Hepatitis B
• Varicella (Chicken Pox)
• Pneumococcal


While there are exemptions to the immunization requirements, child care providers and parents need to be aware that unvaccinated children are not the only ones at risk for contracting disease. When parents choose not to immunize, their decision affects every other child in that child care facility as well as their own child.
Child care facilities usually care for children of different ages and the younger children must rely on the older children to be immunized because some immunizations, like measles and chickenpox, cannot be given until a child is one year old. Other immunizations require multiple doses before a child builds up full immunity, and some children are not able to be vaccinated.  These vulnerable children depend upon “herd immunity” for protection.  It is up to the day care provider to decide whether to accept an unimmunized child into their facility.
Exemptions to the vaccination requirement include:
  • A certification by a physician, certified nurse practitioner, or physician assistant that immunization is not appropriate for a stated medical reason.
  • An affidavit signed by a legally authorized representative stating that the immunization conflicts with the tenets and practices of a recognized religious denomination of which the student is a member. 
       Religious Affidavit for Vaccine Exemption.pdfReligious Affidavit for Vaccine Exemption
Varicella (Chickenpox)

If the student has not had the varicella (chickenpox) vaccine but has had the varicella (chickenpox) disease then a statement signed by a licensed medical physician, parent, or guardian must be submitted verifying the name of the student and the year in which he/she had the disease.

Contact Information
Immunization Program
PO Box 95026
Lincoln NE, 68509-5026
Fax: 402-471-6426
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