Immunization Program : Nebraska Day Care Immunization Laws

All 50 states and the District of Columbia have immunization requirements for children entering day care and school.

Each licensed day care program in Nebraska is required to keep the immunization history of each child enrolled in its program on file.  Parents or guardians must present one of the following documents to the day care provider to verify immunization status.

  1. 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
  1. A certification by a physician, certified nurse practitioner, or physician assistant that immunization is not appropriate for a stated medical reason, or
  1. A written statement that the parent or guardian does not wish to have the child immunized and the reasons why.


 2014 Daycare Immunization Reporting Packet
To open any  particular document, just click on the title.


  Below are forms in PDF PDF and MS Word MS Word format

PDF Documentation of Varicella (Chicken Pox) Disease
MS Word Documentation of Varicella (Chicken Pox) Disease (MS Word)

PDF Refusal of Immunization for Medical Reasons
MS Word Refusal of Immunization for Medical Reasons (MS Word)

PDF Refusal of Immunization of Student for Religious Reasons
MS Word Refusal of Immunization of Student for Religious Reasons (MS Word)

These documents must be presented to the day care provider within 30 days of enrollment and must be updated periodically.

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 their own child as well as every other child in the home or center. These children, if they become ill, can expose all the other children to disease as well. Child care facilities usually care for children of different ages and the younger children must rely on the older children to be immunized so that they are safe. Even babies who are up-to-date on their shots must rely on the rest of the 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.

Contact Information

Immunization Program
PO Box 95026
Lincoln, NE 68509-5026
Phone: (402) 471-6423 or (800) 798-1696
FAX: (402 471-6426


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