Child Care and School Immunization Standards

Lifespan Health
Public Health

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What would you like to do?

What you need to know

What you need to know

​​​​​Nebraska Child Car​e Immunization Laws​

Each licensed childcare program in Nebraska is required to:

  1. Obtain proof of vaccination (or refusal) within 30 days of enrollment and periodically after, for each enrolled child.​
  2. ​Maintain an immunization history on file for each child enrolled (Neb. Rev. Stat. §§ 71-1913.01 through 71-1913.03)
    1. Parents and/or guardians must provide an immunization record for each child verifying age-appropriate immunization against the following diseases:
      • Polio
      • Diphtheria, Tetanus, Pertussis
      • Hepatitis B
      • Pneumococcal
      • Measles, Mumps, Rubella
      • Varicella (chickenpox) or documentation of disease​​
  3. Submit the required immunization reporting by November 1 of each year. Information regarding the survey is mailed each year and a survey link is live at this time.
    • Do not report school aged children or your own children.
    • Medical exemptions and parental refusals must be reported.
    • Nebraska Child Care Licensing Unit will be notified of non-compliant programs.
    • Any licensed childcare provider registered as of September 30 will be required to complete the survey even if no children are currently enrolled with the program.​

To review the full regulations, refer to Title 173 of Nebraska Administrative Code, Chapter 4


​Nebraska School Immunization Laws

All private and public schools/districts in Nebraska are required to ob​tain written proof of each student's immunization status prior to child attending classes (Neb. Rev. Stat.  §§ 79-217 through 79-253). 

  1. Obtain written proof of each student's immunization status prior to child attending classes (Neb. Rev. Stat.  §§ 79-217 through 79-253). 
  2. ​Maintain an immunization history on file for each child enrolled.
    1. In order for a child to attend public or private schools in Nebraska, children are required to be immunized against the following diseases:​
      • Diphtheria, Tetanus, Pertussis
      • Hepatitis B
      • Measles, Mumps, Rubella
      • Varicella (chickenpox) or documentation of the disease​​.
  3. ​Submit the required immunization reporting by November 15 of each year. Information regarding the survey is sent out each year and survey link is live at this time. 
    1. While immunization records are to be kept for all students, only the following groups are required to be reported.
      • Students entering school for the first time. (This may vary within each school system, but typically Kindergarten or first (1st) grade.)
      • Seventh (7th) graders
      • ​All out-of-state transfers, including foreign exchange students



While Nebraska does allow exemptions to immunization requirements, unvaccinated children are not the only children at risk for contracting diseases. 

As many childcare facilities and schools include children of different ages, the younger children rely on the older children to be immunized as some immunizations, like measles and chickenpox, cannot be given until a child is one of age. Some immunizations require multiple doses before a child is considered to have full immunity such as the vaccine for Diphtheria, Tetanus and Pertussis. There are also children who are not medically able to be vaccinated.  These vulnerable children depend upon “herd immunity" for protection.

What If You Don't Vaccinate Your Child?

**Children/students with exemptions on file may need to be excluded from childcare program or school if there is an outbreak of a vaccine-preventable disease.**

Varicella (chickenpox)

If the child is not immunized against Varicella (Chickenpox) due to previously contracting the disease, documentation signed by a licensed medical practitioner (physician, physician assistant or certified nurse practitioner) or parent/guardian must be submitted verifying the name of the student and the year in which the child contracted the disease. Documentation of Varicella Disease Documentation of Varicella Disease - Spanish

Medical Exemption

A statement signed by a physician, physician assistant, or advanced practice registered nurse - nurse practitioner that the required immunization would be injurious to the student or members of the student's family or household. Medical Exemption Form​

Religious affidavit

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

Parental refusal- for childcare programs ONLY

Copy of written statement from the parent or guardian must state the reason(s) why the parent or guardian does not wish to have the child immunized.​

​​Provisional Enrollment

Some immunizations call for multiple doses of vaccine. For students who have not completed all doses required, state statute allows students to be provisionally enrolled in school if at least one dose of each of the required vaccines has been administered prior to enrollment. The student is required to continue to receive the remaining vaccinations as rapidly as medically feasible.

Vaccine series do not need to be restarted if the child has a documented immunization record, regardless of the time passed since the last dose. The series should be resumed from last documented dose. It is the responsibility of the school to monitor progress toward the completion of the required immunizations. ​

​DHHS Immunization Program 
Department of Health & Human Services
DHHS Immunization Program Contact List
Phone Number
(402) 471-6423
Toll Free Number
(800) 798-1696
Fax Number
​(402) 471-6426
Mailing Address
P.O. Box 95026, Lincoln, Nebraska 68509-5026