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N.C. Immunization Requirements

CDC recommends all children receive immunizations according to the recommended immunization schedule to protect them from 14 preventable diseases.  In North Carolina, children are not allowed to attend school (whether public, private, or religious) or a childcare facility, unless they have received all immunizations appropriate for their age.  Vaccination records are checked when they enter a childcare facility, when they enter kindergarten, seventh and twelfth grade, as well as when they enter college or university:

Most parents choose to vaccinate their children according to the recommended schedule, but many parents may still have questions about the vaccines their children need.  For more information, please review these following Frequently Asked Questions.  Talk to your child's doctor if you have additional questions or concerns about immunizations for your children or are not sure if they are up to date with their immunizations. 

Frequently Asked Questions

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 1. How are the vaccine requirements monitored?

In North Carolina, immunization records are checked at the following times:

 2. What exemptions to immunizations are allowed in North Carolina?

North Carolina law provides for two types of exemptions from required immunizations. They are medical and religious.  Learn more about these exemptions, and the process for requesting an exemption for your children.

 3. How do I show proof of vaccination?

A physician, health clinic or local health department must provide a certificate of immunization to the person who brings the child for immunization. A copy of the certificate of immunization should then be presented to your child’s school to show proof of vaccination.  Call your child’s school nurse if you have questions about showing proof of immunizations.  Here are some tips on locating and keeping track of your children’s immunization record.

 4. What immunizations does my child need?

Find parent-friendly immunization schedules for infants and children (birth to 6 years) here. Easy-to-read recommended immunization schedules for preteens and teenagers (ages 7 to 18 years) can be found here. Concerned your child is behind in their immunizations? Review CDC’s immunization catch up schedule or use CDC’s vaccine assessment tool to learn which vaccines your children and adolescents (from birth through 18 years old) may need. Contact your health care provider if you have any questions about immunizations your child may need.

 5. Are the vaccines safe?

Yes. Vaccines are very safe. The United States’ long-standing vaccine safety system ensures that vaccines are as safe as possible. Currently, the United States has the safest vaccine supply in its history. Millions of children safely receive vaccines each year. The most common side effects are typically very mild, such as pain or swelling at the injection site.

 6. Are there any other vaccines my child should receive apart from the required vaccines?

Yes, the Advisory Committee on Immunization Practices (ACIP) also recommends the following vaccines: Hepatitis A, Human Papillomavirus (HPV), and Influenza (Flu). These vaccines are not required by North Carolina law but are strongly recommended for children and/or adolescents. For more information about these vaccines, talk to your doctor. 

 7. Where can I get vaccines and how much do they cost?

You can receive immunizations at your doctor’s office or local health department. If your child is insured, your insurance provider may cover the cost of vaccines and their administration. Contact your health care provider to find out how much the vaccines will cost. If your child is 18 years of age or younger, and meets one of the following qualifications, he or she is eligible to receive the vaccines from the state at no cost:

  • Is eligible for Medicaid
  • Has no health insurance
  • Is Native American or Alaskan Native, or
  • Has health insurance but it does not cover the cost of the vaccine

 8. What if my child is uninsured? How can I get help paying for vaccine administration fees and other health care services my child needs?

Your child may be eligible for Health Check/Medicaid or N.C. Health Choice, which is a free or low-cost health insurance for children and teens under 19 years of age (up to 21 in some cases). Both Health Check and N.C. Health Choice offer an extensive package of benefits. If you are uninsured, contact your local department of social services agency to find out if you qualify.


CDC Vaccine Resources for Parents.  View, download, or print these CDC resources to learn more about immunizations and vaccine-preventable diseases. Find links to immunization schedules, videos, PSAs, fact sheets, posters, infographics, and more.