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Immunization requirements to attend child care and preschool

young children playing

Routine vaccination is important to protect health and prevent the spread of diseases such as measles, mumps, varicella (chickenpox), whooping cough, and others.

Vaccines are:

Families should be aware that children and adolescents with vaccine exemptions may be kept out of school or child care during a disease outbreak. The length of time will vary depending on the type of disease and the circumstances of the outbreak.

For example, if someone at your child’s school becomes sick with measles and your child is not up to date on their MMR vaccine(s), they may need to stay home from their program for at least 21 days.

This page is for child care and preschool. Refer to the appropriate webpage for immunization requirements to attend school (K-12), camp, or college or university. 

Navigating Colorado’s vaccine requirements to attend child care or preschool is easy as 1, 2, 3!

1. Know the requirements:

Colorado law requires students attending Colorado licensed child cares and preschools to be vaccinated against certain diseases unless an exemption is on file at the facility.

Vaccines required to attend child care:

  • Hepatitis B (HepB)
  • Diphtheria, tetanus, pertussis (DTaP)*
  • Haemophilus influenza type b (Hib)
  • Inactivated poliovirus (IPV)*
  • Pneumococcal conjugate (PCV)
  • Measles, mumps, rubella (MMR)*
  • Varicella (chickenpox)*

*Students aged 4 through 6 years are required to have their final doses of DTaP, IPV, MMR, and varicella before kindergarten entry.

Before a child’s first day of child care or preschool, Colorado law requires parents or guardians to provide each school their child attends with at least one of the following:

A: An immunization record showing that the child has received school-required vaccines and is up to date according to their age, 

B: An in-process plan signed by the child’s health care provider showing that the child is in the process of catching up on missing vaccine(s) following the minimum intervals between doses described in the catch-up schedule, 

C: A Certificate of Medical or Nonmedical Exemption for any missing doses of school-required vaccine(s)

To meet the requirements, students may have one or a combination of these documents for the different school-required vaccines.

For example, a student’s kindergarten immunization file at school could contain the following: 

  • An immunization record showing they are up to date for HepB, DTaP, Hib, IPV and Hib,
  • A Certificate of Nonmedical Exemption for MMR, and
  • An in-process plan showing they are catching up for varicella

In the child care and preschool setting, parents or guardians must provide the school with updated immunization documentation every time vaccines are due for their child. 

A child who does not have the required immunization documents on file must be denied attendance in accordance with the law. 

2. Prepare to meet the initial requirements:

Before your child’s first day of child care or preschool, you must provide each child care or preschool your child attends with the following documentation. 

What’s needed for children who are up to date on child care-required vaccines:

An immunization record from your child’s health care provider or other immunization provider that:

  • Shows your child has received school-required vaccines and is up to date according to their age and,
  • Includes the dates and types of immunizations administered

Colorado’s child care/preschool immunization table can help you and your child’s health care provider determine if your child has the required number of doses.

What’s needed for children who are catching up on one or more child care-required vaccine(s):

An immunization record showing which vaccines your child received (if any), and an in-process plan for children who started late or fell behind on vaccines required for child care or preschool.

  • The immunization record must be from your child’s health care provider or other immunization provider and include the dates and types of immunizations administered.
  • The in-process plan (sample), signed by the child’s health care provider, must show that the child is in the process of catching up on missing vaccine(s) following the minimum intervals between doses described in the catch-up schedule.

Your child’s health care provider, immunization provider, or local public health agency can help your child catch up on the vaccines your child needs. 

What’s needed for children who are missing child care-required vaccines  whose parent or guardian wants to obtain an exemption for medical or nonmedical reasons:

A Certificate of Medical or Nonmedical Exemption

If you do not plan on vaccinating your child or they have a medical contraindication from receiving one or more school-required vaccines, you must follow Colorado’s process to obtain a certificate of exemption.

  • Certificates of Medical and Nonmedical Exemption must be obtained using Colorado’s process and documented on Colorado’s forms.

3. Continue to meet the requirements:

Parents or guardians must provide the school with updated immunization documentation before their child’s first day of child care or preschool and every time vaccines are due for their child.  

Updated documentation includes:

  • An immunization record showing your child received vaccines that were due, or
  • An updated Certificate of Nonmedical Exemption

These updated documents are due before your child’s first day of child care or preschool, and at the following ages when school-required vaccines are due: 

  • Birth,
  • 2 months,
  • 4 months,
  • 6 months,
  • 12-15 months,
  • 15-18 months, and
  • Before kindergarten entry

Need tips on locating your child’s immunization record? Visit the finding a student’s immunization vaccine record for school webpage.

Children who have an in-process plan must follow the plan and provide immunization records as indicated on the plan until they are caught up according to their age.