Understanding CA Child Care and School Immunization Requirements and Medical Exemptions

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Understanding CA Child Care and School Immunization Requirements and Medical Exemptions

This enduring material has been approved for 1 AMA PRA Category 1 Credit™.

Original release date: July 11, 2022.  Review date July 11, 2023.  Termination date: July 10, 2025.

Continuing Medical Education Credit(s)

To obtain a CME Certificate (physicians only) or a Certificate of Attendance (other learners), read the article and click here

Article Summary

This article is designed to help health care providers understand and navigate California’s childcare and school immunization requirements and use an evidence-based approach to immunizations and medical exemptions to ensure the best health for their patients. Topics addressed include immunization requirements for childcare and school attendance, medical exemptions , guidance for contraindications and precautions, clinical and other considerations for COVID-19 immunizations, and reporting of possible vaccine adverse events.

Target Audience

The target audience includes all primary care physicians as well as other health care professionals in Los Angeles County who provide pediatric and adolescent vaccinations.  

Learning Objectives

At the conclusion of the article, participants will be able to:

  1. Describe California’s immunization requirements for students entering pre-kindergarten (i.e., childcare), TK/K-12, and 7th grade and the types of exemptions that are permitted under California’s pre-kindergarten and school immunization law.
  2. Assess patients for contraindications and precautions to pediatric and adolescent vaccines required for pre-kindergarten/school attendance in the state of California.
  3. Document and submit medical exemptions correctly.
  4. Access resources, including screening questionnaires, forms, patient education materials.


Candace Gragnani, MD, MPH, FAAP  - University of California, Los Angeles

Franklin D Pratt, MD, MPHTM, FACEP - Executive Office, Los Angeles County Department of Public Health

Julia Heinzerling, MPH  - Bureau of Disease Control, Los Angeles County Department of Public Health

Accreditation Statement
California Medical Association accredited CME provider logo The Los Angeles County Department of Public Health is accredited by the California Medical Association (CMA) to provide continuing medical education for physicians.

The Los Angeles County Department of Public Health designates this enduring activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Other learners may receive a Certificate of attendance. According to the California Board of Registered Nursing, Continuing Medical Education is acceptable for meeting RN continuing education requirements, as long as the course is Category 1, and has been taken within the appropriate time frames.


Dr. Gragnani was a co-investigator on a COVID-19 transmission study that was funded by Pfizer in 2020. This financial relationship has been mitigated. No relevant financial relationships were disclosed by the other authors/planners.

This activity is offered by an accredited CMA-CME provider and is not commercially supported.

Contact Information

For further information, please contact the Vaccine Preventable Disease Control Program at ip@ph.lacounty.gov.

For further information about DPH CME please email: medicalaffairs@ph.lacounty.gov