Understanding CA Child Care and School Immunization Requirements and Medical Exemptions

View the Rx for Prevention Article

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: May 1, 2019.  Review date November 2, 2020.  Termination date: May 1, 2021.

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

Updated immunization requirements go into effect in California on July 1, 2019. This article covers these requirements, describes guidelines for medical exemptions, provides expert guidance regarding contraindications and precautions, and lists helpful resources.

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), Transitional Kindergarten/Kindergarten-12th, and 7th grade.
  2. Identify the types of exemptions that are permitted under California’s pre-kindergarten and school immunization law .
  3. Identify contraindications and precautions to pediatric and adolescent vaccines required for pre-kindergarten and school attendance in California.
  4. List the elements that are required to be documented for medical exemptions.
  5. Access resources, including screening questionnaires and patient education materials. 


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

Franklin Pratt, MD - Medical Director, Vaccine Preventable Disease Program, Los Angeles County Department of Public Health

Julia Heinzerling, MPH  - Special Assistant to the Chief Medical Officer, 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.


No relevant financial relationships were disclosed by the authors or the 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: dphcme@ph.lacounty.gov