Polio (IPV)

Age 6 and under

3 doses, if last dose given after 4^th birthday

or 4 doses anytime

Age 7 and older

3 doses, if last dose given after 2^nd birthday

or 4 doses anytime

DTaP & Td

Age 6 and under

4 doses, if last dose given after 4^th birthday &

6 months between last 2 doses, or 5 doses anytime

Td & DT

Age 7 and older

3 doses, if last dose given after 2^nd birthday &

6 months between last 2 doses. Pertussis not required.

MMR (Measles, Mumps, Rubella)

Grade K - 12

2 doses, both given after 1^st birthday

Hepatitis B (HBV)

Grade K - 12

• 1^st dose
• 2^nd dose – at least 1 month after 1^st dose
• 3^rd dose – at least 2 months after 2^nd dose and

4 months after 1^st dose

• 1^st dose
• 2^nd dose – 4 months after 1^st dose

Varicella

Grade K - 12

Proof of immunization (1 dose after age one) or history

of the disease (documented by a doctor, nurse or clinic).

Any student attending a California school for the first time must show proof of a Varicella immunization or history of the disease (documented by a doctor, nurse or clinic).

Age 13 yrs. or older, 2 doses are needed – 1 month apart

After MMR, wait 1 month to give

TB

Any student in ANY grade attending a California school for the first time and/or returning to a California school after living outside of California for 12 months must show proof of Mantoux given in California within 12 months. TB tests completed outside the US are not accepted.

Chest X-ray is required if Mantoux results come back positive

(Preschool skin tests do not count.)

Grade K – 1

Mantoux must have been given within the previous

school year. For Fall 2008 enrollment, the Mantoux could

be given as far back as September 1, 2007.

First time to California Schools

Grade 2 – 12

Mantoux test may have been at any previous time.

1) Date and Type of test (Tine is not acceptable)

2. Results of test
3. Signature of person / clinic reading test

Spanish Translation for Immunizations

Measles / Sarampion

Diphtheria / Difteria

Tetanus / Tetano

Mumps / Paperas

Rubella / Rubeola

Pertussis / Pertusis