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North Carolina Immunization Branch

Child Care Facilities

All children in North Carolina must be vaccinated against certain diseases. Immunization records are checked when a child enters an early childhood program.

By This Age: Children Need These Shots:
3 months
1 DTaP
1 Polio
 
1 Hib
1 Hep B
1 PCV
 
5 months
2 DTaP
2 Polio
 
2 Hib
2 Hep B
2 PCV
 
7 months
3 DTaP
2 Polio
 
2-3 Hib
2 Hep B
3 PCV
 
12-16 months
3 DTaP
2 Polio
1 MMR
3-4 Hib
2 Hep B
4 PCV
1 Var
19 months
4 DTaP
3 Polio
1 MMR
3-4 Hib
3 Hep B
4 PCV
1 Var
4 years or older (in child care only)
4 DTaP
3 Polio
1 MMR
3-4 Hib
3 Hep B
4 PCV
1 Var
4 years and older (and in kindergarten)
5 DTaP
4 Polio
2 MMR
3-4 Hib
3 Hep B
4 PCV
2 Var

North Carolina Vaccine-Specific Requirements

The North Carolina General Statutes (G.S. 130A-152(a)) require immunizations for every child present in this state. Every parent, guardian or person in loco parentis is responsible for ensuring that their child(ren) receive required immunizations. If you have specific questions regarding your child, please contact your child's health care provider or your local health department. North Carolina requires the following immunizations:

Diphtheria, tetanus and pertussis

Five doses (DTaP). Three doses by age seven months and two booster doses, the first by age 19 months and the second on or after the fourth birthday and before entering school for the first time. If the fourth dose was administered on or after the fourth birthday, the fifth dose is not required.

Polio

Four doses. Two doses by five months of age, a third dose by 19 months of age and a booster dose on or after the fourth birthday and before entering school for the first time. If the third dose was administered on or after the fourth birthday, the fourth dose is not required if the third dose was given at least six months after the second dose.

Measles

Two doses at least 28 days apart. One dose on or after 12 months of age and before 16 months of age, and a second dose before entering school for the first time. Any individual who has been documented by serological testing to have a protective antibody titer against measles is not required to receive measles vaccine.

Mumps

Two doses. One dose on or after 12 months of age and before age 16 months, and a second dose before entering school, college or university for the first time. A physician's diagnosis is not acceptable for mumps disease(s). Individuals must be immunized or have laboratory confirmation of disease or have been documented by serological testing to have a protective antibody against mumps.

Rubella

One dose on or after 12 months of age and before 16 months of age. A physician's diagnosis is not acceptable for rubella disease(s). Individuals must be immunized or have laboratory confirmation of rubella disease or have been documented by serological testing to have a protective antibody titer against rubella.

Haemophilus influenzae type b (Hib)

Several different brands of Hib vaccine are available. Children should receive three or four doses by 16 months of age, depending on which vaccine is used.

Three doses of HbOC or PRP-T, or two doses of PRP-OMP before age seven months and a booster dose of any type on or after age 12 months and by age 16 months.

Individuals who receive the first dose of Hib on or after seven months of age and before 12 months of age are required to have two doses of HbOC, PRP-T or PRP-OMP and a booster dose on or after 12 months of age and by 16 months of age. Individuals who receive the first dose of Hib on or after 12 months of age and before 15 months of age are required to have only two doses of HbOC, PRP-T or PRP-OMG and a booster dose two months later. Individuals who receive the first dose of Hib vaccine on or after 15 months of age are required to have only one dose of any of the Hib conjugate vaccines. Individuals who have passed their fifth birthday are not required to be vaccinated against Hib.

Hepatitis B

Three doses. One dose by three months of age, second dose by five months of age and a third dose by 19 months of age. The last dose of hepatitis B vaccine series shall not be administered prior to 24 weeks of age.

Pneumococcal

Four doses. Three doses by age seven months and a booster dose at 12 through 15 months of age. Individuals who receive the first dose of pneumococcal conjugate vaccine on or after seven months of age and before 12 months of age are required to have two doses at least four weeks apart; and a booster dose at 12 through 15 months of age. Individuals who receive the first dose on or after 12 months of age and before 24 months of age are required to have two doses at least eight weeks apart to complete the series. Individuals who receive the first dose on or after 24 months of age and before five years are required to have one dose to complete the series.

No individual who has passed his or her fifth birthday shall be required to be vaccinated against pneumococcal disease.

Individuals born before July 1, 2015 are not required to receive pneumococcal conjugate vaccine.

Varicella

Two doses administered at least 28 days apart. One dose on or after 12 months of age and before age 19 months, and a second dose before entering school for the first time.

An individual with laboratory confirmation of varicella disease immunity or has been documented by serological testing to have a protective antibody titer against varicella is not required to receive varicella vaccine. An individual who has documentation from a physician, nurse practitioner, or physician's assistant verifying history of varicella disease is not required to receive varicella vaccine. The documentation shall include the name of the individual with a history of varicella disease, the approximate date or age of infection, and a health care provider signature. Individuals born before April 1, 2001 are not required to receive varicella vaccine.

The requirement for the second dose of varicella vaccine shall not apply to individuals who enter kindergarten or first grade for the first time before July 1, 2015.

Required vs. Recommended

North Carolina law requires children receive certain vaccines. But in order to be fully protected from vaccine-preventable diseases, children should receive all age-appropriate immunizations.

For more information about vaccine preventable diseases and immunizations recommended, please refer to the Centers for Disease Control and Prevention (CDC), the Advisory Committee on Immunization Practices (ACIP), and the Immunization Action Coalition.

Child Care Operator's Responsibility

The child care facility maintains on file immunization records for all children attending the child care facility, which contains the information required for a certificate of immunization. When a child transfers to another child care facility, the facility where the child previously attended must, upon request, send a copy of the child’s immunization record, at no charge, to the child care facility or school to which the child has transferred. The child care operator must complete and submit annually to the N.C. Immunization Branch the Annual Child Care Immunization Report. This report is due to the N.C. Immunization Branch on December 1st of each year.

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