California Vaccine Law: Required Shots, Exemptions, and Appeals

California school vaccine requirements apply to every child entering a public or private school, preschool, daycare, or development center in the state. Ten specific immunizations are mandatory, personal belief exemptions have not been available since 2016, and the only way a classroom student can skip a required shot is a medical exemption signed by a licensed physician and filed through the state’s electronic system.¹

The Ten Required Vaccines

California Health and Safety Code Section 120335 lists the diseases every child must be immunized against before admission:

Diphtheria
Haemophilus influenzae type b (Hib)
Hepatitis B
Measles
Mumps
Pertussis (whooping cough)
Poliomyelitis (polio)
Rubella
Tetanus
Varicella (chickenpox)

The California Department of Public Health (CDPH) can add diseases to this list based on recommendations from the federal Advisory Committee on Immunization Practices, the American Academy of Pediatrics, and the American Academy of Family Physicians.¹

The dose count depends on your child’s age, and schools check records closely at two points: entry into transitional kindergarten or kindergarten, and advancement to seventh grade. Hepatitis B is not required for the seventh-grade checkpoint, but an age-appropriate pertussis booster is.¹

If Your Child Is Still Catching Up on Doses

A child who has started a vaccine series but hasn’t finished can be enrolled under “conditional admission.” Two conditions apply: the child must have received the first dose of each required vaccine, and the child must not currently be due for another dose at the moment of admission.²

Schools must review the records of each conditionally admitted student at least every 30 days, notify the parent or guardian of remaining doses, and update the file. Falling behind the schedule allows the school to exclude the student until the next required dose is given.²

Personal Belief Exemptions Are Gone

Senate Bill 277 took effect January 1, 2016, and ended personal belief exemptions for every required school and childcare vaccine. Religious objections and philosophical objections both fall under that elimination. No new personal belief exemption can be filed for any currently required vaccine.³

Exemptions on file before that date were allowed to continue until the student reached the next grade span: birth through preschool, kindergarten through sixth grade, or seventh through twelfth grade. More than a decade on, those grandfathered exemptions have largely expired.¹

Who Is Not Covered by the Mandate

Two narrow groups fall outside the requirement entirely. Children in a home-based private school don’t need to show vaccination records, and neither do students in an independent study program who receive no classroom instruction. Begin attending in-person classes and the exemption disappears.¹

Federal law adds one temporary carve-out. Under the McKinney-Vento Act, schools must immediately enroll children experiencing homelessness or awaiting foster care placement even when immunization records aren’t available. “Immediately” means the same or following day, and the child attends classes while records are tracked down.⁴ This isn’t a permanent exemption; it just stops schools from turning students away at the door.

How to Get a Medical Exemption

A medical exemption is the only route to lasting enrollment without full vaccination for a child in classroom-based school. A licensed M.D. or D.O. must determine that one or more required vaccines are unsafe for the child based on physical condition or medical circumstances, including family medical history. The exemption has to specify which vaccines it covers and the probable duration of the condition.⁵

Since January 1, 2021, every new medical exemption must be submitted through the California Immunization Registry-Medical Exemption system, known as CAIR-ME. The standardized CAIR-ME form is the only documentation a school can accept for a new exemption. The physician files it directly with CDPH’s immunization registry, and the school receives it through that system. Paper-only exemptions no longer work for new filings.⁶

Older exemptions issued before January 1, 2020, remained valid until the child reached the next grade span. After that, a new CAIR-ME exemption or full vaccination is required.⁵

How the State Reviews and Revokes Exemptions

CDPH does not take exemptions at face value. It runs annual reviews of school immunization reports and sends a clinically trained reviewer, a physician or registered nurse, to examine every medical exemption that falls into one of three buckets:⁶

Schools with an overall immunization rate below 95%.
Physicians who have submitted five or more medical exemptions in a calendar year.
Schools that fail to report vaccination rates to CDPH.

Reviewers check the exemption against applicable American Academy of Pediatrics criteria and can contact the issuing physician for additional documentation. If the reviewer concludes the exemption is inappropriate or invalid, the case moves to the State Public Health Officer or a designated physician, who has authority to revoke it.⁶

Revocation does not pull a child out of class the same day. The family has 30 calendar days to begin the vaccination schedule required for conditional admission, and the child keeps attending in the meantime.⁶

Appealing a Revocation

A parent or guardian has 30 days from the revocation to appeal to the Secretary of California Health and Human Services. The Secretary convenes an independent panel of three licensed physicians with training in primary care or immunization, which evaluates the appeal against CDC, Advisory Committee on Immunization Practices, or AAP guidelines and the relevant standard of care. Both the issuing physician and the parent can submit information.⁷

The panel’s determination is binding. The Secretary adopts it and issues a written decision, and that decision is not subject to further administrative review.⁷

Temporary Exclusion During an Outbreak

Compliance with the standard requirements does not guarantee a child stays in class during an outbreak. If there is good cause to believe a child has been exposed to one of the listed diseases and the records don’t show immunization against that disease, the local health officer can exclude the child temporarily until the risk of developing or transmitting illness has passed.⁵ Children with medical exemptions are included. The exemption protects enrollment generally, not outbreak-specific public health measures.

College Students Follow Different Rules

The K-12 statute does not apply to higher education. Each university system sets its own policy, and those policies often add vaccines beyond the K-12 list.

The University of California requires two MMR doses, two varicella doses, one Tdap dose, and one meningococcal conjugate dose for students 21 or younger, along with tuberculosis screening. Positive titer tests showing immunity can be substituted for vaccination records. UC does allow exemptions for medical contraindications, religious objections, or disability, and students who receive one may be required to mask or distance as a condition of campus access. A denied exemption can be appealed to the campus Local Vaccine Administrator.⁸⁹

The California State University system requires MMR, varicella, Tdap, and meningococcal conjugate (for students 21 and younger), and adds hepatitis B for students 18 and younger.¹⁰

1
California Legislative Information. California Health and Safety Code HSC 120335 (2025)
2
Legal Information Institute. California Code of Regulations Title 17 Section 6035 – Conditional Admission
3
California Legislative Information. SB 277 – Public Health Vaccinations
4
National Center for Homeless Education. From the School Office to the Classroom – Strategies for Enrolling and Supporting Students Experiencing Homelessness
5
California Legislative Information. California Health and Safety Code HSC 120370 (2025)
6
California Legislative Information. California Health and Safety Code HSC 120372 (2025)
7
California Health and Human Services Agency. Medical Exemptions Appeal Policy and Procedures
8
University of California. University of California Immunization Requirements and Recommendations
9
University of California. Policy on Vaccination Programs
10
The California State University. Immunization Requirements and Recommendations