Every state has vaccination requirements and exemptions.

Required Immunizations for Children Attending Day Care in PA

by Kathryn Rateliff Barr

Every state in the United States has immunization regulations for children from birth through high school, and many have requirements for college students. Each state also has immunization exemptions for children who have medical reasons that contraindicate vaccines, and most states have religious exemptions. Pennsylvania has medical and religious exemptions for kids in day care and school, with requirements starting at 2 months of age.

Day Care Provider Regulations

Your child’s day care provider is responsible to verify that all children over the age of 2 months are vaccinated, unless the children have a legal medical or religious exemption on file. She must maintain files that verify the immunization status of all children in the day care, including copies of exemptions, updated vaccine records and any documents she issues reminding parents that new vaccines are due. She reports the information to the Pennsylvania Department of Health or the local branch. If your child falls behind in vaccinations with no valid exemptions, she can remove your child from the day care.

Required Vaccines

Vaccines required for 2-month-old infants as of June, 2013 include the first doses of the DTaP, Hib, Polio, Pneumococcal conjugate and Rotovirus, and the second dose of the HepB if it was given at birth. A 4-month-old receives second doses of all vaccines received at 2 months of age, with the exception of the HepB if it was given at birth. It the first dose of the HepB was given at 2 months of age, the second dose of the HepB should also be given. Third doses of these vaccine are given at 6 months of age and a flu vaccine might be added. When your child is between 12 and 15 months old, he will receive the Hib, Pneumococcal conjugate, MMR and Hep A and the chicken pox vaccine when he is between 12 and 18 months of age. When your child is 15 to 19 months old, he will receive another dose of the DTaP and HepA. Between your child’s fourth and sixth birthday, he will receive additional doses of the MMR, Polio, DTap and chicken pox vaccines.


If your child has ever had a serious vaccine reaction, your doctor could issue a medical exemption for that vaccine. Kids with allergies to specific vaccine ingredients can also receive a medical exemption. Kids with compromised immune systems due to cancer, HIV and other medical conditions could receive medical exemptions and kids living in a home with someone with a compromised immune system might receive a temporary medical exemption to prevent infecting them with a live virus from the MMR, chicken pox or the nasal flu vaccines. If you have questions about vaccine reactions or contraindications, consult your child's pediatrician. Religious exemptions are available if immunizations violate your sincerely held religious convictions or if you have strong moral and ethical grounds similar to religious convictions

Exclusion Requirements

If you refuse to immunize your child, the day care provider can remove your child from the day care if you don't present a valid exemption. If there is a serious outbreak of a communicable disease your child could be vaccinated for, but is not, the child care facility may require you to keep your child at home until the outbreak is over.

About the Author

Rev. Kathryn Rateliff Barr has taught birth, parenting, vaccinations and alternative medicine classes since 1994. She is a pastoral family counselor and has parented birth, step, adopted and foster children. She holds bachelor's degrees in English and history from Centenary College of Louisiana. Studies include midwifery, naturopathy and other alternative therapies.

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