Superintendent's Memo #187-09

State seal, Commonwealth of Virginia

Department of Education

July 20, 2009 (revised)

TO: Division Superintendents

FROM: Patricia I. Wright, Superintendent of Public Instruction

SUBJECT: Physical Examination & Immunization Requirements for School Enrollment

Physical examination requirements for school enrollment remain unchanged for the 2009-2010 school year. Pursuant to Code of Virginia §22.1-270, students shall not be permitted to attend school without documentation of a comprehensive physical exam performed within the 12 months prior to the date the student enters public kindergarten or elementary school. The Code does not extend a grace period for complying with this regulation. Several exceptions exist to this requirement: homeless students and those whose parents object due to religious belief. Homeless students are to be enrolled and immediately referred to the local school division homeless liaison for assistance in complying with entrance requirements. Parents objecting to a physical exam based upon religious belief must provide the school division with a written statement that the child is in good health and free from communicable or contagious disease.

Pursuant to Code of Virginia §22.1-3.4, a student who has been placed in foster care by a local social services agency shall be immediately enrolled even if the placing social services agency is unable to produce the documents required for enrollment. In such cases, the person enrolling the student shall provide a written statement that, to the best of his knowledge, sets forth (i) the student's age (ii) compliance with the requirements of Code of Virginia §22.1-3.2, and (iii) that the student is in good health and is free from communicable or contagious disease.

Certain prescribed immunizations are required for a child to enroll or attend public school in Virginia as outlined in School & Day Care Minimum Immunization Requirements, Virginia Department of Health
. Parents are responsible for providing documentation that all required immunizations are up-to-date, completed, or a medical or religious exemption has been obtained. These include the required doses of DTaP (diphtheria, tetanus, pertussis), polio, hepatitis B, MMR (measles, mumps, rubella) and varicella.

A child whose immunizations are incomplete may be admitted conditionally, provided the parent or guardian has documentation at the time of enrollment indicating that the child has received at least one dose of the required immunizations and has a written schedule for completing the remaining doses within 90 calendar days of the opening of school. The 90-day grace period does not apply to the Tdap booster as outlined below (Code of Virginia §22.1-271.2B).

Since the start of the 2006-2007 school year, a booster dose of pertussis-containing vaccine (Tdap) has been required for students entering the sixth grade unless the student has had a tetanus-containing vaccine within the last five years or has a medical or religious exemption. There is no grace period for compliance with this requirement because Tdap is a single dose vaccine, not a series.

Beginning with the 2009-2010 school year, a complete series of three doses of Human Papillomavirus vaccine (HPV) is required for female students (Code of Virginia §32.1-46). The first dose shall be administered prior to entering the sixth grade. Unlike any other required vaccine, after reviewing educational materials approved by the Board of Health, the parent or guardian, at the parent's or guardian's sole discretion, may elect for the child not to receive the HPV vaccine.

Parents/guardians of rising sixth-grade girls are requested to provide the school with documentation of HPV vaccine administration if the student receives the immunization. If the parent/guardian opts not to have his/her daughter vaccinated, the school division should not require parents/guardians to sign a waiver form, and no documentation is needed. Sixth-grade girls who do not have proof of HPV vaccine administration should not be excluded from school. These guidelines apply only to the HPV vaccine.

Should you have further questions, please contact Tia Campbell, school health specialist, at 804-786-8671 or

PIW / tbc