Superintendent’s Memo #217-15

State seal, Commonwealth of Virginia

Department of Education

August 21, 2015

TO:  Division Superintendents

FROM:  Steven R. Staples, Superintendent of Public Instruction

SUBJECT: Student Immunization Status Report Instructions

The Virginia Department of Education has been asked by the Virginia Department of Health (VDH), Office of Epidemiology, Division of Immunization, to remind school divisions that kindergarten and sixth-grade student immunization data must be collected from each Virginia public school for the school year 2015-2016.

The Virginia Board of Health Regulations for the Immunization of School Children (12 VAC 5-110-90.F) require the following:

Each admitting official shall, within 30 days of the beginning of each school year of entrance of a student, or by October 15 of each school year, file with the State Health Department through the health department for his locality, a report summarizing the immunization status of students in his school.  This report shall be filed using the Web-enabled reporting system or Form SIS 1, the Student Immunization Status Report, and shall contain the number of students admitted to that school with documentary proof of immunization, the number of students who have been admitted with a medical or religious exemption, and the number of students who have been conditionally admitted.  The report for students entering the sixth grade shall include the number with a booster dose of tetanus, diphtheria, or pertussis containing vaccine within the last five years.

To complete the report, it is requested that all schools use the electronic Web-based reporting system, accessed by clicking on the following link: Detailed instructions are available in the system once the user has logged on. The password for public schools is: pub*2015.  The password for private schools is: pvt*2015.

Administrators may access data entered by schools and run reports to identify schools that have not reported for the current year.  The link to this Web site and to instructions for obtaining data is:

The VDH is requesting submittal of documentation received for the Human Papillomavirus Vaccine (HPV) this year.  You should report the number of girls enrolled in the sixth grade, and, if data are available, the number of those girls who have had one (or more) doses of the HPV vaccine.

Please have the principal of each school that enrolls kindergarten and sixth-grade students complete the status report on or before October 15, 2015.  Should you have questions, please contact Dr. Sandra Sommer, division epidemiologist, at (804) 864-8055, or by e-mail at, or Tia Campbell, school health specialist, at (804) 786-8671, or by e-mail at