In 1975, Wisconsin passed the Student Immunization Law which detailed required doses of vaccinations for children attending all Wisconsin schools, as well as licensed day care centers in order to prevent transmission of these communicable diseases outlined in the table below. Since then, there have been many changes and additions to the statute (Chapter 252) and administrative rule (DHS 144). These updates can be found at Wisconsin Statute 252.04.

As the District School Nurse, and per the Department of Health Services DHS 144.03(10)(a), I am able to obtain your child's immunization information if it is available on the Wisconsin Immunization Registry. For this reason, I ask that you only submit a copy of your child's immunization records if your child is:
  • from out of state or out of the country,
  • is not listed on the the Wisconsin Immunization Registry, or
  • you have chosen to opt out on immunizations and will complete a waiver form to submit to the school nurse.
*Waiver forms are available for religious, medical or personal conviction reasons. Keep in mind that in the event of an outbreak of a vaccine preventable disease, students with waivers may be excluded from school until the outbreak subsides.

Student Immunization Record & Waiver Form

The table below indicates the current vaccination requirements for children attending Wisconsin schools.
Age/Grade Number of Doses
Pre K (2 yrs to 4 yr) 4 DTP/DTaP/DT1 3 Polio 3 Hep B5 1 MMR6 1 Var7
Grades K through 5 4 DTP/DTaP/DT1,2 4 Polio4 3 Hep B5 2 MMR6 2 Var7
Grades 6 through 12 4 DTP/DTaP/DT1 Tdap3 4 Polio4 3 Hep B5 2 MMR6 2 Var7 
  1. D = diphtheria, T = tetanus, P= pertussis vaccine. DTP/DTaP/DT/Td vaccine for all students Pre K through 12: Four doses are required. However, if the student received the 3rd dose after the 4th birthday, further doses are not required. Note: a dose 4 days or less before the 4th birthday is also acceptable.
  2. DTP/DTaP/DT vaccine for children entering 5K Kindergarten: Each student must have received one dose after the 4th birthday (either the 3rd, 4th or 5th dose) to be compliant.
    Note: a dose 4 days or less before the 4th birthday is also acceptable.
  3. Tdap means adolescent tetanus, diphtheria and acellular pertussis vaccine. If a student received a dose of a tetanus-containing vaccine, such as Td, within 5 years of entering the grade in which Tdap is required, the student is compliant and a dose of Tdap vaccine is not required.
  4. Polio vaccine for students entering grades 5K kindergarten through 12: Four doses are required. However, if the student received the 3rd dose afrer the 4th birthday, further doses are not required. Note: a dose 4 days or less before the 4th birthday is also acceptable.
  5. Laboratory evidence of immunity to hepatitis B is also acceptable.
  6. MMR means Measles, Mumps and Rubella. The first dose of MMR vaccine must have been received on or afer the first birthday (Note: a dose 4 days or less before the 1st birthday is also acceptable). Laboratory evidence of immunity to all three diseases (measles and mumps and rubella) is also acceptable.
  7. Var means Varicella (chickenpox) vaccine. A history of chickenpox disease is also acceptable.

Tdap Vaccine

For student's entering the 6th grade, the Wisconsin Student Immunization Law requires the student to receive one dose of the Tdap vaccine. To be compliant with the school law, the parent/guardian must provide their child's school with proof of immunization or claim a waiver.

Tdap Fact Sheet for Parent/Guardian

Due to two outbreaks of Pertussis in the state of Wisconsin, the Winnebago County Public Health Department offers the Tdap booster FREE of charge, regardless of insurance coverage to our students. Call (920) 232-3000 to make an appointment.

For more information, including the clinic schedule please visit the Winnebago County Public Health Department website.

Some additional information on vaccine preventable diseases

Meningococcal Disease
**Information for parents/guardians and teens on the Meningococcal Vaccine

Human Papillomavirus
***Information for parents/guardians and teens on the Human Papillomavirus (HPV) Vaccine

The CDC recommends receiving the influenza vaccine annually for everyone 6 months of age and older.
***Influenza Vaccine Fact Sheet (Live, intranasal)
***Influenza Vaccine Fact Sheet (Inactivated or recombinant)

Questions about vaccines?? Check out these websites: or

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