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NC Department of Health and Human Services
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North Carolina Immunization Branch

Child Care Facilities

North Carolina law requires all children in the state to receive certain immunizations. Records are checked when children enter school or child care.

The 2022 Annual Childcare Immunization Report will open in fall 2022.

2021-2022 Annual Immunization Deadlines Temporarily Extended

To ensure that children are not excluded from school because of increased demands on health care providers amid the ongoing COVID-19 pandemic, Governor Roy Cooper issued a new Executive Order and State Health Director Dr. Elizabeth Tilson issued a State Health Director Memo that suspends but does not waive documentation deadlines for proof-of-immunization and health assessment requirements for school and child-care facilities.

The Executive Order is needed because increased case rates and viral transmission caused by the Delta variant have limited providers’ ability to schedule immunization and health assessment visits. According to the North Carolina Pediatric Society, pediatricians are experiencing record levels of demand for sick visits due to viral illnesses.

In typical years, proof of required immunizations and health assessments are required within 30 days of the first date of attendance of school. After the 30 days, children are to be excluded from school until the family provides documentation of requirements. This year, the 30-day "grace period" for all students will begin on November 1, 2021. Extending these deadlines by will allow more time for families, schools and providers to facilitate access to needed immunizations and health assessments.

Families are required to provide the school or child care facility proof of an upcoming appointment (which could include a written statement from a parent or guardian) by October 8, 2021, and are strongly encouraged to obtain the required immunizations for their children on a timely basis.

Executive Order and State Health Director Memo will apply to students enrolled in public, private, or religious educational institutions, including child care facilities and K-12 schools. The Order also extends the deadline for each child entering a North Carolina public school for the first time to submit proof of a health assessment with that proof of an upcoming appointment.

Whether children are home-schooled, attend school in-person or by remote learning, they are required by state law to be immunized based on their age for certain vaccinations as recommended by the Centers for Disease Control and Prevention (CDC). More information on North Carolina’s requirements for vaccines can be found on the NCDHHS website.

Thank you for your ongoing partnership.

Annual Immunization Report

The 2021 Annual Childcare Immunization Report is closed. The 2022 Annual Childcare Immunization Report will open in fall 2022.

Q: Why is this report required?
A: Child care facilities are required by law [G.S. 130A-155(c)] to submit the requested information annually. It is also a licensing requirement. You will be contacted if the report is not received on time.

In the case of an outbreak of a vaccine preventable disease, this report will also help identify the children who are most at-risk for contracting the disease.

Q. Our child care facility doesn't have Internet access. May we send our report via standard mail?

A. If you do not have internet access, and are unable to complete your report online, please call the Immunization Branch at 919-707-5550.

Q: What happens if a parent does not submit their child’s immunization records within 30 days of attendance? 
A: The child should be excluded from attending child care until their records are submitted.

Q: What happens if the child is not legally up to date for their age?
A: If the child does not have the required number of shots for their age, the parents need to be informed and the child should be excluded per public health law [G.S. 130A-155(a)].

Q: Do I need to get a new immunization records from all my parents?
A: The Immunization Branch recommends confirming with the parent that you have the most updated record on file.

Q: How can I find out if a child is up to date with their immunizations?
A: CDC has an Instant Childhood Immunization Scheduler. Please click this link to view.



Updated: February 15, 2022