The North Carolina General Statutes (G.S. 130A-152(a)) require immunizations for every child present in this state. Every parent, guardian or person in loco parentis is responsible for ensuring that their child(ren) receives required immunizations. Immunization records are reviewed when a child enters a school or child care facility.
If you have specific questions regarding your child, please contact your child's health care provider or your local health department.
Now required: Before entering 12th grade or by their 17th birthday, whichever comes first, students must get a booster dose of Meningococcal Conjugate Vaccine (MenACWY) to protect against meningococcal disease.
Vaccination requirements by grade level
| Vaccine | Grade Level and Doses Required |
|---|---|
| Polio | Kindergarten 4 doses |
| Measles, mumps and rubella (MMR) | Kindergarten 2 doses MMR |
| Haemophilus Influenzae Type B (Hib) | Kindergarten 4 doses Hib |
| Hepatitis B | Kindergarten 3 doses |
| Varicella (Chickenpox) | Kindergarten 2 doses |
| Pneumococcal conjugate | Kindergarten 4 doses |
| Diphtheria, tetanus and pertussis (DTaP/Tdap) | Kindergarten Seventh grade |
| Meningococcal conjugate | Seventh grade 12th grade |
Children entering seventh and 12th grades must have gotten all immunizations required for the previous grade level(s).
Missing immunizations? Talk with a health care provider about catching up.
North Carolina Vaccine-Specific Requirements
Five doses (DTaP). Three doses by age seven months and two booster doses, the first by age 19 months and the second on or after the fourth birthday and before entering school for the first time. If the fourth dose was administered on or after the fourth birthday, the fifth dose is not required.
A booster dose of tetanus/diphtheria/pertussis (Tdap) vaccine is required for individuals who have not previously received it and are entering the seventh grade or by 12 years of age, whichever comes first.
Individuals entering college or university for the first time on or after July 1, 2008, must have had three doses of tetanus/diphtheria toxoid; one of which must be tetanus/diphtheria/pertussis.
Four doses. Two doses by five months of age, a third dose by 19 months of age, and a booster dose on or after the fourth birthday and before entering school for the first time. If the third dose was administered on or after the fourth birthday, the fourth dose is not required if the third dose was given at least six months after the second dose.
Two doses at least 28 days apart. One dose on or after 12 months of age and before 16 months of age, and a second dose before entering school for the first time. The requirement for a second dose does not apply to individuals who entered school, college or university for the first time before July 1, 1994.
A person who has been diagnosed before January 1, 1994, by a physician (or designee such as a nurse practitioner or physician’s assistant) as having measles (rubeola) or, an individual who has been documented by serological testing to have a protective antibody titer against measles is not required to receive measles vaccine. Individuals born before 1957 are not required to receive the measles vaccine except in measles outbreak situations.
Two doses. One dose on or after 12 months of age and before age 16 months, and a second dose before entering school, college or university for the first time.
A physician's is not acceptable for mumps disease(s). Individuals must be immunized or have laboratory confirmation of disease or have been documented by serological testing to have a protective antibody against mumps. Individuals born before 1957 are not required to receive the mumps vaccine. Individuals who entered the first grade for the first time before July 1, 1987, or college or university before July 1, 1994, are not required to receive the vaccine. Individuals who entered school, college, or university before July 1, 2008, are not required to receive the second dose of mumps vaccine.
One dose on or after 12 months of age and before 16 months of age.
A physician's diagnosis is not acceptable for rubella disease(s). Individuals must be immunized or have laboratory confirmation of rubella disease or have been documented by serological testing to have a protective antibody titer against rubella. Any individual who has attained his or her fiftieth birthday is not required to receive a rubella vaccine except in outbreak situations. Any individual who entered college or university after his or her thirtieth birthday and before February 1, 1989, is not required to receive rubella vaccine except in outbreak situations.
Three doses of HbOC or PRP-T, or two doses of PRP-OMP before age seven months and a booster dose of any type on or after age 12 months and by age 16 months.
Individuals who receive the first dose of Hib on or after seven months of age and before 12 months of age are required to have two doses of HbOC, PRP-T or PRP-OMP and a booster dose on or after 12 months of age and by 16 months of age. Individuals who receive the first dose of Hib on or after 12 months of age and before 15 months of age are required to have only two doses of HbOC, PRP-T or PRP-OMG and a booster dose two months later. Individuals who receive the first dose of Hib vaccine on or after 15 months of age are required to have only one dose of any of the Hib conjugate vaccines. Individuals who have passed their fifth birthday are not required to be vaccinated against Hib.
Three doses. One dose by three months of age, a second dose by five months of age, and a third dose by 19 months of age. The last dose of the hepatitis B vaccine series shall not be administered before 24 weeks of age.
Individuals born before July 1, 1994, are not required to receive the hepatitis B vaccine.
Two doses administered at least 28 days apart. One dose on or after 12 months of age and before age 19 months, and a second dose before entering school for the first time.
An individual with laboratory confirmation of varicella disease immunity or has been documented by serological testing to have a protective antibody titer against varicella is not required to receive varicella vaccine. An individual who has documentation from a physician, nurse practitioner, or physician's assistant verifying a history of varicella disease is not required to receive a varicella vaccine. The documentation shall include the name of the individual with a history of varicella disease, the approximate date or age of infection, and a health care provider signature. Individuals born before April 1, 2001, are not required to receive varicella vaccine. The requirement for the second dose of varicella vaccine shall not apply to individuals who enter Kindergarten or first grade for the first time before July 1, 2015.
Four doses. Three doses by age seven months and a booster dose at 12 through 15 months of age. Individuals who receive the first dose of pneumococcal conjugate vaccine on or after seven months of age and before 12 months of age are required to have two doses at least four weeks apart; and a booster dose at 12 through 15 months of age. Individuals who receive the first dose on or after 12 months of age and before 24 months of age are required to have two doses at least eight weeks apart to complete the series. Individuals who receive the first dose on or after 24 months of age and before five years are required to have one dose to complete the series.
No individual who has passed his or her fifth birthday shall be required to be vaccinated against pneumococcal disease. Individuals born before July 1, 2015, are not required to receive pneumococcal conjugate vaccine.
Two doses. One dose is required for individuals entering the seventh grade or by 12 years of age, whichever comes first, on or after July 1, 2015. A booster dose is required for individuals entering the 12th grade or by 17 years of age, whichever comes first. Individuals who entered seventh grade before July 1, 2015, are not required to receive the first dose. The booster dose does not apply to individuals who entered the 12th grade before August 1, 2020. If the first dose is administered on or after the 16th birthday, a booster dose is not required. Individuals born before January 1, 2003, shall not be required to receive the meningococcal conjugate vaccine.
Required vs. Recommended
North Carolina law requires children to receive certain vaccines. But to be fully protected from vaccine-preventable diseases, children should receive all age-appropriate immunizations.
For more information about vaccine-preventable diseases and immunizations recommended, please refer to the Centers for Disease Control and Prevention (CDC), the Advisory Committee on Immunization Practices (ACIP), and the Immunization Action Coalition.
This page was last modified on 03/04/2025