Iowa State Vaccine Requirements
Quick Facts and Resources for Iowa Residents
Quick Fact: In order to qualify for a religious exemption, the applicant, or if the applicant is a minor, the applicant’s parent or guardian, must submit a notarized certificate of immunization exemption with the applicant’s or parent’s/guardian’s signature attesting that immunization conflicts with a genuine and sincere religious belief and that the belief is in fact religious and not based merely on philosophical, scientific, moral, personal, or medical opposition to immunizations. Medical exemptions are also allowed.
Other Resources: Many vaccination and exemption information links are date specific. If the links below have expired, click on the state's department of health, or immunization program link provided below, as they are likely to provide links to updated information. The General Information link leads to the overview page provided by the state at the time of this webpage's update and may also be helpful. Please email NVIC with broken link information.
- Higher Ed Vaccination Requirements - Request college/university of choice for their Proof of Immunization Compliance, as each institution may use its own form.
- Exemption Information - Request college/university of choice for their Proof of Immunization Compliance, as each institution may use its own form.
- Vaccination Requirements for Healthcare Workers, Patients, Inmates & Developmentally Disabled
- State of Iowa Legislature – see applicable statutes and their hyperlinks below. Visit NVIC’s Advocacy Portal for information on legislation introduced impacting vaccine exemption rights.
- State of Iowa Department of Health
- State of Iowa Immunization Program
- State of Iowa Vaccine Tracking System – You may also wish to contact your state’s vaccine tracking registry to determine if the ability to opt out is available.
- State of Iowa Vaccine Tracking System Opt-Out Information- In any circumstance where a parent or guardian specifically requests that information on their child be removed from Immunization Registry Information System (IRIS) or an adult over the age of 18 request their information be removed, the record will be sealed. Such requests must be in writing, and should be sent to the attention of the IRIS Coordinator.
Iowa Department of Public Health
321 East 12th Street
Des Moines, IA 50319-0075
- State of Iowa Proposed Rule-Making – View your state’s registry to learn about proposed rule-making.
TITLE IV PUBLIC HEALTH
SUBTITLE 2. HEALTH-RELATED ACTIVITIES
CHAPTER 139A. COMMUNICABLE AND INFECTIOUS DISEASES AND POISONINGS
SUBCHAPTER I. GENERAL PROVISIONS
1. A parent or legal guardian shall assure that the person’s minor children residing in the state are adequately immunized against diphtheria, pertussis, tetanus, poliomyelitis, rubeola, rubella, and varicella, according to recommendations provided by the department subject to the provisions of subsections 3 and 4.
2.a.A person shall not be enrolled in any licensed child care center or elementary or secondary school in Iowa without evidence of adequate immunizations against diphtheria, pertussis, tetanus, poliomyelitis, rubeola, rubella, and varicella.
b. Evidence of adequate immunization against haemophilus influenza B and invasive pneumococcal disease shall be required prior to enrollment in any licensed child care center.
c. Evidence of hepatitis type B immunization shall be required of a child born on or after July 1, 1994, prior to enrollment in school in kindergarten or in a grade.
d. Immunizations shall be provided according to recommendations provided by the department subject to the provisions of subsections 3 and 4.
e. A person shall not be enrolled in school in the seventh grade or twelfth grade in Iowa without evidence of adequate immunization against meningococcal disease in accordance with standards approved by the United States public health service of the United States department of health and human services for such biological products and in accordance with immunization practices recommended by the advisory committee on immunization practices of the centers for disease control and prevention.
3. Subject to the provision of subsection 4, the state board of health may modify or delete any of the immunizations in subsection 2.
4.a. Immunization is not required for a person’s enrollment in any elementary or secondary school or licensed child care center if either of the following applies:
(1) The applicant, or if the applicant is a minor, the applicant’s parent or legal guardian, submits to the admitting official a statement signed by a physician, advanced registered nurse practitioner, or physician assistant who is licensed by the board of medicine, board of nursing, or board of physician assistants that the immunizations required would be injurious to the health and well-being of the applicant or any member of the applicant’s family.
(2) The applicant, or if the applicant is a minor, the applicant’s parent or legal guardian, submits an affidavit signed by the applicant, or if the applicant is a minor, the applicant’s parent or legal guardian, stating that the immunization conflicts with the tenets and practices of a recognized religious denomination of which the applicant is an adherent or member.
b. The exemptions under this subsection do not apply in times of emergency or epidemic as determined by the state board of health and as declared by the director of public health.
5. A person may be provisionally enrolled in an elementary or secondary school or licensed child care center if the person has begun the required immunizations and if the person continues to receive the necessary immunizations as rapidly as is medically feasible. The department shall adopt rules relating to the provisional admission of persons to an elementary or secondary school or licensed child care center.6. The local board shall furnish the department, within sixty days after the first official day of school, evidence that each person enrolled in any elementary or secondary school has been immunized as required in this section subject to subsection 4. The department shall adopt rules pursuant to chapter 17A relating to the reporting of evidence of immunization.7. Local boards shall provide the required immunizations to children in areas where no local provision of these services exists.8. The department, in consultation with the director of the department of education, shall adopt rules for the implementation of this section and shall provide those rules to local school boards and local boards.
1. Each institution of higher education that has an on-campus residence hall or dormitory shall provide vaccination information on meningococcal disease to each student enrolled in the institution. The vaccination information shall be contained on student health forms provided to each student by the institution, which forms shall include space for the student to indicate whether or not the student has received the vaccination against meningococcal disease. The vaccination information about meningococcal disease shall include any recommendations issued by the national centers for disease control and prevention regarding the disease. Vaccination information obtained under this section that is in the possession of an institution of higher education pursuant to this section shall not be considered a public record. Data obtained under this section shall be submitted annually to the department in a manner prescribed by the department and such that no individual person can be identified.
2. This section shall not be construed to require any institution of higher education to provide the vaccination against meningococcal disease to students.
3. This section shall not apply if the national centers for disease control and prevention no longer recommend the meningococcal disease vaccine.
4. This section does not create a private right of action.
5. The department shall adopt rules for administration of this section. The department shall review the requirements of this section at least every five years, and shall submit its recommendations for modification to, or continuation of, this section based upon new information about the disease or vaccination against the disease in a report that shall be submitted to the general assembly no later than January 15, 2010, with subsequent reports developed and submitted by January 15 at least every fifth year thereafter.
PUBLIC HEALTH DEPARTMENT
CHAPTER 7. IMMUNIZATION AND IMMUNIZATION EDUCATION: PERSONS ATTENDING ELEMENTARY OR SECONDARY SCHOOLS, LICENSED CHILD CARE CENTERS OR INSTITUTIONS OF HIGHER EDUCATION
“Admitting official” means the superintendent of schools or the superintendent’s designated representative if a public school; if a nonpublic school or licensed child care center, the governing official of the school or child care center.
“Advanced registered nurse practitioner” or “ARNP” means an advanced registered nurse practitioner as defined in 655—7.1(152).
“Applicant” meansanypersonseekingenrollmentinalicensedchildcarecenterorelementaryor secondary school.
“Certified medical assistant” means a person who is certified to practice as a certified medical assistant following completion of a postsecondary medical assistant program accredited by the Commission on Accreditation of Allied Health Education Programs or the Accrediting Bureau of Health Education Schools and successful completion of the certification examination and who is directed by a supervising physician, physician assistant, or nurse practitioner.
“Competent private instruction” means private instruction as defined by the department of education pursuant to Iowa Code section 299A.1.
“Department” means the Iowa department of public health.
“Electronic signature” means a confidential personalized digital key, code, or number that is used for secure electronic data transmission and that identifies and authenticates the signatory.
“Elementary school” means kindergarten if provided, and grades one through eight or grades one through six when grades seven and eight are included in a secondary school.
“Enrolled user” means a user of the registry who has completed an enrollment form that specifies the conditions under which the registry can be accessed and who has been issued an identification code and password by the department.
“Health screening” means a vision screen, dental screen, or refugee health screen.
“Immunization registry” or “registry” means the database and file server maintained by the department as well as the software application that allows enrolled users to exchange immunization or health screening records.
“Institution of higher education” means a postsecondary school.
“Licensed childcare center” means a facility or program licensed by the Iowa department of human services to provide child care for seven or more children or a prekindergarten or preschool, regardless of the source of funding, operated by a local school district, an accredited nonpublic school, an area education agency, or a college or university.
“Nurse” means a person licensed to practice as a nurse pursuant to Iowa Code chapter152.
“On-campus residence hall or dormitory” means campus housing for students that is owned or leased by the institution of higher education and located on a recognized campus site.
“Pharmacist” means a person licensed to practice pharmacy pursuant to Iowa Code chapter 155A.
“Physician” means a person licensed to practice medicine and surgery or osteopathic medicine and surgery pursuant to Iowa Code chapter 148.
“Physician assistant” means a person licensed to practice as a physician assistant pursuant to Iowa Code chapter 148C.
“Postsecondary school” means a postsecondary institution under the control of the state board of regents, a community college established under Iowa Code chapter 260C, or an accredited private institution as defined in Iowa Code section 261.9, subsection 1.
“Postsecondary student” means a person who has officially registered with a postsecondary
school, as determined by the school, and who physically attends class on the school’s campus. For purposes of these rules, “postsecondary student” does not include a person who is exclusively registered in a correspondence course or continuing education class or who attends class exclusively by means of the Internet or the Iowa communications network or through other means which do not require the person’s physical presence on the school’s campus.
“Provisional enrollment” means enrollment for a period of time not to exceed the limit specified in subrule 7.7(2) to allow the applicant to meet the requirements of these rules. A provisionally enrolled applicant is entitled access to all the benefits, activities, and opportunities of the school or licensed child care center. Provisional enrollment shall not deny the school funding for the applicant.
“Screening provider” means an ophthalmologist, optometrist, pediatrician, physician, free clinic, child care center, local public health department, public or accredited nonpublic school, community-based organization, advanced registered nurse practitioner (ARNP), physician assistant, dentist or dental hygienist.
“Secondary school” means (a) a junior high school comprising grades 7, 8 and 9, and a senior high school; (b)a combined junior-senior high school comprising grades 7 through 12;(c) a junior high school comprising grades 7 and 8 and a high school comprising grades 9th ough12; (d) a high school comprising grades 9 through 12.
“Signature” means an original signature or the authorized use of a stamped signature or electronic signature.
“Student” means an individual who is enrolled in a licensed child care enter, elementary school or secondary school.
The immunization requirements specified elsewhere in these rules apply to all persons enrolled or attempting to enroll in a licensed child care center or a public or nonpublic elementary or secondary school in Iowa including those who are provided competent private instruction
7.3(1) To be valid, a certificate of immunization exemption for medical reasons shall contain, at a minimum, the applicant’s last name, first name, and date of birth, the vaccine(s) exempted, and an expiration date (if applicable) and shall bear the signature of a physician, nurse practitioner, or physician assistant. A medical exemption may be granted to an applicant when, in the opinion of a physician, nurse practitioner, or physician assistant:
a. The required immunizations would be injurious to the health and well-being of the applicant or any member of the applicant’s family or household. In this circumstance, a medical exemption may apply to a specific vaccine(s) or all required vaccines. If, in the opinion of the physician, nurse practitioner, or physician assistant issuing the medical exemption, the exemption should be terminated or reviewed at a future date, an expiration date shall be recorded on the certificate of immunization exemption; or
b. Administration of the required vaccine would violate minimum interval spacing. In this circumstance, an exemption shall apply only to an applicant who has not received prior doses of the exempted vaccine. An expiration date, not to exceed 60 calendar days, and the name of the vaccine exempted shall be recorded on the certificate of exemption.
7.3(2) A religious exemption may be granted to an applicant if immunization conflicts with a genuine and sincere religious belief.
a. To be valid, a certificate of immunization exemption for religious reasons shall contain, at a minimum, the applicant's last name, first name, and date of birth and shall bear the signature of the applicant or, if the applicant is a minor, of the applicant's parent or guardian and shall attest that immunization conflicts with a genuine and sincere religious belief and that the belief is in fact religious and not based merely on philosophical, scientific, moral, personal, or medical opposition to immunizations.
b. The certificate of immunization exemption for religious reasons is valid only when notarized.
7.3(3) Medical and religious exemptions under this rule do not apply in times of emergency or epidemic as determined by the state board of health and declared by the director of public health.
641-7.5(139A) Required education.
Each institution of higher education that has an on-campus residence hall or dormitory shall provide vaccination information on meningococcal disease to each postsecondary student enrolled in the institution of higher education. Meningococcal disease information shall be contained on student health forms. For purposes of this rule, student health form(s) means a document(s) prepared by an institution of higher education that contains, at a minimum, information on meningococcal disease, vaccination information and any recommendations issued by the national Centers for Disease Control and Prevention regarding meningococcal disease. The student health form(s) shall also include space for the postsecondary student to indicate whether or not the postsecondary student has received vaccination against meningococcal disease, including, at a minimum, the date of vaccination. The student health form(s) shall also include space for the postsecondary student to indicate whether or not the postsecondary student has received information on meningococcal disease and benefits of vaccine. If a traditional student health form is not utilized by the institution of higher education, any document(s) containing the above information is acceptable.
7.6(2) Persons wishing to enroll who do not have a valid Iowa department of public health certificate of immunization available to submit to the admitting official shall be referred to a physician, a physician assistant, a nurse, or a certified medical assistant to obtain a valid certificate.
a. Any applicant seeking provisional enrollment who does not have a valid Iowa department of public health provisional certificate of immunization to submit to the admitting official shall be referred to a physician, a physician assistant, a nurse, or a certified medical assistant to obtain a valid certificate.
7.7(2) The amount of time allowed for provisional enrollment shall be as soon as medically feasible but shall not exceed 60 calendar days. The period of provisional enrollment shall begin on the date the provisional certificate is signed. The person signing the provisional certificate shall assign an expiration date to the certificate and shall indicate the remaining immunizations required to qualify for a certificate of immunization.
7.7(3) The applicant or parent or guardian shall ensure that the applicant receive the necessary immunizations during the provisional enrollment period and shall submit a certificate of immunization to the admitting official by the end of the provisional enrollment period.
7.7(4) Rescinded IAB 12/3/08, effective 1/7/09.
7.7(5) If at the end of the provisional enrollment period the applicant or parent or guardian has not submitted a certificate of immunization, the admitting official shall immediately exclude the applicant from the benefits, activities, and opportunities of the school or licensed child care center until the applicant or parent or guardian submits a valid certificate of immunization.
7.7(6) If at the end of the provisional enrollment period the applicant has not completed the required immunizations due to minimum interval requirements, a new Iowa department of public health provisional certificate of immunization shall be submitted to the admitting official. The admitting official must maintain all issued certificates of provisional immunization with the original provisional certificate until the applicant submits a certificate of immunization.
Applicants not presenting proper evidence of immunization, or exemption, are not entitled to enrollment in a licensed child care center or elementary or secondary school under the provisions of Iowa Code section 139A.8. It shall be the duty of the admitting official to deny enrollment to any applicant who does not submit proper evidence of immunization according to rule 7.6(139A) and to exclude a provisionally enrolled applicant in accordance with rule 7.7(139A).