Child Care – Exempt

Step 1-Gather a list of children who are exempt from 1 or more vaccines

Children who are exempt from one or more vaccines must have a current Certificate of Exemption on file. There are a couple different ways to track exempted children depending on how a child care provider stores immunization information. If a child care provider uses files and paper, they will need to manually go through and determine which children have Certificates of Exemption on file and make a separate list of these children. Sometimes it is helpful to put them in categories by age. It will also be important to determine which vaccines they have exempted, which will help other steps go faster. This can also be done by a child care’s tracking software. There are then different ways to group children. A center may find it easier to group children by age or classroom. Some centers may find it easier to alphabetize all the children with exemptions by name. A child care provider should find the method of grouping children that works best for them and their center.
Step 2-Determine best way to contact parents

The purpose of contacting these parents is to ensure the information a child care provider has is accurate. Although these children are non-compliant according to the law, there are many times parents change their mind and get their children vaccinated. To ensure a child care provider has the most up-to-date information during an outbreak, it is best to ask parents if the Certificate of Exemption they signed is still accurate. Here are two examples of ways to contact parents that can be modified to meet your needs. Calling parents may not be the best option. Once the contact method is determined, contact each parent.
  1. See the CIS form, which can be completed and provided to parents. This can be a visual for parents to see what immunizations a child care provider does not have on file. There is a chance the child could have gotten the immunizations even though an exemption is on file.

  2. Sample Email/Note/Conversation:
    Hi Parent,

    We are required by law to ensure that our immunization records are accurate. Our records indicate that your child has a Certificate of Exemption on file for ____ vaccines. Is this still accurate? If not, can I please get updated immunization dates? Thank you for your time and for helping us ensure our records are current.
Step 3-Determine best way to track progress

Once a child care provider knows who will be contacting parents, it is important to track progress and attempts at contacting parents. A sample tracking sheet for children that need follow up can be found found here.  A sample tracking sheet for children that are exempt can be found here.
Step 4-Gather immunization data from parents

As records are provided to the child care center from parents, ensure these updates are added to current immunization record keeping system.
Step 5-Make a new list of children still needing follow-up

Repeat Steps 2-5 until data is accurate. Waiting too long for parents to communicate back can decrease the momentum of a record review. After first contact with parents, continue encouraging them every few days to provide the needed information back to the child care center. Keep talking with parents. Although a child care provider may feel like a pest, many times parents are just busy and need reminders. Sample conversations with parents can be found here.
1. Find children who are exempt.
learn more >
2. Determine the best way to contact parents.
(via sign-in sheet, note, email)
learn more >
3. Determine best way to track progress.
learn more >
4. Gather immunization data from parents by a deadline.
learn more >

CIS Transparency Overlay
5. Make a new list of those children from original population that still need follow up.
learn more >