Exemption Review for Childcares

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 exempt children depending on how a child care provider stores immunization information. If a childcare provider uses paper files, 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 childcare’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 childcare provider should find the method of grouping children that works best for them and their center.

2. Determine the best way to contact parents.

The purpose of contacting these parents is to ensure the information a childcare 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 childcare 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 childcare 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.

3. Determine the best way to track progress.

Once a childcare 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 here.  A sample tracking sheet for children that are exempt can be found here.

4. Gather immunization data from parents.

As records are provided to the childcare center from parents, ensure these updates are added to current immunization record keeping system.

CIS Transparency Overlay

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 childcare 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.