Immunization/Physical Exam Requirements

MA Physical Examination Requirements

Physicals
According to Massachusetts state law, physical examinations are required upon entry to the school system (kindergarten and transferring students) and every three to four years thereafter.

Each child needs to present to the school nurse documentation of a physical examination prior to first school entry and at fourth, seventh, and eleventh grades. If participating in competitive sports, physical exams are required annually. 

MA Health Record Form

Sports Physicals
An annual physical is required for participation in school sponsored athletic activities. Special sports physical forms are available in the health offices as well as in the athletic department. All physicals must be current to participate.

Immunization Requirements

Immunization Exemptions and Vaccine-Preventable Disease Exclusion Guidelines

Definition of Allowable Exemptions

There are two situations in which children who are not appropriately immunized may be admitted to school:

1) a medical exemption is allowed if a physician submits documentation that an immunization is medically contraindicated; and
2) a religious exemption is allowed if a parent or guardian submits a written statement that immunizations conflict with their sincere religious beliefs.

Philosophical exemptions are not allowed by law in Massachusetts, even if signed by a physician. Only medical and religious exemptions are acceptable. These exemptions must be kept in the student’s files at school (105 CMR 220.000 and M.G.L. c.76, s. 15, 15C, and 15D).

Policies for Exclusion at School Entry

While the laws and regulations state that unimmunized children who do not meet criteria for medical or religious exemption “shall not be admitted to school,” policies around enforcement of exclusion for unimmunized or partially immunized children are developed by individual schools/school districts.

The only exception for exclusion of unimmunized or partially immunized children is in the case of homeless children, whereby they cannot be denied entry to school if they do not have their immunization records. The federal McKinney-Vento Homeless Assistance Act states that if a homeless student does not have proper documentation of immunizations or any medical records, the Homeless Education Liaison at your school must immediately assist in obtaining them. The student must be enrolled and permitted to attend school in the interim (as cited in the McKinney-Vento Homeless Assistance Act of 2001).

Exclusion During Disease Outbreaks

When one or more cases of disease are present in a school, all susceptibles, including those with medical or religious exemptions, are subject to exclusion as described in the Reportable Diseases and Isolation and Quarantine Requirements (105 CMR 300.000).

The reporting and control of diseases identified as posing a risk to public health is prescribed by state regulation and law. The Isolation and Quarantine Requirements establish isolation and quarantine requirements for cases of certain diseases and their contacts in certain high-risk situations, including the school setting. Your school nurse will help to guide you through any exclusion process for a communicable disease.