Department of Health updates school vaccine requirements

For the first time in nearly two decades, the state Department of Health has updated its vaccine requirements for students.

Additional immunizations will be required for students entering Hawaii schools beginning July 1, 2020, the DOH announced Tuesday.


“The state’s new updated school vaccination requirements follow current national recommendations and reflect what is already occurring in health care providers’ offices and clinics in Hawaii as standard medical practice,” Health Director Bruce Anderson said. “These requirements protect not only the health of our students but their families and our communities as well. Ensuring our students are vaccinated provides protection for those who are too young to be vaccinated and those with medical conditions, such as cancer, who cannot be immunized.”

Currently, the immunizations required for school attendance are DTaP (diptheria/tetanus/pertussis), polio, MMR (measles, mumps, rubella), hepatitis B, hib (Haemophilus influenzae type b, for preschool attendance), and varicella (chickenpox).

According to Anderson, childcare and preschools will require students to also have hepatitis A and PCV (pneumococcal conjugate vaccine) immunizations and students entering kindergarten will also have to have the hepatitis A vaccine.

Students entering seventh grade are required to have the TDaP, HPV (human papillomavirus) and MCV (meningococcal conjugate) vaccines.

In addition to the currently-required immunizations, all new students entering Hawaii schools for the first time also will have to have a hepatitis A vaccine, and new students entering seventh-grade or higher will have to have a TDap, HPV and MCV vaccine.

The new requirements begin July 1, 2020, which Anderson said gives parents and guardians about a year to check with their physicians to ensure their child is properly vaccinated before school starts.

“These are recommendations that most physicians and clinics have been following for a decade or more,” he said.

According to Anderson, the DOH hasn’t updated its vaccine requirements since 2001.

“We’re simply catching up with what is recommended by the Centers for Disease Control and other national organizations.”

The changes are important because Anderson said Hawaii remains a center for travel.

“We are at increased risk in Hawaii for contagious diseases because of large number of visitors.”

Hawaii has a history of devastating illness and death, Anderson said. Smallpox and other diseases introduced to Hawaii had “a devastating impact” on the Native Hawaiian population.

Smallpox has now been eradicated because of vaccines but Anderson said other diseases, such as measles, continue to threaten Hawaii’s public health.

While no measles cases have been reported in Hawaii, the DOH in January confirmed two cases of measles in unvaccinated children visiting the Big Island from Washington state, where an outbreak had been declared.

According to the CDC, 1,215 cases of measles have been confirmed in 30 states between Jan. 1 and Aug. 22, the greatest number of cases reported since 1992 and since measles was declared eliminated in 2000.

Exemptions to immunizations are permitted for medical and religious reasons. Philosophical or personal belief exemptions are not allowed.

Vaccination exemption rates vary throughout East Hawaii schools, according to numbers for the 2018-19 school year, which were released in May.

“The Hawaii State Department of Education supports the state Department of Health’s goal to protect Hawaii’s population from vaccine-preventable diseases,” said Lindsay Ku‘uipo Chambers, communications director for the DOE.

“This is especially true for susceptible groups like our children and immunization is a proven means of stopping outbreaks before they happen. Parents are strongly encouraged to get their children immunized before they attend school to help protect themselves and their fellow students from unnecessary health risks.”

Anderson said there’s “a lot of misinformation out there thanks to the internet and social media and it’s very difficult to counter that, so I think misinformation has contributed to undue concern about vaccinations.”

Vaccinations, he said, are the most effective and safest way to prevent contagious disease and have been proven to be effective over decades.

Email Stephanie Salmons at

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