Governor Bill Lee signed a new law into effect May 17, 2023 and the law was immediately implemented. The law strictly specifies that only legal parents or legal guardians can give informed consent for vaccinations for children. In addition, the law includes new requirements for obtaining and documenting informed consent for vaccinations. The new law affects all children and all standard childhood vaccines. The law has special implications for children in the custody of the Tennessee Department of Children’s Services, commonly referred to as DCS.
The following general guidance and information is offered to parents and guardians:
• Children entering preschool, kindergarten or seventh grade and those enrolling in a Tennessee school for the first time are required to receive specific vaccines. Parents must also provide their child’s school with a state immunization certificate, which documents the vaccinations, before the first day of school.
• Vaccines and immunization certificates are available at your pediatrician’s office or the Knox County or other Health Department. To see if your child has proof of the required vaccines, you may contact the medical office or clinic where your child receives vaccinations. The number for the Knox County Health Department is 865-215-5150.
• The Knox County Health Department and other Health Departments provide vaccines, often at no cost, to any child regardless of where they live, country of origin, language, and insurance status.
Because of the new law and requirements, it is important to schedule back-to-school vaccines as early as possible.
The table below provides basic additional information for parents and guardians.
Tennessee vaccine requirements for children entering preschool, kindergarten or seventh grade and those enrolling in a Tennessee school for the first time are shown on page 3.
Information for Parents and Guardians
Type of parent or guardian or situation | Guidance |
Biological parents | If your infant, child, or teen is due vaccines, when you call to make your appointment, ASK your healthcare provider if you need to be physically present to give consent for your child to be vaccinated. If you do not need to be physically present, can you may be able give consent over the phone? |
Other custodial caregivers, such as grandparents and step-parents | If you are another family member raising the minor child, determine if the biological parent can attend the visit to provide consent. If not possible, talk to your healthcare provider about any other options for obtaining consent such as bringing in written consent and/or the possibility of verbal or telephone consent. |
Adopted children | If you have adopted your child, you ARE the parent. However, your healthcare provider will need to have a copy of your adoption orders on file. ASK when you call for your appointment if they indeed have these on file. |
Children with parents who parental rights have been terminated | If you have PERMANENT LEGAL GUARDIANSHIP, you will be able to consent to immunizations. Your healthcare provider will need to have a copy of your guardianship orders that allow medical decision making on file. Again, ASK. |
Children in Department of Children Services (DCS) who have DCS caseworkers | DCS workers and foster families can be proactive and ensure they have a signed consent from the biological parent, a TPR termination of parental rights) order, or a court authorization for vaccines on file with the healthcare provider when making an appointment. Call your DCS worker in advance to obtain the necessary documentation. |
Required Immunizations
Children enrolling in Kindergarten
- Hepatitis B (HBV)
- Diphtheria-Tetanus-Pertussis (DTaP, or DT if appropriate)
- Poliomyelitis (IPV or OPV) - final dose on or after the 4th birthday
- Measles, Mumps, Rubella - 2 doses of each, usually given together as MMR
- Varicella - 2 doses or credible history of disease
- Hepatitis A - total of 2 doses, spaced at least 6 - 18 months apart
All children entering 7th grade (including currently enrolled students)
- Tetanus-diphtheria-pertussis booster (Tdap) - evidence of one Tdap dose given before 7th grade entry (administered at or after age 10) is required regardless of Td history
- Update to 7th Grade Chickenpox (Varicella) Immunization Requirements
Children who are new enrollees in a TN school in grades other than Kindergarten
- Diphtheria-Tetanus-Pertussis (DTaP, or DT if appropriate)
- Measles, Mumps, Rubella (2 doses of each, normally given together as MMR)
- Poliomyelitis (IPV or OPV) – final dose on or after the 4th birthday now required
- Varicella (2 doses or credible history of disease) – previously only one dose was required
- Hepatitis B (HBV) – previously only for Kindergarten, 7th grade entry
- New students entering grades other than 7th grade are not required to have Tdap
Taken from the Tennessee Department of Health website.
