Tennessee Childcare Immunization Requirements (2026)

Tennessee childcare licensing requires age-appropriate Hepatitis B (HBV) immunization for enrolled children (subject to documented medical or legally permitted exemptions).

Tennessee childcare licensing requires age-appropriate Diphtheria-Tetanus-Pertussis (DTaP; DT if appropriate) immunization for enrolled children (subject to documented medical or legally permitted exemptions).

Tennessee childcare licensing requires age-appropriate Poliomyelitis (IPV or OPV) immunization for enrolled children (subject to documented medical or legally permitted exemptions).

Tennessee childcare licensing requires age-appropriate Haemophilus influenzae type B (Hib) - required for age under 5 only immunization for enrolled children (subject to documented medical or legally permitted exemptions).

Tennessee childcare licensing requires age-appropriate Pneumococcal conjugate vaccine (PCV) - required for age under 5 only immunization for enrolled children (subject to documented medical or legally permitted exemptions).

Tennessee childcare licensing requires age-appropriate Measles, Mumps, Rubella (MMR) - 1 dose each immunization for enrolled children (subject to documented medical or legally permitted exemptions).

Tennessee childcare licensing requires age-appropriate Varicella - 1 dose or credible history of disease immunization for enrolled children (subject to documented medical or legally permitted exemptions).

Tennessee childcare licensing requires age-appropriate Hepatitis A - 1 dose, required by 18 months of age or older immunization for enrolled children (subject to documented medical or legally permitted exemptions).

Tennessee childcare licensing requires age-appropriate Documented on the Tennessee Department of Health Official Certificate of Immunization (TennIIS); positive serology with year documented accepted as alternative for measles/mumps/rubella/hepatitis A/hepatitis B/varicella; medical and religious exemptions permitted immunization for enrolled children (subject to documented medical or legally permitted exemptions).

Tennessee childcare licensing requires age-appropriate Per Tenn. Comp. R. & Regs. 1240-04-01-.08(2)(e), the agency must have the Official Immunization Certificate before accepting any child age 2 months or older immunization for enrolled children (subject to documented medical or legally permitted exemptions).

Which vaccines does Tennessee require for childcare enrollment?

Tennessee requires age-appropriate immunization records for: Hepatitis B (HBV), Diphtheria-Tetanus-Pertussis (DTaP; DT if appropriate), Poliomyelitis (IPV or OPV), Haemophilus influenzae type B (Hib) - required for age under 5 only, Pneumococcal conjugate vaccine (PCV) - required for age under 5 only, Measles, Mumps, Rubella (MMR) - 1 dose each, Varicella - 1 dose or credible history of disease, Hepatitis A - 1 dose, required by 18 months of age or older, Documented on the Tennessee Department of Health Official Certificate of Immunization (TennIIS); positive serology with year documented accepted as alternative for measles/mumps/rubella/hepatitis A/hepatitis B/varicella; medical and religious exemptions permitted, Per Tenn. Comp. R. & Regs. 1240-04-01-.08(2)(e), the agency must have the Official Immunization Certificate before accepting any child age 2 months or older.

Are immunization exemptions allowed in Tennessee?

Tennessee permits documented medical exemptions and, where state law allows, certain non-medical exemptions. Confirm the current exemption rules with the Tennessee Department of Human Services (TDHS), Child Care Services.

When must immunization records be on file in Tennessee?

Tennessee requires up-to-date immunization documentation at enrollment, with records kept current in each child's file thereafter.