Immunization Toolkit


The resources listed below are here to further assist medical and non-medical staff at schools and childcares in establishing immunization record keeping and documentation workflow processes, or modifying existing processes.

Schools & Childcare

Washington State Department of Health Resources

Offers information on:

  • updated changes on exemptions
  • regulations surrounding vaccines, including the Revised Code of Washington (RCW) and Washington Administrative Code (WAC) and
  • training videos for:
    • Washington State Immunization Information System (IIS) training for schools, Headstart, and ECEAP
    • School Immunization Requirements for school nurses, health assistants, registrars, and secretaries.

The Office of Immunization and Child Profile has public health nurse consultants on staff to answer clinical questions about immunizations.

Local health jurisdiction staff, health and child care providers, school staff, and the general public can email the nurses at

Emails are confidential and will be answered within three business days.

Washington State Department of Health Immunization Manual
  • A reference guide designed for staff members who process Certificates of Immunization Status (CIS), complete immunization status reports, and answer questions from parents and guardians about immunization requirements for children in preschools, schools, and childcares. 
Washington State Department of Health Vaccine Requirements
  • Includes easy-reference childcare, preschool, and school vaccine requirement charts for school staff, parents and childcare providers.
  • Provides detailed clinical guidance information for individual vaccine requirements.
  • Links to the most current immunization schedules on the Centers for Disease Control & Prevention (CDC) website.

Reporting & Documentation

Washington State Department of Health School Immunization Status Reporting
  • Provides information for fulfilling and submitting annually-required immunization reporting requirements.
Washington State Department of Health Forms and Letters 

Includes the following documentation resources:

  • Certificate of Exemption (COE)
  • Certificate of Immunization Status (CIS)
  • CIS Overlay for Kindergarten Entry
  • CIS Overlay for Middle School
  • CIS Overlay for High School
  • CIS Overlay for Childcare/Preschool Entry
  • Frequently Asked Questions (FAQ) about the CIS and COE
  • Childcare and school susceptible tracking lists to document exemptions and conditional/noncompliant children that require follow-up

Includes the following sample letters for parents (all are in Microsoft Word and can be modified to include school district/child care logo and associated contact info)

  • Graduating Senior Letter
  • HPV Letter for Private Schools
  • HPV Letter for Public Schools
  • HPV and Meningococcal Letter (combination)
  • Meningococcal Letter
  • Notice of Child’s Conditional Immunization Status (Public and Private Schools)
  • Notice of Exclusion for Immunization Noncompliance (Private Schools)
  • Notice of Exclusion for Immunization Noncompliance (Public Schools)
  • Tdap Letter for 6th-12th grade
  • Tdap/Varicella Letter (combination)
  • Varicella Requirement Letter for 9th-12th Grade


Certificate of Immunization Status (CIS):  

  • Washington state form used by parent/guardian to report immunization information for their student.


  • Student has required immunizations for school entry or parent has signed a Certificate of Exemption that is on file.


  • Does not have required immunizations and is in the process of completing a series of shots.

Early Childhood Education and Assistance Program (ECEAP):

  • Comprehensive preschool programs that provide free services and support to eligible children and their families run by Washington State Department of Early Learning.


  • Parent chose to not obtain one or more of the required immunizations for school entry and has a healthcare provider-signed Certificate of Exemption.

Out-of-compliance (OOC):

  • Does not have required immunizations, does not have a signed Certificate of Exemption, and is not considered conditional.

Student Information System (SIS):

  • A software system used statewide for student and fiscal data.

Washington Immunization Information System (WAIIS) or (IIS): 

  • Formerly known as Child Profile, a lifetime registry that keeps track of immunization records for people of all ages.