Staying on vaccine schedules is important for children before they had back to school
Gabrielle Teiner
COLUMBIA, Mo. (KMIZ)
In less than a month, more than a million children across Missouri will be shoving notebooks into their backpacks, sharpening their pencils and walking down the halls of their schools for the new school year.
While having all the right supplies on the first day is important, making sure you have all your immunizations is crucial.
The Immunization of School Children law requires Missouri students to get their immunizations to attend any school, except those granted religious and medical exemptions. Dr. Laura Morris with MU Health Care said the state relies on the recommendations of the advisory committee on immunization practices for vaccine scheduling to the CDC, following the national standard.
The following immunizations are required and listed by the Department of Health and Senior Services for students kindergarten through 12th grade for the 2025-26 school year:
DTaP: Missouri students heading into kindergarten need five doses of DTaP, with the final dose given on or after a child turns 4, according to DHSS. A final dose of pediatric pertussis needs to be administered before the child turns 7 years old.
DTaP is a combination immunization given to children under seven years old and protects children from diphtheria, tetanus (“lockjaw”) and pertussis (whooping cough), according to the nonprofit organization immunize.org. Diphtheria and pertussis can spread from person to person, whereas tetanus enters the body through a cut in the skin.
Missouri schools also accept DTP and DT in place of DTaP. DTP is used in low- and middle-income countries and was phased out of the U.S. when DTaP became the standard. DTa1 does not include the pertussis immunization, and is administered to children who can’t receive the Pertussis vaccine due to a medical reason, according to the CDC.
DTaP trains the immune system by introducing chemically inactive toxins and purified fragments of bacterium found in the infections the immunization fights to the immune system. This mimics the infection without causing the disease, so the body is ready to fight it if exposed to the real disease later, according to research from the CDC.
IPV(Polio): Missouri students need four polio vaccinations with the last dose on or after their 4th birthday and at least six months apart from each shot, according to DHSS. IPV is a series of shots filled with inactive or killed, poliovirus that trains the body to fight the highly contagious disease, according to the CDC. It allows the body to create proteins to fight the live disease if exposed. This will not give you the disease, but you may have mild side effects like fever, pain and swelling where the shot was given.
MMR: A combination immunization that protects against measles, mumps and rubella. DHSS requires students to receive 2 doses total, with the first dose administered anywhere between 12-15 months and final dose between 4-6 years old. Measles, mumps and rubella can cause fever, rash, pneumonia, meningitis, birth defects and more, according to the Cleveland Clinic. According to DHSS, there have been seven confirmed cases of measles in Missouri this year.
Hepatitis B: Missouri students need three hepatitis B immunizations before the start of kindergarten. You must wait at least four weeks between dose one and two, at least eight weeks before two and three, wait at least 16 weeks between one and three and the final dose must be given no sooner than 24 weeks old, according to DHSS. Hepatitis B is a contagious virus that can cause a liver infection, causing short-term and long-term issues like liver failure, cirrhosis and cancer.
Varicella: Following CDC guidelines, Missouri students need two doses of the Varicella immunization, with the first dose being given on or after twelve months old and the final dose being before four years old. Varicella is a highly contagious virus that causes an itchy rash with blisters, fever and fatigue.
Tdap booster: One dose required for incoming eighth graders. According to the CDC, Tdap is only for children seven years old and up, and should receive the shot around 11 and 12 years old.
MCV booster (Meningococcal): One dose for eighth graders or after 11 years old and two doses for 12th graders unless one dose was given at 16 years old, then only one dose is required for 12th graders.
Vaccine
Age needed by
What it protects against
Doses
DTaP
Pre-K
Diphtheria, tetanus (“lockjaw”) and pertussis (whooping cough)
5 last dose given on or after 4th birthday
IPV
Pre-K
Polio
4last dose given on or after 4th birthday
MMR
Pre-K
Measles, mumps and rubella
2last dose given on or after 4th birthday
Hepatitis B
Pre-K
Viral infection that can cause liver inflammation/damage
3last dose given between 6-18 months
Varicella
Pre-K
Chicken pox
2last dose given on or after 4th birthday
Tdap
Eighth grade
Booster shot to continue protection against diphtheria, tetanus (“lockjaw”) and pertussis (whooping cough)
1
MCV
Eighth grade12th grade
Meningococcal disease
2one dose required after 10-years-oldsecond dose required by 12th grade the latest.
Data provided from the Centers for Disease Control and Prevention and The Missouri Department of Health and Senior Services.
A four-day grace period is allowed before vaccine due dates, according to DHSS. Students can also be considered “in progress” if they have begun the immunization process and have an appointment for the next dose on record. These students must have an immunizations in progress form (Imm.P.14).
Missouri does allow medical and religious exemptions and paperwork is required for both. If a Missouri school were subject to an outbreak of a preventable disease, under Missouri law, those children can be excluded from school.
An uninsured child can get free vaccinations through the Vaccines for Children Program, funded by the CDC. Lynelle Paro, Bureau Chief of the Missouri Bureau of Immunizations, said children can receive free immunizations through the program as long as they are Medicaid-eligible, do not have health insurance, are an American Indian or Alaskan Native, or are underinsured.
While vaccine-preventable diseases have started to spread more nationwide in recent years, misinformation is also spreading. A common misconception DHSS addresses is the idea that immunizations aren’t necessary because the disease is rare now. While yes, certain diseases are rare in the United States, they can be more common to catch in foreign countries or by being exposed to folks from other countries who may not be vaccinated against the disease. Certain diseases are rare in the United States because of vaccines, and if vaccine distribution were stopped, diseases could spread very quickly.
Another misconception is that children can get sick from getting an immunization, but Morris said that is not true. A majority of vaccines given are inactive and incapable of giving you the infection. You may have some mild side effects, like a sore arm at the injection site or a slight fever, which typically go away quickly.
“It is a good sign that your immune system is reacting to the vaccine,” Morris said. “Your immune system has been activated, but you’re not infected and you’re not contagious, so those are important considerations that even if you don’t feel great for a day or two while your immune system reacts to you and creates immunity against that vaccine product, it’s not the same thing as being sick.”
Health officials recommend that any parent or guardian who has questions or concerns about vaccines should contact a health professional, like a pediatrician, pharmacist, nurse, family doctor or other licensed health care provider.
“It’s been our life’s work to make sure we understand this and we want to take care of you and your family, so asking those questions and reaching out right now is a great time,” Morris said.
While these vaccines are mandatory for students to go to school, the latest reports on immunization rates in Missouri show those numbers are falling.
Multiple counties in Mid-Missouri are reporting certain immunization rates falling below the threshold for herd immunity. Herd immunity is reached when 90-95% of a community is fully vaccinated against a vaccine-preventable disease. Without it, the chance for an outbreak rises.
“For dropping school vaccination rates, there’s a certain level and when you drop below that the outbreak becomes more likely and at some point, even inevitable,” said Dr. George Turabelidze, who is an epidemiologist at the Missouri Department of Health and Senior Services.
The threshold is different for different vaccines. Measles, for example, needs 95% of a community to be fully vaccinated against the disease for herd immunity.