San Diego Immunization Information > Child Care Providers

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FREQUENTLY ASKED QUESTIONS

Where can I get blue cards?
Do I need blue cards for all children in my care?
Is a TB skin test required for a child to enter child care?
Are CHDP (Child Health and Disability Prevention Program) and other California physical exam forms acceptable records of immunization history?
What should I do if a parent says they can't find their child's shot record?
What type of documentation is accepted for chickenpox disease?
How do we document chickenpox disease on the blue card?
Can a child be exempted from California School Immunization Law requirements for child care?
Whom can I contact for more information about immunizations?

Q: Where can I get blue cards?
A: California School Immunization Records (blue cards) are available free of charge from the County of San Diego Immunization Program at (619) 692-8661 and the YMCA Childcare Resource Service at (800) 481-2151.

Q: Do I need blue cards for all children in my care?
A: You need blue cards for all children not enrolled in school. This includes your own children.

Q: Is a TB skin test required for a child to enter child care?
A: The TB skin test is not a vaccine, therefore, it is not part of the California School Immunization Law. Please ask Community Care Licensing at 619-767-2200 for TB requirements. To view or download more information on TB screening guidelines, click on the link below:

FAQs for Tuberculosis (TB) Screening Guidelines for Schools and Child Care Facilities in San Diego County

Q: Are CHDP (Child Health and Disability Prevention Program) and other California physical exam forms acceptable records of immunization history?
A: No. A child needs to have an official immunization record with a provider's stamp or signature for each dose.

Q: What should I do if a parent says they can't find their child's shot record?
A: Refer these parents to their doctor or clinic to get another copy. In situations where immunizations cannot be verified, children will need to get more shots and a new immunization record. Remind parents that the shot record is an important document, and they will need to keep it safe and show it for child care, school, doctor visits, etc.

The San Diego Regional Immunization Registry (SDIR) is a way to safeguard immunization records for both children and adults! Click here for more info.

Q: What type of documentation is accepted for chickenpox disease?
A: If a child has already had chickenpox disease, a doctor will need to note that on the child's California immunization record. A letter on the doctor's letterhead stating that the child had the disease is also acceptable. You cannot accept a verbal or written statement from the parent. For an example, click on the links below:

About chickenpox disease & the requirement (4/02)
English - imm705.pdf (4/02)
Spanish - imm705s.pdf (4/02)

Q: How do we document chickenpox disease on the blue card?
A: Write the words "had disease" in the varicella section of the blue card, specifically where the date of the shot would normally be written. For an example, click on the links above.

Q: Can a child be exempted from California School Immunization Law requirements for child care?
A: There are two situations where the law allows a child to be exempted from the immunization requirements. These are known as Medical Exemptions and Personal Beliefs Exemptions.

Medical Exemptions: A medical exemption is granted when a child should not get some or all shots for temporary or permanent medical reasons. To grant a Temporary Medical Exemption (TME), ask the parent to bring in an official letter from the doctor (preferably on letterhead), telling you which vaccines the child cannot have at this time, and why and when the vaccines will be given. Attach the letter to the blue card (CSIR) and note the follow-up date on your calendar. It's your responsibility to follow up before the TME expires. The child must either get the shot needed or another TME when the current TME expires.

To grant a Permanent Medical Exemption (PME) ask the parent to bring in an official letter from the doctor telling you which vaccines the child is exempted from and why. Note the exemption on the blue card.

Personal Beliefs Exemptions: Although it is strongly advised that children be immunized, the final decision to immunize or not is that of the parent or guardian. However, the Personal Beliefs Exemption is to be granted to parents/guardians only for reasons of personal belief, and not as a matter of convenience because a parent can't find the immunization record, or does not "have time" to take the child to get the shots. If parents oppose some or all immunizations, they must sign the Personal Beliefs Affidavit on the back of the blue card. By signing the affidavit, parents acknowledge that if there is an outbreak of any disease their child is not protected against, the child may be temporarily excluded from attending child care.

Q: Whom can I contact for more information about immunizations?
A: For more information about immunizations contact Health Educator Anita Secor by email at: Anita.Secor@sdcounty.ca.gov or by calling
(619) 692-8691.

The information on this website should not be used as a substitute for the medical care and advice of your healthcare provider. Your healthcare provider may recommend variations in treatment based on individual facts and circumstances.