5110 - Immunization

Policy 5110 Immunization title box

The Boards of Directors of the Southwest Vermont Supervisory Union, Bennington School District, Inc., Mount Anthony Union School District, North Bennington Graded School District, Pownal School District, Shaftsbury School District, and Woodford School District recognize that all students must meet immunization requirements as defined by Vermont State Law.
  1. A student may be exempted from immunization requirements for medical or religious reasons if one of the following is provided to the school:

  2. a. Medical exemptions - A signed statement from a physician statingthat immunization is contraindicated. See administrative regulations for link to exemption form.
    b. Religious exemptions - A signed statement from the parent(s)/guardian(s) that immunization is against their religious beliefs. See administrative regulations for link to exemption form.

  3. A student may be admitted to school provisionally while he/she is in the process of acquiring the required immunizations with a written statement from a physician and/or health clinic.

  4. A student who does not comply with the state immunization law will be excluded from school until compliant in accordance with Vermont State law.

  5. Statistical reports of student immunization status will be submitted to the state as required.

  6. Students attending school with a provisional, medical or religious exemption will be excluded from school should an outbreak of measles, polio, rubella, or diphtheria occur.

Legal Citation: 18 VSA §§1120-1126.

Policy 5110 warning and update dates

Administrative Regulations

Religious exemption form


Medical exemption form


Students must provide the school with immunization records from a physician or health clinic as cited in the Vermont Department of Health Immunizations for Providers online for information about the enforcement of the Vermont school immunization law.

Please note that without the necessary documentation, the student will not be able to enroll in school.

The student must have received the following immunizations:
  • 5 doses of DTaP (diphtheria, tetanus, and pertussis) vaccine
  • 4 doses of polio vaccine
  • 2 doses of MMR (measles, mumps, and rubella) vaccine
  • 3 doses of Hepatitis B vaccine
  • 2 doses of chickenpox (varicella) vaccine or history of the disease

If the student is enrolling in the seventh grade* s/he must have received:
  • All of the immunizations listed above and
  • One dose of Tdap (tetanus, diphtheria, and pertussis) vaccine.

Students attending and residing in a residential boarding school* must have:
  • All of the immunizations listed in both sections above and
  • One dose of meningococcal vaccine

* These same requirements apply to all students entering as a new student at a new school. This would include a student newly enrolling into a school, and that school is not within the same school district or supervisory union as his/her previous one.

Administrative regulations adopted November 12, 2008