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[9] PH-4103 (Rev. 4/13) RDA-N/A. Vaccine Requirements for Attending Child Care Facilities, Pre-Schools and Schools in Tennessee*
The Executive Order requires covered employees to be fully vaccinated by Jan. 4, 2022 to be in compliance with the Jan. 18, 2022 deadline.
The HPV cancer vaccine and first meningococcal meningitis vaccine are not required for school attendance, but are recommended by pediatricians and public health experts for all children at this age and can be given at the same visit.
This form must be completed by a physician (MD/DO) or Tennessee Department of Health Public Health Nurse (PHN) licensed in the State of Tennessee to document a true medical contraindication/precaution to an immunization(s). This document may be accepted by agencies that require proof of medical exemption.
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