Elementary to Intermediate/Middle

On this page

  • Recommended vaccines for specific age group
  • Actions recommended for school nurses
  • Communication tools
    • Sample newsletter blurb
    • Sample letter to parents: transitioning from elementary to middle school
  • Resources for parents and school nurses
  • References

Recommended vaccines for specific age group 

The Centers for Disease Control and Prevention (CDC) schedule below shows the recommended vaccines for children age 7-18. Vaccines for elementary to intermediate/middle school-aged students that may be transitioning is outlined in red. Each state determines the immunizations required for students at the different grade/age levels.1 Depending on your district, the age of the children may vary depending on what level the transition occurs.

Information for Parents 2019 Recommended Immunizations for Children 7 - 18 Years Old

Information for Parents 2019 Recommended Immunizations for Children 7 - 18 Years Old2

Actions recommended for school nurses

  • Prepare interventions Although immunizations are only one aspect of the school nurse’s role3, it is a very important one. According to the NASN position statement for the role of the 21st century school nurse, “immunization compliance is much greater in schools with school nurses (Baisch, Lundeen, & Murphy, 2011).”3 Therefore, school nurses must be cognizant of the transitioning student and how they can appropriately intervene to improve optimal outcomes of immunization compliancy.
  • Collaborate with receiving school nurses The grade level that will be transitioning out of the building in the coming year should be reviewed for missing immunizations, or a status of behind on doses, and preparing for any new doses or immunizations needed for the coming year, according to state law.1 The school nurse, collaborating with the school nurse at the receiving building can communicate about any students that may need monitoring or intervention. Include a note on a student’s chart if there are issues or concerns regarding vaccinations for the receiving nurse to follow up on. As always in charting, be mindful of professionalism.
  • Communicate with parents The school nurse also has the role of communicator with the parents. Required immunizations, as well as recommended immunizations, should be part of the discussion with the parent; the importance of a student’s continued health should be the focus. Parents look to school nurses to provide guidance, education, and to give research-driven information on why they should immunize their child.4 School nurses can host education sessions for parents, students and the school community to address and dispel vaccination myths or mistruths through evidenced-based presentations.
  • Encourage compliance How parents receive information regarding vaccine preventable diseases (VPD) is an individual decision for each school nurse to make, depending on resources available. Technology affords the school nurse the easiest way to send communication home via student systems available in each district. However, this may not be the most effective for parents who are not “technology-savvy.” For those students who may be lacking many vaccines, a phone call or face-to-face meeting with families may be warranted. Parents want to keep their child disease-free and may need encouragement if they do not understand the benefits. Writing a newsletter article, sending follow-up letters to parents, and providing easy access to immunizations by having school-located vaccination (SLV) clinics may help parents arrange for needed boosters.4 Collaborating with community partners to hold SLV clinics or partnering with a mobile vaccination clinic at transitioning times may increase the number of compliant students at the next grade level.
  • Communicate evidence-based information With students transitioning out of elementary, this is a key time to provide evidence-based information on all recommended vaccines including human papillomavirus vaccine,5 as well as the meningococcal vaccine.6 In some states, it may even be required. When given accurate, consistent information, “protection against vaccine-preventable diseases will be increased,” especially “if clinicians consistently recommend and simultaneously administer Tdap, MenACWY, and HPV vaccines at age 11–12 years.”7
  • Collaborate with community resources School nurses use community resources for many student health issues, with immunizations being one of those issues. Area healthcare providers, public health departments, community centers, and other local organizations may all be useful resources to collaborate with to provide information and access to immunizations as well as reliable health care options. Notifying these resources of school compliance deadlines approaching or offering summer clinics with summer sports physicals can help to meet improved outcomes.

Communication tools


1. State-by-State Requirements 
2. CDC Information for Parents 2019 Recommended Immunizations for Children 7 - 18 Years Old 
3. National Association of School Nurses. (2016). The role of the 21st century school nurse (Position Statement). Silver Spring, MD: Author. 
4. CDC HPV Vaccine for Preteens and Teens
5. CDC Meningococcal Vaccines for Preteens and Teens
6. National Association of School Nurses. (2017). School-located vaccination (Position Statement). Silver Spring, MD: Author.  
7. Walker TY, Elam-Evans LD, Singleton JA, et al. National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13–17 Years — United States, 2016. MMWR Morb Mortal Wkly Rep 2017;66:874–882. DOI: http://dx.doi.org/10.15585/mmwr.mm6633a2