SC School Vaccine Playbook for Administrators

A Playbook for School Administrators

Ensuring Families Understand the Rules for Vaccines in South Carolina

Executive Summary

This guide provides a comprehensive framework for South Carolina school administrators to ensure compliance with state vaccination laws. It covers legal mandates, operational procedures, exemption protocols, and communication strategies. The goal is to equip school staff with the necessary tools and knowledge to manage student vaccine records effectively, work with families, and maintain a healthy school environment for all students.

The Year-Round Compliance Cycle

Managing vaccine compliance is an ongoing process. This interactive timeline outlines the key phases and actions required throughout the school year. Click on each phase to see the specific steps for administrators and health staff.

Phase 1: Spring/Summer (Proactive Communication)

Begin early communication with families. Encourage scheduling annual well-child visits during the spring or summer to obtain an updated SC Certificate of Immunization (DPH Form 4024). This proactive approach helps avoid last-minute rushes and ensures a smoother registration process.

2025-2026 Vaccine Requirements

The SC Department of Public Health sets specific immunization requirements for each grade level. Use the filter below to see the required number of doses for key vaccines for a specific grade. This chart visualizes the data from the official schedule.

A Procedural Guide to Exemptions

South Carolina law allows for three distinct types of exemptions. It is critical to use the correct form and follow the specific procedure for each to ensure legal compliance. Accepting incorrect documentation can place the school in legal jeopardy.

Medical Exemption

For when a vaccine is medically contraindicated for a child.

  • 📄 Form: Official DPH Form 4024, "Medical Exemption" section.
  • ✍️ Issuer: Licensed Doctor (MD/DO) or approved staff (APRN, PA).
  • 🔑 Key Rule: Must specify if temporary (with an end date) or permanent. A simple doctor's note is not sufficient.

Religious Exemption

For families with deeply held religious beliefs against vaccination.

  • 📄 Form: SC Certificate of Religious Exemption (formerly DHEC Form 1126).
  • ✍️ Issuer: DPH Health Department (in-person or online).
  • 🔑 Key Rule: A parent/guardian signs and has the state form notarized. The form may only be obtained from a health department. Personal or philosophical objections do not qualify.

Special Exemption

A temporary pass for students to enroll while obtaining records.

  • 📄 Form: SC Certificate of Special Exemption (formerly DHEC Form 1123).
  • ✍️ Issuer: School Principal or designee.
  • 🔑 Key Rule: Strictly limited to 30 calendar days. Issued only once per student for transfer or extenuating circumstances.

Protocol for Student Non-Compliance

Enforcing vaccination laws is a serious responsibility. A clear, consistently applied protocol ensures fairness and legal compliance, framing exclusion not as a punishment but as a necessary public health measure mandated by law.

The 30-Day Mandate & Exclusion Process

  1. Day 1: Issue Special Exemption. The 30-day countdown begins immediately upon enrollment for any student without proper documentation.
  2. Track & Remind. Log the 30-day expiration date. Send formal reminders to parents at the 15-day and 7-day marks.
  3. Day 31: Enforce Exclusion. If documentation is not received, the special exemption expires. The student is legally barred from attending school.
  4. Provide Formal Written Notice. The principal must give the parent a letter stating the student is excluded effective immediately, citing SC Code § 44-29-180.
  5. Mark Absences as Unexcused. All days missed due to non-compliance are recorded as unexcused absences.

Proactive Strategies for Improving Vaccination Rates

Beyond enforcement, administrators can be public health partners. This section provides strategies to help families overcome barriers and address misinformation.

Responding to Common Parental Concerns

Effective Response: "I understand why you'd be concerned. It can seem like a lot. The good news is that a baby's immune system is incredibly powerful and handles thousands of germs every day. The vaccines contain only a tiny, weakened fraction of what they encounter naturally, just enough to teach their body how to fight off the real disease safely."

Effective Response: "I know there's been a lot of confusing information about that online. It's a concern many parents have heard. The great news is that this has been studied extensively all over the world, with millions of children, and these large-scale studies have consistently shown there is no link between vaccines and autism. We can provide you with information from the CDC and AAP on this."

Effective Response: "It's a testament to how well vaccines work that we don't see diseases like measles or polio very often. They are still very common in other parts of the world and can be brought here easily. Vaccination is what keeps our community safe and ensures your child is protected if an outbreak does occur."

Effective Response: "That's an interesting thought. The challenge with 'natural' infection is that it comes with the risk of serious, and sometimes life-threatening, complications. For example, getting measles can lead to pneumonia or permanent brain damage. A vaccine provides immunity without your child having to suffer through the actual illness and its dangerous risks."

School-Located Vaccination (SLV) Clinic Checklist

  • Assemble a planning team.
  • Confirm partners (health dept, pharmacies, etc.).
  • Select a date and location within the school.
  • Develop a communication plan.
  • Distribute parental consent forms.
  • Work with the health department to order vaccine supply.
  • Ensure proper storage and handling protocols are in place.
  • Recruit and schedule clinical and non-clinical volunteers.
  • Plan the physical layout and flow of the clinic.

Day of Clinic: Set up registration, screening, vaccination, and observation stations. Manage patient flow. Ensure all vaccinations are properly documented (e.g., in SIMON) and have a medical emergency plan in place.

Post-Clinic: Debrief with partners, review what worked well, report the number of vaccinations administered, and begin planning for the next event.

Strategic Communications Toolkit

Effective, proactive communication is key to achieving high vaccination rates and building trust with families. This toolkit provides ready-to-use templates and evidence-based techniques for discussing vaccines.

Enhancing Compliance Through Partnerships & Data

Improving vaccination rates requires a collaborative effort beyond individual schools. Leveraging data to identify trends and building strong community partnerships are essential strategies for protecting student health across the state.

Using Data to Make Smart Choices

Districts should use student data systems to track vaccination rates at the school and grade level. Identifying trends—like a high number of special exemptions at one school—can pinpoint areas needing targeted outreach or support from local health partners. Following Tennessee's model of a public, statewide annual report could significantly improve transparency and guide public health efforts.

Building Community Partnerships

Schools should not work in isolation. Forging partnerships with local health organizations is proven to overcome barriers to access. The MUSC-CCSD partnership, which provides free in-school vaccinations, is a model for the state. Additionally, actively connecting eligible families with the federal Vaccines for Children (VFC) program through local health centers can make a significant impact.