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 Legal Foundation

SC Code of Laws § 44-29-180

The law is unambiguous: "No school leader, school board, or principal can allow a student to start, sign up for, or stay in school if that student doesn't have good proof of having been vaccinated."

This places a direct, non-negotiable duty of enforcement upon school leadership. Compliance is an ongoing requirement for legal school attendance.

The Official Document: DPH Form 4024

Compliance is verified using one document: the SC Certificate of Immunization (DPH Form 4024). Parents can obtain this official form from their healthcare provider or download it directly from the SIMON public portal.

Other records, like a vaccine history from MyChart, are not acceptable substitutes.

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.

Show requirements for:

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

Day 1: Issue Special Exemption. The 30-day countdown begins immediately upon enrollment for any student without proper documentation.
Track & Remind. Log the 30-day expiration date. Send formal reminders to parents at the 15-day and 7-day marks.
Day 31: Enforce Exclusion. If documentation is not received, the special exemption expires. The student is legally barred from attending school.
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.
Mark Absences as Unexcused. All days missed due to non-compliance are recorded as unexcused absences.

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.

Event: Spring Back-to-School Prep

Subject: Get Ready for the 2025-26 School Year!

Dear Families, As we plan for the new school year, we want to remind you of South Carolina's school immunization requirements. Scheduling your child's well-visit now is the best way to beat the back-to-school rush. Please ask your provider for an updated SC Certificate of Immunization (DPH Form 4024). For a full list of requirements, visit our website at [Link].

Event: Grade-Specific Requirement (11th Grade)

Subject: Important Vaccine Update for Rising 11th Graders

Dear Parents of Rising 11th Graders, For the 2025-2026 school year, the SC DPH now requires all 11th-grade students to have two (2) doses of the Varicella (chickenpox) vaccine. Please ensure this is reflected on your child's DPH Form 4024 and submit it to the school nurse before the first day of school.

Event: Notice of Non-Compliance

Subject: URGENT: Student Immunization Record Incomplete

Dear [Parent Name], This letter is to inform you that your student's immunization record is not in compliance with SC Law § 44-29-180. Your student was issued a 30-day special exemption on [Date], which expires on [Expiration Date]. You have 5 school days to provide a valid SC Certificate of Immunization (DPH Form 4024) or a valid medical/religious exemption. If this documentation is not received by [Deadline], your child will be excluded from school until compliance is met.

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.

A Playbook for School Administrators