Changes to Colorado’s school entry immunization process

A partner post from the Colorado Department of Public Health & Environment.

After a robust legislative session, changes to Colorado’s school entry immunization process will take effect when students return for the 2021-2022 school year, beginning July 1. 

The changes, approved by the legislature and signed into law by Gov. Jared Polis on June 26, 2020 and further codified by the Colorado Board of Health in November 2020, were focused on strengthening Colorado’s rules for exemptions from school entry vaccinations and improving Colorado’s tracking and reporting systems for all immunizations. 

The new law makes the following specific changes: 

  • It preserves the non-medical exemption option, so parents with deeply held beliefs are not required to vaccinate.
  • It consolidates the personal belief and religious exemptions into a single non-medical exemption category.
  • It changes existing practice to require the use of a single, state-developed certificate when electing either a medical or non-medical exemption.
  • For parents or caregivers opting not to vaccinate and obtain a non-medical exemption, it requires them to complete one of two additional actions. Non-vaccinating families must either have their certificates of exemption signed by an immunizing provider or complete a state-issued online vaccine education module.
  • All immunizing health care providers are required to report both immunizations and exemptions to the Colorado Immunization Information System (CIIS).
  • The new law establishes a statewide vaccination goal of 95 percent for all children, for all school-required vaccines, including child care facilities and provides additional resources to help schools and communities reach this goal.
  • It requires schools to notify parents of annual school MMR immunization rates proactively.

Advocates who have worked to strengthen Colorado’s existing immunization laws and improve overall vaccination rates see the changes as a win that will help kids get a healthier start and help facilitate important conversations between families and their physicians. 

“This is an opportunity for the physician to talk to the parent about immunization. While we know there are some families out there that will choose not to vaccinate, we know many more might be unsure and just need their questions addressed. The conversation with a trusted medical provider is the key here,” said Kelly Grenham, National Association of School Nurses director representing Colorado. “If a physician is asked to sign a non-medical exemption, that is just acknowledgment that the physician has had the conversation, not that they agree with a decision not to vaccinate.” 

Colorado’s childhood vaccination rates were already some of the lowest in the country. National and state data show those rates have dipped even lower during the pandemic as families put off routine medical checkups and care.

All families and caregivers with children in K-12 schools in Colorado and all immunizing providers must comply with the changes at the start of the 2021-2022 school year. 

If you have questions or need additional information, please contact CDPHE’s immunization branch at 303-692-2700 or