If your child is entering daycare in Ohio, you may be asked to provide immunization records or documentation of a vaccine exemption. The rules can be difficult to follow because Ohio law applies different requirements to children, daycare employees, and family child-care providers.

This guide explains the current Ohio daycare vaccine exemption requirements, including Ohio Revised Code § 5104.014 and the Ohio Administrative Code rules for licensed child-care centers and family child-care homes. Our Vaccine Act Lawyers are here to help you understand the documentation process and your available options.

Ohio daycare immunization requirements under R.C. § 5104.014

Ohio Revised Code § 5104.014 generally requires a caretaker parent to provide a medical statement showing that a child has been immunized or is in the process of being immunized against listed diseases.

These requirements apply to children enrolled in:

• Licensed child-care centers.

• Type A family child-care homes.

• Licensed Type B family child-care homes.

• Care provided by a certified in-home aide.

The diseases listed in the statute include chickenpox, diphtheria, Haemophilus influenzae type b, hepatitis A, hepatitis B, influenza, measles, mumps, pertussis, pneumococcal disease, polio, rotavirus, rubella, and tetanus.

The medical statement must identify the dates of the child's immunizations and indicate whether an exception applies.

The 30-day and 13-month documentation cycle

Under R.C. § 5104.014, the caretaker parent generally must provide the medical statement:

• Within 30 days after the child enrolls or begins receiving care.

• Every 13 months afterward while the child remains enrolled or continues receiving care.

The current Ohio child-care rules also require the immunization record to be dated and to include the child's name, birth date, and the month, day, and year of each immunization.

If your child is in the process of receiving a vaccine series, the records should be updated as the child follows the recommended schedule or catch-up schedule.

What vaccine exemptions are available for Ohio daycare?

Ohio law identifies several exceptions to the child immunization requirement.

Medical exemption

A child is not required to receive a particular immunization when the immunization is medically contraindicated for that child.

This exception generally requires documentation from a licensed physician, physician assistant, or advanced practice registered nurse. The medical statement should identify the applicable disease or vaccine and explain the medical basis for the exception.

Conscience or religious exemption

A parent or guardian may decline to have the child immunized for reasons of conscience, including religious convictions.

The Ohio child-care rules allow a statement from the parent documenting that the parent has declined immunization for those reasons. The statement should be clear, specific, and provided to the daycare in the format it requests.

Ohio law does not require a parent to prove membership in a particular religious organization. However, a daycare may request that the statement be complete and properly signed for its records.

Age-inappropriate immunization

A child may also be excepted when an immunization is not medically appropriate for the child's age.

This may apply when a child is too young for a particular vaccine or when the recommended schedule has not yet reached the child's age. A physician, physician assistant, or APRN may provide documentation confirming that the vaccine is not currently age-appropriate.

Influenza vaccine is unavailable

Ohio law contains a specific exception for influenza. A child is not required to receive the seasonal influenza vaccine when that vaccine is not available.

This exception is limited. It does not create a general exemption from all vaccines, and it may not apply once the seasonal influenza vaccine becomes available.

Current rules for licensed child-care centers

Ohio Administrative Code Rule 5180:2-12-15 governs child records for licensed child-care centers. It requires the center to maintain the child's enrollment information and immunization record.

A center may accept one or more of the following types of exemption documentation:

• A statement from a physician, PA, or APRN confirming that the child is in the process of being immunized.

• A statement from a physician, PA, or APRN confirming that an immunization is medically contraindicated.

• A statement from a physician, PA, or APRN confirming that an immunization is not medically appropriate for the child's age.

• A statement from the parent confirming that the parent declined immunization for reasons of conscience, including religious convictions.

Children attending kindergarten or a higher grade in an elementary school are exempt from the child-care immunization record requirement under the current center rule. This does not necessarily eliminate school immunization requirements, which are addressed under separate Ohio laws and school rules.

Child records are confidential, but they must be available to the Ohio Department of Children and Youth for administration of the child-care laws. Immunization records may also be reviewed by the Ohio Department of Health for outbreak control and immunization-level assessments.

Current rules for licensed family child-care homes

Ohio Administrative Code Rule 5180:2-13-15 applies to licensed family child-care providers. The rule covers Type A and Type B family child-care homes.

The immunization record must generally be maintained at the home:

• Within 30 days after the child's first day of attendance.

• No more than 13 months after the previous record or update.

The requirement also applies to the provider's own children in the home, subject to the rule's exceptions.

A family child-care home may maintain an exemption record based on:

• Certification from a physician, PA, or APRN that the child is in the process of being immunized.

• Certification that an immunization is medically contraindicated.

• Certification that an immunization is not medically appropriate for the child's age.

• A parent statement declining immunization for reasons of conscience, including religious convictions.

Children attending kindergarten or a higher grade in an elementary school are exempt from the family child-care immunization record requirement under the current rule.

Child enrollment rules are different from staff and provider rules

A common source of confusion is assuming that the child exemption rules also apply to daycare employees. They do not.

Child-care center employees

Under Ohio Administrative Code Rule 5180:2-12-08, employees of licensed child-care centers generally must provide immunization records within 30 days after starting employment unless an exemption applies.

The employee requirements address:

• Measles, mumps, and rubella, commonly called MMR.

• Tetanus, diphtheria, and pertussis, commonly called Tdap.

• Medical exemptions supported by a physician, PA, or APRN.

• Conscience or religious exemptions supported by a written statement signed by the employee.

These employee rules are not the same as the child requirements under R.C. § 5104.014. The child rules list additional diseases and provide the specific influenza-unavailable exception.

Family child-care providers and staff

Under Ohio Administrative Code Rules 5180:2-13-07 and 5180:2-13-08, family child-care providers and employees must provide evidence of MMR and Tdap immunization or an applicable medical or conscience-based exemption.

For a medical exemption, documentation must be signed by a licensed physician, PA, or APRN. A conscience or religious exemption may be documented in writing or electronically by the individual.

The provider or staff member generally has 30 days from the start of employment or operation to provide the required documentation. These staff and provider requirements should be tracked separately from the 13-month child-record cycle.

Daycare policies and communicable-disease requirements

A daycare provider may have recordkeeping and communicable-disease policies in addition to the statutory exemption requirements.

For example, licensed centers and family child-care homes must follow current Ohio rules regarding:

• Confidential child records.

• Communicable-disease charts.

• Parent notification after certain exposures.

• Illness exclusion and isolation procedures.

• Emergency health plans.

• Medical care plans for children with chronic conditions.

A provider may also have a written enrollment policy explaining how records must be submitted, when a parent must update information, and how the provider responds during a communicable-disease event. Ask for the policy in writing if you are uncertain about what is required.

An exemption from an immunization requirement does not automatically answer every question about enrollment, exclusion during an outbreak, or a provider's private contract. Those issues may depend on the facility's license, policies, the type of care provided, and the facts of the situation.

Checklist for parents requesting a daycare vaccine exemption

Please consider gathering the following documents:

• Your child's complete immunization record.

• The child's birth date and enrollment information.

• A medical statement from a physician, PA, or APRN, if seeking a medical or age-related exception.

• A signed parent statement, if declining immunization for reasons of conscience or religious convictions.

• Documentation identifying the specific diseases or vaccines covered by the exception.

• Any records showing that the child is following a vaccine series or catch-up schedule.

• The daycare's written enrollment, recordkeeping, and communicable-disease policies.

• A calendar reminder for the 13-month documentation update.

Keep a copy of everything you provide. If the daycare rejects the documentation or gives you conflicting instructions, ask for the reason in writing.

Guidance for Ohio daycare providers

Providers should maintain a consistent process for reviewing exemption documentation.

A practical compliance process includes:

• Use the current Ohio Department of Children and Youth enrollment and health forms or equivalent forms.

• Track the 30-day deadline for new enrollment records.

• Track the 13-month update cycle for children who remain in care.

• Keep child and staff records separate.

• Confirm that medical statements are signed by an authorized medical professional.

• Keep parent conscience or religious statements in the child's confidential record.

• Maintain records so they are available for DCY or ODH review when permitted.

• Review communicable-disease and outbreak procedures regularly.

If a provider is unsure whether a policy conflicts with Ohio law, professional legal advice can help clarify the issue before a dispute develops.

Frequently asked questions

Does Ohio require a religious exemption form for daycare?

Ohio law allows a parent to decline a child's immunization for reasons of conscience, including religious convictions. The parent should provide a written statement in the format requested by the licensed daycare.

Does a medical exemption need a doctor's signature?

Generally, yes. The Ohio child-care rules identify a licensed physician, PA, or APRN as the medical professionals who may provide the required statement or certification.

Does the 13-month rule apply to daycare employees?

The 13-month cycle applies to child immunization records. Employee and provider rules generally require documentation within 30 days of employment or operation and use different immunization categories.

Can a daycare ask for additional paperwork?

A provider may have reasonable recordkeeping and health policies in addition to the statute. You should ask the provider to identify the legal or policy basis for any additional document request.

Can a daycare refuse to accept my child's exemption?

The answer may depend on the daycare's license, written policies, the type of exemption, and the circumstances. If you believe a valid exemption was rejected or your child was treated inconsistently, consider obtaining legal advice.

Official Ohio sources

For current information, review:

• Ohio Revised Code § 5104.014.

• Ohio Administrative Code Rule 5180:2-12-15 for licensed child-care centers.

• Ohio Administrative Code Rule 5180:2-13-15 for licensed family child-care homes.

• Ohio Administrative Code Rule 5180:2-12-08 for center employees.

• Ohio Administrative Code Rule 5180:2-13-07 for family child-care providers.

• Ohio Administrative Code Rule 5180:2-13-08 for family child-care employees.

• Ohio Department of Children and Youth.

You may also wish to review our information about the National Vaccine Injury Compensation Program and common vaccine injuries.

Contact Our Vaccine Act Lawyers

Ohio daycare vaccine exemption rules can be difficult to interpret, especially when a provider's policy, a medical statement, and state licensing requirements overlap.

Our Vaccine Act Lawyers will listen to your concerns, explain the applicable rules in understandable language, and help you identify practical next steps. Please contact Vaccine Act Lawyers at your convenience to schedule a consultation. Give us a call at 614-508-1677 to learn more about your vaccine exemption rights.