Washington Kinship Caregiver Immunization Consent: Vaccines, School Requirements, and Exemptions

Your Declaration Covers Vaccines

If you're a grandparent or relative raising a child in Washington and the child needs vaccinations — whether to start school, catch up on a missed series, or get a flu shot — your RCW 7.70.065 caregiver health declaration authorizes you to consent.

Immunizations are routine outpatient medical care. The same declaration that lets you take the child to the pediatrician or dentist lets you say yes to vaccines. But the process of actually getting a child up to date, especially one who arrived in your care with incomplete or missing records, involves several moving parts.

The Certificate of Immunization Status (CIS)

Washington requires every child enrolled in school or licensed childcare to have a completed Certificate of Immunization Status (CIS) form on file. The CIS documents which vaccines the child has received and whether they meet state requirements.

When a child comes to live with you, you may not have the CIS — especially if the transition happened suddenly. Here's how to reconstruct it:

Check the state immunization registry. Washington's Immunization Information System (IIS) tracks vaccines administered in the state. Your child's pediatrician, the local public health clinic, or the Department of Health can look up the child's record. You can also access it through the MyIR Mobile app.

Contact the previous provider. If the child had a regular pediatrician before coming to live with you, that office should have immunization records. Using your health declaration and a records release request, you can obtain copies.

If no records exist, the child may need catch-up doses. Ask the pediatrician whether blood testing is appropriate for particular vaccines; it is not a substitute for records or recommended doses for every vaccine.

School Enrollment and Immunization Gaps

Schools require a Certificate of Immunization Status (CIS) or Certificate of Exemption (COE) by the first day of attendance. Under Department of Health rules (WAC 246-105-060), a child may attend in conditional status if all doses already due are documented by the first day. Additional doses must be received within 30 calendar days after the first day of attendance, or, for a series with recommended intervals, no later than 30 calendar days after the next dose's recommended date. This status is sometimes called provisional enrollment.

This provisional window gives you time to:

1. Locate existing immunization records
2. Schedule catch-up vaccinations
3. Complete the CIS form with the child's pediatrician

If you enrolled the child under a Caregiver Authorization Form and the school is pushing back about immunization documentation, ask whether the child qualifies for conditional status under WAC 246-105-060. Children identified as homeless under McKinney-Vento or in foster care who lack immunization records have a separate immediate-enrollment protection.

Consenting to Catch-Up Vaccines

When a child needs catch-up vaccinations, you sign the consent forms at the doctor's office or public health clinic. Present your RCW 7.70.065 declaration and let the provider know you're authorized to consent to routine medical care including immunizations.

Public health clinics across Washington administer vaccines on a walk-in or appointment basis, often at no cost for children enrolled in Apple Health or through the Vaccines for Children (VFC) federal program. You don't need private insurance to get the child vaccinated.

Exemptions

Washington allows two types of immunization exemptions:

Medical exemptions require a licensed healthcare provider to certify that a specific vaccine is medically contraindicated for the child. As the caregiver authorized to consent to healthcare, you work with the child's doctor to determine whether a medical exemption is appropriate.

Religious or philosophical exemptions are more restrictive in Washington than in some states. Since 2019, Washington has prohibited a philosophical or personal exemption for the measles, mumps, and rubella (MMR) vaccine. Religious exemptions remain available, but the signer must be a parent, legal guardian, or adult in loco parentis whose religious beliefs are contrary to the required immunizations. A medical exemption requires a healthcare practitioner. The DOH exemption form also requires a healthcare practitioner to certify that the signer received information about immunization benefits and risks.

If an exemption is already on file, ask the school to confirm it. To submit a new exemption, use the DOH Certificate of Exemption and confirm that you are an authorized signer; an RCW 7.70.065 health declaration alone does not establish that status.

Adolescent Vaccine Consent

For teenagers who've reached Washington's self-consent thresholds, the immunization picture shifts. Routine vaccines like Tdap boosters and meningococcal vaccines fall under general medical care — you consent with your declaration.

The age-14 rule in RCW 70.24.110 applies when a minor may have come in contact with an STI and covers related diagnosis or treatment and treatment to avoid HIV infection. Do not assume it gives a 14-year-old a separate right to consent to an HPV vaccine; arrange routine immunizations through the child's parent, legal guardian, or other authorized caregiver.

The Washington Consent Guide for Kinship Caregivers covers immunization consent alongside the other medical situations you'll encounter, including a checklist for getting a child up to date when records are missing or incomplete.

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