The Journal of School Nursing2025, Vol. 41(4) 516–518© The Author(s) 2025Article reuse guidelines:sagepub.com/journals-permissionsDOI: 10.1177/10598405251332809journals.sagepub.com/home/jsn
It is the position of the National Association of School Nurses that timely, up-to-date, and complete required vaccinations for members of the school population are essential to protecting school-age children, youth, and the public from preventable, serious infectious diseases. School immunization requirements should align with the best available evidence as set forth by the Advisory Committee on Immunization Practices (ACIP) and the Centers for Disease Control and Prevention. Vaccine exemptions should be eliminated, except when necessary for validated medical contraindications. Professional registered nurses (RNs), hereinafter referred to as school nurses, provide expertise and leadership in applying evidence-based immunization information and strategies to prevent and reduce the spread of infectious diseases. School nurses collaborate with other health professionals, families, and school staff to protect the health of each student, as well as the public’s health.
Vaccination is the process of administering medication which results in the body becoming immunized against a disease (Boyer-Chu & Yonkaitis, 2019; CDC, 2021). For the purpose of this position statement, the words vaccination and immunization are used interchangeably. Vaccines prevent serious infectious diseases that can cause illness, lifelong disability, or death (Pediatric Infectious Diseases Society, 2019). All children and youth should have equitable access to the protection provided by immunizations. Vaccine requirements for school entry prevent missed days from school due to illness and keep students healthy, safe, in class, and ready to learn (Public Health Foundation, 2024b). Every state requires that school-age children and youth receive certain vaccinations to attend school, though regulations and mandates differ by state (National Conference of State Legislatures, 2024; Public Health Law, 2022). School vaccine requirements should align with the best available evidence as set forth by the ACIP (Wodi et al., 2023) and the CDC (2023; 2024). States should eliminate vaccine exemptions, except when necessary for individuals with validated medical contraindications (Immunize.org., 2025; Weber et al., 2021). Student immunization coverage rates are higher in states where there are fewer exemptions, resulting in lower incidences of vaccinepreventable illnesses (Pingali et al., 2021; Tomlinson, 2023). The umbrella of community protection increases when more individuals are immunized (Public Health Foundation, 2024a). States also maintain immunization information systems that are confidential, population-based electronic databases of vaccination records (Congressional Research Service, 2022). Immunization information systems are important tools for facilitating immunization adherence and should be fully accessible to school nurses (Davis-Alldritt, 2024).
School nurses have significant positive impacts on increasing vaccination rates in school-age youth (Davis-Alldritt, 2024; Guarinoni & Dignanai, 2021; McCullough et al., 2020). As trusted professionals, school nurses are able to address vaccine hesitancy and misinformation nonjudgmentally (O’Shea et al., 2023; U.S. Department of Health and Human Services [HHS], 2021; Wilson et al., 2023). School nurses have the necessary knowledge to provide students, families, and school staff with reliable messages about the safety and importance of immunizations and the critical role vaccines play in preventing disease and protecting the public’s health (Sela et al., 2023). Using their expertise, school nurses improve immunization coverage by leading and implementing effective, evidence-based strategies such as reinforcing vaccination requirements, reminding families about immunization schedules, or conducting school-located vaccination clinics (Huber et al., 2022; Park et al., 2021; Seither et al., 2023). School nurses typically assess student immunization adherence and accurately track and record vaccinations in student health records (Boyer-Chu & Yonkaitis, 2019). When a student’s routine vaccination schedule is disrupted, school nurses can follow-up and assist families to complete catch-up immunizations (Badeh et al., 2023; HHS, 2024; Public Health Foundation, 2024b). School nurses are resources for referrals to community health professionals and sites that provide vaccinations (Guarinoni & Dignani, 2021). School nursing interventions are instrumental to eliminating barriers, improving access, and increasing adherence to vaccinations that protect health and support student learning (D’Souza-Vazirani et al., 2023; Huber et al., 2022).
In summary, immunizations are critical for preventing and reducing the spread of vaccine-preventable diseases. School nurses are vital vaccine champions who apply effective, evidence-based immunization strategies and interventions to create a circle of protection around individual students and communities so that everyone has equitable opportunities to lead healthier lives (Talbird et al., 2022).
National Association of School Nurses11 NASN, MD, USA
nasn@nasn.org
Wendy A Doremus: Conceptualization; Writing – original draft; Writing – review & editing.
Adopted: 1978Revised: 1982, 1996, 2001, 2006, 2010, 2015, 2020, 2025
All position statements from the National Association of School Nurses will automatically expire five years after publication unless renewed, revised, or retired at or before that time. To access additional NASN professional practice documents including the most up-to-date position statements, position briefs, and joint and endorsed statements, please go to https://www.nasn.org/nasnresources/professional-practice-documents
Wendy A. Doremus DNP, RN - NASN Clinical Writer
Elizabeth Pray, MSN-Ed., RN, NCSN
Carissa Jensen, MSN, RN
Laura Phillips, MPH, BSN, RN, NCSN
Teri Schloss, MSN, RN, NCSN
Wendy A Doremus https://orcid.org/0000-0001-7584-0192
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