This page reflects information found on www.shotsforschool.org/laws/exemptions/ current as of January 6, 2021. Please visit the page for any updated information.

As of January 1, 2021, a new law took into effect that will require electronic medical exemptions (ME) for enrolling new students in child care facilities and K-12 schools.

For parents, providers, and schools/child care facilities, you can register to access the new CAIR-ME web site to request, issue, manage, and track medical exemptions from required immunizations for children attending school or child care facilities: https://cair.cdph.ca.gov/exemptions. 

For any questions regarding electronic medical exemptions, please email the California Department of Health (CDPH) directly at medicalexemptions@cdph.ca.gov.  

Capture Electronic Medical Exemptions 21

CDPH ANNOUNCEMENT

January 4, 2021

The California Department of Public Health has launched the California Immunization Registry – Medical Exemption (CAIR-ME, https://cair.cdph.ca.gov/exemptions) website to request, issue, manage, and track medical exemptions from required immunizations for children attending school or child care facilities.  CAIR-ME was created in response to laws passed in 2019 (Senate Bills 276 and 714).  

Starting January 1, 2021, new medical exemptions for children can only be issued using the CAIR-ME website. MDs and DOs licensed in California can register to use CAIR-ME at any time in order to issue a medical exemption.  Current users of CAIR2 will still need to register to use CAIR-ME.  Instructions are available on CAIR-ME along with on-screen prompts to guide you through registration and the submission of a medical exemption.
 
Per state law, medical exemptions should meet applicable Centers for Disease Control and Prevention (CDC), Advisory Committee on Immunization Practices (ACIP), and American Academy of Pediatrics (AAP) criteria for appropriate medical exemptions or be consistent with the relevant standard of care. 

CDPH will host a provider webinar Tuesday, January 26th, 2021 from 12pm-1pm to review the new requirements and process for submitting exemptions in CAIR-ME. Look for an email invitation in the next week. The webinar will be recorded and available for on-demand viewing on the CAIR-ME website.  
 

CDPH EXEMPTION FAQS

Current as of January 6, 2021​. Source: https://www.shotsforschool.org/laws/exemptions/

1. For admissions on or after January 1, 2021, what is required for a medical exemption to a required immunization?

Starting January 1, 2021:

  • Medical exemptions can only be issued through the California Immunization Registry – Medical Exemption website (CAIR-ME) by physicians licensed in California. 

  • Schools and child care facilities may only accept from parents new medical exemptions that are issued using CAIR-ME.

 
2. Are medical exemptions filed for children in attendance at a California child care facility or school before 2021 valid in later years?

A medical exemption filed at a pre-kindergarten facility or school remains valid until the earliest of:

  • When the child enrolls in the next grade span (TK/K-6th grade, 7th-12th grade)

  • The expiration date specified in a temporary medical exemption

  • Revocation of the exemption because the issuing physician has been subject to disciplinary action from the physician’s licensing entity.

 
3. A doctor has told a child’s parents that their child needs a medical exemption from a required immunization. How do parents get a medical exemption for their child?

Starting January 1, 2021, all new medical exemptions for school and child care entry must be issued through CAIR-ME.  Parents can create an account and log in to CAIR-ME to submit a request for a medical exemption.  Next, the child's doctor can complete the medical exemption in CAIR-ME and print a copy for the parents to give to the child’s school or child care facility.
 

4. When should schools and child care facilities sign up to use CAIR-ME?

 

Schools and child care facilities should register to use CAIR-ME once they receive a medical exemption issued using CAIR-ME for one of their enrollees.  Schools and child care facilities can email medicalexemptions@cdph.ca.gov to request access to the CAIR-ME website.  After registering and creating an account, schools and child care facilities will be able to see the medical exemptions in CAIR-ME that have been issued for children that attend their school or child care facility.

 

5. How early may a physician issue a medical exemption in CAIR-ME before a child first enters a grade span starting in 2021?

 

A medical exemption may be issued in CAIR-ME no more than 12 months before a child first enters a grade span (grade spans are birth-preschool, TK/K-6th, and 7th-12th).
 

6. Which medical exemptions in CAIR-ME will the State of California Department of Public Health (CDPH) review?

 

Starting January 1, 2021, new medical exemptions must be issued using the medical exemption website CAIR-ME.  Under Senate Bills (SB) 276 and SB 714 (Pan, 2019), CDPH is required to review exemptions in CAIR-ME when:

  • A school's immunization rate falls below 95% or

  • A doctor writes more than 5 medical exemptions per year beginning January 1, 2020 or

  • A school fails to provide reports of vaccination rates to CDPH

 

CDPH may also review a medical exemption if CDPH determines it is necessary to protect public health.

 

7. Who at CDPH will review my child's medical exemption in CAIR-ME?

 

Medical exemptions reviewed based on the specific criteria under SB 276 and SB 714 will be reviewed by clinical staff at CDPH with expertise in immunization. Only the State Public Health Officer, or a physician they designate from the CDPH's immunization program, can revoke a medical exemption.
 

8. Does a child with an existing medical exemption in CAIR-ME need a new medical exemption if the child enrolls in a new school or child care facility within the same grade span?

 

No.  While a new medical exemption does not need to be issued, the school or child care facility information listed in CAIR-ME for the exemption must be the same as the new school or child care facility.  Parents must log in to CAIR-ME, update the school or child care facility information, and show proof of the change to the new school or child care facility.  Parents will be able to print a copy of the changes to show the school or child care facility.  The new school or child care facility can also log in to CAIR-ME to confirm that the medical exemption is listed for their school or child care facility.

 

9. What happens if my child's medical exemption in CAIR-ME is revoked? May I appeal?

 

SB 276 and SB 714 provide an appeal process for parents if CDPH revokes a medical exemption because the exemption did not meet applicable Centers for Disease Control and Prevention (CDC), Advisory Committee on Immunization Practices (ACIP), and American Academy of Pediatrics (AAP) criteria or the standard of medical care.  Parents will receive information about their options if their child’s medical exemption is revoked.  Parents will have 30 days to appeal.

Appeals will be reviewed by an independent expert panel appointed by the California Health and Human Services (CHHS). The panel’s decision shall be adopted by CHHS and is final.

10. Who can access the medical exemption website CAIR-ME? 

 

CAIR-ME is available to parents/guardians seeking a medical exemption, California-licensed physicians, schools and child care facilities, local health departments, the Medical Board of California, the Osteopathic Medical Board of California, the California Department of Public Health, and the California Health and Human Services Agency.  Access to information in CAIR-ME is restricted based on the type of user and in compliance with state and federal confidentiality and privacy laws.

 

11. To meet the chickenpox immunization requirement for TK/K-12 admission or for advancement into 7th grade, may a school accept an immunization record that indicates a "history of chickenpox disease"? 

 

No, this is not sufficient documentation to meet school requirements. A medical exemption may be used for a child who had chickenpox disease that was documented by a physician. Starting in 2021, new medical exemptions must be issued using CAIR-ME.

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