School Nurse Immunization Resources
Information for School Nurses to Share with Parents
Who is required to have the Certificate of Immunization (Form 3231)?
Children attending any childcare facility, pre-kindergarten, Head Start program, nursery, or school are required to
have this form on file. This includes public and private operations and all enterprises, educational programs and
institutions involved in the care, supervision or instruction of children. Certificates are required for all children
through grade 12.
The certificate becomes invalid on the expiration date indicated. If a current certificate has not been
submitted within 30 days after the expiration date, the child must be excluded from attendance until a
current certificate is obtained.
Who may issue certificates?
Only a licensed Georgia physician, Advanced Practice Registered Nurse, Physician Assistant or qualified
employee of a local Board of Health or the State Immunization Office may issue this certificate. The physician,
APRN, PA or health department is responsible for interpretation of and compliance with the requirements set forth
in Chapter 511-2-2 of the Rules of the Department of Public Health.
The Official Code of Georgia provides for only two types of exemptions from immunization requirements:
1. Medical: Medical exemption for a vaccine should be filled in only when there is a physical disability or
condition that contraindicates immunization for that particular vaccine. There must be an annual review of
medical exemptions, and certificates must be reissued with or without indication of exemption.
2. Religious: For a child to be exempt from immunizations on religious grounds, the parent or guardian must
furnish the school/facility with a notarized Affidavit of Religious Objection to Immunization (DPH Form
2208) Chapter 511-2-2-.07 of the Rules of the Department of Public Health. The school/facility must keep the
affidavit on file and available for inspection by health officials in lieu of the Georgia Immunization Certificate
(Form 3231). The affidavit does not expire. O.C.G.A. §20-2-771(e)