Maryland Childcare Licensing

Maryland Childcare Immunization Requirements (2026)

Children enrolled in a licensed Maryland childcare center must show proof of age-appropriate immunization. Maryland requires documentation for 9 vaccine series, with limited medical and legally permitted exemptions.

Licensing Agency

Maryland State Department of Education (MSDE), Division of Early Childhood, Office of Child Care (OCC), Licensing Branch →

Last updated: April 2026

Researched by the TotReady Research Team

Maryland Immunization Requirements: The Specifics

Maryland childcare licensing requires age-appropriate DTaP/DTP (diphtheria, tetanus, pertussis) immunization for enrolled children (subject to documented medical or legally permitted exemptions).

Maryland childcare licensing requires age-appropriate Polio (IPV) immunization for enrolled children (subject to documented medical or legally permitted exemptions).

Maryland childcare licensing requires age-appropriate MMR (measles, mumps, rubella) — doses on or after first birthday immunization for enrolled children (subject to documented medical or legally permitted exemptions).

Maryland childcare licensing requires age-appropriate Hib (Haemophilus influenzae type b) — required through 59 months of age immunization for enrolled children (subject to documented medical or legally permitted exemptions).

Maryland childcare licensing requires age-appropriate PCV (pneumococcal conjugate / Prevnar) — required through 59 months of age immunization for enrolled children (subject to documented medical or legally permitted exemptions).

Maryland childcare licensing requires age-appropriate Hepatitis B immunization for enrolled children (subject to documented medical or legally permitted exemptions).

Maryland childcare licensing requires age-appropriate Varicella (chickenpox) — doses on or after first birthday immunization for enrolled children (subject to documented medical or legally permitted exemptions).

Maryland childcare licensing requires age-appropriate Documentation required on Maryland Department of Health Immunization Certificate (MDH Form 896). COMAR 13A.16.03.04 (Child Records) requires the operator to obtain and maintain an immunization record showing the child has age-appropriate immunizations meeting Maryland Department of Health guidelines; temporary/provisional admission pending immunization is addressed in COMAR 13A.16.03.02 F. Medical and religious exemptions are recognized. immunization for enrolled children (subject to documented medical or legally permitted exemptions).

Maryland childcare licensing requires age-appropriate Blood lead screening / test verification required for children under 6 years old (COMAR 13A.16.03.02 E) immunization for enrolled children (subject to documented medical or legally permitted exemptions).

Maryland Immunization Requirements Checklist

  • DTaP/DTP (diphtheria, tetanus, pertussis)
  • Polio (IPV)
  • MMR (measles, mumps, rubella) — doses on or after first birthday
  • Hib (Haemophilus influenzae type b) — required through 59 months of age
  • PCV (pneumococcal conjugate / Prevnar) — required through 59 months of age
  • Hepatitis B
  • Varicella (chickenpox) — doses on or after first birthday
  • Documentation required on Maryland Department of Health Immunization Certificate (MDH Form 896). COMAR 13A.16.03.04 (Child Records) requires the operator to obtain and maintain an immunization record showing the child has age-appropriate immunizations meeting Maryland Department of Health guidelines; temporary/provisional admission pending immunization is addressed in COMAR 13A.16.03.02 F. Medical and religious exemptions are recognized.
  • Blood lead screening / test verification required for children under 6 years old (COMAR 13A.16.03.02 E)

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Maryland Immunization Requirements: Frequently Asked Questions

Which vaccines does Maryland require for childcare enrollment?

Maryland requires age-appropriate immunization records for: DTaP/DTP (diphtheria, tetanus, pertussis), Polio (IPV), MMR (measles, mumps, rubella) — doses on or after first birthday, Hib (Haemophilus influenzae type b) — required through 59 months of age, PCV (pneumococcal conjugate / Prevnar) — required through 59 months of age, Hepatitis B, Varicella (chickenpox) — doses on or after first birthday, Documentation required on Maryland Department of Health Immunization Certificate (MDH Form 896). COMAR 13A.16.03.04 (Child Records) requires the operator to obtain and maintain an immunization record showing the child has age-appropriate immunizations meeting Maryland Department of Health guidelines; temporary/provisional admission pending immunization is addressed in COMAR 13A.16.03.02 F. Medical and religious exemptions are recognized., Blood lead screening / test verification required for children under 6 years old (COMAR 13A.16.03.02 E).

Are immunization exemptions allowed in Maryland?

Maryland permits documented medical exemptions and, where state law allows, certain non-medical exemptions. Confirm the current exemption rules with the Maryland State Department of Education (MSDE), Division of Early Childhood, Office of Child Care (OCC), Licensing Branch.

When must immunization records be on file in Maryland?

Maryland requires up-to-date immunization documentation at enrollment, with records kept current in each child's file thereafter.

Maryland childcare licensing rules are amended regularly. This page is compiled from published Maryland administrative codes and statutes for informational purposes only — always verify current requirements with the Maryland State Department of Education (MSDE), Division of Early Childhood, Office of Child Care (OCC), Licensing Branch before relying on them. TotReady provides information and document templates, not legal or regulatory advice.