The number increased from 2,937 students in 2019 to 5,571 in 2025. Nonpublic schools recorded the highest rate, with 15.2% of students missing one or more vaccinations required for a complete immunization record.
By Hola Iowa
The number of Polk County students who were not fully vaccinated increased by nearly 90% over six years, rising from 2,937 in 2019 to 5,571 in 2025.
The increase occurred across every public school district in the county. Nonpublic schools experienced the sharpest change: their share of students without complete immunizations nearly tripled, reaching 15.2% in 2025.
The figures do not mean all 5,571 students were entirely unvaccinated. The category includes students missing at least one required dose, those completing a vaccine series under a provisional certificate and students with valid medical or religious exemptions.
Religious exemptions have also increased in Polk County. Iowa changed the exemption process in 2024, removing the previous notarization requirement for the religious exemption certificate.
Iowa schools require an immunization certificate or valid alternative
Iowa’s school vaccination rules apply to students attending public and nonpublic elementary and secondary schools, as well as children receiving private instruction.
A student’s school must have one of the following documents on file by the first day of attendance:
- A valid Iowa Certificate of Immunization showing the required vaccines.
- A Provisional Certificate of Immunization for an eligible student completing the required series.
- A valid medical or religious Certificate of Immunization Exemption.
Students without one of those documents cannot attend school on the first day under current Iowa requirements.
The regular immunization certificate must include the student’s name, birth date and the dates each required vaccine was administered. It must be signed by a physician, physician assistant, nurse or certified medical assistant.
Required school immunizations cover diphtheria, tetanus and pertussis; polio; measles and rubella; hepatitis B; and varicella, or chickenpox. The number of doses depends on the student’s age and vaccination history.
Students entering seventh grade or a higher grade need a Tdap dose received at age 10 or older. A meningococcal vaccine is also required for students in grades seven through 11. Twelfth-grade students generally need two meningococcal doses, including one received at age 16 or older, although one dose is sufficient when it was administered at age 16 or later.
The full schedule and state certificates are available through the Iowa Health and Human Services school immunization page.
Provisional enrollment allows time to complete a vaccine series
A provisional certificate may be issued when a child has started but has not completed the vaccinations required for that age. It is also available to students transferring from another U.S. school.
Eligibility generally requires at least one dose of every vaccine required for the student’s age. The next dose must be administered as soon as medically possible and no later than 60 days after the previous dose.
If the next required dose is not received within the provisional period, the student can be excluded from school until the family submits an updated certificate.
Medical exemptions require certification from an Iowa-licensed physician, physician assistant or nurse practitioner. A religious exemption applies when vaccination conflicts with a genuine and sincere religious belief rather than a personal, scientific or medical opinion.
Families can request school vaccination records through IRIS
Iowa stores many vaccination records in the Immunization Registry Information System, known as IRIS. A participating health care provider can retrieve an available record, or a parent or guardian can submit the state’s immunization record request form.
Parents and legal guardians may request records for children younger than 18. Once a person turns 18, the adult must request the record directly.
IRIS may not contain every historical vaccination. Iowa HHS does not maintain old paper records that were never entered into the registry, so a missing record may require contacting the physician, clinic or health department that administered the vaccines.
The official IRIS page includes the record request form. The IRIS Help Desk can also be reached at 1-800-374-3958.
The growing number of incomplete immunization records follows earlier health concerns in local schools. In January 2025, 14 Polk County schools reported illness-related absence rates above 10% on at least one day, according to previous Hola Iowa coverage of school absences and declining vaccination rates.
Polk County provides childhood vaccination appointments
The Polk County Health Department offers childhood vaccinations for children age 2 months and older at 1907 Carpenter Ave. in Des Moines.
Appointments are available by calling (515) 286-3798. The department’s regular hours are Monday through Friday from 8 a.m. to 4:30 p.m.
Families can bring the child’s available immunization records and insurance card to the appointment. Costs depend on insurance coverage and eligibility for the federal Vaccines for Children program, which supplies vaccines for eligible children through age 18.
Appointment details, eligibility information and current administration fees are available on the Polk County childhood vaccine service page.
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