By Hola Iowa
Polk County counted 3,722 religious exemptions in 2025, up from 1,551 in 2019. Iowa families must provide an immunization, provisional or exemption certificate before a student attends school.
Updated Friday, Aug. 7, 2026.
POLK COUNTY, IA — Religious exemptions from Iowa’s school vaccine rules more than doubled in Polk County over six years. The number rose from 1,551 students in 2019 to 3,722 in 2025.
Polk County also counted 5,571 students in its “not fully vaccinated” category in 2025. The county recorded 2,937 in 2019, according to local school immunization data.
That category does not mean every student lacked all required vaccines. It includes students who missed at least one dose. It also includes students with provisional certificates and students with medical or religious exemptions.
Nonpublic schools had the highest share in 2025. They placed 15.2% of students in the “202not fully vaccinated” category, nearly three times the 2019 rate.
The six-year comparison has an important limit. Iowa moved its annual data review to an earlier point in the school year in 2021. Polk County warns that the timing change can affect the totals for provisional certificates and incomplete records. Some students may submit documents or receive more doses after the annual review.
The new school year also follows Iowa’s first measles case of 2026. In July, health officials warned of possible exposure at nine places in central Iowa. The case involved a vaccinated Polk County adult who had recently traveled abroad. Read Hola Iowa’s coverage of the measles exposure alert.
Iowa schools require one of three certificates
Iowa’s vaccine rules cover public and nonpublic schools, as well as children who receive private instruction.
Before a student attends, the school must have one of these documents:
- Certificate of Immunization: Lists the vaccines the student received.
- Provisional Certificate of Immunization: Gives an eligible student more time to finish a vaccine series.
- Certificate of Immunization Exemption: Records a valid medical or religious exemption.
A school cannot admit a student who lacks one of these documents.
The regular certificate must include the student’s name, date of birth and vaccine dates. A physician, physician assistant, nurse or certified medical assistant must sign it.
Families can find the forms and full vaccine schedule on the Iowa Health and Human Services immunization page.
Students in seventh and 12th grades need added doses
Iowa requires vaccines against diphtheria, tetanus and pertussis; polio; measles and rubella; hepatitis B; chickenpox; and meningococcal disease.
A student’s age, grade and vaccine history determine the number and timing of doses.
Students entering seventh grade or above need a Tdap dose given at age 10 or later.
Students in grades seven through 11 also need a meningococcal vaccine. Those entering 12th grade usually need two meningococcal doses. They must receive one of those doses at age 16 or later.
One meningococcal dose meets the 12th-grade rule if the student received it at age 16 or later.
A provisional certificate gives students time to finish a series
A student can use a provisional certificate after starting, but not finishing, a required vaccine series. Students who transfer from another U.S. school may also qualify.
In most cases, the student must have at least one dose of every vaccine required for that age. The student must receive the next dose as soon as medically possible and within 60 days of the previous dose.
If the student misses that deadline, the school can stop attendance until the family provides a new certificate.
Religious exemption forms no longer need a notary
Families may request a religious exemption when vaccination conflicts with a genuine and sincere religious belief. Iowa does not grant this exemption for a personal, scientific, medical, moral or philosophical objection alone.
The student must sign the form. For a minor, a parent or guardian must sign it instead.
Iowa Health and Human Services removed the notary rule on July 1, 2024. A religious exemption no longer needs a notary’s signature.
An Iowa-licensed physician, physician assistant or nurse practitioner must approve a medical exemption. The clinician must determine that a required vaccine could harm the student or someone in the student’s household.
Families can request vaccine records through IRIS
Iowa’s Immunization Registry Information System, or IRIS, stores records that health care providers submit.
Families can request an available record from a provider that uses IRIS. They can also send the state’s record request form to the Iowa Immunization Program.
Parents and legal guardians may request records for children younger than 18. After a person turns 18, that adult must request the record.
IRIS may not contain every older vaccine record. Families may need to contact the doctor, clinic or health department that gave a missing dose.
The official IRIS page provides the form and instructions. Families can also call the IRIS Help Desk at 1-800-374-3958.
Polk County offers childhood vaccine appointments
The Polk County Health Department offers routine childhood vaccines at 1907 Carpenter Ave. in Des Moines.
Families can make an appointment by calling 515-286-3798. The clinic opens Monday through Friday from 8 a.m. to 4:30 p.m.
The clinic takes part in the federal Vaccines for Children program. The program covers vaccine costs for eligible children age 18 or younger.
Eligible groups include children who have Medicaid, lack insurance or have limited insurance. American Indian and Alaska Native children also qualify.
The clinic may charge administration fees. Polk County offers a hardship policy for families who qualify and asks parents to call if cost could prevent care.
Families should bring any vaccine records and an insurance card. The Polk County childhood vaccine page lists current fees, eligibility rules and appointment details.
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