Understanding vaccine guidance and immunization schedules help school nurses do their part in keeping students healthy, safe, in school, and ready to learn. When students are protected from vaccine-preventable diseases, they are less likely to miss class due to illness, and both medically vulnerable students and the community benefit from increased resistance to potentially dangerous or debilitating diseases.
The biggest issue is, though, that helping families make informed immunization decisions has become more complicated. Parents and caregivers may encounter different recommendations from federal agencies, state officials, professional medical organizations, health care providers, and online sources. Many of them do not agree, and it is also true that some sources are biased, incorrect, and/or outdated. Fortunately, school nurses are able to build a trusted relationship with schools and families to support them with the clinical knowledge in order to make decisions about children’s health.
Immunization Keep Students Healthy and Learning
Vaccine-preventable illnesses affect more than a single student. They can lead to significant absences, interrupted classroom learning, parents and caregivers missing work, and increased risk for students who can’t get vaccines for medical reasons, such as allergies. An outbreak can also be demanding for school staff as they communicate with families, review records, coordinate with public health agencies, and respond to concerns.
School nurses see these effects directly. As Lynn Nelson, MSN, RN, NCSN, president of the National Association of School Nurses (NASN), explained in an August 2026 NASN statement:
“School nurses see the consequences of vaccine-preventable illness in real time — students missing school, families missing work, medically vulnerable students placed at greater risk, and learning disrupted. Childhood vaccine recommendations should be driven by rigorous evidence and expert review. School nurses need clear, credible guidance so they can help families make informed decisions and keep students healthy, safe, and ready to learn.”
Since health directly impacts education, immunization is an important topic. Schools supporting vaccination efforts is intended to reduce preventable absences and maintain a learning environment in which every student has an equitable chance to participate, learn, grow, and be a part of improving their communities through education.
How To Help Families Navigate Today’s Vaccine Guidance
Vaccine guidance is already having an impact on families because of how it has been under scrutiny. According to NASN, 29 states and the District of Columbia referred to sources outside the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices for at least some of their childhood vaccine recommendations as of May 4, 2026. Maybe more surprising is that of those 30 jurisdictions, 27 did so for all childhood vaccines, not just one or two.
The changes raise significant questions for families because they might receive one recommendation from a national organization, find different information from a state agency, and then see conflicting claims online. School nurses can help by discussing various guidance available while also advising based on reputable public health sources.
For example, professional immunization recommendations and legal requirements for school attendance aren’t necessarily the same. States are still responsible for setting school-entry vaccination requirements, which often do vary by jurisdiction. School nurses need to follow applicable state and local laws and district procedures while directing families to evidence-based clinical guidance.
School Nurses Are Trusted Voices
School nurses get to know students and families over time. They understand the school community, recognize barriers that may prevent a student from receiving care, learn about specific health issues that certain students face, and know how health concerns affect students’ daily attendance and classroom experience. They are trusted and have clinical expertise that positions them well to support immunization.
Those who work as school nurses need to begin with accurate record reviews, identifying missing documentation, notifying parents about relevant requirements, determining if a student is behind on vaccinations, or determining when they may not qualify for vaccination. When there are concerns, the school nurse can refer the parents or caregivers to pediatricians, public health departments, community clinics, or other local vaccination providers to get the support they need to protect their children’s health.
In addition to this, a school nurse needs to focus on educating their school community. A question about a vaccine isn’t always a refusal. It may reflect uncertainty about timing, safety, cost, transportation, or where to obtain care — parents and guardians have a right to ask, understand potential side effects, determine if the vaccine is in the best interests of their child at that time, and to have a respectful conversation with the nurse. By listening without judgment and sharing relevant information in plain language, school nurses can help reduce confusion and encourage decisions made on current, accurate scientific knowledge and standards of care.
How To Recommend Vaccines With Confidence
Existing public health materials and professional guidance provide a reliable foundation that nurses can use to support conversations within the school community. Keep in mind that consistency is important: Families should receive the same core information whether it appears in a letter, parent portal, school website, telephone conversation, or in-person meeting.
Some practical communication strategies may include:
- Starting with a shared goal: keeping a student healthy
- Asking open-ended questions to understand a family’s current concerns
- Using plain language to explain key terminology
- Separating school guidance and requirements from other regulations or guidance set by the government or other authorities
- Referring questions to other authorities, such as pediatricians, when they go beyond what a nurse is comfortable answering
Nurses should also contribute to timely conversations. Reviewing records before enrollment deadlines or anticipated seasons (like flu season) gives families more time to ask questions and get the answers they need to make informed decisions.
Credible Clinical References
It’s important for school nurses to use credible clinical references. NASN identifies the American Academy of Pediatrics (AAP) as one of the reputable professional organizations that state leaders and health professionals may consult for scientifically supported information. The AAP Recommended Child and Adolescent Immunization Schedule provides the most current guidance for children up to age 18.
This schedule can be a great place to start conversations about routine and catch-up vaccination, but it doesn’t replace individualized medical care. A child’s age, vaccination history, health conditions, contraindications, and other circumstances may affect clinical recommendations. School nurses should discuss and share the schedule as an educational resource while encouraging families to review any additional questions with the child’s health care provider.
Nurses should also review this information regularly and ensure it has a date, so families know when it was published and if it’s the most recent guidance.
Building Healthier Schools With SHC
School nurses are central to effective student immunization efforts, maintaining records, explaining requirements, connecting families with care, addressing questions, and helping school leaders prepare for communicable disease issues and periods of high illness, such as flu seasons or pandemics. Just as importantly, they translate complex guidance into guidance anyone can understand clearly.
SHC Education connects dedicated school nurses with opportunities to support students, families, and school communities. With local, travel, and one-on-one school nursing assignments available across the country, SHC helps nurses find roles where their clinical knowledge and commitment to student well-being may make a meaningful difference.
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