Missouri requires both an immunization record and a physical exam within 12 months of enrollment — two documents, one appointment window. This page covers the exact records Missouri law requires under RSMo §167.181, the ShowMeVax registry, the Hib and PCV requirements that apply through age 5, and the 30-day grace period schools may grant for students mid-series.
Last verified: September 8, 2026
Under RSMo §167.181, every student attending a Missouri public or private school must present a certificate of immunization before or at enrollment. Missouri is also one of the states that separately requires a physical exam within the preceding 12 months for students entering kindergarten and certain other grade levels — that documentation is distinct from the immunization certificate but typically requested at the same time.
The required vaccine records for K–12 entry:
ShowMeVax is Missouri's statewide immunization registry. Missouri healthcare providers report vaccinations to ShowMeVax, which stores the complete dose history for each patient. Parents can request a ShowMeVax record through their child's provider or through the Missouri Department of Health and Senior Services. A ShowMeVax printout identifies documented doses and any gaps in required series.
(Source: Missouri Department of Health and Senior Services — ShowMeVax, accessed Aug 30, 2026)
Missouri requires a physical exam within the 12 months preceding enrollment for kindergarten entry and certain other grade levels. This is in addition to the immunization certificate — one appointment may cover both, but confirm with your provider that the physical exam documentation will be completed on a form acceptable to your school district.
Missouri requires Haemophilus influenzae type b (Hib) and Pneumococcal conjugate (PCV) records for children through age 5. These series are typically completed in infancy and early childhood, but the number of required doses varies by the child's age at first dose. Check ShowMeVax to confirm the series is complete and documented.
Missouri schools may grant a 30-day provisional enrollment period for students who have begun a vaccine series but have not yet completed all doses. The student must show documentation of the incomplete series and evidence that completion is scheduled. After 30 days, the immunization certificate must be complete or the student may be excluded.
(Source: Missouri Department of Health and Senior Services, accessed Aug 30, 2026)
Missouri's requirement for both an immunization certificate and a physical exam within 12 months makes early scheduling important. Many families don't realize until August that their child's last physical was 13 months ago — just outside the window — which requires a new appointment before enrollment can be finalized.
(Source: RSMo §167.181, accessed Aug 30, 2026)
Every person gets one health story, and one private Family Stork email address every clinic already knows how to use. Give that address to your pediatrician, your local health department, or your school nurse — they send records to it, and the immunization history builds itself into one timeline.
When Missouri schools ask for the immunization certificate and the physical exam record — at kindergarten entry, when you transfer into a new district, or when the 30-day grace period is ticking — the dose dates, series status, and exam dates are already organized in one place.
Family Stork gives every family member a private @families.familystork.com address. Providers send immunization records to it automatically. ShowMeVax data, physical exam records, dose dates — organized in one place, ready for every Missouri enrollment. $99/year — about $10/month.
Start your family's record — freeMissouri recognizes medical exemptions and religious exemptions from school immunization requirements, both governed by RSMo §167.181. Medical exemptions require a licensed physician's signed statement. Religious exemptions require a written statement from the parent or guardian affirming a sincere religious belief against immunization. Missouri does not recognize philosophical exemptions.
Missouri Department of Health and Senior Services — School Immunizations →
More resources:
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