Nebraska licensed childcare programs require immunization records verified against the state schedule, a physical examination within 30 days of enrollment, and compliance with Title 391 NAC 1. Hepatitis A is required — a detail that catches many out-of-state families off guard. Here's every form, who fills it out, and where to get it, cited from official Nebraska sources.
Last verified: September 2, 2026
Nebraska licensed childcare programs are governed by Title 391 NAC 1 (Nebraska Administrative Code for childcare licensing), which incorporates the immunization requirements of Neb. Rev. Stat. §79-221. An immunization certificate documenting age-appropriate vaccines must be on file before a child begins attending.
Hepatitis A is required in Nebraska for both childcare and school entry. Families arriving from states where Hep A is not mandated should confirm completion of the 2-dose series with their pediatrician before enrollment.
Source: Nebraska DHHS — School and Childcare Immunization Requirements; Neb. Rev. Stat. §79-221; Title 391 NAC 1, accessed September 2, 2026
Nebraska licensed childcare programs require a physical examination within 30 days of enrollment. The physical must be performed by a licensed healthcare provider and document the child's overall health status. Children who have had a recent physical from another state or provider can typically use that exam if it falls within the 30-day window from enrollment.
The physical examination requirement applies to licensed daycare centers and family childcare homes regulated by Nebraska DHHS. Contact your specific program to confirm their preferred documentation format — some use their own health history forms.
Source: Nebraska DHHS — Child Care Licensing (Title 391 NAC 1), accessed September 2, 2026
The Nebraska State Immunization Information System (NESIIS), managed by Nebraska DHHS, tracks immunization records for children vaccinated in Nebraska. Your child's pediatrician can access NESIIS and print a current immunization history for daycare enrollment.
To get a NESIIS-verified record:
Source: Nebraska DHHS — NESIIS, accessed September 2, 2026
Nebraska camp requirements vary by camp type and licensing:
Source: Nebraska DHHS — Child Care and Camp Licensing, accessed September 2, 2026
Infants in licensed childcare must be current on all age-appropriate doses. The immunization schedule at this stage moves quickly — DTaP, Hib, IPV, PCV, Hep B doses are all due in the first year. A NESIIS-verified record is updated at each well-child visit and should travel with the enrollment paperwork.
The 12–15 month MMR and Varicella doses are critical checkpoints. Hep A first dose is typically given at 12–23 months; the second dose follows 6 months later. Confirm both Hep A doses are complete before enrollment if your child is old enough.
Children entering Nebraska pre-K or licensed preschool follow the same immunization requirements as kindergarten entry. This includes both doses of Hep A and all age-appropriate doses on the NESIIS record. A physical exam within 30 days of enrollment is required.
Ask your child's provider to pull a NESIIS printout. Verify all required vaccines are on file — especially Hep A. Address any missing doses before enrollment.
Bring your immunization record and any camp-specific health forms. Your provider updates NESIIS, completes the physical exam documentation, and signs off on any required health history forms at the same visit.
Nebraska county health departments can look up NESIIS records, administer catch-up vaccines, and provide documentation for daycare enrollment. Many offer low-cost or free immunization services.
Deliver immunization records and the physical exam documentation to your daycare or camp before enrollment begins. Keep copies — you'll need both for school enrollment in Omaha, Lincoln, or Bellevue when that time comes.
Nebraska childcare immunization exemptions follow the same rules as school entry under Neb. Rev. Stat. §79-221: medical and religious exemptions are available. For official exemption forms and process, contact Nebraska DHHS — Immunization Program →
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