By: Bianca Escotto – Morales, MPHE. Provider Education Department

Vaccinating children in the required time is critical, as vaccines provide immunity before exposure to diseases that could be very harmful and even deadly.

According to data provided by the World Health Organization (WHO) and the United Nations International Children’s Emergency Fund (UNICEF), since 2019 there are 400 thousand children who have not received the complete vaccination schedule that protects them from serious diseases.

Vaccines are part of one of the most important advances in health and development worldwide. Thanks to immunization efforts around the world, vaccines have for two centuries safely reduced the scourge of diseases such as polio, measles, and smallpox, and helped children grow up healthy and happy.

Like any medication, vaccines have potential risks and associated side effects.

  • Vaccines undergo a variety of rigorous tests before being approved by the Food and Drug Administration (FDA).
  • The safety of each vaccine is monitored continuously.
  • Each ingredient is evaluated to validate that they are safe.
  • Vaccines are also being studied to be given together to work together to safely develop a child’s immune system.
  • According to the Centers for Disease Control and Prevention (CDC), in most cases, side effects from the vaccine are few and last only a few days.

After giving vaccines:

  • Encourage the child’s parents to report serious side effects to the Vaccine Adverse Event Reporting System (VAERS), which serves to report, analyze, and provide public access to information on the incidence of adverse side effects. Website:
  • Watch for unusual circumstances, such as high fever, weakness, or changes in behavior.
  • Some signs of an allergic reaction may include: 
    • Shortness of breath
    • Hoarseness or wheezing
    • Urticaria
    • Pallor
    • Weakness
    • Tachycardia or dizziness

If the child shows signs of allergic reactions or unusual or visible side effects, the child’s doctor should contact them immediately.

What does the law say?

Act No. 25 of September 25, 1983, lays down the vaccination requirements that must be complied with for minors to attend school. Every child enrolled in schools or childcare facilities must have an up-to-date immunization certificate according to their age. However, there are two types of exemptions for which an immunization certificate will not be required for admission or enrollment in any of these institutions:

Religious Exemptions*

  • Affidavit that the student, preschooler, or parent belongs to a religious organization or whose dogmas conflict with immunization.
  • The affidavit must include the name of the religion or sect.
  • It must be signed by the student or his/her guardians.
  • It must be signed by the minister of the religion or sect.

*This type of exemption will be null and void in any case of: epidemic declared by the Secretary of Health.

Medical Exemptions

  • Certification signed by a physician authorized to practice in Puerto Rico.
  • The certificate shall state the specific reason and possible duration of the conditions contraindicating immunization.
  • It must be signed by the student or his/her guardians.

All minors shall be exempt from being immunized against any diseases from which they have suffered. To prove this, you will need to submit a medical certificate or an affidavit. Provider, vaccination is everyone’s responsibility, and your participation is key to meeting the required vaccinations.