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Student Certificate of Immunization


The Student Certificate of Immunization is now available in the State Reports tab and provides dose dates for twelve vaccines in a form provided by the Department of Public Health. The report must be run for a student selection, otherwise, an error message is displayed, and the Submit button is disabled. Student Name, Parent/Guardian name, and student date of birth is located in the header. The output displays the required vaccines along with immunization dates for the students for up to six shots. If more than 6 shots are entered for the student, the first six shots (by date) are shown.

Required Set-up

  • Use the Immunizations setup to populate the State Report Name and Code fields on the Vaccines, Exemption Types, and Certificate Types screens (Start Page > District > Health > Immunizations).
  • Enter student vaccine information on the student Immunization page (Start Page > select a student > Health > Immunizations).
  • To set exemption for a vaccine in the Add/Edit Exemption Types page (Start Page > District > Health Setup > Add/Edit Exemption Types)

Selection Criteria

Selection criteria determine which database records are used in the report. Refer to selection criteria for analysis when the report does not return the correct records.

Student Selection

The report selects Parent/Guardian records from the [Students] table based on the following criteria:

  • The student is not flagged as Exclude from State Reporting.
  • The student contact record has name listed with the highest contact priority order where the 'Lives With' and 'Custody' flags are selected. If student does not have Lives with and custody flags selected with priority:
    • If there are no contacts that match the criteria, the Guardian names are selected

    • If the Guardian name fields are blank, then the mother field

    • If the above fields are blank, then the father field

This report pulls vaccine dose dates based on specific State Report Code values in the vaccines/exemptions. View the CO District Setup for more information.

Report Input

For help with navigation and running the report, see How to Find and Generate a Report.


Report Parameters

Set Select All; this will store your selections for this report which is helpful when you need to submit a new file and you are unsure of how you created your last file.

Select Schools*

If run at the district level, choose one of the following:

  • Select Multiple Schools – Select schools to include in the report. To select a single school, click that school. To select multiple schools, use Ctrl+Click and select each school to be included. Select schools to include in the report
  • All Schools – Run the report for the entire district.

If run at the school level, the report includes all records associated with the current school that meet the selection criteria. To change the current school, click School at the top of the page and choose the appropriate school from the list.

Current Selection Students*

Indicate which students to include in the report by selecting one of the following options:

  • The Selected [number] Students Only
  • All Students

If running the report for a single student, or group of students, select the students prior to running report.

Report Medical Exemption CommentSelect No or Yes to include Medical Exemption Comment in the report output.


Click Run Now to run this report immediately, or click Schedule to schedule it to run later.

Report Output

Each of the fields displayed in the output of the report are described below. See Understanding the Report Output Table for a definition of each column in the table.

Data ElementDescription


Student NameThe student's last name, first name, middle name.




Date of birthThe birth date of the student.[Students]DOB
Parent or Guardian Name

Name of student's parent or guardian in the Contacts page with the Lives With and Custody flags selected. If there are no contacts that meet this criterion then the mother's name is printed. If the mother's name is unavailable, then the father's name is printed.

[Prefs] MD_p1_first_name


[Prefs] MD_p1_last_name




Required Vaccines
Hep B Hepatitis BVaccination dates for Hepatitis B.




DTaP Diphtheria, Tetanus, Pertussis (pediatric)Vaccination dates for Diphtheria/Tetanus/Pertussis (DTaP/DTP/Tdap/DT/Td)




Tdap Tetanus, Diphtheria, PertussisVaccination dates for Tetanus, Diphtheria, Pertussis.




Hib Haemophilus influenzae type bVaccination dates for Hib.[HealthStudDoseRec]DateAdministered



IPV/OPV PolioVaccination dates for Polio.[HealthStudDoseRec]DateAdministered



MMR Measles, Mumps, RubellaVaccination dates for Measles, Mumps, Rubella.[HealthStudDoseRec]DateAdministered



MeaslesVaccination dates for Measles.




MumpsVaccination dates for Mumps.




RubellaVaccination dates for Rubella.




Varicella (Chickenpox)Vaccination dates for Varicella (Chickenpox).[HealthStudDoseRec]DateAdministered



Varicella - date of disease

If the student has a documented Varicella diagnosis, the date of diagnosis is printed. If the student does not have a Varicella diagnosis, the field is left blank.

Varicella - positive screen dateThe date when the Varicella screening was completed.

Recommended Vaccines
HPV Human PapillomavirusVaccination dates for HPV.[HealthStudDoseRec]DateAdministered



Rota RotavirusVaccination dates for Rotavirus.[HealthStudDoseRec]DateAdministered



MCV4/MPSV4 MeningococcalVaccination dates for Meningococcal (MCV4/MPSV4).[HealthStudDoseRec]DateAdministered



Men B MeningococcalVaccination dates for Meningococcal (Men B)[HealthStudDoseRec]DateAdministered



Hep A Hepatitis AVaccination dates for Hepatitis A.[HealthStudDoseRec]DateAdministered



Flu InfluenzaVaccination dates for FLU.[HealthStudDoseRec]DateAdministered



OtherOther vaccines administered.[HealthStudDoseRec]DateAdministered



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