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Vaccines

What Vaccines Does a New Job Require — and How Do You Get the Records?

Vaccines required for a new job depend on the work: healthcare workers need annual influenza, hepatitis B series, MMR, varicella, and Tdap per CDC recommendations. Childcare and school roles often mirror those requirements. Most employers require documented proof or titer blood tests to confirm immunity. Your occupational health office or primary care clinician can review your history, order titers, and fill gaps before your start date.

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Which industries typically require vaccination documentation?

Requirements vary widely by role:

  • Healthcare (hospitals, clinics, nursing homes): The most demanding. CDC recommends annual influenza, hepatitis B series, MMR (measles, mumps, rubella), varicella (chickenpox), and Tdap for all healthcare workers with direct patient contact 2. Many facilities also require a TB skin test or IGRA blood test at hire.
  • Childcare and schools: Often require MMR, varicella, and Tdap, mirroring what children in their care must have 1.
  • Food service: Requirements vary by state; some require hepatitis A vaccination.
  • Military and first responders: Have their own regulated schedules.
  • General office, retail, and service jobs: Typically no routine requirements, though individual employers may set policies.

Your employer's HR department or occupational health office is the right first call — they can give you the exact list for your role.

How do I find and verify what vaccines I already have?

Before getting any new shots, try to locate existing records:

  • Your childhood shot record card, often kept by parents; your pediatrician's office may have older records.
  • Your state's immunization information system (IIS) — search your state health department's website for how to request your record; the CDC provides a directory of all state IIS contacts 3.
  • Prior employer or school records, if vaccination was required there.
  • Your primary care doctor, who may have records of shots given in their office.

If records are lost or incomplete, a titer test — a blood draw that checks for protective antibodies — can confirm immunity without repeating an entire vaccine series. For some vaccines, such as hepatitis B, employers may require titer proof even if you completed the series 2.

What should I do if I am missing vaccines or cannot find records?

A primary care clinician or occupational health provider can:

1. Review your history and identify gaps. 2. Order titer tests where appropriate to avoid unnecessary repeat doses 2. 3. Administer any missing vaccines on the correct schedule — note that some series require multiple doses over weeks or months, so plan ahead if your start date is soon. 4. Provide a signed, stamped immunization record or complete your employer's specific documentation form.

Timing matters: the standard hepatitis B series requires three doses over approximately six months, though an accelerated schedule exists — ask your clinician 2. If your start date is imminent, discuss urgent scheduling with the occupational health office early.

What about religious or medical exemptions?

Exemption policies vary by employer, industry, and state. Healthcare settings bound by accreditation standards may have very limited exemptions. Your HR department can explain the process; your clinician can provide medical documentation if there is a recognized clinical contraindication — for example, a documented severe allergy to a vaccine component 2. A clinician cannot write an exemption on the basis of personal preference alone.

Common questions

I grew up outside the U.S. — will my childhood vaccine records be accepted?

Vaccine schedules differ by country, and some records may be accepted while others require serologic proof of immunity or revaccination. A clinician familiar with international vaccine equivalencies can help sort this out, and titer tests can confirm immunity without repeating a full series.

What is a titer test and why might my employer require one?

A titer test is a blood draw that measures protective antibodies against a specific disease. Employers — particularly in healthcare — may require it to confirm that a completed vaccine series actually produced immunity, or to verify immunity when vaccination records are unavailable.

What TB test will a healthcare employer likely require?

Most healthcare employers use either a tuberculin skin test (TST) or an IGRA blood test. Which one depends on your prior BCG vaccination history and the institution's policy. Your occupational health office will specify which test they use.

How long does it take to complete the hepatitis B vaccine series?

The standard hepatitis B series is three doses: the first at the start, the second at one month, and the third at six months after the first. An accelerated schedule (0, 1, 2, and 12 months) is also available — ask your clinician if your start date is soon.

Talk to a clinician

Nina Osei, NP — Nurse Practitioner

checkups, refills & skin. Gale can match you with a licensed clinician for a visit.

Find care →

Good to know

This article provides general health education and does not constitute a diagnosis, medical advice, or a personalized immunization plan. Requirements vary by employer, industry, and jurisdiction. Speak with a licensed clinician or your employer's occupational health office for guidance specific to your situation.

References

  1. 1.Issa AN, Wodi AP, Moser CA, Cineas S (2025). Advisory Committee on Immunization Practices Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger — United States, 2025. MMWR Morb Mortal Wkly Rep. doi:10.15585/mmwr.mm7402a2 ✓MMR, varicella, and Tdap requirements that childcare and school employers mirror from the childhood schedule
  2. 2.Centers for Disease Control and Prevention (2024). Recommended Vaccines for Healthcare Workers. CDC / Adult Vaccines. link ✓CDC-recommended vaccines for healthcare workers: annual influenza, hepatitis B series, MMR, varicella, Tdap; titer testing to verify immunity for hepatitis B and other vaccines
  3. 3.Centers for Disease Control and Prevention (2024). Contacts for IIS Immunization Records. CDC / Immunization Information Systems (IIS). link ✓State immunization information systems as a resource for locating prior vaccination history to satisfy employer documentation requirements

3 sources, numbered by first appearance. General health information, not medical advice — synthetic demonstration content.