Ready to go back to school? Are you caught up on all your vaccinations? What about the COVID and flu shots?

Most schools start next week, unless you’re in Austin school district, which doesn’t start until Aug. 20 (lucky kids!), and schools like Del Valle, which started this week (completely unlucky kids!).

Here’s what vaccines you need to get into school without getting a waiver, and when you can expect the flu and COVID shots:

When will the latest COVID and flu vaccines be available?

The Centers for Disease Control and Prevention last week recommended updated COVID-19 and flu vaccines for everyone ages 6 months and older for this fall season.

We need a new vaccine of each of these because they are worldwide viruses that are constantly evolving, said Dr. Edgar Navarro Garza, a pediatrician at Harbor Health. “The virus changes because it’s trying to fight our defenses.”

You get a COVID-19 and flu vaccine to not get complications, Garza said. “You might still get sick with the virus,” he said, but you are less likely to be part of these statistics: In 2023, almost a million people in the United States were hospitalized for COVID and more than 75,000 died from the virus. In the most recent flu season, almost 45,000 people died from flu, according to the CDC.

This season’s flu vaccines usually start to show up in mid- to late August or the beginning of September. The new COVID-19 booster is expected to be available by mid- to late-September. You can do both at the same time, with the ideal time being before Halloween. That gives your body time to form a new set of the protective antibodies before the height of the winter COVID-19 and flu season, which usually is at its height from Thanksgiving and lasts through February.

Of course, as we have learned this summer, COVID-19 and flu can happen at any time. Texas currently has a very high level of COVID-19 in the wastewater and locally 80% to 100% of the water sampled at Travis County treatment plant has COVID in it. A Hays County plant had 60% to 80%. If you didn’t get the current COVID-19 booster last fall or later, you could go ahead and get that version before school starts. You don’t have to wait until the newest shot.

Learn more: Is COVID still around in Central Texas? Austin area seeing spike in cases this summer.

What vaccines do you need to get into school?

Anytime you enroll your child in a new public school, you’ll need your child’s vaccine record.

There are two key times when all students’ vaccines records are checked: kindergarten and seventh grade. The seventh grade one often sneaks up on parents.

Children are not allowed to attend school without required vaccines unless they have an exemption. For kids who have never had any vaccines, there is a catch-up schedule from the CDC that doctors will follow.

The Texas Department of State Health Services has a handy worksheet with all the required vaccines, but basically it breaks down to this:

By kindergarten:

• Diphtheria/tetanus/pertussis (usually four or five doses)
• Polio (three to four doses)
• Measles, mumps and rubella (two doses)
• Hepatitis B (three doses)
• Varicella (two doses)
• Hepatitis A (two doses)

By seventh grade:

• All of the above plus:
• Diphtheria/tetanus/pertussis (three doses, plus one booster within the past five years)
• Meningococcal (one dose)

Eighth grade and beyond:

• All of the above plus:
• Diphtheria/tetanus/pertussis (three doses, plus one booster within the past 10 years)

Not required but also a good idea are:

• HPV vaccine beginning at age 9
• Annual flu and COVID-19 shots
• A second dose of Meningococcal in 10th grade. Colleges usually require it for entry.
• Two doses of Meningococcal B at age 16.

Learn more: When does school start in Texas? An ultimate guide to 2024-25 start dates

Where can I get these vaccines?

Your primary care doctor should have them. People ages 3 and older also can be given vaccines at local pharmacies. Call ahead to see what they have.

Austin Public Health offers vaccines for free or at reduced rates for children and adults who do not have insurance or have Medicaid or are underinsured. The typical cost is $13 for children and $25 for adults. You can make an appointment at 512-972-5520 for either of the clinics at 405 W. Stassney Lane in South Austin or the 7500 Blessing Ave. in Northeast Austin.

Austin Public Health also will be at the Back to School Basics event from 9 a.m.-1 p.m. on Sunday at East Austin Neighborhood Center, 211 Comal St., as well as other mobile vaccine events. Find the list at austintexas.gov.

Can I get an exemption from vaccines?

Children can get exemptions for medical reasons or for what is called “Reasons of Conscience.” A medical exemption happens because of cancer treatment or another immune-suppressing treatment that would cause the vaccine to be ineffective, said Dr. Meena Iyer, chief medical officer of Dell Children’s Medical Center. Kids with medical exemptions have their doctor sign an exemption form, which is good for one year, unless the child has a lifelong disease, which makes the exemption good for the rest of their school career.

“It’s a very, very rare situation when a child should have a medical exemption,” said Dr. Elizabeth Knapp, a pediatric chief at Austin Regional Clinic

For reasons of conscience, such as religious or other personal values that do not align with vaccinations, parents can ask the state to send them an affidavit form at co-request.dshs.texas.gov. The form is good for two years only, then must be resubmitted.

There is a big caveat with an exemption: During an outbreak of a disease for which there is a vaccine, like measles, mumps, chicken pox, at the child’s school, the school can prevent your child from attending during the outbreak.

Why do we vaccinate children?

Vaccines help prevent diseases, such as measles, mumps, diphtheria and polio, Iyer said.

These diseases come with days or weeks of illness, horrible side effects and lifelong complications or death. “We’ve seen those cases after measles or chicken pox with complications in the brain and body,” Garza said. “Their quality of life will never be the same.”

What happens if not enough kids are vaccinated?

“Any time vaccination rates are lower, the risk of illness goes up,” said Dr. Danielle Grant, a pediatrician at Texas Children’s Pediatrics in Spicewood.

Two years ago, New York state had cases of polio in an unvaccinated population.

In June 2023, Texas reported a case of measles in Hood County — the first in Texas since 2019. Measles is especially worrisome, said Grant, because if one person with measles comes into a room with 10 unvaccinated people, nine of those people will become infected, according to the World Health Organization.