TAFDC and the immunization rule

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Massachusetts Law Reform Institute

Under the TAFDC immunization rules, applicants and recipients must show either

  • their TAFDC eligible children are up to date with all vaccines and immunizations, or
  • that there is a medical or religious reason to refuse immunizations. 
How does the immunization rule work?

When DTA notifies you about the immunization rule you have 60 days

  • to bring in proof that your children's immunizations are up to date, or
  • to show that you have an appointment scheduled with their doctor or clinic.

DTA usually notifies you about the rule

  • when you first apply,
  • when a child is born, and
  • when your child turns 2.

If your child is enrolled in school or a licensed childcare provider, immunization is verified by:

  • Proof of enrollment in a Head Start or licensed childcare program (unless DTA pays for the Head Start or day care in which case DTA has the proof already), or
  • Proof that your child is enrolled in school.

If your child is not enrolled in school or a licensed childcare provider, proof includes one of the following:

  • A DTA immunization form filled out by your child's health care provider,
  • A letter from your child's health care provider that your child is up to date on immunizations
  • A copy of a MassHealth or other insurance bill showing that your child had a well-child visit within a year,
  • A well child visit summary (including screen shot from provider's online portal) or a bill or receipt from a well child visit dated within a year, or
  • A copy of immunizations record book 

If your child is under age two, you may be asked to show your child is still up-to-date on immunizations after they turn age two.

If your provider has lost the records or cannot schedule an appointment for you, you can ask your DTA worker for help to get the documents or get an appointment for a well-child visit.

If you don’t bring in proof of up-to-date immunizations, or proof that you have an appointment scheduled, you will lose your portion of the TAFDC grant. You may also lose income deductions on any earnings and other DTA support services (transportation or child care) you need to work or go to school. 

Your MassHealth should not be cut. But your SNAP will not increase if your TAFDC goes down due to an immunization sanction. 

Contact [email protected] if DTA sanctions you.

Are there any exceptions?

You are exempt from this rule if immunizing your children

  • is against your religious beliefs, or
  • you or your doctor believe it would be medically harmful for your child.

If you do not want your children immunized, be sure to tell your DTA worker. DTA says that there are 3 situations when you do not have to follow the immunization rule:

  • If the immunizations are against your religious beliefs (statement from you),
  • If a doctor says in writing that your child should not be immunized for medical reasons, or
  • If you believe that there is a health risk from the immunizations after discussing this with a doctor (statement from you).

In all of these situations, you must give DTA this information in writing.

What if I need help finding a doctor?

You get MassHealth coverage automatically with your TAFDC benefits. MassHealth will pay for all required shots, as well as checkups and other medical services. 

If you need help finding a doctor, call MassHealth. Ask them to give you the name of a MassHealth doctor. You can also call your local neighborhood health center or hospital pediatric clinic for information and help.

How can I challenge a denial of TAFDC benefits?

If you get a written notice saying your TAFDC benefits will be reduced because of this rule, you have the right to appeal. If your worker refused your request for help in getting proofs, be sure to tell this to the hearings officer.


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