Skip to content

Immunization Guidelines in Northern Virginia

PediatriCare of Northern Virginia follows the immunization guidelines recommended by the American Academy of Pediatrics. For descriptions of these vaccines and the diseases they protect against, please visit ,, or

For detailed informational sheets published by the Centers for Disease Control (CDC) please visit

immunization image

Click here for PDF version


At PediatriCare of Northern Virginia, we strongly believe that all parents and patients should be informed about the risks and benefits of preventive and therapeutic procedures, including vaccination. We realize that it is a parents right to consent to or decline vaccination. Declination often results from families misinterpreting or misunderstanding information presented by the media and on unmonitored and biased web sites, causing substantial and often unrealistic fears. It is our responsibility to provide education and resources to our families that promote the general health and well being of a child and to minimize harm.

When faced with the decision to immunize a child, the welfare of the child should be the primary focus. As a practice, we strongly believe in the benefit of immunization. We do understand that there are families that will wish to defer immunizations, follow an alternative vaccine schedule or decline vaccines entirely. In that case, our policy is to have the parent read and complete the AAP Refusal to Vaccinate form. The sole purpose of this form is to acknowledge that you are exercising your right of “informed consent” and that you have had the opportunity to express your concerns and have any questions addressed.   As it is your right to defer and decline vaccination of your child, it is also a joint responsibility between parent and health care provider to acknowledge in writing that you have been provided information and the forum to ask questions.

Immunization Refusal Form – English

Immunization Refusal Form – Spanish

Request Appointment