Vaccine-Preventable Diseases and Immunization Program

Data & Reports

Explore Tennessee immunization and respiratory disease data here, including vaccination coverage dashboards, school compliance measures, 24-month-old immunization status, respiratory trend dashboards, and weekly flu reports.

Dashboard accessibility notice: Interactive dashboards (including embedded Tableau content) may not be fully accessible for all users or assistive technologies. If you need an accessible alternative format or assistance accessing data, please contact the Tennessee Vaccine-Preventable Diseases and Immunization Program (VPDIP):

• Phone: (800) 342-1813
• Email: TennIIS.Help@tn.gov

Immunization Coverage Rate Resources

This section includes two types of resources: annual report PDFs and TennIIS-reported dashboards.

Annual report data (PDFs): These reports include data visualizations for the 24-Month Old Immunization Status and Kindergarten Immunization Compliance reports. The reports use TennIIS data at the outset and then undergo additional manual review of immunization records by public health professionals to help achieve as complete an immunization record as possible. With the additional information added through manual review, these datasets can be considered representative of the true immunization status of Tennesseans and may be used to compare against national objectives such as Healthy People 2030.

TennIIS reported data (dashboards): These dashboards include data visualizations generated from Tennessee’s immunization information system and are intended to be a continuation or extension of the CDC VaxView series. Data in these dashboards are based on information reported to the Tennessee Immunization Information System (TennIIS).

Immunization reporting to TennIIS is mandatory for all federally funded vaccines (Vaccines for Children (VFC), 317, COVID, and MPX). Reporting for all other vaccines is voluntary, and individuals must opt out of TennIIS if they do not wish to participate. Because some providers do not report all vaccinations to TennIIS, coverage rates derived from TennIIS data may vary geographically and demographically depending on provider participation.

These datasets cannot be considered representative of the true immunization status of Tennesseans and should not be used to draw direct comparisons against comprehensive objectives. Instead, use these dashboards to:

• Compare like populations
• Assess trends over time
• Measure the impact of public health interventions

Annual Immunization Reports (PDFs)

Use the dropdowns below to learn more about each report and access the related PDF(s).

Annual Reports Dashboards

These dashboards provide interactive views of the annual report datasets described above.

24-Month Immunization Status Dashboard

Kindergarten Immunization Compliance Dashboard

TennIIS-Reported Coverage Rate Dashboards 

Child Coverage Rate Dashboard

School Coverage Rate Dashboard

Teen Coverage Rate Dashboard

Adult Coverage Rate Dashboard

Region Coverage Rate Dashboard

Download Data Sets

Click the links below to download datasets and supporting documentation:

Respiratory Trends Dashboards

Use these dashboards to explore respiratory disease trends across Tennessee.

Tennessee Respiratory Virus Trends

Tennessee RVI Trends by Total

Tennessee RVI Trends by Age

Tennessee’s Weekly Flu Reports

The Tennessee Department of Health conducts year-round influenza surveillance and publishes a weekly flu report summarizing influenza activity across the state.

New reports are available each Friday and contain data from the prior week.

2026 Archives

For the Public

This section helps you find vaccines, review trusted vaccine information, follow recommended immunization schedules, request immunization records, and learn about vaccine safety.

External link and accessibility notice: Some links on this page take you to websites outside the Tennessee Department of Health (TDH). TDH does not control the content, privacy policies, or accessibility of external sites.

Where to Find Vaccines

• Find vaccines near you
• Find a vaccine at your local health department

Vaccine Information Statements

Vaccine Information Statements (VIS) explain a vaccine’s benefits and possible side effects and what to expect before and after vaccination. VIS are available for many vaccines and are often provided at the time of vaccination.

Vaccine Information Statements (VISs) (CDC)

CDC Immunization Schedules

Use the CDC schedules to learn which vaccines are recommended by age and other factors.

CDC Immunization Schedules (CDC)

Request a Copy of Your Immunization Record

You may be able to request your immunization record through your health care provider, your local health department, or Tennessee’s immunization information system (TennIIS), depending on your situation.

• Request a copy of your immunization record

Vaccine Safety

Learn about vaccine safety, how to report possible side effects, and where to find reliable information.

Information for Parents

These resources explain how the Vaccines for Children (VFC) Program helps eligible children get free, recommended vaccines on schedule to protect against preventable diseases.

VFC Program: Information for Parents (CDC)

Information for Parents Flyer (CDC)

For Providers

This section includes vaccine administration guidance, storage and handling resources, vaccine transport tools, Vaccines for Children (VFC) program materials, TennIIS participation resources, and reporting tools.

External link and accessibility notice: Some links on this page take you to websites outside the Tennessee Department of Health (TDH). TDH does not control the content, privacy policies, or accessibility of external sites.

Vaccine Administration (Operations)

Use these tools and trainings to support safe, effective vaccine administration.

CDC Vaccine Administrator Tools (CDC)

Immunization: You Call the Shots – Vaccine Administration e-Learn (Module 18) (CDC)

How to administer intramuscular and subcutaneous vaccine injections (Infographic) (CDC)

Intramuscular (IM) Vaccine Administration Video (CDC)

Subcutaneous (SC) Vaccine Administration Video (CDC)

Vaccine Storage and Handling

Use these resources to meet storage, temperature monitoring, and equipment standards.

CDC Resources

CDC Vaccine Storage and Handling Toolkit (CDC)

CDC resources on proper vaccine storage and handling (CDC)

CDC guidance for manually defrosting storage units (CDC)

TDH Resources

• Refrigerator temperature range guidance
• Freezer temperature range guidance
• Hourly Celsius (°C) temperature log
• Report a temperature excursion
• Vaccine storage unit & digital data logger (DDL) guidance
• Vaccine storage unit digital data logger sign-off sheet
• Power source — Do Not Disconnect (sign)
• Circuit breaker — Do Not Disconnect (sign)

Vaccine Transportation Guides

Use these forms and logs to support safe transport and mobile operations.

• Vaccine Borrowing Form
• Packing vaccines for transport
• Mobile immunization clinic log
• Refrigerated vaccine transport log
• Freezer vaccine transport log
• Frozen vaccine transport guide

Vaccines for Children (VFC) Program

The VFC Program provides vaccines at no cost to eligible children and supports providers who administer VFC vaccines. Use the resources below for program guidance, enrollment, eligibility screening, and required tools.

Program and Enrollment Guidance

Learn about the VFC Program’s history, purpose, and the role of participating providers.

Have questions about joining the VFC Program and the benefits of becoming a VFC provider? Use the links below to find program information and enrollment answers.

Vaccines for Children (VFC) Program: Information for Providers (CDC)

VFC Enrollment FAQ (CDC)

VFC Enrollment

If you are interested in participating in the VFC Program, complete the VFC Interest Form. Providers are strongly encouraged to review the VFC Provider Handbook and become familiar with program requirements before starting enrollment and again before completing annual re-enrollment.

• VFC Interest Form
• VFC Provider Handbook Appendices
• VFC Enrollment Walkthrough Guide
• VFC Re-Enrollment Walkthrough Guide
• Routine and Emergency Vaccines Management Plan (REVMP)
• Routine and Emergency Vaccine Management Plan (REVMP) Recommendations
• Common Non-Compliance Issues for VFC Requirements
• CDC You Call the Shots Training Modules (10 and 16) (CDC)

VFC Eligibility Screening Guides

Use these resources to screen for eligibility and document eligibility appropriately.

VFC Eligibility Criteria & Provider Responsibility to Screen for VFC Eligibility (CDC)

How Public Programs and Federal Agencies Support the VFC Program (CDC)

Patient Eligibility Screening Record (CDC Form 2014) (CDC)

VFC Vaccine Tables (Provider Type)

Use the table that matches your provider type.

• Private Providers (VFC Vaccine Table)
• RHC and FQHC (VFC Vaccine Table)

VFC Program Promotional Materials and Parent Resources

Use these resources to promote the program and share parent-friendly information.

Vaccines for Children (VFC) Program: Information for Parents (CDC)

Information Flyer for Parents (CDC)

VFC Fraud Prevention

Use these tools to report concerns and support program integrity.

• VFC Fraud and Abuse Reporting Tool
• Office of Inspector General (OIG) Exclusions Program

TennIIS for Providers

Providers use the Tennessee Immunization Information System (TennIIS) to access consolidated immunization records and to support public health reporting and electronic data exchange through your EHR.

Electronic Data Exchange (EDE) with TennIIS

The Tennessee Vaccine-Preventable Diseases and Immunization Program (VPDIP) invites Tennessee health care providers, pharmacies, and other immunizing partners to exchange immunization data electronically with TennIIS through your EHR.

Become an Electronic Trading Partner

To become an electronic trading partner and exchange data electronically with TennIIS, submit the Welcome Packet to the TennIIS Data Exchange Team at TennIIS.MU@tn.gov.

Welcome Packet attachments:

• Organization Contact Information
• Facility Contact Information
• Vendor Contact and Messaging Transport Information

Trading Partner Registration (TPR) for Public Health Reporting

This information supports Immunization Registry Reporting for Eligible Professionals (EPs), Eligible Clinicians (ECs), Eligible Hospitals (EHs), and Critical Access Hospitals (CAHs).

To satisfy TDH requirements for Public Health Reporting using Certified Electronic Health Record Technology (CEHRT), potential trading partners must first register their intent to exchange data through Trading Partner Registration (TPR). After registering in TPR, contact TennIIS.MU@tn.gov to initiate onboarding.

TPR provides documentation that may be used for attestation and audits, including milestone letters documenting onboarding progress and active engagement status.

TDH Declaration of Readiness for Public Health Reporting (Summary)

As of January 1, 2023, TDH is declaring readiness for specific Public Health Reporting objectives and measures. Promoting Interoperability and Merit-Based Incentive Payment System (MIPS) participants should check periodically for updates to TDH’s declaration of readiness to receive data from Certified Electronic Health Record Technology (CEHRT).

For questions related to the TDH Declaration of Readiness, contact the TDH Meaningful Use Coordinator:

• Phone: (615) 253-8945
• Email: MU.Health@tn.gov

Note: The time until live data exchange varies and depends upon the quality and speed of data exchange testing.

Helpful Links

External link and accessibility notice: Some links below take you to websites outside the Tennessee Department of Health (TDH). TDH does not control the content, privacy policies, or accessibility of external sites.

• Register a facility / Become a TennIIS user
• Electronic Data Exchange (EDE): Fact Sheet and On-Boarding Checklist
• Trading Partner Registration (TPR)
• Trading Partner Registration Worksheet

For brochures, FAQs, full onboarding documents, and technical specifications, visit the TennIIS tab.

Vaccine Information, Safety, and Reporting Adverse Events

Use these resources to provide required vaccine information and report possible adverse events.

Vaccine Information Statements (VIS) (CDC)

Vaccine Adverse Event Reporting System (VAERS)

About the Vaccine Adverse Event Reporting System (VAERS) (CDC)

Recent Educational Updates

Tennessee Health Alert Network (TNHAN) Updates

• Measles TNHAN
• Respiratory TNHAN

Additional Provider Resources (CDC)

CDC Vaccine Resources for Providers (CDC)

CDC Influenza Educational Materials (CDC)

For Schools

Schools, child care programs, and colleges use Tennessee immunization requirements to help protect students and staff from vaccine-preventable diseases. This section explains the requirements, where to get an official immunization certificate, and where to find guidance and tools for families, schools, and health care providers.

External link and accessibility notice: Some links on this page take you to websites outside the Tennessee Department of Health (TDH). TDH does not control the content, privacy policies, or accessibility of external sites.

Quick Links

Use these links to navigate to key school and college immunization resources. 

Required Immunizations

The Tennessee Department of Health (TDH) is responsible for immunization requirements for individuals who attend child care, pre-school, K–12 school, and college. Current requirements are established in TDH Health Rules.

The state’s immunization requirements consider the schedule published by the Centers for Disease Control and Prevention (CDC) and endorsed by the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP). Tennessee’s list of required immunizations is developed through the normal, open rulemaking process.

Child Care and K–12 Requirements

TDH has immunization requirements for children attending child care, pre-school, and school. These requirements must be documented on the Official Immunization Certificate.

Children enrolling in child care, pre-school, or pre-K

Infants entering child care must be up to date at the time of enrollment. An updated certificate is required after completing vaccines due no later than 18 months of age.

Required vaccines include:

• Hepatitis B (HBV)
• Diphtheria-Tetanus-Pertussis (DTaP, or DT if appropriate)
• Poliomyelitis (IPV or OPV)
• Haemophilus influenzae type B (Hib) (younger than 5 years only)
• Pneumococcal conjugate vaccine (PCV) (younger than 5 years only)
• Measles, Mumps, Rubella (MMR) (1 dose)
• Varicella (1 dose or credible history of disease)
• Hepatitis A (1 dose required by 18 months of age or older)

Children enrolling in Kindergarten

Required vaccines include:

• Hepatitis B (HBV)
• Diphtheria-Tetanus-Pertussis (DTaP, or DT if appropriate)
• Poliomyelitis (IPV or OPV) (final dose on or after the 4th birthday)
• Measles, Mumps, Rubella (2 doses of each, usually given together as MMR)
• Varicella (2 doses or credible history of disease)
• Hepatitis A (2 total doses spaced at least 6–18 months apart)

All children entering 7th grade (including currently enrolled students)

Required vaccines include:

• Tetanus-diphtheria-pertussis booster (Tdap) (one Tdap dose required before 7th grade entry; administered at or after age 10; required regardless of Td history)
• Varicella (2 doses or credible history of disease) — see Update to 7th Grade Chickenpox Immunization Requirements

Children new to a Tennessee school in grades other than Kindergarten

Required vaccines include:

• Hepatitis B (HBV) (previously required only for Kindergarten and 7th grade entry)
• Diphtheria-Tetanus-Pertussis (DTaP, or DT if appropriate)
• Poliomyelitis (IPV or OPV) (final dose on or after the 4th birthday is required)
• Measles, Mumps, Rubella (2 doses of each, normally given together as MMR)
• Varicella (2 doses or credible history of disease; previously only one dose was required)

Note: New students entering grades other than 7th grade are not required to have Tdap.

College Immunization Requirements

TDH has immunization requirements for individuals who attend college. Requirements are established in TDH Health Rules. A brief summary of the required immunizations for colleges is listed in the TN Immunization Requirements Summary Table.

Full-time Tennessee college students

Requirements include:

• Measles, Mumps, Rubella (2 doses of each, normally given together as MMR) — if born on or after January 1, 1957
• Varicella (2 doses or credible history of disease) — if born on or after January 1, 1980
• Hepatitis B (HBV) — for health science students expected to have patient contact (before patient contact begins)
• Meningococcal — at minimum, 1 dose at age 16 or older if enrolling in a public institution for the first time, under age 22, and living in on-campus housing (private institutions set their own requirements for this vaccine)

Official Immunization Certificate

The Official Immunization Certificate is available through local health departments using the Tennessee Immunization Information System (TennIIS). The certificate may also be available at many medical offices in Tennessee.

Detailed guidance for health care providers on the rules and certificate is available through TennIIS. Tennessee health care providers who administer vaccines can register as authorized TennIIS users to access and download certificate forms.

Immunization Certificate Validation Tool (ICVT)

Through the Tennessee Immunization Information System (TennIIS), authorized users can access the Immunization Certificate Validation Tool (ICVT) to print validated Official Immunization Certificates for children. The tool compares a child’s record in the state immunization registry against Tennessee immunization requirements for pre-school and school attendance.

The ICVT can produce:

• An Official TN Immunization Certificate that does not require a health care provider signature when complete records are available
• Validation failure reports for children with incomplete records
• Temporary certificates for children who are as up-to-date as possible
• TN Immunization Certificate Sample

When to Use the ICVT

The ICVT may be used each time an Official TN Immunization Certificate is required, including:

• At child care enrollment, or when a child is 18 months or older and has completed required child care vaccines
• At kindergarten enrollment
• When a child enrolls in a Tennessee school for the first time in a grade other than kindergarten
• When all students enter 7th grade (Tdap booster and a second varicella dose are required if the student has not had chickenpox)

If a Record Does Not Meet Requirements

If a record does not meet Tennessee requirements, the tool produces a failure report showing which required vaccines are still needed. The tool may also produce a temporary certificate for a child who has not completed required immunizations but is as up-to-date as possible.

• Temporary certificates expire one month after the date the next catch-up immunization is due.
• The ICVT does not produce certificates for children with medical or religious exemptions.

All authorized TennIIS users may use the ICVT to print validated Official Immunization Certificates, validation failure reports, and temporary certificates.

Exemptions

According to T.C.A. § 49-6-5001, a parent or guardian may file with school authorities a signed, written statement that immunization or other preventive measures conflict with the parent’s or guardian’s religious tenets and practices, affirmed under penalties of perjury.

TDH does not track or grant exemptions. Contact your school or school district for local exemption procedures and documentation requirements.

Minimum Ages, Dose Intervals, and Valid Doses

Tennessee follows published CDC guidelines for minimum ages and dose intervals.

• Doses are considered valid if given up to 4 days before the minimum age or minimum interval.
• Doses given more than 4 days early are considered invalid and should be repeated as recommended.

Live Vaccine Spacing

Injectable or nasally administered live vaccines not given on the same day should be administered at least 4 weeks apart.

• The 4-day grace period does not apply to the 28-day interval between live vaccines given at different visits.
• If live vaccines are separated by less than 4 weeks, the second dose is not valid and should be repeated at least 4 weeks after the invalid dose.

Alternative Proof of Immunity

Alternative proof of immunity may be accepted for certain diseases:

• Positive serology (with year of test documented) may be used for measles, mumps, rubella, hepatitis A, hepatitis B, or varicella.
• For varicella, documentation of provider-diagnosed disease (year) or provider-verified credible history from a parent/guardian (year) is also acceptable.

Immunization Schedules

External link and accessibility notice: The link below goes to a website outside TDH. TDH does not control the content, privacy policies, or accessibility of external sites.

CDC Immunization Schedules (CDC)

Tennessee Immunization Information System (TennIIS)

The Tennessee Immunization Information System (TennIIS) is Tennessee’s statewide Immunization Information System (IIS). It was developed by the Tennessee Department of Health (TDH) to serve as a single source of immunization records for Tennessee residents of all ages.

External link and accessibility notice: Some links on this page take you to websites outside the Tennessee Department of Health (TDH). TDH does not control the content, privacy policies, or accessibility of external sites.

Who Uses TennIIS

Authorized TennIIS users may include:

• Health care providers
• Pharmacists
• School and child care (daycare) administrators

What You Can Do in TennIIS

Immunization Certificate Validation Tool (ICVT)

Authorized users can access the Immunization Certificate Validation Tool (ICVT) to print:

• Validated Official TN Immunization Certificates for children with complete records
• Validation failure reports for children with incomplete records
• Temporary certificates for children who are as up-to-date as possible

ICVT compares a child’s record in the state immunization registry against Tennessee immunization requirements for pre-school or school attendance.

• TN Immunization Certificate Sample

Vaccine Ordering Management System (VOMS)

TennIIS also serves as the Vaccine Ordering Management System (VOMS) for the Vaccines for Children (VFC) Program.

Register a Facility or Become a User

To register a facility in TennIIS, complete the online TennIIS Facility Registration Application located on the TennIIS homepage.

TN Immunization Record Request

TN Immunization Registry (TennIIS)

TennIIS is a statewide online immunization registry where immunization records may be recorded for people of all ages.

Tennessee law authorizes access to immunization information by health care professionals and pharmacists, as well as school and child care personnel responsible for ensuring children meet immunization requirements for participation in school or child care. Only legally authorized users who register and are approved by TDH staff may be granted secure access to TennIIS.

Important information about completeness of records: Not all immunization providers choose to record immunizations in TennIIS. Records in TennIIS are only as complete as the information reported by immunization providers.

Paper immunization records can be entered into TennIIS by your local Tennessee health department or by any medical office with TennIIS access.

TennIIS Immunization Record Request (Not an Official Certificate)

Upon request, the Vaccine-Preventable Diseases and Immunization Program (VPDIP) can provide a copy of an individual’s immunization record in TennIIS. This record lists vaccinations that have been reported to TennIIS. It is not an Official TN Immunization Certificate.

An Official TN Immunization Certificate is required for child care centers, preschools, and schools to meet attendance requirements for child care through 12th grade. Certificates are available at your local Tennessee health department and at medical offices with TennIIS access. 

TennIIS Resources

• TennIIS Brochure
• TennIIS – Frequently Asked Questions (FAQ)

TDH Declaration of Readiness for Public Health Reporting

As of January 1, 2023, TDH is declaring readiness for specific Public Health Reporting objectives and measures. Promoting Interoperability and Merit-Based Incentive Payment System (MIPS) participants should check periodically for updates to TDH’s declaration of readiness to receive data from Certified Electronic Health Record Technology (CEHRT).

For questions related to the TDH Declaration of Readiness, contact the TDH Meaningful Use Coordinator:

• Phone: (615) 253-8945
• Email: MU.Health@tn.gov

TDH is currently accepting immunization data from Eligible Professionals (EPs), Eligible Hospitals (EHs), and Critical Access Hospitals (CAHs).

Electronic Data Exchange (EDE) with TennIIS

The Tennessee Vaccine-Preventable Diseases and Immunization Program (VPDIP) invites Tennessee health care providers, pharmacies, and other immunizing partners to exchange immunization data electronically with TennIIS through your EHR.

Become an Electronic Trading Partner (ETP)

To become an electronic trading partner and exchange data electronically with TennIIS, submit the Welcome Packet to the TennIIS Data Exchange Team at TennIIS.MU@tn.gov.

Welcome Packet attachments:

• Organization Contact Information
• Facility Contact Information
• Vendor Contact and Messaging Transport Information

Onboarding Resources

• Roadmap to TennIIS
• On-boarding Fact Sheet and Checklist
• Roles and Responsibilities
• Vendor Qualifications Chart

Technical Specifications and Agreement

• 2.5.1 QBP and RSP Technical Specifications for TennIIS
• 2.5.1 VXU and ACK Technical Specifications for TennIIS
• Immunization Trading Partner Agreement (TPA)

Trading Partner Registration (TPR)

To satisfy TDH requirements for Public Health Reporting using Certified Electronic Health Record Technology (CEHRT), potential trading partners must first register their intent to exchange data through Trading Partner Registration (TPR). After registering in TPR, contact TennIIS.MU@tn.gov to initiate onboarding.

Important: You must register as a parent organization, and register each location as a facility.

Meaningful Use Background

CMS has specified three components for demonstrating Meaningful Use under the Medicare and Medicaid EHR Incentive Program:

1. Use of certified EHR technology in a meaningful manner (for example, electronic prescribing)
2. Use of certified EHR technology for the electronic exchange of health information to improve quality of health care
3. Use of certified EHR technology to report clinical quality measures (CQMs) and other measures selected by the U.S. Department of Health and Human Services (HHS)

Definitions

Eligible Professionals (EPs)

Professionals described in 42 CFR § 495.304(b) eligible to participate in the EHR Provider Incentive Program, including:

• Physicians (medical and osteopathic)
• Dentists
• Nurse practitioners
• Certified nurse midwives
• Physician assistants (PAs) who practice in an FQHC led by a PA, or in an RHC led by a PA

Eligible Hospitals (EHs)

Hospitals described in 42 CFR § 495.304(a), including:

• Acute care hospitals
• Critical access hospitals (CAHs)
• Children’s hospitals

Eligible Clinicians (ECs)

You may be part of the Quality Payment Program if you are in an Advanced APM, or if you bill Medicare more than $30,000 annually and provide care for more than 100 Medicare patients annually. For MIPS, eligible clinician types include:

• Physician
• Nurse practitioner
• Physician assistant
• Clinical nurse specialist
• Certified registered nurse anesthetist

NPI (National Provider Identifier)

External link and accessibility notice: The following link will take you to a website outside the Tennessee Department of Health (TDH). TDH does not control the content, privacy policies, or accessibility of external sites.

Search for your NPI

HL7

Health Level Seven (HL7) is a health care interoperability standard for the exchange, integration, sharing, and retrieval of electronic health information.

• HL7 messaging standard versions: 2.5.1 (uni-directional or bi-directional)

Diseases & Vaccines

Find information about vaccine-preventable diseases (VPDs), viral respiratory diseases, and vaccine resources. Select a topic below to go to the related page on this site.

Vaccine-Preventable Diseases

Select a disease to learn about symptoms, prevention, reporting, and vaccine recommendations.

Hepatitis and Perinatal Hepatitis B

Hepatitis A (Overview)

What it is: Hepatitis A is an inflammation of the liver caused by a virus. Anyone can get hepatitis A, but it occurs more frequently in children and young adults.

Incubation period and contagious period: Symptoms usually begin 15–50 days after exposure. An infected person can spread the virus 1–2 weeks before symptoms appear and up to 1 week after jaundice begins.

Symptoms: Symptoms may start suddenly and can include fever, fatigue, loss of appetite, nausea, vomiting, and abdominal pain. Some people may also have dark urine, light-colored stool, and jaundice (yellowing of the skin or whites of the eyes). Illness may range from mild (1–2 weeks) to more severe (4–6 weeks). Infants and young children often have mild symptoms. Some people may have no symptoms but can still spread the virus.

How it spreads: Hepatitis A spreads when the virus is swallowed after contact with microscopic stool contamination (often through unwashed hands, contaminated food, or contaminated objects). Spread can occur easily in households and child care settings. The virus is not airborne, but it can survive on contaminated objects for up to one month.

Treatment: There is no specific medicine that cures hepatitis A once symptoms begin. Care may include rest, fluids, and avoiding alcohol and non-essential medications. Medical care may be needed for vomiting or dehydration.

Prevention: The hepatitis A vaccine is the best protection. Frequent, thorough handwashing and good sanitation are also important.

If exposed: Immune globulin may help prevent illness if given within two weeks of exposure. Protection is temporary (about three months) and may cause only mild soreness at the injection site.

Attribution: Information courtesy of the Memphis–Shelby County Health Department.

For health care providers, laboratories, and public health professionals: Select the links below for additional guidance on hepatitis B conditions and reporting through the Tennessee Department of Health Reportable Diseases pages.

Meningococcal Disease (Meningococcal Meningitis)

What it is: Meningitis is inflammation of the tissues and fluid surrounding the brain and spinal cord. It can be caused by bacteria or viruses. Meningococcal meningitis is bacterial meningitis caused by Neisseria meningitidis and can also cause bloodstream infection (septicemia). Common strains in the U.S. include B, C, Y, and W.

Symptoms: Symptoms can include fever, sudden severe headache, stiff neck, rash, nausea, and vomiting. Seek medical care right away if you have two or more of these symptoms.

How it spreads: Meningococcal bacteria spread through exchange of respiratory droplets or saliva (for example: kissing, coughing, sneezing, sharing drinks/utensils/cigarettes). It is not spread by casual contact or simply being in the same room. Close contacts may be given antibiotics as a precaution.

How serious it is: Meningococcal meningitis can progress quickly and may cause severe outcomes, including long-term disability or death.

Incubation period: Illness typically develops in 2–7 days (often less than 4).

Vaccine: Vaccination can reduce the risk of certain types of meningococcal disease, but it does not eliminate risk. Protection can last 3–5 years.

For health care providers, laboratories, and public health professionals: Select the link below for additional guidance on this disease and other reportable conditions on the Tennessee Department of Health Reportable Diseases page.

Smallpox

What it is: Smallpox is a serious disease caused by the variola virus. It caused severe illness, disfigurement, and often death before it was declared eradicated worldwide in 1980. Although naturally occurring smallpox has been eliminated, it remains a concern because of the potential for deliberate release.

How it spreads: Smallpox spreads person to person through infected respiratory droplets. People are most contagious during the first week of illness, when virus levels are highest in the throat. Some risk of spread continues until all scabs have fallen off. Contaminated clothing and bed linens can also spread the virus.

Symptoms: After an incubation period of about 12–14 days, symptoms may include high fever, fatigue, headache, and backache. Severe abdominal pain and delirium can occur. A rash typically appears within 2–3 days, starting in the mouth and throat, then spreading to the face and forearms, and later the trunk and legs. Within 5–7 days, the rash may become pus-filled lesions that later crust into scabs.

Treatment: There is no proven curative treatment for smallpox. Care is supportive (for example, IV fluids, medications for fever or pain, and antibiotics for secondary bacterial infections).

Vaccine: Vaccination can prevent illness or reduce severity if given within 3–4 days after exposure. Routine smallpox vaccination ended in 1972, and protection from vaccination received before then is uncertain.

Who should not be vaccinated (non-emergency): People with certain skin conditions (especially eczema/atopic dermatitis), weakened immune systems, pregnancy, or certain allergies should not receive smallpox vaccine unless directed as part of an emergency response. Smallpox vaccination is not recommended for people under 18 in non-emergency situations.

For more information: Contact the Tennessee Department of Health at (615) 741-7247.

For health care providers, laboratories, and public health professionals: Select the link below for additional guidance on this disease and other reportable conditions on the Tennessee Department of Health Reportable Diseases page.

External link and accessibility notice: The resources below are on CDC webpages outside TDH. TDH does not control the content, privacy policies, or accessibility of external sites.

CDC Public Response Hotline

• 1-888-246-2675 (English)
• 1-888-246-2857 (Español)
• 1-866-874-2646 (TTY)

CDC Smallpox Resources

Vaccine Information

Frequently Asked Questions (FAQ)

Who Should Not Be Vaccinated

Reactions After Smallpox Vaccination

Respiratory Viral Illness

When viruses attack the respiratory system, they can cause illness. Respiratory viral illnesses include the common cold, coronaviruses, influenza, and respiratory syncytial virus (RSV). These illnesses often share similar symptoms, risk factors, and prevention strategies. This section includes information and resources to help Tennesseans reduce the risk of severe respiratory viral illness.

Prevention and Preparedness

Stay up to date with immunizations: Immunizations are available from health care providers and local health departments for COVID-19, flu, and RSV. Vaccines help your body prepare to fight viruses and are a safe and effective way to protect you and your family.

Practice good hygiene:

• Wash hands often and use proper handwashing techniques.
• Clean surfaces frequently with soap or detergent to remove germs and dirt.
• Cover coughs and sneezes to limit the spread of germs and protect others.

Some practices (such as nasal rinsing) may be helpful. If you choose to do nasal rinsing, use distilled, sterile, or boiled water. If tap water is the only option, boil it for 1–3 minutes, allow it to cool, and follow product directions. Talk with your health care provider about whether nasal rinsing is safe for you.

Steps for cleaner air:

• Bring in fresh air by opening doors/windows and/or using exhaust fans.
• If you have central HVAC, set the fan to “on” (instead of “auto”) when you have visitors and use a pleated filter. Change filters about every 3 months or as directed.
• Use a portable HEPA air cleaner.
• Move activities outdoors when possible.

When You’re Sick

Stay home and away from others (including people you live with who are not sick) if you have symptoms that are not explained by another cause. Symptoms can include fever, chills, fatigue, cough, runny nose, and headache, among others.

You can return to normal activities when:

• Symptoms are improving, and
• You have been fever-free for at least 24 hours without using fever-reducing medication.

For the next 5 days after returning to normal activities, take extra precautions when you will be around other people indoors. Additional prevention strategies may include masking, distancing, and testing.

Treatment

Plan with a health care provider about accessing treatment before you might need it.

External link and accessibility notice: The treatment locator below is on a website outside TDH. TDH does not control the content, privacy policies, or accessibility of external sites.

ASPR Treatment Locator (to find locations that have medications in stock to treat COVID-19 or influenza)

Follow treatment guidance from a health care provider and take medications only as prescribed.

External link and accessibility notice: The resources below are on CDC webpages outside TDH. TDH does not control the content, privacy policies, or accessibility of external sites.

More Resources

Find out if respiratory viruses are causing a lot of illness in your community

Learn more about risk factors for severe illness from respiratory viruses

CDC respiratory virus guidance

Resources for Health Care Facilities and Public Health

• Respiratory Viral Illness Frequently Asked Questions (RVI FAQs) (PDF)
• Respiratory Disease Outbreak Investigation Toolkit (PDF)

Learn More

Learn more about respiratory viral illness prevention and guidance on the Respiratory Viral Illness Information and Prevention page.

Influenza (Flu)

Influenza (flu) is a contagious respiratory illness that can lead to mild to severe disease and is monitored in Tennessee through ongoing public health surveillance.

For health care providers, laboratories, and public health professionals: Select the links below for additional guidance on influenza-related reporting and other reportable conditions on the Tennessee Department of Health Reportable Diseases pages.

Tennessee’s Weekly Flu Reports

The Tennessee Department of Health conducts year-round influenza surveillance and publishes a weekly flu report summarizing influenza activity across the state.

New reports are available each Friday and contain data from the prior week.

2026 Archives

External link and accessibility notice: The link below takes you to a website outside TDH. TDH does not control the content, privacy policies, or accessibility of external sites.

CDC Weekly Flu Reports

Find a Flu Vaccine

Coronavirus Disease (COVID-19)

Reporting requirements (effective January 1, 2025): Health care providers and laboratories are no longer required to report COVID-19 test results. Health care providers must continue to report:

• COVID-19–associated deaths in persons under 18 years old, and
• Any suspected outbreaks of COVID-19.

This change is part of annual updates to the Tennessee List of Reportable Diseases and Conditions and aligns with Tennessee’s move toward pan-respiratory surveillance and response.

COVID-19 data availability: COVID-19 laboratory and illness data from 2020–2024 will remain available online. Updates to COVID-19 dashboards ended after January 15, 2025, and PDF reports of these dashboards will be made available. Downloadable datasets were consolidated and made available in mid-January. If additional data are needed, they can be requested through the TDH data request process.

Final COVID-19 Dashboards (data through January 11, 2025)

Critical Indicator Report

COVID-19 Epidemic Curves

COVID-19 Summary Report

COVID-19 County Reports

COVID-19 Health Disparities

COVID-19 in Children

Multi-System Inflammatory Syndrome in Children (MIS-C)

Download Summary COVID-19 Data (2020–2024)

Data Dictionary - (dataset documentation)

Statewide Cases and Outcomes by Age -  (weekly cases, hospitalizations, and deaths by 10-year age groups)

Statewide Cases and Outcomes by Race, Ethnicity, and Sex -  (weekly cases by race, ethnicity, and sex)

County Cases -  (weekly cases, hospitalizations, and deaths by county)

COVID-19 Annual Reports (2020–2022)

2020 COVID-19 Annual Report

2021 COVID-19 Annual Report

2022 COVID-19 Annual Report

COVID-19 Pediatric Deaths

• COVID Pediatric Deaths Case Definition (PDF)

Vaccine Information

External link and accessibility notice: The CDC links below take you to websites outside TDH. TDH does not control the content, privacy policies, or accessibility of external sites.

CDC: Stay Up to Date on COVID-19 Vaccines

CDC: COVID-19 Vaccine FAQs

Find a COVID-19 Vaccine