Children are required to have immunizations for 11 different diseases when attending public school in Tennessee.

Doctors fill out a form in Tennessee's Immunization Information System or TennIIS.

Amanda Goodhard is the Public Information Officer for the Southeast region of the Tennessee Department of Health.

She said TennIIS is an online database used by doctors and school systems in Tennessee to track immunizations.

"We do audits on those occasionally to make sure everyone is in compliance. And if we do see that a child isn't caught up, we make sure we do everything we can to catch them up," she added.

In the system, students are classified under four categories: Fully Immunized, Religious Exemption, Medical Exemption, or Temporary Certificate (meaning they are in the process of receiving immunizations).

The state allows a student to be exempt from having the required vaccinations for religious and medical reasons.

Goodhard said that discussion happens in the doctor's office.

"There are different reasons why a child may not be able to receive a certain vaccine. We typically see seizure disorders or immune disorders as the most common reason. But it's different for each vaccine," she added.

Channel 3 checked Tennessee's Kindergarten Immunization Compliance Assessment for the 2017-2018 school year.

We found Etowah City (6%), Bradley County (3.1%) and (Cleveland City (2%) schools topped the list with the highest percentages of exemptions.

Fifty kindergarteners used exemptions (48- religious, 2- medical) in Hamilton County, which comes out to 1.4%.

"We use TennIIS from the state level to let us know what the situation is with immunizations," Tim Hensley with Hamilton County Schools said.

If using a religious exemption, some school systems may require a document from a person's church.

By law, schools and public health officials are not allowed to question a person's religious beliefs.

With the Centers for Disease Control reporting more than 100 cases of measles in the United States since January 1, 2019, including three in Atlanta, it's a situation school and public health officials are monitoring closely.

"We do encourage as many people as possible to get vaccinated because there are children who cannot, for medical reasons, receive vaccinations. To keep that herd immunity and the community strong, we really encourage people that can to get their vaccinations so we can protect those children," Goodhard said.

To learn more about Tennessee vaccination requirements, click HERE.