California passed Senate Bill 277 in 2015, eliminating nonmedical exemptions to school immunization requirements. California elementary school personnel who worked with parents on meeting school immunization requirements were surveyed in 2022. Of the 122 survey respondents, half (50 %) were school principals, 11 % were registrars, 9 % were health clerks, and 7 % were nurses. Only one-quarter (26 %) believed their school had authority to deny medical exemptions. Almost half supported COVID-19 vaccine mandates for children in elementary (43 %), middle (44 %), and high (49 %) schools. Almost half (42 %) were concerned that children's immune systems could be weakened by too many shots, and nearly one-third thought immunizations do more harm than good (32 %). Among our sample of California schools, many personnel working with parents on meeting immunization requirements were not clinically trained, were unaware of their responsibility to deny invalid medical exemptions, and had vaccine concerns. Vaccine education for school personnel and further involvement of school nurses in the implementation and enforcement of school immunization requirements could have a positive impact on vaccine coverage and disease prevention.