Religious Exemptions from Mandatory Vaccinations

All states require children to be immunized or to be in the process of receiving immunizations against certain contagious diseases before a child care facility or a school may admit them. For each state, the immunization schedule may be found in the state code or its administrative regulations, usually in the sections governing education (for schools) or public health (for child care facilities). Besides specific vaccine requirements, these schedules may also refer to the schedules provided by the United States Department of Health and Human Services, American Academy of Family Physicians, or American Academy of Pediatrics.

Where states significantly differ is in their recognition of exemptions from vaccination. All states grant a medical exemption to children who cannot be immunized for health reasons. For example, the administration of a vaccine may be contraindicated in children who are allergic to a component of the vaccine or have a suppressed immune system. These exemptions are specific to the vaccine and health condition, and remain so long as the contraindication lasts.

Additionally, 48 states and the District of Columbia permit parents to claim a non-scientific exemption, such as if their religious tenets or practices conflict with immunization or if their personal, philosophical or moral beliefs are opposed to immunization. The lone holdouts are Mississippi and West Virginia. However, in the event of an outbreak, child care facilities and schools may exclude children who have not been vaccinated against the disease until the end of the outbreak.

Verdict offers some insightful analysis into the issue of religious exemptions:

• How to Craft a Religious Exemption Regime Guaranteed to Be Dangerous for Children:
  The Case of Idaho. By Professor Marci A. Hamilton.
• The Deep Roots of the Left/Right Anti-Vaxxer Coalition. By Professor Michael C. Dorf.
• The Vaccine for Pollyanna Attitudes Toward Public Health and Religious Beliefs:
  Religious Exemptions for Vaccinations and Medical Neglect Need to Be Repealed Now and the Federal Government (and the Insurance Industry) Need to Incentivize the States to Do So. By Professor Marci A. Hamilton.

Below, you will find links to state codes, statutes and regulations governing the immunization of children who attend day care, child care, elementary schools, private schools and colleges.

Alabama School Immunization Law – AL Code § 16-30-1

• Medical Exemption: Certification by a competent medical authority providing individual exemption from the required immunization or testing is presented the admissions officer of the school.
• Religious Exemption: In the absence of an epidemic or immediate threat thereof, the parent or guardian of the child shall object thereto in writing on grounds that such immunization or testing conflicts with his religious tenets and practices.

Alabama School Immunization Regulations – Ala. Admin Code, Regulation 420-6-1

• Religious Exemption: A written objection from the parent or guardian of a student or child based on religious tenets and practices shall be submitted in person by the parent or guardian to the County Health Department for issuance of a Certificate of Religious Exemption from the required immunizations or testing.
• Medical Exemption: A written objection from the parent or guardian of a student or child based on religious tenets and practices shall be submitted in person by the parent or guardian to the County Health Department for issuance of a Certificate of Religious Exemption from the required immunizations or testing.

Alaska School Immunization Law – 4 AAC 06.055

• Medical Exemption: This section does not apply if the child has a statement signed by a doctor of medicine (M.D.), doctor of osteopathy (D.O.), physician assistant, or advanced nurse practitioner licensed to practice in this state, stating that immunizations would, in that individual’s professional opinion, be injurious to the health of the child or members of the child’s family or household.
• Religious Exemption: This section does not apply if the child has an affidavit signed by his parent or guardian affirming that immunization conflicts with the tenets and practices of the church or religious denomination of which the applicant is a member.

Arizona Child Care Immunization Law – AZ Rev Stat § 36-883

• Religious Belief Exemption: Any rule that relates to educational activities, physical examination, medical treatment or immunization shall include appropriate exemptions for children whose parents object on the ground that it conflicts with the tenets and practices of a recognized church or religious denomination of which the parent or child is an adherent or member.

Arizona School Immunization Law – AZ Rev Stat § 15-872

• Medical Exemption: The school administrator receives written certification that is signed by the parent or guardian and by a physician or a registered nurse practitioner, that states that one or more of the required immunizations may be detrimental to the pupil’s health and that indicates the specific nature and probable duration of the medical condition or circumstance that precludes immunization.
• Personal Belief Exemption: The parent or guardian of the pupil submits a signed statement to the school administrator stating that the parent or guardian has received information about immunizations provided by the department of health services and understands the risks and benefits of immunizations and the potential risks of nonimmunization and that due to personal beliefs, the parent or guardian does not consent to the immunization of the pupil.

Arizona Child Care and School Immunization Regulations – Ariz. Admin. Code R9-6-701

Arizona Child Care Immunization Regulations – Ariz. Admin. Code R9-5-305

Arkansas School Immunization Law – AR Code § 6-18-702

• Medical Exemption: If in the discretion of the health authority having jurisdiction or of any physician licensed to practice by the Arkansas State Medical Board any person to whom this section applies shall be deemed to have a physical disability that may contraindicate vaccination, a certificate to that effect issued by the health officer may be accepted in lieu of a certificate of vaccination, provided that the exemption shall not apply when the disability shall have been removed.
• Religious or Philosophical Beliefs Exemption: This section shall not apply if the parents or legal guardian of that child object thereto on the grounds that immunization conflicts with the religious or philosophical beliefs of the parent or guardian.

California School Immunization Law – CA Health & Safety Code § 120325

• Medical Exemption: If the parent or guardian files with the governing authority a written statement by a licensed physician to the effect that the physical condition of the child is such, or medical circumstances relating to the child are such, that immunization is not considered safe, indicating the specific nature and probable duration of the medical condition or circumstances that contraindicate immunization, that person shall be exempt from the requirements of Chapter 1 (commencing with Section 120325, but excluding Section 120380) and Sections 120400, 120405, 120410, and 120415 to the extent indicated by the physician’s statement.
• Personal Belief Exemption. Immunization of a person shall not be required for admission to a school or other institution listed in Section 120335 if the parent or guardian or adult who has assumed responsibility for his or her care and custody in the case of a minor, or the person seeking admission if an emancipated minor, files with the governing authority a letter or affidavit that documents which immunizations required by Section 120355 have been given and which immunizations have not been given on the basis that they are contrary to his or her beliefs.

California College Immunization Law – CA Health & Safety Code § 120390.5

• Medical Exemption: If a person seeking enrollment in an institution of higher education to which subdivision (a) is applicable, or the parent or guardian of a person seeking enrollment, files with the governing body a written statement by a physician and surgeon that the physical condition of the person or medical circumstances relating to the person are such that immunization is not considered safe, indicating the specific nature and probable duration of the medical condition or circumstances that contraindicate immunization, that person shall be exempt from the requirements of subdivision (a).
• Personal Belief Exemption: Immunization of a person shall not be required for admission to an institution of higher education to which subdivision (a) is applicable if any of the following persons files with the governing body of the educational institution a letter or affidavit stating that the immunization is contrary to the beliefs of either of the following: (1) The parent, guardian, or adult who has assumed responsibility for the care and custody of the person seeking admission, if that applicant is a minor who is not emancipated or who is 17 years of age or younger. (2) The person seeking admission, if that applicant is an emancipated minor or is 18 years of age.

Colorado School Immunization Law – CO Rev. Stat. § 25-4-901

Colorado College Immunization Law – CO Rev. Stat. § 25-4-902.5

• Medical Exemption: By submitting to the student’s school certification from a licensed physician or advanced practice nurse that the physical condition of the student is such that one or more specified immunizations would endanger his or her life or health or is medically contraindicated due to other medical conditions.
• Religious or Personal Belief Exemption: By submitting to the student’s school a statement of exemption signed by one parent or guardian or the emancipated student or student eighteen years of age or older that the parent, guardian, or student is an adherent to a religious belief whose teachings are opposed to immunizations or that the parent or guardian or the emancipated student or student eighteen years of age or older has a personal belief that is opposed to immunizations.

Colorado Immunization Regulations – 6 CCR 1009-2

• Medical Exemption: By submitting to the student’s school a Certificate of Immunization with the statement of medical exemption signed by an advanced practice nurse or physician licensed to practice medicine or osteopathic medicine in any state or territory of the United States indicating that the physical condition of the student is such that immunizations would endanger his/her life or health or is medically contraindicated due to other medical conditions.
• Religious Exemption: By submitting to the student’s school a Certificate of Immunization with the statement of religious exemption signed by the parent(s) or the emancipated student indicating that the parent(s) or emancipated student is an adherent to a religious belief whose teachings are opposed to immunizations.
• Personal Belief Exemption: By submitting to the student’s school a Certificate of Immunization with the statement of personal exemption signed by the parent(s) or the emancipated student indicating that the parent(s) or emancipated student has a personal belief that is opposed to immunizations.

Connecticut School Immunization Law – CT Gen Stat § 10-204a

• Medical Exemption: Any such child who presents a certificate from a physician, physician assistant or advanced practice registered nurse stating that in the opinion of such physician, physician assistant or advanced practice registered nurse such immunization is medically contraindicated because of the physical condition of such child shall be exempt from the appropriate provisions of this section.
• Religious Belief Exemption: Any such child who presents a statement from the parents or guardian of such child that such immunization would be contrary to the religious beliefs of such child shall be exempt from the appropriate provisions of this section.

Connecticut Child Care Immunization Law – CT Gen Stat § 19a-79

• Medical and Religious Belief Exemption: Including appropriate exemptions for children for whom such immunization is medically contraindicated and for children whose parents object to such immunization on religious grounds.

Connecticut College Immunization Law – CT Gen Stat § 10a-155

• Medical Exemption: Any such student who (1) presents a certificate from a physician or an advanced practice registered nurse stating that in the opinion of such physician or advanced practice registered nurse such immunization is medically contraindicated, shall be exempt from the appropriate provisions of this section.
• Religious Belief Exemption: Any such student who provides a statement that such immunization would be contrary to his religious beliefs shall be exempt from the appropriate provisions of this section.

Delaware School Immunization Law – 2 DE Code § 131

• Medical Exemption: Provision for exemption from any or all of the immunization program prescribed for a particular enrollee upon a written statement from a physician, i.e., medical doctor or doctor of osteopathy, stating that the enrollee should not receive the prescribed immunization or immunizations required in the basic series because of the reasonable certainty of a reaction detrimental to that person.
• Religious Belief Exemption. Provision for exemption from the immunization program for an enrollee whose parents or legal guardian, because of individual religious beliefs, reject the concept of immunization.

Delaware Child Care Immunization Law – 16 DE Admin. Code 4202

• Medical Exemption: Immunization requirements pursuant to sections 7.1.1 – 7.1.2 shall be waived for children whose physicians have submitted, in writing, that a specific immunizing agent would be detrimental to that child
• Religious Belief Exemption: Immunization requirements pursuant to sections 7.1.1 – 7.1.2 shall be waived for children whose parents or guardians present a notarized document that immunization is against their religious beliefs.

District of Columbia School Immunization Law – DC Code § 38-501

• Medical Exemption: No certification of immunization shall be required for the admission to a school of a student for whom the school has written certification by a private physician, his or her representative, or the public health authorities that immunization is medically inadvisable.
• Religious Belief Exemption: No certification of immunization shall be required for the admission to a school of a student for whom the responsible person objects in good faith and in writing, to the chief official of the school, that immunization would violate his or her religious beliefs.

Florida School Immunization Law – FL Stat § 1003.22

• Medical Exemption: A physician licensed under the provisions of chapter 458 or chapter 459 certifies in writing, on a form approved and provided by the Department of Health, that the child should be permanently exempt from the required immunization for medical reasons stated in writing, based upon valid clinical reasoning or evidence, demonstrating the need for the permanent exemption.
• Religious Belief Exemption: The provisions of this section shall not apply if the parent of the child objects in writing that the administration of immunizing agents conflicts with his or her religious tenets or practices.

Florida Child Care Immunization Law – FL Stat § 402.305

Florida College Immunization Law – FL Stat § 1006.69

• Exemption: An individual enrolled in a postsecondary educational institution who will be residing in on-campus housing shall provide documentation of vaccinations against meningococcal meningitis and hepatitis B unless the individual, if the individual is 18 years of age or older, or the individual’s parent, if the individual is a minor, declines the vaccinations by signing a separate waiver for each of these vaccines, provided by the institution, acknowledging receipt and review of the information provided.

Georgia School Immunization Law – O.C.G.A. 20-2-771

• Medical Exemption: If, after examination by the local board of health or any physician licensed under the laws of this state or of any other state having comparable laws governing the licensure of physicians, any child to whom this Code section applies is found to have any physical disability which may make vaccination undesirable, a certificate to that effect issued by the local board of health or such physician licensed under the laws of this or such other state may be accepted in lieu of a certificate of immunization and shall exempt the child from the requirement of obtaining a certificate of immunization until the disability is relieved.
• Religious Belief Exemption: This Code section shall not apply to a child whose parent or legal guardian objects to immunization of the child on the grounds that the immunization conflicts with the religious beliefs of the parent or guardian; however, the immunization may be required in cases when such disease is in epidemic stages. For a child to be exempt from immunization on religious grounds, the parent or guardian must first furnish the responsible official of the school or facility an affidavit in which the parent or guardian swears or affirms that the immunization required conflicts with the religious beliefs of the parent or guardian.

Georgia College Immunization Law – O.C.G.A. 31-12-3.2

Hawaii School Immunization Law – HI Rev Stat § 302A-1154

• Medical Exemption: A child may be exempted from the required immunizations if a licensed physician or physician assistant certifies that the physical condition of the child is such that immunizations would endanger the child’s life or health.
• Religious Belief Exemption: A child may be exempted from the required immunizations if any parent, custodian, guardian, or any other person in loco parentis to a child objects to immunization in writing on the grounds that the immunization conflicts with that person’s bona fide religious tenets and practices. Upon showing the appropriate school official satisfactory evidence of the exemption, no certificate or other evidence of immunization shall be required for entry into school.

Hawaii Immunization Law – HI Rev Stat § 325-32

• Medical Exemption: Section 325-32 shall be construed not to require the vaccination or immunization of any person for three months after a duly licensed physician, physician assistant, or an authorized representative of the department of health has signed two copies of a certificate stating the name and address of the person and that because of a stated cause the health of the person would be endangered by the vaccination or immunization, and has forwarded the original copy of the certificate to the person or, if the person is a minor or under guardianship, to the person’s parent or guardian, and has forwarded the duplicate copy of the certificate to the department for its files.
• Religious Belief Exemption: No person shall be subjected to vaccination, revaccination or immunization, who shall in writing object thereto on the grounds that the requirements are not in accordance with the religious tenets of an established church of which the person is a member or adherent, or, if the person is a minor or under guardianship, whose parent or guardian shall in writing object thereto on such grounds, but no objection shall be recognized when, in the opinion of the director of health, there is danger of an epidemic from any communicable disease.

Idaho School Immunization Law – ID Code § 39-4801

• Medical Exemption: Any minor child whose parent or guardian has submitted to school officials a certificate signed by a physician licensed by the state board of medicine stating that the physical condition of the child is such that all or any of the required immunizations would endanger the life or health of the child shall be exempt from the provisions of this chapter.
• Religious or Other Belief Exemption: Any minor child whose parent or guardian has submitted a signed statement to school officials stating their objections on religious or other grounds shall be exempt from the provisions of this chapter.

Idaho Child Care Immunization Law – ID Code § 39-1118

• Medical Exemption: Any minor child whose parent or guardian has submitted to officials of a licensed daycare facility a certificate signed by a physician licensed by the state board of medicine stating that the physical condition of the child is such that all or any of the required immunizations would endanger the life or health of the child shall be exempt from the provisions of this section.
• Religious or Other Belief Exemption: Any minor child whose parent or guardian has submitted a signed statement to officials of the daycare facility stating their objections on religious or other grounds shall be exempt from the provisions of this section.

Illinois School Immunization Law – 105 ILCS 5/27-8.1

• Medical Exemption: If the physical condition of the child is such that any one or more of the immunizing agents should not be administered, the examining physician, advanced practice nurse, or physician assistant responsible for the performance of the health examination shall endorse that fact upon the health examination form.
• Religious Belief Exemption: Parents or legal guardians who object to health, dental, or eye examinations or any part thereof, or to immunizations, on religious grounds shall not be required to submit their children or wards to the examinations or immunizations to which they so object if such parents or legal guardians present to the appropriate local school authority a signed statement of objection, detailing the grounds for the objection.

Illinois Child Care Immunization Law – 225 ILCS 10/7

• Religious Belief Exemption: Any standards involving immunization shall include appropriate exemptions for children whose parents object thereto on the grounds that they conflict with the tenets and practices of a recognized church or religious organization, of which the parent is an adherent or member, and for children who should not be subjected to immunization for clinical reasons.

Indiana School Immunization Law – IC 20-34-4-1

• Medical Exemption: If a physician certifies that a particular immunization required by this chapter or IC 20-34-4 is or may be detrimental to a student’s health, the requirements of this chapter or IC 20-34-4 for that particular immunization is inapplicable for the student until the immunization is found no longer detrimental to the student’s health.
• Religious Exemption: Except as otherwise provided, a student may not be required to undergo any testing, examination, immunization, or treatment required under this chapter or IC 20-34-4 when the child’s parent objects on religious grounds.

Indiana Child Care Center Immunization Law – IC 12-17.2-4-18.1

• Medical Exemption: A licensee meets the requirement of subsection (a) if the child’s physician provides documentation of a medical reason the child should not be immunized.
• Religious Belief Exemption: A licensee meets the requirement of subsection (a) if a child’s parent objects to immunizations for religious reasons; and provides documentation of the parent’s objection.

Indiana Child Care Homes Immunization Law – IC 12-17.2-5-18.1

• Medical Exemption: A licensee meets the requirement of subsection (a) if the child’s physician provides documentation of a medical reason the child should not be immunized.
• Religious Belief Exemption: A licensee meets the requirement of subsection (a) if a child’s parent objects to immunizations for religious reasons; and provides documentation of the parent’s objection.

Indiana Child Care Ministries Immunization Law – IC 12-17.2-6-11

• Medical Exemption: If a physician certifies that a particular immunization required by this section is or may be detrimental to the child’s health, the requirements of this section for that particular immunization are inapplicable to that child until the immunization is found to be no longer detrimental to the child’s health.
• Religious Belief Exemption: A child enrolled in a child care ministry may not be required to undergo an immunization required under this section if the parents object for religious reasons. The objection must be (1) made in writing; (2) signed by the child’s parent or guardian; and (3) delivered to the child care ministry.

Iowa Immunization Law – IA Code § 139A.8

• Medical Exemption: The applicant, or if the applicant is a minor, the applicant’s parent or legal guardian, submits to the admitting official a statement signed by a physician, advanced registered nurse practitioner, or physician assistant who is licensed by the board of medicine, board of nursing, or board of physician assistants that the immunizations required would be injurious to the health and well-being of the applicant or any member of the applicant’s family.
• Religious Belief Exemption: The applicant, or if the applicant is a minor, the applicant’s parent or legal guardian, submits an affidavit signed by the applicant, or if the applicant is a minor, the applicant’s parent or legal guardian, stating that the immunization conflicts with the tenets and practices of a recognized religious denomination of which the applicant is an adherent or member.

Kansas Child Care Immunization Law – KS Stat § 65-508

• Medical Exemption: The immunization requirement of subsection (d) shall not apply if one of the following is obtained: (1) Certification from a licensed physician stating that the physical condition of the child is such that immunization would endanger the child’s life or health.
• Religious Belief Exemption: The immunization requirement of subsection (d) shall not apply if one of the following is obtained: (2) a written statement signed by a parent or guardian that the parent or guardian is an adherent of a religious denomination whose teachings are opposed to immunizations.

Kansas School Immunization Law – KS Stat §72-5209

• Medical Exemption: As an alternative to the certification required, a pupil shall present an annual written statement signed by a licensed physician stating the physical condition of the child to be such that the tests or inoculations would seriously endanger the life or health of the child.
• Religious Belief Exemption: As an current to the certification required, a pupil shall present a written statement signed by one parent or guardian that the child is an adherent of a religious denomination whose religious teachings are opposed to such tests or inoculations.

Kentucky Student Immunization Law – KY Rev Stat § 158.035

Kentucky Immunization Law – KY Rev Stat § 214.034

• Medical Exemption: Nothing contained in KRS 158.035, 214.010, 214.020, 214.032 to 214.036, and 214.990 shall be construed to require the testing for tuberculosis or the immunization of any child at a time when, in the written opinion of his attending physician, such testing or immunization would be injurious to the child’s health.
• Religious Belief Exemption: Nothing contained in KRS 158.035, 214.010, 214.020, 214.032 to 214.036, and 214.990 shall be construed to require the testing for tuberculosis or the immunization of any child at a time when, in the written opinion of his attending physician, such testing or immunization would be injurious to the child’s health.

Louisiana School Immunization Law – LA Rev Stat § 17:170

• Medical, Religious and Philosophical Exemption. Medical, religious, and philosophic exemptions will be allowed for compliance with regulations concerning day care attendees and school enterers.

Louisiana College Immunization Law – LA Rev Stat § 17:170.1

• Medical Exemption: The provisions of Subsection A of this Section shall not apply to the following persons: (3) Any person who has submitted a written statement from a physician stating that the procedure is contraindicated for medical reasons or, if a minor, any person whose parent, tutor, or legal guardian has submitted such a statement.
• Religious or Personal Belief Exemption: The provisions of Subsection A of this Section shall not apply to the following persons: (1) Any person who is eighteen years of age or older and who signs a waiver provided by the postsecondary education institution stating that the person has received and reviewed the information provided pursuant to Subsection B of this Section and has chosen not to be vaccinated against meningococcal disease for religious or other personal reasons. (2) Any person who is a minor and whose parent, tutor, or legal guardian signs a waiver stating that the person has received and reviewed the information provided pursuant to Subsection B of this Section and has chosen for the student not to be vaccinated against meningococcal disease for religious or other personal reasons.

Maine Child Care Immunization Law – 10-148 CMR 32 § 17.

• Religious or Personal Belief Exemption: No child shall be required under this rule to have any such immunization if his/her parent(s) states in writing a sincere religious or philosophical belief that it is contrary to the immunization requirements of this rule.
• Medical Exemption: No child shall be required under this rule to have any such immunization if the child’s physician submits documentation that immunization against one or more of the diseases is medically inadvisable.

Maine School Immunization Law – ME Rev Stat § 6352

• Medical Exemption: The parent or the child provides a physician’s written statement that immunization against one or more of the diseases may be medically inadvisable.
• Philosophical or Religious Exemption. The parent states in writing a sincere religious belief that is contrary to the immunization requirement of this subchapter or an opposition to the immunization for philosophical reasons.

Maryland Family Day Care Immunization Regulations – COMAR 13A.15.03.02

Maryland Child Care Center Immunization Regulations – COMAR 13A.16.03.04

• Medical Exemption: A licensed physician or a health officer has determined that immunization is medically contraindicated according to accepted medical standards.
• Religious Exemption: The parent objects to the child’s immunization because it conflicts with the parent’s bona fide religious beliefs and practices.

Maryland School Immunization Regulations – COMAR 10.06.04.03

• Medical Exemption: requirements of Regulation .03 of this chapter do not apply to a student who presents a licensed physician’s or health officer’s written statement that the student’s immunization against a disease in Regulation .03 of this chapter is medically contraindicated.

Maryland Immunization Law – MD Educ Code § 7-403

• Religious Belief Exemption: Unless the Secretary declares an emergency or disease epidemic, the Department may not require the immunization of an individual if (1) The individual objects to immunization because it conflicts with the individual’s bona fide religious beliefs and practices; or (2) The individual is a minor and the individual’s parent or guardian objects to immunization because it conflicts with the parent or guardian’s bona fide religious beliefs and practices.

Massachusetts Immunization Law – MA Gen L ch 76 § 15

• Medical Exemption: A child shall be admitted to school upon certification by a physician that he has personally examined such child and that in his opinion the physical condition of the child is such that his health would be endangered by such vaccination or by any of such immunizations.
• Religious Belief Exemption: In the absence of an emergency or epidemic of disease declared by the department of public health, no child whose parent or guardian states in writing that vaccination or immunization conflicts with his sincere religious beliefs shall be required to present said physician’s certificate in order to be admitted to school.

Massachusetts School Immunization Regulations – 105 CMR 220.000

• Medical or Religious Belief Exemption: The requirements in 105 CMR 220.500 (A) and (B) shall not apply: (1) upon presentation of written documentation that the student meets the standards for medical or religious exemption set forth in M.G.L. c. 76, § 15.

Michigan Immunization Law – MI Comp L § 333.9205

Michigan Preschool Immunization Law – MI Comp L § 333.9211

Michigan School Immunization Law – MI Comp L § 333.9208

• Medical Exemption: A child is exempt from the requirements of this part as to a specific immunization for any period of time as to which a physician certifies that a specific immunization is or may be detrimental to the child’s health or is not appropriate.
• Religious or Personal Belief Exemption: A child is exempt from this part if a parent, guardian, or person in loco parentis of the child presents a written statement to the administrator of the child’s school or operator of the group program to the effect that the requirements of this part cannot be met because of religious convictions or other objection to immunization.

Michigan School Immunization Regulations Mich. Admin Code R. 325-176

• Medical Exemption: “Medical exemption” means a written statement from a physician that a vaccination is medically contraindicated for a particular child for a specified period of time.
• Religious or Personal Belief Exemption: “Religious or other exemption” means a written statement which is signed by the parent, guardian, or person in loco parentis of a child, which certifies that immunization is in conflict with religious or other convictions of the signer, and which includes the name and date of birth of the child.

Minnesota School Immunization Law – MN Stat § 121A.15

• Medical Exemption: If a statement, signed by a physician, is submitted to the administrator or other person having general control and supervision of the school or child care facility stating that an immunization is contraindicated for medical reasons or that laboratory confirmation of the presence of adequate immunity exists, the immunization specified in the statement need not be required.
• Personal Belief Exemption: If a notarized statement signed by the minor child’s parent or guardian or by the emancipated person is submitted to the administrator or other person having general control and supervision of the school or child care facility stating that the person has not been immunized as prescribed in subdivision 1 because of the conscientiously held beliefs of the parent or guardian of the minor child or of the emancipated person, the immunizations specified in the statement shall not be required.

Minnesota College Immunization Law – MN Stat § 135A.14

• Medical Exemption: An immunization listed in subdivision 2 is not required if the student submits to the administrator a statement signed by a physician that shows that, for medical reasons, the student did not receive an immunization.
• Personal Belief Exemption: If the student submits a notarized statement that the student has not been immunized as required in subdivision 2 because of the student’s conscientiously held beliefs, the immunizations described in subdivision 2 are not required.

Mississippi Immunization Law – MS Code § 41-23-37

• Medical Exemption: A certificate of exemption from vaccination for medical reasons may be offered on behalf of a child by a duly licensed physician and may be accepted by the local health officer when, in his opinion, such exemption will not cause undue risk to the community.

Missouri Child Care Immunization Law – MO Rev Stat § 210.003

• Medical Exemption: A medical exemption, by which a child shall be exempted from the requirements of this section upon certification by a licensed physician that such immunization would seriously endanger the child’s health or life.
• Personal Belief Exemption: A parent or guardian exemption, by which a child shall be exempted from the requirements of this section if one parent or guardian files a written objection to immunization with the day care administrator.

Missouri School Immunization Law – MO Rev Stat § 167.181

• Medical and Religious Belief Exemption: This section shall not apply to any child if one parent or guardian objects in writing to his school administrator against the immunization of the child, because of religious beliefs or medical contraindications.

Montana School Immunization Law – MT Code § 20-5-403

• Medical Exemption: When a parent, guardian, or adult who has the responsibility for the care and custody of a minor seeking to attend school or the person seeking to attend school, if an adult, files with the governing authority a written statement signed by a physician licensed to practice medicine in any jurisdiction of the United States or Canada stating that the physical condition of the person seeking to attend school or medical circumstances relating to the person indicate that some or all of the required immunizations are not considered safe and indicating the specific nature and probable duration of the medical condition or circumstances that contraindicate immunization, the person is exempt from the requirements of this part to the extent indicated by the physician’s statement. The statement must be maintained as part of the person’s immunization records.
• Religious Exemption: When a parent, guardian, or adult who has the responsibility for the care and custody of a minor seeking to attend school or the person seeking to attend school, if an adult, signs and files with the governing authority, prior to the commencement of attendance each school year, a notarized affidavit on a form prescribed by the department stating that immunization is contrary to the religious tenets and practices of the signer, immunization of the person seeking to attend the school may not be required prior to attendance at the school. The statement must be maintained as part of the person’s immunization records. A person who falsely claims a religious exemption is subject to the penalty for false swearing provided in 45-7-202.

Montana Day Care Immunization Regulations – Mont. Admin. R. 37.95.140

• Medical Exemption: A child seeking to attend a day care facility is not required to have any immunizations which are medically contraindicated. A written and signed statement from a physician that an immunization is medically contraindicated will exempt a person from the applicable immunization requirements of this rule.
• Religious Belief Exemption: A child under five years of age seeking to attend a day care facility is not required to be immunized against Haemophilus influenza type B if the parent or guardian of the child objects thereto in a signed, written statement indicating that the proposed immunization interferes with the free exercise of the religious beliefs of the person signing the statement.

Montana School Immunization Regulation – Mont. Admin. R. 37.114.7

• Medical Exemption: A prospective pupil seeking to attend school is not required to have any immunizations which are medically contraindicated. A written and signed statement from a physician that an immunization is medically contraindicated will exempt a prospective pupil from those immunization requirements as deemed necessary by the physician.
• Religious Belief Exemption: A prospective pupil seeking to attend school is exempt from all or part of the immunization requirements if the parent or guardian of that prospective pupil, an adult responsible for that prospective pupil, or the prospective pupil if an adult or an emancipated minor, objects thereto in a signed, written statement indicating that the proposed immunization interferes with the free exercise of the religious beliefs of the person signing the statement.

Nebraska Child Care Immunization Law – NE Code § 71-1913.01.

• Medical Exemption: certification by a physician, an advanced practice registered nurse practicing under and in accordance with his or her respective certification act, or a physician assistant that immunization is not appropriate for a stated medical reason.
• Personal Belief Exemption: a written statement that the parent or guardian does not wish to have such child so immunized and the reasons therefor.

Nebraska School Immunization Law – NE Code § 79-217

• Medical Exemption: A statement signed by a physician, a physician assistant, or an advanced practice registered nurse practicing under and in accordance with his or her respective certification act, stating that, in the health care provider’s opinion, the immunizations required would be injurious to the health and well-being of the student or any member of the student’s family or household.
• Religious Belief Exemption: An affidavit signed by the student or, if he or she is a minor, by a legally authorized representative of the student, stating that the immunization conflicts with the tenets and practice of a recognized religious denomination of which the student is an adherent or member or that immunization conflicts with the personal and sincerely followed religious beliefs of the student.

Nebraska College Immunization Law – NE Code § 85-902

Nevada School Immunization Law – NV Rev Stat § 392.435

• Medical Exemption: If the medical condition of a child will not permit the child to be immunized to the extent required by NRS 392.435 and a written statement of this fact is signed by a licensed physician and by the parents or guardian of the child, the board of trustees of the school district or governing body of the charter school in which the child has been accepted for enrollment shall exempt the child from all or part of the provisions of NRS 392.435, as the case may be, for enrollment purposes.
• Religious Exemption: A public school shall not refuse to enroll a child as a pupil because the child has not been immunized pursuant to NRS 392.435 if the parents or guardian of the child has submitted to the board of trustees of the school district or the governing body of a charter school in which the child has been accepted for enrollment a written statement indicating that their religious belief prohibits immunization of such child or ward.

Nevada Private School Immunization Law – NV Rev Stat § 394.192

• Medical Exemption: If the medical condition of a child will not permit the child to be immunized to the extent required by NRS 394.192, a written statement of this fact signed by a licensed physician and presented to the governing body by the parents or guardian of such child shall exempt such child from all or part of the provisions of NRS 394.192, as the case may be, for enrollment purposes.
• Religious Belief Exemption: A private school shall not refuse to enroll a child as a pupil because such child has not been immunized pursuant to NRS 394.192 if the parents or guardian of such child have submitted to the governing body a written statement indicating that their religious belief prohibits immunization of such child or ward.

New Hampshire Immunization Law – NH Rev Stat § 141-C:20-a

• Medical Exemption: A child shall be exempt from immunization if a physician licensed under RSA 329, or a physician exempted under RSA 329:21, III, certifies that immunization against a particular disease may be detrimental to the child’s health. The exemption shall exist only for the length of time, in the opinion of the physician, such immunization would be detrimental to the child. An exemption from immunization for one disease shall not affect other required immunizations.
• Religious Belief Exemption: A child shall be exempt from immunization ifa parent or legal guardian objects to immunization because of religious beliefs. The parent or legal guardian shall sign a notarized form stating that the child has not been immunized because of religious beliefs.

New Jersey College Immunization Law – NJ Rev Stat § 18A:61D-1

See also Meningococcal and Hepatitis B vaccine requirements, as well as exemptions from such vaccines.

• Medical Exemption: A student who submits to the institution a written statement that an immunization is medically contraindicated shall submit a valid immunization record of other administered immunizations in accordance with regulations promulgated by the department.
• In-State Student Exemption: An institution may, in accordance with regulations promulgated by the department, exempt from the requirements of section 1 of P.L.1988, c.158 (C.18A:61D-1) any student who attended an elementary or secondary school located in this State.
• Religious Belief Exemption: A student who submits to the institution of higher education a written statement that immunization conflicts with his religious beliefs shall not be required to submit a list of immunizations to the institution as a condition of admission or continued enrollment.

New Jersey High School Hepatitis B Immunization Law

New Jersey School Immunization Law – NJ Rev Stat § 26:1A-9

• Medical Exemption: A child shall not be required to receive a pertussis vaccine as a condition for admission to a public or private school if the child’s health care provider states in writing that the vaccine is medically contraindicated pursuant to subsection b. (1) of section 2 of this act and the reasons for the medical contradictions.
• Religious Belief Exemption: Provisions in the State Sanitary Code in implementation of this act shall provide for exemption for pupils from mandatory immunization if the parent or guardian of the pupil objects thereto in a written statement signed by the parent or guardian upon the ground that the proposed immunization interferes with the free exercise of the pupil’s religious rights.

New Mexico School Immunization Law – NM Stat § 24-5-1

• Medical Exemption: Any minor child through his parent or guardian may file with the health authority charged with the duty of enforcing the immunization laws: (1) a certificate of a duly licensed physician stating that the physical condition of the child is such that immunization would seriously endanger the life or health of the child.
• Religious Belief Exemption: Any minor child through his parent or guardian may file with the health authority charged with the duty of enforcing the immunization laws: (2) affidavits or written affirmation from an officer of a recognized religious denomination that such child’s parents or guardians are bona fide members of a denomination whose religious teaching requires reliance upon prayer or spiritual means alone for healing; or (3) affidavits or written affirmation from his parent or legal guardian that his religious beliefs, held either individually or jointly with others, do not permit the administration of vaccine or other immunizing agent.

New York School Immunization Law – NY Educ L § 914

New York Child Care and School Immunization Law – NY Pub Health L § 2164

• Medical Exemption: If any physician licensed to practice medicine in this state certifies that such immunization may be detrimental to a child’s health, the requirements of this section shall be inapplicable until such immunization is found no longer to be detrimental to the child’s health.
• Religious Belief Exemption: This section shall not apply to children whose parent, parents, or guardian hold genuine and sincere religious beliefs which are contrary to the practices herein required, and no certificate shall be required as a prerequisite to such children being admitted or received into school or attending school.

New York College Immunization Law – NY Pub Health L § 2165

See also New York Meningococcal Meningitis Immunization Law.

• Medical Exemption: If any licensed physician or nurse practitioner certifies that such immunization may be detrimental to the person’s health or is otherwise medically contraindicated, the requirements of this section shall be inapplicable until such immunization is found no longer to be detrimental to such person’s health or is no longer medically contraindicated.
• Religious Belief Exemption: This section shall not apply to a person who holds genuine and sincere religious beliefs which are contrary to the practices herein required, and no certificate shall be required as a prerequisite to such person being admitted or received into or attending an institution.

North Carolina Immunization Law – NC Gen Stat § 130A-152

North Carolina School Immunization Law – NC Gen Stat § 130A-155

• Medical Exemption: The Commission for Public Health shall adopt by rule medical contraindications to immunizations required by G.S. 130A-152. If a physician licensed to practice medicine in this State certifies that a required immunization is or may be detrimental to a person’s health due to the presence of one of the contraindications adopted by the Commission, the person is not required to receive the specified immunization as long as the contraindication persists.
• Religious Exemption: If the bona fide religious beliefs of an adult or the parent, guardian or person in loco parentis of a child are contrary to the immunization requirements contained in this Chapter, the adult or the child shall be exempt from the requirements.

North Dakota School Immunization Law – N.D.C.C. § 27-07-17.1

• Medical or Religious, Philosophical, or Moral Belief Exemption: Any minor child, through the child’s parent or guardian, may submit to the institution authorities either a certificate from a licensed physician stating that the physical condition of the child is such that immunization would endanger the life or health of the child or a certificate signed by the child’s parent or guardian whose religious, philosophical, or moral beliefs are opposed to such immunization. The minor child is then exempt from the provisions of this section.

Ohio School Immunization Law – Ohio Rev Code § 3313.67

• Medical Exemption: A child whose physician certifies in writing that such immunization against any disease is medically contraindicated is not required to be immunized against that disease.
• Religious Belief Exemption: A pupil who presents a written statement of the pupil’s parent or guardian in which the parent or guardian declines to have the pupil immunized for reasons of conscience, including religious convictions, is not required to be immunized.

Ohio College Immunization Law – Ohio Rev Code § 1713.55

Ohio Child Care Immunization Regulations – Ohio Admin. Code 5101:2-12-37.

Oklahoma Child Care Immunization Law – 10 O.S. § 10-411

• Medical Exemption: Any minor child, through his or her parent or guardian, may submit to the health authority charged with the enforcement of the immunization laws, a certificate of a licensed physician stating that the physical condition of the child is such that immunization would endanger the life or health of the child.
• Religious Belief Exemption: Upon receipt of a written statement by the parent or guardian objecting to such immunizations because of religious or other reasons, then such child shall be exempt from the provisions of this act.

Oklahoma School Immunization Law – 70 O.S. § 70-1210.191

• Medical Exemption: Any minor child, through the parent, guardian, or legal custodian of the child, may submit to the health authority charged with the enforcement of the immunization laws of this state: 1. A certificate of a licensed physician as defined in Section 725.2 of Title 59 of the Oklahoma Statutes, stating that the physical condition of the child is such that immunization would endanger the life or health of the child; whereupon the child shall be exempt from the immunization laws of this state.
• Religious Belief Exemption: Any minor child, through the parent, guardian, or legal custodian of the child, may submit to the health authority charged with the enforcement of the immunization laws of this state: 2. A written statement by the parent, guardian or legal custodian of the child objecting to immunization of the child; whereupon the child shall be exempt from the immunization laws of this state.

Oklahoma College Immunization Law – 70 O.S. § 70-3244

• Medical Exemption: A written statement from a licensed physician indicating that a vaccine is medically contraindicated shall exempt a student from the vaccination.
• Religious or Moral Belief Exemption: A student shall be exempt from the vaccination if the student submits a written, signed statement declaring that the administration of the vaccine conflicts with the student’s moral or religious tenets or, if the student is a minor, the student’s parent or guardian provides a written statement that the administration of the vaccine conflicts with the parent’s or guardian’s moral or religious tenets.

Oregon School Immunization Law – OR Rev Stat § 433.267

• Medical Exemption: A document signed by a physician or a representative of the local health department stating that the child should be exempted from receiving specified immunization because of indicated medical diagnosis.
• Religious or Philosophical Belief Exemption: A document, on a form prescribed by the authority by rule and signed by the parent of the child, stating that the parent is declining one or more immunizations on behalf of the child. A document submitted under this paragraph: (A) May include the reason for declining the immunization, including whether the parent is declining the immunization because of a religious or philosophical belief; and (B) Must include either: (i) A signature from a health care practitioner verifying that the health care practitioner has reviewed with the parent information about the risks and benefits of immunization that is consistent with information published by the Centers for Disease Control and Prevention and the contents of the vaccine educational module approved by the authority pursuant to rules adopted under ORS 433.273; or (ii) A certificate verifying that the parent has completed a vaccine educational module approved by the authority pursuant to rules adopted under ORS 433.273.

Oregon College Immunization Law – OR Rev Stat § 433.282

Oregon Community College Immunization Law – OR Rev Stat § 433.283

Oregon School Immunization Regulations – OAR 333-050-0010

• Medical Exemption: “Medical Exemption” means a document signed by a physician or an authorized representative of the local health department stating that the child should be exempted from receiving specified immunizations based on a medical diagnosis resulting from a specific medical contraindication.
• Personal Belief Exemption: “Nonmedical Exemption” means a document, on a form prescribed by the Public Health Division, signed by the parent stating that the parent is declining one or more immunizations on behalf of the child, and including documentation of completion of the vaccine educational module or a signature from a health care practitioner verifying discussion of risks and benefits of immunization.

Pennsylvania School Immunization Law – 1949, Act 14 § 1303

• Medical Exemption: The provisions of this section shall not apply in the case of any child deemed to have a medical contraindication which may contraindicate immunization and so certified by a physician. Such certificates may be accepted in lieu of a certificate of immunization.
• Religious Exemption: The provisions of this section shall not apply in the case of any child whose parent or guardian objects in writing to such immunization on religious grounds.

Pennsylvania Immunization Regulations – 28 Pa. Code § 23.81

• Medical Exemption: Children need not be immunized if a physician or the physician’s designee provides a written statement that immunization may be detrimental to the health of the child. When the physician determines that immunization is no longer detrimental to the health of the child, the child shall be immunized according to this subchapter.
• Religious Exemption: Children need not be immunized if the parent, guardian or emancipated child objects in writing to the immunization on religious grounds or on the basis of a strong moral or ethical conviction similar to a religious belief.

Rhode Island School Immunization Law – RI Gen L § 16-38-2

• Medical Exemption: A certificate from a licensed physician stating that the person is not a fit subject for immunization for medical reasons.
• Religious Belief Exemption: a certificate signed by the pupil, if over eighteen (18) years of age, or by the parent or guardian stating that immunization and/or testing for communicable diseases is contrary to that person’s religious beliefs.

Rhode Island Child Care Immunization Law – RI Gen L § 42-72.1-3

Rhode Island School Immunization Regulations

K-12 Exemptions:

• Medical Exemption: A physician, a physician assistant, a certified registered nurse practitioner, or other licensed practitioner acting within his/her scope of practice signs the Rhode Island Department of Health’s “Medical Immunization Exemption Certificate” provided by the school attesting that the student is exempt from a specific vaccine because of medical reasons, in accordance with ACIP recommendations; or
• Religious Belief Exemption: A parent or guardian completes and signs the Department’s “Religious Immunization Exemption Certificate” provided by the school, attesting that immunization conflicts with the tenets of their religious beliefs.

College Exemptions:

• Medical Exemption: A physician, physician assistant, certified registered nurse practitioner, or other licensed practitioner acting within his/her scope of practice signs the Department’s “Medical Immunization Exemption Certificate” provided by the college/university attesting that the student is exempt from a specific vaccine because of medical reasons, in accordance with ACIP guidelines.
• Religious Belief Exemption: A parent or guardian or student (if eighteen) 18 years of age or older) completes and signs the Department’s “Religious Immunization Exemption Certificate” provided by the college/university, attesting that immunization conflicts with the tenets of their religious beliefs.

South Carolina School Immunization Law – SC Code § 44-29-180

South Carolina Department of Health and Environmental Control Regulation 61-8, as amended, “Vaccination, Screening and Immunization Regarding Contagious Diseases”, and its exemptions apply to this section.

South Carolina School Immunization Regulations – S.C. Code Reg. 61-8.

• Medical Exemption: A Medical Exemption, may be granted when a licensed physician has determined, for medical reasons, that a particular vaccine(s) required by this regulation is not advisable for the child. The exemption is granted when the physician or his/her authorized representative completes and signs the South Carolina Certificate of Immunization containing the Medical Exemption. The physician must indicate whether the exemption is permanent or temporary. If the exemption is temporary, an updated South Carolina Certificate of Immunization showing proof of immunization must be presented to the school or childcare by the end of the exemption period.
• Religious Belief Exemption: A South Carolina Certificate of Religious Exemption may be granted to any student whose parent, guardian, or person in loco parentis signs the appropriate section of the South Carolina Certificate of Religious Exemption stating that one or more immunizations conflicts with their religious beliefs. The Certificate of Religious Exemption form may only be obtained from the local health department.

South Dakota School Immunization Law – SD Codified L § 13-28-7.1

• Medical Exemption: Certification from a licensed physician stating the physical condition of the child would be such that immunization would endanger the child’s life or health.
• Religious Belief Exemption: A written statement signed by one parent or guardian that the child is an adherent to a religious doctrine whose teachings are opposed to such immunization.

South Dakota College Immunization Law – SD Codified L § 13-53-47

• Medical Exemption: As an alternative to the requirement for a physician’s certification, the student may present: (1) Certification from a licensed physician stating the physical condition of the student would be such that immunization would endanger the student’s life or health.
• Religious Belief Exemption: As an alternative to the requirement for a physician’s certification, the student may present: (4) A written statement signed by the student that the student is an adherent to a religious doctrine whose teachings are opposed to such immunizations. If the student is under the age of eighteen, the written statement shall be signed by one parent or guardian.

Tennessee Immunization Law – TN Code Ann. § 37-10-401

• Religious Belief Exemption: In the absence of an epidemic or immediate threat thereof, this section does not apply to any child whose parent or guardian files with proper authorities a signed, written statement that such immunization and other preventative measures conflict with the religious tenets and practices of the parent or guardian affirmed under penalties of perjury.

Tennessee School Immunization Law – TN Code Ann. § 49-6-5001

• Medical Exemption: No child shall be denied admission to any school or school facility if the child has not been immunized due to medical reasons if the child has a written statement from the child’s doctor excusing the child from the immunization.
• Religious Belief Exemption: In the absence of an epidemic or immediate threat of an epidemic, this section shall not apply to any child whose parent or guardian files with school authorities a signed, written statement that the immunization and other preventive measures conflict with the parent’s or guardian’s religious tenets and practices, affirmed under the penalties of perjury.

Tennessee Immunization Regulations – Tenn. Comp. R. & Regs.1200-14-01-.29

• Medical Exemption: Where a physician licensed by the Board of Medical Examiners, the Board of Osteopathic Examiners or a public health nurse employed by a local Health Department determines that a particular vaccine is contraindicated for one of the following reasons: 1. the individual meets the criteria for contraindication set forth in the manufacturer’s vaccine package insert; or 2. the individual meets the criteria for contraindication published by the U.S. Centers for Disease Control or the ACIP; 3. in the best professional judgment of the physician, based upon the individual’s medical condition and history, the risk of harm from the vaccine outweighs the potential benefit.
• Religious Belief Exemption: Where a parent or guardian, or in the case of an adult student, the student, provides to the school a written statement, affirmed under penalties of perjury, that vaccination conflicts with the religious tenets and practices of the parent or guardian, or in the case of an adult student, the student.

Texas Immunization Law – Tex. Health & Safety § 161.004

• Medical Exemption: A child is exempt from an immunization required by this section if the immunization is medically contraindicated based on the opinion of a physician licensed by any state in the United States who has examined the child.
• Religious Belief Exemption: A child is exempt from an immunization required by this section if a parent, managing conservator, or guardian states that the immunization is being declined for reasons of conscience, including a religious belief.

Texas School Immunization Law – Tex. Educ. Code § 38.001

• Medical Exemption: Immunization is not required for a person’s admission to any elementary or secondary school if the person applying for admission: (1) submits to the admitting official: (A) an affidavit or a certificate signed by a physician who is duly registered and licensed to practice medicine in the United States, in which it is stated that, in the physician’s opinion, the immunization required poses a significant risk to the health and well-being of the applicant or any member of the applicant’s family or household; or
• Religious or Personal Belief Exemption: Immunization is not required for a person’s admission to any elementary or secondary school if the person applying for admission: (1) submits to the admitting official: (B) an affidavit signed by the applicant or, if a minor, by the applicant’s parent or guardian stating that the applicant declines immunization for reasons of conscience, including a religious belief.

Texas College Immunization Law – Tex. Educ. Code § 51.933

• Medical Exemption: No form of immunization is required for a person’s admission to an institution of higher education if the person applying for admission submits to the admitting official an affidavit or a certificate signed by a physician who is duly registered and licensed to practice medicine within the United States in which it is stated that, in the physician’s opinion, the immunization required poses a significant risk to the health and well-being of the applicant or any member of the applicant’s family or household.
• Religious Belief Exemption: No form of immunization is required for a person’s admission to an institution of higher education if the person applying for admission submits to the admitting official an affidavit signed by the applicant or, if a minor, by the applicant’s parent or guardian stating that the applicant declines immunization for reasons of conscience, including a religious belief.

Texas Child Care Immunization Law – Tex. Hum. Res. Code § 42.043

• Medical Exemption: No immunization may be required for admission to a facility regulated under this chapter if a person applying for a child’s admission submits one of the following affidavits: (1) an affidavit signed by a licensed physician stating that the immunization poses a significant risk to the health and well-being of the child or a member of the child’s family or household
• Religious Belief Exemption: No immunization may be required for admission to a facility regulated under this chapter if a person applying for a child’s admission submits one of the following affidavits: (2) an affidavit signed by the child’s parent or guardian stating that the applicant declines immunization for reasons of conscience, including a religious belief.

Texas Immunization Regulations – 25 Tex. Admin. Code § 97.61

• Medical Exemption: To claim an exclusion for medical reasons, the child or student must present a statement signed by the child’s physician (M.D. or D.O.), duly registered and licensed to practice medicine in the United States who has examined the child, in which it is stated that, in the physician’s opinion, the vaccine required is medically contraindicated or poses a significant risk to the health and well-being of the child or any member of the child’s household. Unless it is written in the statement that a lifelong condition exists, the exemption statement is valid for only one year from the date signed by the physician.
• Religious Belief Exemption: To claim an exclusion for reasons of conscience, including a religious belief, a signed affidavit must be presented by the child’s parent or legal guardian, stating that the child’s parent or legal guardian declines vaccinations for reasons of conscience, including because of the person’s religious beliefs. The affidavit will be valid for a two-year period. The child, who has not received the required immunizations for reasons of conscience, including religious beliefs, may be excluded from school in times of emergency or epidemic declared by the commissioner of public health.

Utah School Immunization Law – UT Code § 53A-11-301

• Medical Exemption: A student is exempt from receiving the required immunizations if there is presented to the appropriate official of the school one or more of the following: a certificate from a licensed physician stating that due to the physical condition of the student one or more specified immunizations would endanger the student’s life or health.
• Personal Belief Exemption: A student is exempt from receiving the required immunizations if there is presented to the appropriate official of the school one or more of the following: A completed form obtained at the local health department where the student resides, providing: (i) the information required under Subsection 53A-11-302.5(1); and (ii) a statement that the person has a personal belief opposed to immunizations, which is signed by one of the individuals listed in Subsection 53A-11-302(3)(c) and witnessed by the local health officer or his designee.
• Religious Belief Exemption: A student is exempt from receiving the required immunizations if there is presented to the appropriate official of the school one or more of the following: a statement that the person is a bona fide member of a specified, recognized religious organization whose teachings are contrary to immunizations, signed by one of the following persons: (i) one of the student’s parents; (ii) the student’s guardian; (iii) a legal age brother or sister of a student who has no parent or guardian; or (iv) the student, if of legal age.

Utah School Immunization Regulations – Utah Admin. Code r. 396-100-3

• Exemptions: A parent claiming an exemption to immunization for medical, religious or personal reasons, as allowed by Section 53A-11-302, shall provide to the student’s school or early childhood program the required completed forms. The school or early childhood program shall attach the forms to the student’s USIR.

Vermont School Immunization Law – 18 V.S.A. § 1121

• Medical Exemption: Notwithstanding subsections 1121(a) and (b) of this title, a person may remain in school or in the child care facility without a required immunization: (2) If a health care practitioner, licensed to practice in Vermont and authorized to prescribe vaccines, certifies in writing that a specific immunization is or may be detrimental to the person’s health or is not appropriate, provided that when a particular vaccine is no longer contraindicated, the person shall be required to receive the vaccine.
• Religious or Personal Belief Exemption: Notwithstanding subsections 1121(a) and (b) of this title, a person may remain in school or in the child care facility without a required immunization: (3) If the person or, in the case of a minor, the person’s parent or guardian annually provides a signed statement to the school or child care facility on a form created by the Vermont department of health that the person, parent, or guardian: (A) holds religious beliefs or philosophical convictions opposed to immunization; (B) has reviewed and understands evidence-based educational material provided by the department of health regarding immunizations, including information about the risks of adverse reactions to immunization; (C) understands that failure to complete the required vaccination schedule increases risk to the person and others of contracting or carrying a vaccine-preventable infectious disease; and (D) understands that there are persons with special health needs attending schools and child care facilities who are unable to be vaccinated or who are at heightened risk of contracting a vaccine-preventable communicable disease and for whom such a disease could be life-threatening.

Vermont Immunization Regulations – Vt. Code R. 13 140 021

• Medical Exemption: Persons are exempt from these regulations provided they meet one or more of the following exemptions as defined in 18 V.S.A. § 1122 (a) or, in the case of non-recurring childcare services, in the Department for Children and Families Early Childhood Program Licensing Regulations: (a) If the person or, in the case of a minor, the person’s parent or guardian, presents a Department-supplied form, signed by a health care practitioner authorized to prescribe vaccines, indicating a specific immunization is or may be detrimental to the person’s health or is not appropriate, provided that when a particular vaccine is no longer contraindicated, the person shall be required to receive the vaccine. The form must include the reason for the contraindication and the time period for which the immunization is contraindicated. This form shall be maintained by the child care facility or school as part of the child’s or student’s immunization record.
• Religious Belief Exemption: Persons are exempt from these regulations provided they meet one or more of the following exemptions as defined in 18 V.S.A. § 1122 (a) or, in the case of non-recurring childcare services, in the Department for Children and Families Early Childhood Program Licensing Regulations: (b) If the person or, in the case of a minor, the person’s parent or guardian, annually provides a signed statement to the school or child care facility on a Department-supplied form, indicating that the person, parent, or guardian: (i) holds religious beliefs or philosophical convictions opposed to immunizations; and (ii) has reviewed the evidence-based educational material provided by the department of health regarding immunizations, including: a) the information about the risks of adverse reactions to immunization; b) the information that failure to complete the required vaccination schedule increases risk to the person and others of contracting or carrying a vaccine-preventable infectious disease; and c) the information that there are persons with special health needs attending schools and child care facilities who are unable to be vaccinated or who are at heightened risk of contracting a vaccine-preventable communicable disease and for whom such a disease could be life-threatening.

Virginia School Immunization Law – VA Code § 22.1-271.2

• Medical Exemption: No certificate of immunization shall be required for the admission to school of any student if the school has written certification from a licensed physician, licensed nurse practitioner, or local health department that one or more of the required immunizations may be detrimental to the student’s health, indicating the specific nature and probable duration of the medical condition or circumstance that contraindicates immunization.
• Religious Belief Exemption: No certificate of immunization shall be required for the admission to school of any student if the student or his parent submits an affidavit to the admitting official stating that the administration of immunizing agents conflicts with the student’s religious tenets or practices.

Virginia Home School Immunization Law – VA Code § 22.1-271.4 (2014)

• Medical Exemption: No proof of immunization shall be required of any child upon submission of a written certification from a licensed physician, licensed nurse practitioner, or local health department that one or more of the required immunizations may be detrimental to the child’s health, indicating the specific nature of the medical condition or circumstance that contraindicates immunization.
• Religious Belief Exemption: No proof of immunization shall be required of any child upon submission of an affidavit to the division superintendent stating that the administration of immunizing agents conflicts with the parent’s or guardian’s religious tenets or practices.

Virginia Immunization Law – VA Code § 32.1-46

• Medical Exemption: The provisions of this section shall not apply if the parent or guardian presents a statement from a physician licensed to practice medicine in Virginia, a licensed nurse practitioner, or a local health department that states that the physical condition of the child is such that the administration of one or more of the required immunizing agents would be detrimental to the health of the child
• Religious Belief Exemption: The provisions of this section shall not apply if the parent or guardian of the child objects thereto on the grounds that the administration of immunizing agents conflicts with his religious tenets or practices, unless an emergency or epidemic of disease has been declared by the Board.
• HPV Vaccine Exemption: Because the human papillomavirus is not communicable in a school setting, a parent or guardian, at the parent’s or guardian’s sole discretion, may elect for the parent’s or guardian’s child not to receive the human papillomavirus vaccine, after having reviewed materials describing the link between the human papillomavirus and cervical cancer approved for such use by the Board.

Virginia Child Care Immunization Regulation – 22VAC40-111-90

• Medical Exemption: Pursuant to subsection C of § 22.1-271.2 of the Code of Virginia, documentation of immunizations is not required for any child whose physician or a local health department states on a Department of Health-approved form that one or more of the required immunizations may be detrimental to the child’s health, indicating the specific nature and probable duration of the medical condition or circumstance that contraindicates immunization.
• Religious Belief Exemption: Pursuant to subsection C of § 22.1-271.2 of the Code of Virginia, documentation of immunizations is not required for any child whose parent submits an affidavit to the family day home on the current form approved by the Virginia Department of Health stating that the administration of immunizing agents conflicts with the parent’s or child’s religious tenets or practices.

Virginia School Immunization Regulations – 12VAC5-110-70

• Medical Exemption: No certificate of immunization shall be required of any student for admission to school if the school has written certification on either of the documents specified under “documentary proof” in 12VAC5-110-10 from a physician, registered nurse, or a local health department that one or more of the required immunizations may be detrimental to the student’s health. Such certification of medical exemption shall specify the nature and probable duration of the medical condition or circumstance that contraindicates immunization.
• Religious Belief Exemption: No certificate of immunization shall be required of any student for admission to school if the student or his parent or guardian submits a Certificate of Religious Exemption (Form CRE 1), to the admitting official of the school to which the student is seeking admission. Form CRE 1 is an affidavit stating that the administration of immunizing agents conflicts with the student’s religious tenets or practices.
• HPV Vaccine Exemption: Because the human papillomavirus is not communicable in a school setting, a parent or guardian, at the parent’s or guardian’s sole discretion, may elect for the parent’s or guardian’s child not to receive the HPV vaccine, after having reviewed materials describing the link between the human papillomavirus and cervical cancer approved for such use by the board.

Virginia Immunization Regulation – 12VAC5-90-110

Washington School Immunization Law – WA Rev Code § 28A.210.080

• Medical Exemption: Any child shall be exempt in whole or in part from the immunization measures required by RCW 28A.210.060 through 28A.210.170 upon the presentation of any one or more of the certifications required by this section, on a form prescribed by the department of health: (a) A written certification signed by a health care practitioner that a particular vaccine required by rule of the state board of health is, in his or her judgment, not advisable for the child: PROVIDED, That when it is determined that this particular vaccine is no longer contraindicated, the child will be required to have the vaccine.
• Religious Belief Exemption: Any child shall be exempt in whole or in part from the immunization measures required by RCW 28A.210.060 through 28A.210.170 upon the presentation of any one or more of the certifications required by this section, on a form prescribed by the department of health: (b) A written certification signed by any parent or legal guardian of the child or any adult in loco parentis to the child that the religious beliefs of the signator are contrary to the required immunization measures.
• Personal Belief Exemption: Any child shall be exempt in whole or in part from the immunization measures required by RCW 28A.210.060 through 28A.210.170 upon the presentation of any one or more of the certifications required by this section, on a form prescribed by the department of health: (c) A written certification signed by any parent or legal guardian of the child or any adult in loco parentis to the child that the signator has either a philosophical or personal objection to the immunization of the child.

West Virginia School Immunization Law – WV Code § 16-3-4

West Virginia Private School Immunization Law – WV Code § 18-28-2

West Virginia School Immunization Regulation – W. Va. C.S.R. §64-95-4

• Medical Exemption: The provisions of this rule may not apply if a child has a valid medical contraindication or precaution to a particular vaccine. To obtain a medical exemption the child’s parent or guardian shall present a written request for an exemption from a physician who has treated or examined the child to the local health officer in the county where the child attends school.

Wisconsin School Immunization Law – WI Stat § 252.04

• Health, Religious Belief and Personal Belief Exemptions: The immunization requirement is waived if the student, if an adult, or the student’s parent, guardian, or legal custodian submits a written statement to the school, child care center, or nursery school objecting to the immunization for reasons of health, religion, or personal conviction.

Wisconsin College Immunization Law – WI Stat § 252.09

Wisconsin Immunization Regulations – Wis. Admin. Code DHS § 144.03

• Medical Exemption: Upon certification by a licensed physician that an immunization required under s. 252.04, Stats., is or may be harmful to the health of a student, the requirements for that immunization shall be waived by the department. Written evidence of any required immunization which the student has previously received shall be submitted to the school or day care center with the waiver form.
• Religious or Personal Belief Exemption: Immunization requirements under s. 252.04, Stats., shall be waived by the department upon presentation of a signed statement by the parent of a minor student or by the adult student which declares an objection to immunization on religious or personal conviction grounds. Written evidence of any required immunization which the student has previously received shall be submitted to the school or day care center with the waiver form.

Wyoming School Immunization Law – WY Stat § 21-4-309

Medical or Religious Belief Exemption: Waivers shall be authorized by the state or county health officer upon submission of written evidence of religious objection or medical contraindication to the administration of any vaccine. In the presence of an outbreak of vaccine preventable disease as determined by the state or county health authority, school children for whom a waiver has been issued and who are not immunized against the occurring vaccine preventable disease shall be excluded from school attendance for a period of time determined by the state or county health authority, but not suspended from school as provided in W.S. 21-4-305.

Wyoming Child Care Immunization Law – WY Stat § 14-4-116

Wyoming School Immunization Regulation – Wyo. Code R., Dept. of Health, Mandatory Immunizations, Ch. 1, § 4

• Medical Exemption: A pupil shall not be required to have any immunizations which are medically contraindicated. The State Health Officer or County Health Officer shall grant a medical exemption from the specific immunization requirement in these regulations upon receiving a signed and notarized Wyoming Department of Health Medical Exemption form. This form must be accompanied by written evidence from any physician licensed to practice medicine in any jurisdiction of the United States, that the administration of the specific immunization is medically contraindicated to the pupil. The exemption shall be maintained by the school as part of the immunization record of the pupil.
• Religious Belief Exemption: A pupil shall be exempted from mandatory immunizations based on evidence of a truly held and genuine religious objection. The parent or guardian shall sign a notarized Wyoming Department of Health Religious Exemption form stating that the administration of immunizing agents conflicts with his religious tenets and religious practices. This exemption will be maintained by the school as part of the immunization record of the pupil. Approved Religious Exemptions must be renewed upon entry into the seventh grade.

Photo Credit: National Archives.