States With Religious and Philosophical Exemptions From School Immunization Requirements

6/14/2019

All 50 states have legislation requiring specified vaccines for students. Although exemptions vary from state to state, all school immunization laws grant exemptions to children for medical reasons. There are 45 states and Washington D.C. that grant religious exemptions for people who have religious objections to immunizations. Currently, 15 states allow philosophical exemptions for those who object to immunizations because of personal, moral or other beliefs.

Immunization map

Source: Adapted from the LexisNexis StateNet Database and the Immunization Action Coalition, May 2019.
* The existing statute in Minnesota and Louisiana does not explicitly recognize religion as a reason for claiming an exemption, however, as a practical matter, the non-medical exemption may encompass religious beliefs.

**In Virginia, parents can receive a personal exemption only for the HPV vaccine.

***Missouri’s personal belief exemption does not apply to public schools, only child care facilities.

 


 

Enacted Legislation 2019

  • Washington House Bill 1638 removes the personal belief exemption for the measles, mumps and rubella vaccine requirement for public schools, private schools and day care centers.
  • Maine House Bill 586 removes personal and religious belief exemptions for public school immunization requirements.
  • New York Senate Bill 2994 removes the religious exemption for public school immunization requirements.

Enacted Legislation 2017

  • Indiana House Bill 1069 adds meningitis to the required immunizations a student enrolling in a residential campus of an approved postsecondary educational institution must be immunized against. 
  • Utah House Bill 308 requires the Department of Health to create an online education module regarding certain preventable diseases; amends the grounds for exemptions from required vaccines; requires the renewal of a student's vaccination exemption under certain conditions; create a new vaccination exemption form; allows for the vaccination exemption form to be completed online in conjunction with the education module and discontinues the practice of allowing local health departments to vaccinate students and recover costs.

 

Enacted Legislation 2016

  • Delaware House Bill 91 adds language around its existing religious exemption, explaining that in the event that the Division of Public Health declares that there is an outbreak of a vaccine preventable disease, or if in the estimation of the Division of Public Health, an unvaccinated child has had, or is at risk of having an exposure to a vaccine preventable disease, the child shall be temporarily excluded from attendance at the public school. It also gives the Division of Public Health the authority to review medical exemptions signed by a physician. 
  • Minnesota House Bill 2749 applied its statutes related public school immunization requirements and exemption criteria to its free voluntary prekindergarten program.

 

Enacted Legislation 2015

  • With the passage of Senate Bill No. 277, California removed exemptions based on personal beliefs, which are defined in that state as also including religious objections.
  • Connecticut HB 6949 requires an annual, notarized, statement from parents or guardians specifying religious objection to required vaccinations. 
  • Illinois SB1410, awaiting the governors’ action in June 2015, would require each public school district to make exemption data available to the public. It also would require parents or guardians who claim a religious exemption to detail their objections for specific immunizations, obtain a health care provider’s signature, and submit an exemption certificate for each child before kindergarten, sixth and ninth grade. Local school authorities would determine if the exemption request constitutes valid religious objection, as philosophical exemption is not permitted in Illinois.
  • South Dakota’s new law requires a child’s immunization records to be shared among health care providers, federal and state health agencies, child welfare agencies, and schools, unless the patient or guardian signs a refusal. It requires providers to inform parents or guardians that they have the right to refuse disclosure of records.
  • With passage of H. 98, Vermont became the first state to repeal its personal belief exemption. (The legislation does not change the existing exemption for parents who wish to opt out for religious reasons.) , Vermont H. 98 also requires schools and child care facilities to provide school immunization rates to parents.
  • West Virginia Senate Bill No. 286, among other things, requires certification by a licensed physician for medical exemption requests. It also authorizes the commissioner of the Bureau for Public Health to appoint an immunization officer to make determinations about requests for exemptions.

 

School Vaccine Requirements and Exemptions
State Statute Religious Exemption Philosophical Exemption

 Alabama

 Ala. Code § 16-30-3

 Yes

 No

 Alaska

 Ak. Stat. §14.30.125

 Yes

 No

 Arizona

 Ariz. Rev. Stat. Ann. § 15-872, 873

 Yes

 Yes

 Arkansas

 Ark. Code Ann. § 6-18-702

 Yes

 Yes

 California

 Cal. Health & Safety Code § 120325 et seq.

 No

 No

 Colorado

 Colo. Rev. Stat. § 25-4-902, 903

 Yes

 Yes 

 Connecticut

 Conn. Gen. Stat. § 10-204a

 Yes

 No

 Delaware

 Del. Code Ann.  tit. 14  § 131

 Yes

 No 

 Washington, DC

 D.C. Code Ann. § 38-501, 506

 Yes

 No

 Florida

 Fla. Stat. Ann. § 1003.22

 Yes

 No

 Georgia

 Ga. Code Ann. § 20-2-771

 Yes

 No

 Hawaii

 Haw. Rev. Stat. § 302A-1154, 1156

 Yes

 No

 Idaho

 Idaho Code § 39-4801, 4802

 Yes

 Yes

 Illinois

 105 Ill. Comp. Stat. § 5/27-8.1

 Yes

 No

 Indiana

 Ind. Code Ann. § 21-40-5

 Yes

 No

 Iowa

 Iowa Code Ann. § 139A.8

 Yes

 No

 Kansas

 Kan. Stat. Ann. § 72-5209

 Yes

 No

 Kentucky

 Ky. Rev. Stat. Ann. § 214.034

 Yes

 No

 Louisiana

 La. Rev. Stat. Ann. § 17:170(A); 40:31.16

 Yes

 Yes

 Maine

 Me. Rev. Stat. Ann. tit. 20-A § 6355

 Yes

 Yes

 Maryland

 Md. Code Ann. Educ. § 7-403

 Yes

 No 

 Massachusetts

 Mass. Gen Laws ch.76, § 15

 Yes

 No 

 Michigan

 Mich. Comp. Laws Ann. § 333.9208, 9215

 Yes

 Yes

 Minnesota

 Minn. Stat. Ann. § 121A-15

 Yes

 Yes

 Mississippi

 Miss. Code Ann. § 41-23-37

 No 

 No 

 Missouri

 Mo. Rev. Stat. § 167.181, 210.003

 Yes

 Yes*

 Montana

 Mont. Code Ann. § 20-5-403, 405

 Yes

 No

 Nebraska

 Neb. Rev. Stat. Ann. § 79-217, 221

 Yes 

 No

 Nevada

 Nev. Rev. Stat. § 392.435, 437, 439

 Yes 

 No 

 New Hampshire

 N.H. Rev. Stat. Ann. § 141-C:20-a, 20-c

 Yes 

 No 

 New Jersey

 N.J. Stat. Ann. § 26:1A-9, 9.1

 Yes 

 No 

 New Mexico

 N.M. Stat. Ann. § 24-5-1, 3

 Yes 

 No

 New York

 N.Y. Pub. Health Law § 2164

 Yes 

 No 

 North Carolina

 N.C. Gen. Stat. § 130A-155, 156, 157

 Yes 

 No 

 North Dakota

 N.D. Cent. Code § 23-07-17.1

 Yes 

 Yes

 Ohio

 Ohio Rev. Code Ann. § 3313.671

 Yes 

 Yes

 Oklahoma

 Okla. Stat. Ann. tit. 70, § 1210.191, 192

 Yes 

 Yes

 Oregon

 Or. Rev. Stat. § 433.267

 Yes 

 Yes

 Pennsylvania

 28 Pa. Code § 23-83, 84

 Yes 

 Yes

 Rhode Island

 R.I. Gen. Laws § 16-38-2

 Yes 

 No 

 South Carolina

 S.C. Code Ann. § 44-29-180

 Yes 

 No 

 South Dakota

 S.D. Codified Laws § 13-28-7.1

 Yes 

 No 

 Tennessee

 Tenn. Code Ann. § 49-6-5001

 Yes

 No

 Texas

 Tex. Edu Code Ann. § 38.001

 Yes

 Yes

 Utah

 Utah Code Ann. § 53A-11-301, 302

 Yes

 Yes

 Vermont

 Vt. Stat. Ann. tit. 18, § 1121, 1122

 Yes

 No

 Virginia

 Va. Code Ann. § 22.1-271.2, § 32.1-46

 Yes

 No

 Washington

 Wash. Rev. Code Ann. § 28A.210.080, 90

 Yes 

 Yes

 West Virginia

 W. Va. Code § 16-3-4

 No

 No

 Wisconsin

 Wis. Stat. Ann. § 252.04

 Yes 

 Yes

 Wyoming

 Wyo. Stat. Ann. § 21-4-309

 Yes

 No

Religious exemption indicates that there is a provision in the statute that allows parents to exempt their children from vaccination if it contradicts their sincere religious beliefs.

Philosophical exemption indicates that the statutory language does not restrict the exemption to purely religious or spiritual beliefs.  For example, Maine allows restrictions based on "moral, philosophical or other personal beliefs," and Minnesota allows objections based on “conscientiously held beliefs of the parent or guardian.”

Sources: Chart adapted from Immunization Action Coalition, "Exemptions Permitted for State Immunization Requirements," 2017; LexisNexis; StateNet 2017

Note: List may not be comprehensive, but is representative of state laws that exist. NCSL appreciates additions and corrections.

NCSL Resources: "Vaccination Policies: Requirements and Exemptions for Entering Schools," NCSL LegisBrief, December 2017

"Calling the Shots," State Legislatures Magazine Article, February 2015