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School Immunization Exemption State Laws

States With Religious and Philosophical Exemptions From School Immunization Requirements

3/3/2015

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. Almost all states grant religious exemptions for people who have religious beliefs against immunizations. Twenty states allow philosophical exemptions for those who object to immunizations because of personal, moral or other beliefs.

State Non-Medical Exemptions from School Immunization Requirements, 2015

United States map of State Non-medical exemptions from school immunization requirements, 2015

 

Source: Adapted from Immunization Action Coalition, June 2014.
* The existing statute in California, 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 religous beliefs.
** In Arizona, the personal exemption is for school enrollees. In Missouri, it is for childcare enrollees only.


In recent years, state legislatures have considered numerous bills to either expand or restrict the personal belief exemptions. In Washington, California and Vermont, parents who want to claim an exemption must now get a doctor’s signature. In 2013, Oregon passed a law that would require parents to obtain a signature of their primary care provider or watch an online educational video that presents information about vaccine risks and benefits. In 2013, Colorado passed legislation  that requires schools to collect and make publicly available information about their vaccination and exemption rates.

As of February 2015, several states have introduced legislation that would address non-medical exemptions, including the following (which may not be a comprehensive list):

  • Arizona H 2466 would require each public school, including charter schools, that maintains a website to post the immunization rate of enrolled pupils.
  • California SB 277 would eliminate the personal belief exemption and require the governing board of a school district to notify parents or guardians at the beginning of the school term about immunization rates for the school in which the child is enrolled.
  • Illinois SB 1410 would require the State Board of Education to publish on its website the exemption data it receives from schools. It would also require parents who object to immunizations on the basis of religious grounds to present the objections to the school authority on a Department of Public Health form, detailing the grounds for the objection and signed by the parent or legal guardian, as well as a notarized signature from a religious official attesting to the religious objection. It would also require parents or guardians to submit to the school a statement signed by the child’s primary care provider for children who are not able to receive one or more immunizations for medical reasons.
  • Minnesota HB 393 and SB 380 would require parents to submit a certificate of exemption for one or more immunizations based on personal beliefs. The bill would require that the certificate must contain: specification of the exempted vaccine(s) and explanation; statement from physician that they have discussed risks and benefits with parent; acknowledgment that the child may be prohibited from school during an outbreak; and the signature of the parent or legal guardian.
  • Missouri H 846 would require parental notification if a non-immunized child is in attendance at the child’s school.
  • New York A.B. 943 and SB 1536, the “philosophical exemption to immunizations act” would provide for a philosophical exemption.
  • Oregon SB 442 directs the Oregon Health Authority to adopt a schedule requiring submission of a document that declines immunizations. It would require all families with children currently in school to meet the requirements for claiming an exemption, not just newly-entering families.
  • South Dakota HB 1059 requires immunization records to be disclosed to health care providers and other authorized agencies and schools unless the patient or guardian signs a refusal. The bill requires the providers to inform patients or patient guardians that they have the right to refuse disclosure.
  • Texas S. 547 would require each school district to provide an annual report on the immunization status of students for the district as a whole and for each school campus in the district. It would also require the Department of State Health Services to make this report available to the public in electronic form.
  • Vermont S. 87 would remove the philosophical exemption to immunizations.
  • Vermont H 98 would amend 18 V.S.A. 1129 to add school administrators to the list of authorized parties to whom immunization records can be released. The bill authorizes the health department to exchange confidential registry information with the immunization registries of other states in order to obtain comprehensive immunization records for Vermont residents.
  • Vermont H 212 removes the religious and philosophical exemptions to vaccinations.
  • Washington HB 2009 would remove the state’s current philosophical/personal belief exemption to immunization requirements.
  • West Virginia SB 286 would require the public health commissioner to notify new parents of immunization requirements for admission into public, private or parochial school or a state-regulated child care center. The bill would require that a request for exemption would need to be accompanied by a certification from a licensed physician stating that the child’s physical condition “is such that immunization is contraindicated or there exists a specific precaution to a particular vaccine.”
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.

 Yes

 Yes

 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

 Yes

 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 California allows objections based on simply the parent(s) beliefs.

* The Missouri philosophical exemption applies only to daycare, preschool and nursery school.

Sources: Chart adapted from Immunization Action Coalition, "Exemptions Permitted for State Immunization Requirements," 2014; LexisNexis 2015.

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

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