States With Religious and Philosophical Exemptions From School Immunization Requirements

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. As a result of legislation passed in 2015, two of those states—California and Vermont—will no longer allow philosophical exemptions beginning in July 2016, bringing the number of states that allow philosophical exemptions to eighteen.

State Non-Medical Exemptions from School Immunization Requirements, 2015

Source: Adapted from Immunization Action Coalition, June 2014.
* 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 Arizona, the personal exemption is for school enrollees. In Missouri, it is for childcare enrollees only.

Note: As of June 30, 2015, California and Vermont enacted legislation to repeal exemptions (description is below).  The new laws go into effect on July 1, 2016.

Several states, including California, Connecticut, Illinois, South Dakota, Vermont and West Virginia passed legislation in 2015 related to exemptions.

• 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.

Several other states considered legislation in 2015 that addresses exemptions from required immunizations.

• New York S01536 would have established a personal belief exemption.
• Arizona, Missouri and Texas would have required schools or state agencies to provide information about immunization rates on websites or by other means. For example, Arizona HB 2466 would have required schools with websites to post immunization rates for enrolled students and Missouri House Bill No. 846 would have required schools to inform parents or guardians if a student in attendance was not immunized.
• Minnesota House Bill 393 would have required parents claiming a personal belief exemption to obtain a physician’s statement attesting that they had reviewed information about vaccine risks and benefits with the parents or guardians.
• Oregon Senate Bill 442 (Pending) would require the Oregon Health Authority to adopt a schedule for exemption submissions.
• Washington’s House Bill 2009 (Pending), reintroduced in May 2015, would eliminate the personal belief or philosophical exemption.

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.”

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

** California and Vermont enacted legislation (as described above) repealing philosophical exemptions (CA and VT) and religious exemptions (CA).  The laws go into effect on July 1, 2016.

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.