States With Religious and Philosophical Exemptions From School Immunization Requirements

11/22/2021

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 44 states and Washington D.C. that grant religious exemptions for people who have religious objections to immunizations. Currently, 15 states allow philosophical exemptions for children whose parents object to immunizations because of personal, moral or other beliefs. Many states align their vaccine requirements with recommendations from the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices. At this time, California is the only state requiring children to receive the COVID-19 vaccine for school entry in 2022. Some cities, counties and school districts have added COVID-19 vaccine requirements for certain age groups or for certain activities such as participating in sports. Below this map are examples of enacted legislation related to school immunization requirements for the last several years.

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 2021

  • Connecticut House Bill 6423 removes the religious exemption for vaccine requirement for children in grade 12 or below. 

 

Enacted Legislation 2020

  • Colorado Senate Bill 163 requires a person seeking a nonmedical exemption (either religious or personal belief) to submit a certificate of completion of an online educational module or a certificate of nonmedical exemption. It establishes an immunization goal of 95% of each school's student population and requires schools to publish its immunization and exemption rates on a document that is distributed to parents, guardians and students.
  • Virginia House Bill 1090 provides that the Board of Health's Regulations for the Immunization of School Children shall be consistent with the Immunization Schedule developed and published by the Centers for Disease Control and Prevention, the Advisory Committee on Immunization Practices, the American Academy of Pediatrics, and the American Academy of Family Physicians.

 

Enacted Legislation 2019

  • Arkansas House Bill 1786 requires a public or private school to create and maintain a report that provides certain information regarding the number and percentage of students who have an exemption from the requirement to obtain vaccinations.
  • 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.
  • 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.

 

Enacted Legislation 2018

  • Illinois Senate Bill 2866 provides for the distribution of written information about the link between HPV and certain types of cancers to all students entering sixth grade and their parents or legal guardians.
  • Louisiana House Bill 176 requires students who are entering eleventh grade or who are 16 and entering any grade to provide satisfactory evidence of current immunization against meningococcal disease as a condition of school entry, and provides for exceptions.

 

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. 

 

 

 

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

 No

 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

 No

 No

 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

 No*

 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-9.1

 Yes 

 No 

 New Mexico

 N.M. Stat. Ann. § 24-5-1, 3

 Yes 

 No

 New York

 N.Y. Pub. Health Law § 2164

 No

 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. § 53G-9-303

 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 

 No

 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.”

*Missouri's philosophical exemption only applies to day care centers.

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: 

Immunization Policy Issues Overview | NCSL Webpage

Kindergarten Immunization Coverage Rates 2018-19: Mumps, Measles and Rubella Vaccine | NCSL Postcard

HPV Vaccine: State Legislation and Regulation | NCSL Webpage

Preventing and Mitigating the Flu | NCSL LegisBrief

Vaccination Policies: Requirements and Exemptions for Entering Schools | NCSL LegisBrief