States With Religious and Philosophical Exemptions From School Immunization Requirements

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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.

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.

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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  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. § 333.92089215  Yes  Yes
 Minnesota  Minn. Stat. Ann. § 121A-15  Yes  Yes
 Mississippi  Miss. Code Ann. § 41-23-37  No  No
 Missouri  Mo. Rev. Stat. § 167.181210.003  Yes  Yes*
 Montana  Mont. Code Ann. § 20-5-403, 405  Yes  No
 Nebraska  Neb. Rev. Stat. Ann. § 79-217221  Yes  No
 Nevada  Nev. Rev. Stat. § 392.435, 437, 439  Yes  No
 New Hampshire  N.H. Rev. Stat. Ann. § 141-C:20-a20-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  No  No
 North Carolina  N.C. Gen. Stat. § 130A-155156157  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 § 23-8384  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, § 11211122  Yes  No
 Virginia  Va. Code Ann. § 22.1-271.2§ 32.1-46  Yes  No
 Washington  Wash. Rev. Code Ann. § 28A.210.08090  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.”

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

Read more at https://www.ncsl.org/research/health/school-immunization-exemption-state-laws.aspx