State Vaccine Doctor Feeds Orgon Lawmakrs

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. 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  and the District of Columbia will require children to receive a FDA-approved 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.

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, 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

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

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