School Vaccine Exemption Laws by State

Vaccination is an important public health measure. Through vaccination, we become immune to certain diseases. The federal government, via the CDC, decides which vaccines will guard against communicable diseases. State governments set different school vaccine laws.

Immunization requirements vary from state to state. Each state requires children to be vaccinated for certain diseases before entering school or daycare. This includes children who attend public schools or state-licensed child care centers, family day care homes, and private schools.

In many states, immunization laws or mandates require children aged 4 or older and entering school or daycare need immunization against the following:

• Poliovirus vaccine (IPV)
• Two doses of the measles, mumps, and rubella vaccine (MMR)
• Hepatitis A vaccine
• Hepatitis B vaccine
• Two doses of the varicella (chicken pox) vaccine
• A booster dose of diphtheria, tetanus, and acellular pertussis vaccine (DTaP)

A child's pediatrician keeps track of these vaccinations. They can also provide an immunization record when the child starts school or daycare.

This article covers vaccine basics and exemptions. It also provides a chart of state vaccination requirements and exemptions.

Vaccine Basics

A vaccine is “a preparation to stimulate the body's immune response against diseases." Vaccination is the process through which we receive a vaccine. For example, the COVID-19 vaccine uses an injection. Immunization is not the same as vaccination. Immunization occurs when we are immune from a communicable disease.

Immunity can wane over time, so immunization is not limited to children. Interested adults should consult their local health department, healthcare provider, or pharmacist. College-age adults should learn the school immunization requirements for their institution.

Immunization Programs

The term “immunization programs" refers to all the services that “ensure immunity to vaccine-preventable diseases." These services include vaccine administration and documentation.

Vaccine Recommendations

Medical professionals and one consumer representative make up the CDC's Advisory Committee on Immunization Practices (ACIP). The ACIP develops vaccine recommendations for the public. The CDC makes recommendations, but state governments can accept or reject those recommendations.

Conflicts can happen when CDC and state guidelines differ. This means childcare and healthcare facilities, for example, can differ on vaccine requirements. For example, either facility can mandate a vaccine for their workers but not for the children using the facility. If a child with influenza enters a care facility, everyone is at risk of catching a communicable disease.

Exemptions

According to the Centers for Disease Control and Prevention (CDC), all 50 states and the District of Columbia have vaccination exemption laws. The type of vaccine exemption allowed depends on state laws.

Most other states allow vaccine exemptions for religious or personal beliefs. Personal, philosophical, and religious exemptions are all examples of nonmedical exemptions. Now, 44 states, plus the District of Columbia, allow religious exemptions. Only 15 states allow philosophical exemptions.

Parents must submit an exemption form as part of the exemption process. Some states do not grant exemptions during an outbreak. Parents should check with their local Department of Health or the local school for more information.

Religious Exemptions

Most states have religious exemptions with varying requirements. For example, Oregon requires proof of vaccine education for exemption.

Personal Belief Exemptions

Less than half of all states allow exemptions for children whose parents have philosophical or personal belief objections to vaccination. Many personal belief objections concern vaccine safety. Some parents believe vaccines are not safe for their children.

In most cases, parents must file a one-time or annual form with a school district attesting to a personal objection to vaccination.

Medical Exemptions

Every state exempts children from vaccination requirements for medical reasons. Contraindications are one medical reason for an exemption. A contraindication exists when a child has an underlying condition that increases the risk of a serious adverse event. For example, a child with a severely compromised immune system cannot handle all the required immunizations.

School Vaccination Requirements and Exemptions by State

State laws can change through legislation, court decisions, ballot initiatives, etc. While we strive to provide the most current information available, please consult an attorney or conduct your legal research to verify the state law(s) you are researching.

Get Legal Help

Parents need help navigating school vaccine rules and exemptions. Parents should speak to a local healthcare law attorney about these issues.