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Elementary School Kids

Understanding School Vaccination Exemptions

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State mandates for the vaccination of schoolchildren have long been in place in the United States, with Massachusetts being the first state to legally require immunizations as far back as 1855. Today in the U.S., all states require that children be vaccinated for certain diseases prior to being admitted to school, although the laws and specific immunizations required vary by state (including whether these mandates apply to private schools and childcare settings).

However, a variety of exemptions are allowed on a state by state basis for medical reasons or for religious or philosophical/personal beliefs. Here’s a closer look at the vaccination exemptions that are valid in most states and what’s generally required for a child to qualify for them.

Medical Exemptions

This is the only type of vaccination exemption that’s available in all 50 states and the District of Columbia. There are several types of circumstances under which a particular child might qualify for an exemption. Some of the most common include:

  • A compromised immune system, whether caused by a permanent or temporary condition. This can be anything from a permanent congenital issue or disease that negatively impacts the immune system, to a more temporary circumstance, such as the child is receiving chemotherapy, steroids, or another medication that impairs the immune system.
  • A severe or life threatening allergic reaction to a component of the vaccine. One factor commonly seen here is a severe allergy to eggs (protein from eggs is used in vaccine manufacture).
  • A history of severe adverse reaction related to a vaccination. If the child has experienced a negative response to prior immunizations, then he or she may qualify for this type of exemption.

Religious Exemptions

Parents can apply for exemption based on religious objections in in 47 out of 50 states and the District of Columbia. However, what a parent needs to do to prove the validity of this type of exemption varies greatly from state to state.

  • In some states, in order to receive a religious exemption the family must be able to demonstrate membership within a religious group with documented objections to vaccinations.
  • In other states, parents have to attest that their objection to having their child immunized directly conflicts with a genuine and sincere religious belief (and not based on philosophical, moral, or scientific values).
  • Other states require nothing more than a signed form stating merely that the parent has religious objections to vaccination.

Philosophical/Personal Belief Exemptions

This is the least common type of vaccination exemption, with only 19 states allowing an exemption at this time. However, in those states that do offer all three types of exemptions, the philosophical/personal belief variety tend to be the most popular. Although procedures vary from state to state, in many cases parents are required to file either a one-time or annual form with the school district attesting to their philosophical objection. Often, in order to qualify, parents must also object to all vaccinations and not just a specific one.


Keep in mind that just as the type of exemptions available varies from state to state, so does the process of securing those exemptions. Interested parents should contact their school district, state health department or school nurse to find out what protocols are required to exempt a student from inoculation.

Nothing in this article is intended as medical advice. Consult your doctor before making any health decisions for you or your child.

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