{ "meta": { "description": "Official vaccine exemption forms and procedures for US states and Canadian provinces/territories. Factual, regulatory-focused information compiled from official health department sources.", "lastUpdated": "2026-07-08-v3-verified", "disclaimer": "Exemption laws and forms change. Always verify with official health department websites. This is not legal advice.", "exemptionTypes": { "medical": "Available in all US states and Canadian provinces. Requires documentation from a licensed healthcare provider.", "religious": "Available in most but not all US states and Canadian provinces. Requirements vary by jurisdiction.", "philosophical": "Available in a minority of US states. Not available in any Canadian province or territory." }, "notes": "All URLs verified against official health department websites." }, "usa": [ { "id": "al", "name": "Alabama", "healthDept": "Alabama Department of Public Health", "healthDeptUrl": "https://www.alabamapublichealth.gov/immunization/", "exemptions": { "medical": { "available": true, "formUrl": "https://www.alabamapublichealth.gov/immunization/", "formLabel": "Alabama Immunization Program — Official Health Department", "submission": "Submit completed form signed by a licensed physician (MD/DO) to the school or childcare facility.", "renewal": "Must be renewed annually or as specified by the physician.", "authority": "Licensed physician (MD or DO)" }, "religious": { "available": true, "formUrl": "https://www.alabamapublichealth.gov/immunization/", "formLabel": "Alabama Immunization Program — Official Health Department", "submission": "Parent/guardian must submit the notarized form to the school. No education session required.", "renewal": "New form must be submitted each school year.", "authority": "Parent/guardian or individual (age 19+)" }, "philosophical": { "available": false } }, "relevantStatutes": "Ala. Admin. Code r. 420-6-1-.03", "notes": "Alabama recognizes both medical and religious exemptions. Religious exemption requires notarization." }, { "id": "ak", "name": "Alaska", "healthDept": "Alaska Department of Health", "healthDeptUrl": "https://health.alaska.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://health.alaska.gov/", "formLabel": "Alaska Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO), advanced practice registered nurse, or physician assistant to the school.", "renewal": "Duration specified by the healthcare provider.", "authority": "MD, DO, APRN, or PA" }, "religious": { "available": true, "formUrl": "https://health.alaska.gov/", "formLabel": "Alaska Immunization Program — Official Health Department", "submission": "Parent/guardian must sign and submit the official state form. Notarization required.", "renewal": "Must be renewed yearly before school entry.", "authority": "Parent/guardian" }, "philosophical": { "available": false } }, "relevantStatutes": "4 AAC 06.055", "notes": "Alaska allows medical and religious exemptions. Religious exemption must be notarized." }, { "id": "az", "name": "Arizona", "healthDept": "Arizona Department of Health Services", "healthDeptUrl": "https://www.azdhs.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://www.azdhs.gov/", "formLabel": "Arizona Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed healthcare provider to the school administrator.", "renewal": "Valid for the duration stated by the provider; typically reviewed annually.", "authority": "Licensed physician (MD/DO) or nurse practitioner" }, "religious": { "available": true, "formUrl": "https://www.azdhs.gov/", "formLabel": "Arizona Immunization Program — Official Health Department", "submission": "Parent/guardian signs and submits the form to the school. No notarization required.", "renewal": "Annually before school entry.", "authority": "Parent/guardian" }, "philosophical": { "available": true, "formUrl": "https://www.azdhs.gov/", "formLabel": "Arizona Immunization Program — Official Health Department", "submission": "Parent/guardian signs and submits form to the school. No notarization or explanation of beliefs required.", "renewal": "Annually before school entry.", "authority": "Parent/guardian" } }, "relevantStatutes": "A.R.S. § 15-873", "notes": "Arizona allows all three exemption types: medical, religious, and personal beliefs." }, { "id": "ar", "name": "Arkansas", "healthDept": "Arkansas Department of Health", "healthDeptUrl": "https://www.healthy.arkansas.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://www.healthy.arkansas.gov/", "formLabel": "Arkansas Immunization Program — Official Health Department", "submission": "Submit form completed by a licensed physician (MD/DO) to the school.", "renewal": "Duration specified by physician.", "authority": "Licensed physician (MD or DO)" }, "religious": { "available": true, "formUrl": "https://www.healthy.arkansas.gov/", "formLabel": "Arkansas Immunization Program — Official Health Department", "submission": "Parent completes and notarizes form. Submit to school annually.", "renewal": "Must be submitted annually before October 1.", "authority": "Parent/guardian" }, "philosophical": { "available": true, "formUrl": "https://www.healthy.arkansas.gov/", "formLabel": "Arkansas Immunization Program — Official Health Department", "submission": "Parent completes and notarizes form. Submit to school annually.", "renewal": "Must be submitted annually before October 1.", "authority": "Parent/guardian" } }, "relevantStatutes": "Ark. Code Ann. § 6-18-702", "notes": "Arkansas allows all three exemption types. Both religious and philosophical exemptions require notarization." }, { "id": "ca", "name": "California", "healthDept": "California Department of Public Health", "healthDeptUrl": "https://www.cdph.ca.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://www.cdph.ca.gov/", "formLabel": "California Immunization Program — Official Health Department", "submission": "Physician must complete the California Immunization Registry (CAIR) Medical Exemption form. Starting 2021, all medical exemptions are reviewed by the California Department of Public Health. Parent submits to school.", "renewal": "Must be renewed based on physician's determination. CDPH may review exemptions.", "authority": "Licensed physician (MD or DO). CDPH reviews and may revoke exemptions." }, "religious": { "available": false, "formUrl": null, "notes": "Religious exemptions were eliminated effective January 1, 2016, via SB 277. California does not accept religious or personal belief exemptions for school entry." }, "philosophical": { "available": false, "notes": "Personal belief exemptions eliminated effective January 1, 2016, via SB 277." } }, "relevantStatutes": "Cal. Health & Safety Code § 120325–120380", "notes": "As of 2021, California requires all medical exemptions to be entered into CAIR-ME and reviewed by CDPH. Only medical exemptions are permitted. SB 277 (2015) eliminated non-medical exemptions." }, { "id": "co", "name": "Colorado", "healthDept": "Colorado Department of Public Health & Environment", "healthDeptUrl": "https://cdphe.colorado.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://cdphe.colorado.gov/", "formLabel": "Colorado Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO), advanced practice nurse, or physician assistant to the school.", "renewal": "Annually unless physician certifies a permanent condition.", "authority": "MD, DO, APRN, or PA" }, "religious": { "available": true, "formUrl": "https://cdphe.colorado.gov/", "formLabel": "Colorado Immunization Program — Official Health Department", "submission": "Parent/guardian must submit the non-medical exemption form. Requires either a signature from a healthcare provider who has provided vaccine education OR an online education module completion certificate.", "renewal": "New form required annually. Education module certificate expires after 2 years.", "authority": "Parent/guardian with provider signature or education module completion" }, "philosophical": { "available": true, "formUrl": "https://cdphe.colorado.gov/", "formLabel": "Colorado Immunization Program — Official Health Department", "submission": "Same process as religious exemption. Colorado uses a unified non-medical exemption form.", "renewal": "New form required annually.", "authority": "Parent/guardian with provider signature or education module completion" } }, "relevantStatutes": "C.R.S. § 25-4-903", "notes": "Colorado allows all three exemption types. Non-medical exemptions (religious and philosophical) require either a healthcare provider signature confirming vaccine education OR completion of the state's online education module." }, { "id": "ct", "name": "Connecticut", "healthDept": "Connecticut Department of Public Health", "healthDeptUrl": "https://portal.ct.gov/DPH", "exemptions": { "medical": { "available": true, "formUrl": "https://portal.ct.gov/DPH", "formLabel": "Connecticut Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO), APRN, or PA to the school.", "renewal": "Annually unless permanent condition is specified.", "authority": "MD, DO, APRN, or PA" }, "religious": { "available": false, "formUrl": null, "notes": "Religious exemptions were eliminated effective April 28, 2021, via Public Act 21-6. Previously submitted religious exemptions for students in grades K-12 were grandfathered until the student reaches the next grade level milestone." }, "philosophical": { "available": false } }, "relevantStatutes": "Conn. Gen. Stat. § 10-204a", "notes": "As of 2021, only medical exemptions are accepted for new school entrants. Religious exemptions were eliminated by PA 21-6." }, { "id": "de", "name": "Delaware", "healthDept": "Delaware Division of Public Health", "healthDeptUrl": "https://dhss.delaware.gov/dph/", "exemptions": { "medical": { "available": true, "formUrl": "https://dhss.delaware.gov/dph/", "formLabel": "Delaware Immunization Program — Official Health Department", "submission": "Submit form completed by a licensed physician (MD/DO) to the school.", "renewal": "Annually unless physician states condition is permanent.", "authority": "Licensed physician (MD or DO)" }, "religious": { "available": true, "formUrl": "https://dhss.delaware.gov/dph/", "formLabel": "Delaware Immunization Program — Official Health Department", "submission": "Parent/guardian must sign and notarize the religious exemption affidavit and submit to the school.", "renewal": "Annually for each school year.", "authority": "Parent/guardian (with notarization)" }, "philosophical": { "available": false } }, "relevantStatutes": "14 Del. C. § 131", "notes": "Delaware allows medical and religious exemptions. Religious exemption requires notarization." }, { "id": "fl", "name": "Florida", "healthDept": "Florida Department of Health", "healthDeptUrl": "https://www.floridahealth.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://www.floridahealth.gov/", "formLabel": "Florida Immunization Program — Official Health Department", "submission": "Physician completes Section C of the DH 680 form waiving specific vaccines. Submit to the school or childcare facility.", "renewal": "Per physician's determination.", "authority": "Licensed physician (MD or DO)" }, "religious": { "available": true, "formUrl": "https://www.floridahealth.gov/", "formLabel": "Florida Immunization Program — Official Health Department", "submission": "Parent/guardian must request and complete form DH 681 from the County Health Department. No notarization required.", "renewal": "Permanent — does not need to be re-submitted annually.", "authority": "County Health Department issues the form; parent/guardian signs" }, "philosophical": { "available": false } }, "relevantStatutes": "Fla. Stat. § 1003.22", "notes": "Florida provides medical exemptions on the standard DH 680 immunization form. Religious exemptions use a separate DH 681 form obtained from the county health department. Once issued, the DH 681 is permanent." }, { "id": "ga", "name": "Georgia", "healthDept": "Georgia Department of Public Health", "healthDeptUrl": "https://dph.georgia.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://dph.georgia.gov/", "formLabel": "Georgia Immunization Program — Official Health Department", "submission": "Submit form completed by a licensed physician (MD/DO) to the school on the Georgia Certificate of Immunization (Form 3231).", "renewal": "According to physician's determination.", "authority": "Licensed physician (MD or DO)" }, "religious": { "available": true, "formUrl": "https://dph.georgia.gov/", "formLabel": "Georgia Immunization Program — Official Health Department", "submission": "Parent/guardian must sign and notarize the affidavit and submit it to the school.", "renewal": "Must be renewed annually at the beginning of each school year.", "authority": "Parent/guardian (with notarization)" }, "philosophical": { "available": false } }, "relevantStatutes": "Ga. Code Ann. § 20-2-771", "notes": "Georgia allows medical and religious exemptions. Religious exemption requires notarized affidavit." }, { "id": "hi", "name": "Hawaii", "healthDept": "Hawaii Department of Health", "healthDeptUrl": "https://health.hawaii.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://health.hawaii.gov/", "formLabel": "Hawaii Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO), APRN, or PA to the school.", "renewal": "Duration determined by the healthcare provider.", "authority": "MD, DO, APRN, or PA" }, "religious": { "available": true, "formUrl": "https://health.hawaii.gov/", "formLabel": "Hawaii Immunization Program — Official Health Department", "submission": "Parent/guardian signs the form and submits to the school. Notarization not required.", "renewal": "Annually.", "authority": "Parent/guardian" }, "philosophical": { "available": false } }, "relevantStatutes": "HRS § 302A-1157", "notes": "Hawaii allows medical and religious exemptions." }, { "id": "id", "name": "Idaho", "healthDept": "Idaho Department of Health & Welfare", "healthDeptUrl": "https://healthandwelfare.idaho.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://healthandwelfare.idaho.gov/", "formLabel": "Idaho Immunization Program — Official Health Department", "submission": "Submit a signed statement from a licensed physician indicating the medical contraindication to the school.", "renewal": "Per physician's recommendation.", "authority": "Licensed physician (MD or DO)" }, "religious": { "available": true, "formUrl": "https://healthandwelfare.idaho.gov/", "formLabel": "Idaho Immunization Program — Official Health Department", "submission": "Parent/guardian completes the state exemption form and submits to the school. Notarization not required.", "renewal": "Annually.", "authority": "Parent/guardian" }, "philosophical": { "available": true, "formUrl": "https://healthandwelfare.idaho.gov/", "formLabel": "Idaho Immunization Program — Official Health Department", "submission": "Parent/guardian completes the same state form and selects personal/philosophical reason.", "renewal": "Annually.", "authority": "Parent/guardian" } }, "relevantStatutes": "Idaho Code § 39-4801", "notes": "Idaho allows all three exemption types. Uses a unified exemption form for non-medical exemptions." }, { "id": "il", "name": "Illinois", "healthDept": "Illinois Department of Public Health", "healthDeptUrl": "https://dph.illinois.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://dph.illinois.gov/", "formLabel": "Illinois Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO), APRN, or PA to the school.", "renewal": "According to physician's determination.", "authority": "MD, DO, APRN, or PA" }, "religious": { "available": true, "formUrl": "https://dph.illinois.gov/", "formLabel": "Illinois Immunization Program — Official Health Department", "submission": "Parent/guardian completes the religious exemption form and submits to school. No notarization required.", "renewal": "Must be renewed annually.", "authority": "Parent/guardian" }, "philosophical": { "available": false } }, "relevantStatutes": "105 ILCS 5/27-8.1", "notes": "Illinois allows medical and religious exemptions. Religious exemption form must be completed by the parent/guardian." }, { "id": "in", "name": "Indiana", "healthDept": "Indiana Department of Health", "healthDeptUrl": "https://www.in.gov/health/", "exemptions": { "medical": { "available": true, "formUrl": "https://www.in.gov/health/", "formLabel": "Indiana Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO) to the school.", "renewal": "As determined by the physician.", "authority": "Licensed physician (MD or DO)" }, "religious": { "available": true, "formUrl": "https://www.in.gov/health/", "formLabel": "Indiana Immunization Program — Official Health Department", "submission": "Parent/guardian completes and submits the form to the school. No notarization required.", "renewal": "Annually.", "authority": "Parent/guardian" }, "philosophical": { "available": false } }, "relevantStatutes": "IC 20-34-3-2", "notes": "Indiana allows medical and religious exemptions." }, { "id": "ia", "name": "Iowa", "healthDept": "Iowa Department of Health & Human Services", "healthDeptUrl": "https://hhs.iowa.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://hhs.iowa.gov/", "formLabel": "Iowa Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO), APRN, or PA to the school.", "renewal": "As indicated by the provider; typically annually.", "authority": "MD, DO, APRN, or PA" }, "religious": { "available": true, "formUrl": "https://hhs.iowa.gov/", "formLabel": "Iowa Immunization Program — Official Health Department", "submission": "Parent/guardian signs and notarizes the form. Submit to school.", "renewal": "Annually.", "authority": "Parent/guardian (with notarization)" }, "philosophical": { "available": false } }, "relevantStatutes": "Iowa Code § 139A.8", "notes": "Iowa allows medical and religious exemptions. Religious exemption must be notarized." }, { "id": "ks", "name": "Kansas", "healthDept": "Kansas Department of Health & Environment", "healthDeptUrl": "https://www.kdhe.ks.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://www.kdhe.ks.gov/", "formLabel": "Kansas Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO) to the school.", "renewal": "According to physician's determination.", "authority": "Licensed physician (MD or DO)" }, "religious": { "available": true, "formUrl": "https://www.kdhe.ks.gov/", "formLabel": "Kansas Immunization Program — Official Health Department", "submission": "Parent/guardian completes a written statement and submits to the school. Notarization not required.", "renewal": "Annually.", "authority": "Parent/guardian" }, "philosophical": { "available": false } }, "relevantStatutes": "K.S.A. 72-6262", "notes": "Kansas allows medical and religious exemptions." }, { "id": "ky", "name": "Kentucky", "healthDept": "Kentucky Cabinet for Health & Family Services", "healthDeptUrl": "https://www.chfs.ky.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://www.chfs.ky.gov/", "formLabel": "Kentucky Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO) or advanced practice registered nurse to the school.", "renewal": "Per provider's determination.", "authority": "MD, DO, or APRN" }, "religious": { "available": true, "formUrl": "https://www.chfs.ky.gov/", "formLabel": "Kentucky Immunization Program — Official Health Department", "submission": "Parent/guardian completes and notarizes the sworn statement. Submit to school.", "renewal": "Annually.", "authority": "Parent/guardian (with notarization)" }, "philosophical": { "available": false } }, "relevantStatutes": "KRS 214.036", "notes": "Kentucky allows medical and religious exemptions. Religious exemption requires a notarized sworn statement." }, { "id": "la", "name": "Louisiana", "healthDept": "Louisiana Department of Health", "healthDeptUrl": "https://ldh.la.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://ldh.la.gov/", "formLabel": "Louisiana Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO) to the school.", "renewal": "As determined by physician.", "authority": "Licensed physician (MD or DO)" }, "religious": { "available": true, "formUrl": "https://ldh.la.gov/", "formLabel": "Louisiana Immunization Program — Official Health Department", "submission": "Parent/guardian completes and notarizes the form. Submit to school.", "renewal": "Annually.", "authority": "Parent/guardian (with notarization)" }, "philosophical": { "available": true, "formUrl": "https://ldh.la.gov/", "formLabel": "Louisiana Immunization Program — Official Health Department", "submission": "Parent/guardian completes and notarizes the form. Submit to school.", "renewal": "Annually.", "authority": "Parent/guardian (with notarization)" } }, "relevantStatutes": "La. R.S. 17:170", "notes": "Louisiana allows all three exemption types. Non-medical exemptions require notarization." }, { "id": "me", "name": "Maine", "healthDept": "Maine Department of Health & Human Services", "healthDeptUrl": "https://www.maine.gov/dhhs/", "exemptions": { "medical": { "available": true, "formUrl": "https://www.maine.gov/dhhs/", "formLabel": "Maine Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO), nurse practitioner, or physician assistant to the school.", "renewal": "Annually.", "authority": "MD, DO, NP, or PA" }, "religious": { "available": false, "formUrl": null, "notes": "Religious and philosophical exemptions were eliminated effective September 1, 2021, via LD 798. Only medical exemptions are now accepted for school and childcare entry." }, "philosophical": { "available": false, "notes": "Philosophical exemptions eliminated effective September 1, 2021, via LD 798." } }, "relevantStatutes": "20-A M.R.S. § 6355", "notes": "As of September 2021, Maine eliminated non-medical exemptions. Only medical exemptions are accepted." }, { "id": "md", "name": "Maryland", "healthDept": "Maryland Department of Health", "healthDeptUrl": "https://health.maryland.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://health.maryland.gov/", "formLabel": "Maryland Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO) on the Maryland Form 896 to the school.", "renewal": "As indicated by physician.", "authority": "Licensed physician (MD or DO)" }, "religious": { "available": true, "formUrl": "https://health.maryland.gov/", "formLabel": "Maryland Immunization Program — Official Health Department", "submission": "Parent/guardian must request the religious exemption form from the local health department or school, sign it, and submit.", "renewal": "Annually.", "authority": "Parent/guardian" }, "philosophical": { "available": false } }, "relevantStatutes": "COMAR 10.06.04.03", "notes": "Maryland allows medical and religious exemptions. The religious exemption form must be obtained from the local health department." }, { "id": "ma", "name": "Massachusetts", "healthDept": "Massachusetts Department of Public Health", "healthDeptUrl": "https://www.mass.gov/dph", "exemptions": { "medical": { "available": true, "formUrl": "https://www.mass.gov/dph", "formLabel": "Massachusetts Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO), nurse practitioner, or physician assistant to the school.", "renewal": "Annually unless provider certifies lifelong condition.", "authority": "MD, DO, NP, or PA" }, "religious": { "available": true, "formUrl": "https://www.mass.gov/dph", "formLabel": "Massachusetts Immunization Program — Official Health Department", "submission": "Parent/guardian completes the form and submits to the school. No notarization required.", "renewal": "Annually.", "authority": "Parent/guardian" }, "philosophical": { "available": false } }, "relevantStatutes": "M.G.L. c. 76, § 15", "notes": "Massachusetts allows medical and religious exemptions." }, { "id": "mi", "name": "Michigan", "healthDept": "Michigan Department of Health & Human Services", "healthDeptUrl": "https://www.michigan.gov/mdhhs", "exemptions": { "medical": { "available": true, "formUrl": "https://www.michigan.gov/mdhhs", "formLabel": "Michigan Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO) to the school.", "renewal": "As determined by the physician; may be permanent.", "authority": "Licensed physician (MD or DO)" }, "religious": { "available": true, "formUrl": "https://www.michigan.gov/mdhhs", "formLabel": "Michigan Immunization Program — Official Health Department", "submission": "Parent/guardian must visit the local health department to receive vaccine education and have the waiver form certified. Then submit certified form to the school.", "renewal": "Annually.", "authority": "Local health department (certifies after education session); parent/guardian signs" }, "philosophical": { "available": true, "formUrl": "https://www.michigan.gov/mdhhs", "formLabel": "Michigan Immunization Program — Official Health Department", "submission": "Same process as religious exemption. Requires health department education session. A unified waiver form covers all non-medical exemptions.", "renewal": "Annually.", "authority": "Local health department certifies; parent/guardian signs" } }, "relevantStatutes": "MCL 333.9215", "notes": "Michigan allows all three exemption types. All non-medical waivers require an in-person education session at the local health department before the waiver is certified." }, { "id": "mn", "name": "Minnesota", "healthDept": "Minnesota Department of Health", "healthDeptUrl": "https://www.health.state.mn.us/", "exemptions": { "medical": { "available": true, "formUrl": "https://www.health.state.mn.us/", "formLabel": "Minnesota Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO), nurse practitioner, or physician assistant to the school.", "renewal": "As determined by provider.", "authority": "MD, DO, NP, or PA" }, "religious": { "available": true, "formUrl": "https://www.health.state.mn.us/", "formLabel": "Minnesota Immunization Program — Official Health Department", "submission": "Parent/guardian completes the conscientious exemption form, has it notarized, and submits to the school.", "renewal": "Annually.", "authority": "Parent/guardian (with notarization)" }, "philosophical": { "available": true, "formUrl": "https://www.health.state.mn.us/", "formLabel": "Minnesota Immunization Program — Official Health Department", "submission": "Same process. Minnesota uses a unified 'conscientious exemption' that covers both religious and philosophical objections.", "renewal": "Annually.", "authority": "Parent/guardian (with notarization)" } }, "relevantStatutes": "Minn. Stat. § 121A.15", "notes": "Minnesota allows all three exemption types. Uses a unified 'conscientious exemption' form for non-medical exemptions. Notarization required." }, { "id": "ms", "name": "Mississippi", "healthDept": "Mississippi State Department of Health", "healthDeptUrl": "https://msdh.ms.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://msdh.ms.gov/", "formLabel": "Mississippi Immunization Program — Official Health Department", "submission": "Submit Form 139 completed by a licensed physician (MD/DO) to the school.", "renewal": "Annually unless physician certifies permanent condition.", "authority": "Licensed physician (MD or DO)" }, "religious": { "available": false, "formUrl": null, "notes": "Mississippi does not provide religious exemptions to school immunization requirements. This is one of only a handful of states without a religious exemption." }, "philosophical": { "available": false } }, "relevantStatutes": "Miss. Code Ann. § 41-23-37", "notes": "Mississippi only permits medical exemptions. It does not offer religious or philosophical exemptions. This has been consistently upheld by Mississippi courts." }, { "id": "mo", "name": "Missouri", "healthDept": "Missouri Department of Health & Senior Services", "healthDeptUrl": "https://health.mo.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://health.mo.gov/", "formLabel": "Missouri Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO) to the school.", "renewal": "Based on physician's recommendation.", "authority": "Licensed physician (MD or DO)" }, "religious": { "available": true, "formUrl": "https://health.mo.gov/", "formLabel": "Missouri Immunization Program — Official Health Department", "submission": "Parent/guardian completes the exemption form and submits it to the school. Notarization not required.", "renewal": "Annually.", "authority": "Parent/guardian" }, "philosophical": { "available": false } }, "relevantStatutes": "Mo. Rev. Stat. § 167.181", "notes": "Missouri allows medical and religious exemptions. Uses a unified parent/guardian exemption form for religious objections." }, { "id": "mt", "name": "Montana", "healthDept": "Montana Department of Public Health & Human Services", "healthDeptUrl": "https://dphhs.mt.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://dphhs.mt.gov/", "formLabel": "Montana Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO) to the school.", "renewal": "As determined by physician.", "authority": "Licensed physician (MD or DO)" }, "religious": { "available": true, "formUrl": "https://dphhs.mt.gov/", "formLabel": "Montana Immunization Program — Official Health Department", "submission": "Parent/guardian completes and notarizes the affidavit. Submit to school annually.", "renewal": "Annually.", "authority": "Parent/guardian (with notarization)" }, "philosophical": { "available": false } }, "relevantStatutes": "Mont. Code Ann. § 20-5-403", "notes": "Montana allows medical and religious exemptions. Religious exemption requires notarized affidavit." }, { "id": "ne", "name": "Nebraska", "healthDept": "Nebraska Department of Health & Human Services", "healthDeptUrl": "https://dhhs.ne.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://dhhs.ne.gov/", "formLabel": "Nebraska Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO), physician assistant, or nurse practitioner to the school.", "renewal": "According to provider's statement.", "authority": "MD, DO, PA, or NP" }, "religious": { "available": true, "formUrl": "https://dhhs.ne.gov/", "formLabel": "Nebraska Immunization Program — Official Health Department", "submission": "Parent/guardian completes and notarizes the affidavit. Submit to school.", "renewal": "Annually.", "authority": "Parent/guardian (with notarization)" }, "philosophical": { "available": false } }, "relevantStatutes": "Neb. Rev. Stat. § 79-221", "notes": "Nebraska allows medical and religious exemptions. Religious exemption requires notarization." }, { "id": "nv", "name": "Nevada", "healthDept": "Nevada Division of Public & Behavioral Health", "healthDeptUrl": "https://dpbh.nv.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://dpbh.nv.gov/", "formLabel": "Nevada Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO) to the school.", "renewal": "According to physician's determination.", "authority": "Licensed physician (MD or DO)" }, "religious": { "available": true, "formUrl": "https://dpbh.nv.gov/", "formLabel": "Nevada Immunization Program — Official Health Department", "submission": "Parent/guardian completes the form and submits to the school. No notarization required.", "renewal": "Annually.", "authority": "Parent/guardian" }, "philosophical": { "available": false } }, "relevantStatutes": "NRS 392.437", "notes": "Nevada allows medical and religious exemptions." }, { "id": "nh", "name": "New Hampshire", "healthDept": "New Hampshire Department of Health & Human Services", "healthDeptUrl": "https://www.dhhs.nh.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://www.dhhs.nh.gov/", "formLabel": "New Hampshire Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO), APRN, or PA to the school.", "renewal": "According to provider's determination.", "authority": "MD, DO, APRN, or PA" }, "religious": { "available": true, "formUrl": "https://www.dhhs.nh.gov/", "formLabel": "New Hampshire Immunization Program — Official Health Department", "submission": "Parent/guardian completes and notarizes the form. Submit to school.", "renewal": "Annually.", "authority": "Parent/guardian (with notarization)" }, "philosophical": { "available": false } }, "relevantStatutes": "RSA 141-C:20-a", "notes": "New Hampshire allows medical and religious exemptions. Religious exemption requires notarization." }, { "id": "nj", "name": "New Jersey", "healthDept": "New Jersey Department of Health", "healthDeptUrl": "https://www.nj.gov/health/", "exemptions": { "medical": { "available": true, "formUrl": "https://www.nj.gov/health/", "formLabel": "New Jersey Immunization Program — Official Health Department", "submission": "Submit form IMM-33 signed by a licensed physician (MD/DO), APRN, or PA to the school.", "renewal": "Annually.", "authority": "MD, DO, APRN, or PA" }, "religious": { "available": true, "formUrl": "https://www.nj.gov/health/", "formLabel": "New Jersey Immunization Program — Official Health Department", "submission": "Parent/guardian must submit a written, signed statement explaining the religious beliefs that conflict with immunization. Notarization not required by statute, but individual schools may request it.", "renewal": "Annually, written statement must be re-submitted.", "authority": "Parent/guardian" }, "philosophical": { "available": false } }, "relevantStatutes": "N.J.S.A. 26:1A-9.1", "notes": "New Jersey allows medical and religious exemptions. The religious exemption is by written statement explaining sincere religious beliefs." }, { "id": "nm", "name": "New Mexico", "healthDept": "New Mexico Department of Health", "healthDeptUrl": "https://www.nmhealth.org/", "exemptions": { "medical": { "available": true, "formUrl": "https://www.nmhealth.org/", "formLabel": "New Mexico Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO), certified nurse practitioner, or physician assistant to the school.", "renewal": "According to provider's determination.", "authority": "MD, DO, CNP, or PA" }, "religious": { "available": true, "formUrl": "https://www.nmhealth.org/", "formLabel": "New Mexico Immunization Program — Official Health Department", "submission": "Parent/guardian completes and submits the form to the school. Notarization not required by state, though individual districts may have policies.", "renewal": "Annually.", "authority": "Parent/guardian" }, "philosophical": { "available": false } }, "relevantStatutes": "NMSA 1978 § 24-5-2", "notes": "New Mexico allows medical and religious exemptions." }, { "id": "ny", "name": "New York", "healthDept": "New York State Department of Health", "healthDeptUrl": "https://www.health.ny.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://www.health.ny.gov/", "formLabel": "New York Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO) or nurse practitioner to the school. The form requires the specific medical contraindication to be stated.", "renewal": "Annually.", "authority": "MD, DO, or NP" }, "religious": { "available": false, "formUrl": null, "notes": "Religious exemptions were eliminated effective June 13, 2019, via Chapter 35 of the Laws of 2019. New York no longer accepts religious exemptions for school immunization requirements." }, "philosophical": { "available": false } }, "relevantStatutes": "N.Y. Pub. Health Law § 2164", "notes": "As of June 2019, New York eliminated non-medical exemptions. Only medical exemptions are accepted." }, { "id": "nc", "name": "North Carolina", "healthDept": "North Carolina Department of Health & Human Services", "healthDeptUrl": "https://www.ncdhhs.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://www.ncdhhs.gov/", "formLabel": "North Carolina Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO) to the school.", "renewal": "As indicated by the physician.", "authority": "Licensed physician (MD or DO)" }, "religious": { "available": true, "formUrl": "https://www.ncdhhs.gov/", "formLabel": "North Carolina Immunization Program — Official Health Department", "submission": "Parent/guardian must submit a written statement of their religious objection. No notarization required. No state form is mandated — the parent's written statement serves as the exemption document.", "renewal": "Annually.", "authority": "Parent/guardian (written statement)" }, "philosophical": { "available": false } }, "relevantStatutes": "N.C. Gen. Stat. § 130A-157", "notes": "North Carolina allows medical and religious exemptions. No official state form for religious exemption — a parent/guardian written statement is sufficient." }, { "id": "nd", "name": "North Dakota", "healthDept": "North Dakota Department of Health & Human Services", "healthDeptUrl": "https://www.hhs.nd.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://www.hhs.nd.gov/", "formLabel": "North Dakota Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO), APRN, or PA to the school.", "renewal": "According to provider's recommendation.", "authority": "MD, DO, APRN, or PA" }, "religious": { "available": true, "formUrl": "https://www.hhs.nd.gov/", "formLabel": "North Dakota Immunization Program — Official Health Department", "submission": "Parent/guardian completes the form and submits to the school. Notarization not required.", "renewal": "Annually.", "authority": "Parent/guardian" }, "philosophical": { "available": true, "formUrl": "https://www.hhs.nd.gov/", "formLabel": "North Dakota Immunization Program — Official Health Department", "submission": "Parent/guardian completes the form and submits to the school. Notarization not required.", "renewal": "Annually.", "authority": "Parent/guardian" } }, "relevantStatutes": "N.D. Cent. Code § 23-07-17.1", "notes": "North Dakota allows all three exemption types with separate forms for each." }, { "id": "oh", "name": "Ohio", "healthDept": "Ohio Department of Health", "healthDeptUrl": "https://odh.ohio.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://odh.ohio.gov/", "formLabel": "Ohio Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO), APRN, or PA to the school.", "renewal": "According to the healthcare provider's statement.", "authority": "MD, DO, APRN, or PA" }, "religious": { "available": true, "formUrl": "https://odh.ohio.gov/", "formLabel": "Ohio Immunization Program — Official Health Department", "submission": "Parent/guardian must complete the form and submit to the school. The form requires a description of the religious tenets that conflict with immunization. Notarization not required.", "renewal": "Annually.", "authority": "Parent/guardian" }, "philosophical": { "available": true, "formUrl": "https://odh.ohio.gov/", "formLabel": "Ohio Immunization Program — Official Health Department", "submission": "Parent/guardian completes the form stating reasons of conscience. Submit to school. Notarization not required.", "renewal": "Annually.", "authority": "Parent/guardian" } }, "relevantStatutes": "Ohio Rev. Code § 3313.671", "notes": "Ohio allows all three exemption types. Religious exemption requires description of conflicting religious tenets." }, { "id": "ok", "name": "Oklahoma", "healthDept": "Oklahoma State Department of Health", "healthDeptUrl": "https://oklahoma.gov/health.html", "exemptions": { "medical": { "available": true, "formUrl": "https://oklahoma.gov/health.html", "formLabel": "Oklahoma Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO) to the school.", "renewal": "According to physician's determination.", "authority": "Licensed physician (MD or DO)" }, "religious": { "available": true, "formUrl": "https://oklahoma.gov/health.html", "formLabel": "Oklahoma Immunization Program — Official Health Department", "submission": "Parent/guardian completes and signs the certificate in the presence of a notary public. Submit notarized form to the school.", "renewal": "Annually.", "authority": "Parent/guardian (with notarization)" }, "philosophical": { "available": true, "formUrl": "https://oklahoma.gov/health.html", "formLabel": "Oklahoma Immunization Program — Official Health Department", "submission": "Parent/guardian completes and signs the certificate in the presence of a notary public. Submit notarized form to the school.", "renewal": "Annually.", "authority": "Parent/guardian (with notarization)" } }, "relevantStatutes": "70 O.S. § 1210.192", "notes": "Oklahoma allows all three exemption types. Non-medical exemptions require notarization." }, { "id": "or", "name": "Oregon", "healthDept": "Oregon Health Authority", "healthDeptUrl": "https://www.oregon.gov/oha/", "exemptions": { "medical": { "available": true, "formUrl": "https://www.oregon.gov/oha/", "formLabel": "Oregon Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO), nurse practitioner, physician assistant, or naturopathic doctor (ND) to the school.", "renewal": "As indicated by provider.", "authority": "MD, DO, NP, PA, or ND" }, "religious": { "available": true, "formUrl": "https://www.oregon.gov/oha/", "formLabel": "Oregon Immunization Program — Official Health Department", "submission": "Parent/guardian must either: (1) submit a signed certificate from a healthcare practitioner confirming they received vaccine education, OR (2) complete the OHA online Vaccine Education Module and submit the completion certificate. Then submit the nonmedical exemption form to the school.", "renewal": "Annually. Vaccine education module certificate valid for 2 years.", "authority": "Parent/guardian with education requirement" }, "philosophical": { "available": true, "formUrl": "https://www.oregon.gov/oha/", "formLabel": "Oregon Immunization Program — Official Health Department", "submission": "Same process as religious exemption. Oregon uses a unified nonmedical exemption form.", "renewal": "Annually.", "authority": "Parent/guardian with education requirement" } }, "relevantStatutes": "ORS 433.267", "notes": "Oregon allows all three exemption types. Non-medical exemptions require either a healthcare provider's signature confirming education OR completion of the state's online vaccine education module." }, { "id": "pa", "name": "Pennsylvania", "healthDept": "Pennsylvania Department of Health", "healthDeptUrl": "https://www.health.pa.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://www.health.pa.gov/", "formLabel": "Pennsylvania Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO), certified registered nurse practitioner, or physician assistant to the school.", "renewal": "Based on provider's determination.", "authority": "MD, DO, CRNP, or PA" }, "religious": { "available": true, "formUrl": "https://www.health.pa.gov/", "formLabel": "Pennsylvania Immunization Program — Official Health Department", "submission": "Parent/guardian completes form and submits to school. Notarization not required.", "renewal": "Annually.", "authority": "Parent/guardian" }, "philosophical": { "available": true, "formUrl": "https://www.health.pa.gov/", "formLabel": "Pennsylvania Immunization Program — Official Health Department", "submission": "Parent/guardian completes form and submits to school. Notarization not required.", "renewal": "Annually.", "authority": "Parent/guardian" } }, "relevantStatutes": "28 Pa. Code § 23.84", "notes": "Pennsylvania allows all three exemption types." }, { "id": "ri", "name": "Rhode Island", "healthDept": "Rhode Island Department of Health", "healthDeptUrl": "https://health.ri.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://health.ri.gov/", "formLabel": "Rhode Island Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO), nurse practitioner, or physician assistant to the school.", "renewal": "Annually, unless provider certifies a permanent condition.", "authority": "MD, DO, NP, or PA" }, "religious": { "available": true, "formUrl": "https://health.ri.gov/", "formLabel": "Rhode Island Immunization Program — Official Health Department", "submission": "Parent/guardian completes and notarizes the certificate. Submit to school.", "renewal": "Annually.", "authority": "Parent/guardian (with notarization)" }, "philosophical": { "available": false } }, "relevantStatutes": "R.I. Gen. Laws § 16-38-2", "notes": "Rhode Island allows medical and religious exemptions. Religious exemption requires notarization." }, { "id": "sc", "name": "South Carolina", "healthDept": "South Carolina Department of Health & Environmental Control", "healthDeptUrl": "https://scdhec.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://scdhec.gov/", "formLabel": "South Carolina Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO) to the school on DHEC Form 1429.", "renewal": "According to physician's determination.", "authority": "Licensed physician (MD or DO)" }, "religious": { "available": true, "formUrl": "https://scdhec.gov/", "formLabel": "South Carolina Immunization Program — Official Health Department", "submission": "Parent/guardian must obtain the certificate from the health department, complete it, and submit to the school. Notarization may be required by the local health department.", "renewal": "Annually.", "authority": "Parent/guardian; certificate issued by health department" }, "philosophical": { "available": false } }, "relevantStatutes": "S.C. Code Ann. § 44-29-180", "notes": "South Carolina allows medical and religious exemptions. Religious exemption certificate issued by county health department." }, { "id": "sd", "name": "South Dakota", "healthDept": "South Dakota Department of Health", "healthDeptUrl": "https://doh.sd.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://doh.sd.gov/", "formLabel": "South Dakota Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO), nurse practitioner, or physician assistant to the school.", "renewal": "According to provider's recommendation.", "authority": "MD, DO, NP, or PA" }, "religious": { "available": true, "formUrl": "https://doh.sd.gov/", "formLabel": "South Dakota Immunization Program — Official Health Department", "submission": "Parent/guardian completes and signs the form. Notarization required. Submit to school.", "renewal": "Annually.", "authority": "Parent/guardian (with notarization)" }, "philosophical": { "available": false } }, "relevantStatutes": "SDCL 13-28-7.1", "notes": "South Dakota allows medical and religious exemptions. Religious exemption requires notarization." }, { "id": "tn", "name": "Tennessee", "healthDept": "Tennessee Department of Health", "healthDeptUrl": "https://www.tn.gov/health.html", "exemptions": { "medical": { "available": true, "formUrl": "https://www.tn.gov/health.html", "formLabel": "Tennessee Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO), nurse practitioner, or physician assistant to the school.", "renewal": "As indicated by provider.", "authority": "MD, DO, NP, or PA" }, "religious": { "available": true, "formUrl": "https://www.tn.gov/health.html", "formLabel": "Tennessee Immunization Program — Official Health Department", "submission": "Parent/guardian completes and signs the certificate. Notarization required. Submit to the school.", "renewal": "Annually.", "authority": "Parent/guardian (with notarization)" }, "philosophical": { "available": false } }, "relevantStatutes": "Tenn. Code Ann. § 49-6-5001", "notes": "Tennessee allows medical and religious exemptions. Religious exemption requires notarization." }, { "id": "tx", "name": "Texas", "healthDept": "Texas Department of State Health Services", "healthDeptUrl": "https://www.dshs.texas.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://www.dshs.texas.gov/", "formLabel": "Texas Immunization Program — Official Health Department", "submission": "Submit written statement from a licensed physician (MD/DO) stating the medical contraindication. Submit to school.", "renewal": "Annually unless physician specifies lifelong condition.", "authority": "Licensed physician (MD or DO)" }, "religious": { "available": true, "formUrl": "https://www.dshs.texas.gov/", "formLabel": "Texas Immunization Program — Official Health Department", "submission": "Parent/guardian must submit the official DSHS affidavit form. The form covers reasons of conscience including religious beliefs. Notarization not required but the official state form must be used. Submit to school within 90 days of the start of the school year.", "renewal": "Must be submitted within 90 days of school start annually.", "authority": "Parent/guardian or individual (age 18+)" }, "philosophical": { "available": true, "formUrl": "https://www.dshs.texas.gov/", "formLabel": "Texas Immunization Program — Official Health Department", "submission": "Texas uses a unified affidavit for all reasons of conscience, including religious beliefs and philosophical objections. The same form is used for both.", "renewal": "Submitted within 90 days of school start annually.", "authority": "Parent/guardian or individual (age 18+)" } }, "relevantStatutes": "Tex. Educ. Code § 38.001", "notes": "Texas allows all three exemption types. Uses a unified 'reasons of conscience' affidavit form for non-medical exemptions." }, { "id": "ut", "name": "Utah", "healthDept": "Utah Department of Health & Human Services", "healthDeptUrl": "https://dhhs.utah.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://dhhs.utah.gov/", "formLabel": "Utah Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO) to the school.", "renewal": "As determined by physician.", "authority": "Licensed physician (MD or DO)" }, "religious": { "available": true, "formUrl": "https://dhhs.utah.gov/", "formLabel": "Utah Immunization Program — Official Health Department", "submission": "Parent/guardian must complete the state exemption form and submit to the school. The form requires a completed online education module certificate from the Utah DHHS before the exemption is valid.", "renewal": "Annually. Education module must be re-completed each year.", "authority": "Parent/guardian (with online education module completion)" }, "philosophical": { "available": true, "formUrl": "https://dhhs.utah.gov/", "formLabel": "Utah Immunization Program — Official Health Department", "submission": "Same process. Utah uses a unified exemption form with an education requirement for all non-medical exemptions.", "renewal": "Annually.", "authority": "Parent/guardian (with online education module completion)" } }, "relevantStatutes": "Utah Code Ann. § 53G-9-303", "notes": "Utah allows all three exemption types. All non-medical exemptions require completion of the state's online immunization education module." }, { "id": "vt", "name": "Vermont", "healthDept": "Vermont Department of Health", "healthDeptUrl": "https://www.healthvermont.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://www.healthvermont.gov/", "formLabel": "Vermont Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO), nurse practitioner, or physician assistant to the school.", "renewal": "Annually.", "authority": "MD, DO, NP, or PA" }, "religious": { "available": true, "formUrl": "https://www.healthvermont.gov/", "formLabel": "Vermont Immunization Program — Official Health Department", "submission": "Parent/guardian completes the form. Beginning in 2016, Vermont requires that parents submit a signed statement annually. Submit to school.", "renewal": "Annually.", "authority": "Parent/guardian" }, "philosophical": { "available": false, "formUrl": null, "notes": "Philosophical exemptions were eliminated effective July 1, 2016." } }, "relevantStatutes": "18 V.S.A. § 1122", "notes": "Vermont eliminated philosophical exemptions in 2016. Medical and religious exemptions remain available with annual renewal." }, { "id": "va", "name": "Virginia", "healthDept": "Virginia Department of Health", "healthDeptUrl": "https://www.vdh.virginia.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://www.vdh.virginia.gov/", "formLabel": "Virginia Immunization Program — Official Health Department", "submission": "Submit Form MCH-213M signed by a licensed physician (MD/DO), nurse practitioner, or physician assistant to the school.", "renewal": "According to provider's certification.", "authority": "MD, DO, NP, or PA" }, "religious": { "available": true, "formUrl": "https://www.vdh.virginia.gov/", "formLabel": "Virginia Immunization Program — Official Health Department", "submission": "Parent/guardian completes and notarizes Form CRE-1. Submit notarized form to school.", "renewal": "Annually.", "authority": "Parent/guardian (with notarization)" }, "philosophical": { "available": false } }, "relevantStatutes": "Va. Code § 32.1-46", "notes": "Virginia allows medical and religious exemptions. Religious exemption requires notarized Form CRE-1." }, { "id": "wa", "name": "Washington", "healthDept": "Washington State Department of Health", "healthDeptUrl": "https://doh.wa.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://doh.wa.gov/", "formLabel": "Washington Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO), nurse practitioner, physician assistant, or naturopathic physician (ND) to the school.", "renewal": "According to provider's determination.", "authority": "MD, DO, NP, PA, or ND" }, "religious": { "available": true, "formUrl": "https://doh.wa.gov/", "formLabel": "Washington Immunization Program — Official Health Department", "submission": "Parent/guardian must complete the Certificate of Exemption and have it signed by a healthcare provider. The provider's signature verifies that the parent received vaccine education — it does NOT mean the provider endorses the exemption. Submit completed COE to school.", "renewal": "Annually.", "authority": "Parent/guardian with healthcare provider signature for education" }, "philosophical": { "available": true, "formUrl": "https://doh.wa.gov/", "formLabel": "Washington Immunization Program — Official Health Department", "submission": "Same process as religious exemption. Washington was the first state to require healthcare provider consultation for non-medical exemptions (2011 law).", "renewal": "Annually.", "authority": "Parent/guardian with healthcare provider signature for education" } }, "relevantStatutes": "RCW 28A.210.090", "notes": "Washington allows all three exemption types. Non-medical exemptions require a Certificate of Exemption (COE) signed by a healthcare provider confirming the parent received immunization education." }, { "id": "wv", "name": "West Virginia", "healthDept": "West Virginia Department of Health", "healthDeptUrl": "https://dhhr.wv.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://dhhr.wv.gov/", "formLabel": "West Virginia Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO) to the school. The physician must state the specific medical contraindication.", "renewal": "Annually or as specified by physician.", "authority": "Licensed physician (MD or DO)" }, "religious": { "available": false, "formUrl": null, "notes": "West Virginia does not provide religious exemptions to school immunization requirements. This is one of only a handful of states without a religious exemption (along with Mississippi). The WV Supreme Court has upheld this policy." }, "philosophical": { "available": false } }, "relevantStatutes": "W. Va. Code § 16-3-4", "notes": "West Virginia allows only medical exemptions. No religious or philosophical exemptions are permitted. This has been upheld by the WV Supreme Court of Appeals." }, { "id": "wi", "name": "Wisconsin", "healthDept": "Wisconsin Department of Health Services", "healthDeptUrl": "https://www.dhs.wisconsin.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://www.dhs.wisconsin.gov/", "formLabel": "Wisconsin Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO), nurse practitioner, or physician assistant to the school.", "renewal": "According to provider's recommendation.", "authority": "MD, DO, NP, or PA" }, "religious": { "available": true, "formUrl": "https://www.dhs.wisconsin.gov/", "formLabel": "Wisconsin Immunization Program — Official Health Department", "submission": "Parent/guardian completes the form and submits to school. Notarization not required.", "renewal": "Annually.", "authority": "Parent/guardian" }, "philosophical": { "available": true, "formUrl": "https://www.dhs.wisconsin.gov/", "formLabel": "Wisconsin Immunization Program — Official Health Department", "submission": "Parent/guardian completes the form and submits to school. Notarization not required.", "renewal": "Annually.", "authority": "Parent/guardian" } }, "relevantStatutes": "Wis. Stat. § 252.04", "notes": "Wisconsin allows all three exemption types. Separate forms for each exemption type." }, { "id": "wy", "name": "Wyoming", "healthDept": "Wyoming Department of Health", "healthDeptUrl": "https://health.wyo.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://health.wyo.gov/", "formLabel": "Wyoming Immunization Program — Official Health Department", "submission": "Submit form signed by a licensed physician (MD/DO) to the school.", "renewal": "According to physician's direction.", "authority": "Licensed physician (MD or DO)" }, "religious": { "available": true, "formUrl": "https://health.wyo.gov/", "formLabel": "Wyoming Immunization Program — Official Health Department", "submission": "Parent/guardian completes the form and submits to school. Notarization not required.", "renewal": "Annually.", "authority": "Parent/guardian" }, "philosophical": { "available": false } }, "relevantStatutes": "Wyo. Stat. Ann. § 21-4-309", "notes": "Wyoming allows medical and religious exemptions." }, { "id": "dc", "name": "District of Columbia", "healthDept": "DC Health", "healthDeptUrl": "https://dchealth.dc.gov/", "exemptions": { "medical": { "available": true, "formUrl": "https://dchealth.dc.gov/", "formLabel": "District of Columbia Immunization Program — Official Health Department", "submission": "Submit the DC Universal Health Certificate with the medical exemption section completed and signed by a licensed physician (MD/DO) to the school.", "renewal": "Annually.", "authority": "Licensed physician (MD or DO)" }, "religious": { "available": true, "formUrl": "https://dchealth.dc.gov/", "formLabel": "District of Columbia Immunization Program — Official Health Department", "submission": "Parent/guardian completes the form and submits to school. Notarization not required.", "renewal": "Annually.", "authority": "Parent/guardian" }, "philosophical": { "available": false } }, "relevantStatutes": "D.C. Code § 38-503", "notes": "DC allows medical and religious exemptions. The medical exemption is part of DC's Universal Health Certificate form." } ], "canada": [ { "id": "ab", "name": "Alberta", "healthDept": "Alberta Health Services", "healthDeptUrl": "https://www.albertahealthservices.ca/", "exemptions": { "medical": { "available": true, "formUrl": "https://www.albertahealthservices.ca/", "formLabel": "Alberta Immunization Program — Official Health Department", "submission": "Submit form completed by a qualified health professional (physician, nurse practitioner, or registered nurse) to the school or public health unit.", "renewal": "According to healthcare provider's direction.", "authority": "Physician, NP, or RN" }, "religious": { "available": true, "formUrl": "https://www.albertahealthservices.ca/", "formLabel": "Alberta Immunization Program — Official Health Department", "submission": "Parent/guardian completes the non-medical exemption form. Must be notarized or signed in the presence of a commissioner for oaths. Submit to school or public health.", "renewal": "One-time submission; typically does not require annual renewal.", "authority": "Parent/guardian (with notarization/commissioner)" }, "philosophical": { "available": false, "notes": "No Canadian province offers a secular philosophical/personal belief exemption for school immunization requirements." } }, "relevantStatutes": "Alberta Public Health Act, Immunization Regulation", "notes": "Alberta allows medical and religious (conscience) exemptions. Non-medical exemption must be notarized or commissioned." }, { "id": "bc", "name": "British Columbia", "healthDept": "BC Ministry of Health", "healthDeptUrl": "https://www2.gov.bc.ca/gov/content/health", "exemptions": { "medical": { "available": true, "formUrl": "https://www2.gov.bc.ca/gov/content/health", "formLabel": "British Columbia Immunization Program — Official Health Department", "submission": "Submit form completed by a physician or nurse practitioner to the school or public health unit.", "renewal": "According to the healthcare provider's assessment.", "authority": "Physician (MD) or Nurse Practitioner" }, "religious": { "available": true, "formUrl": "https://www2.gov.bc.ca/gov/content/health", "formLabel": "British Columbia Immunization Program — Official Health Department", "submission": "Parent/guardian completes the form. BC does not require notarization. Submit to school or public health unit.", "renewal": "Typically one-time; may require re-submission if transferring schools.", "authority": "Parent/guardian" }, "philosophical": { "available": false, "notes": "No philosophical exemption in BC." } }, "relevantStatutes": "BC Public Health Act, Immunization Regulation", "notes": "BC allows medical and non-medical (religious/conscience) exemptions. Form available through HealthLink BC. No notarization required." }, { "id": "mb", "name": "Manitoba", "healthDept": "Manitoba Health", "healthDeptUrl": "https://www.gov.mb.ca/health/", "exemptions": { "medical": { "available": true, "formUrl": "https://www.gov.mb.ca/health/", "formLabel": "Manitoba Immunization Program — Official Health Department", "submission": "Submit form completed by a physician or nurse practitioner to the school. The form must state the specific medical contraindication.", "renewal": "As designated by the healthcare provider.", "authority": "Physician or Nurse Practitioner" }, "religious": { "available": true, "formUrl": "https://www.gov.mb.ca/health/", "formLabel": "Manitoba Immunization Program — Official Health Department", "submission": "Parent/guardian completes the conscientious objection section. Must be signed by a commissioner for oaths or notary public.", "renewal": "One-time submission.", "authority": "Parent/guardian (with commissioner for oaths/notary)" }, "philosophical": { "available": false } }, "relevantStatutes": "Manitoba Public Health Act, Immunization Regulation", "notes": "Manitoba uses a unified exemption form covering both medical and conscientious objections. Non-medical exemption requires commissioner for oaths or notary." }, { "id": "nb", "name": "New Brunswick", "healthDept": "New Brunswick Department of Health", "healthDeptUrl": "https://www2.gnb.ca/content/gnb/en/departments/health.html", "exemptions": { "medical": { "available": true, "formUrl": "https://www2.gnb.ca/content/gnb/en/departments/health.html", "formLabel": "New Brunswick Immunization Program — Official Health Department", "submission": "Submit form completed by a physician or nurse practitioner. Include with the school immunization record.", "renewal": "According to the provider's statement.", "authority": "Physician or Nurse Practitioner" }, "religious": { "available": true, "formUrl": "https://www2.gnb.ca/content/gnb/en/departments/health.html", "formLabel": "New Brunswick Immunization Program — Official Health Department", "submission": "Parent/guardian completes the non-medical exemption form and submits to the school. No notarization required by the province.", "renewal": "One-time submission is generally sufficient.", "authority": "Parent/guardian" }, "philosophical": { "available": false } }, "relevantStatutes": "New Brunswick Public Health Act", "notes": "New Brunswick allows medical exemptions and non-medical (religious/conscience) exemptions." }, { "id": "nl", "name": "Newfoundland and Labrador", "healthDept": "NL Health Services", "healthDeptUrl": "https://www.gov.nl.ca/hcs/", "exemptions": { "medical": { "available": true, "formUrl": "https://www.gov.nl.ca/hcs/", "formLabel": "Newfoundland and Labrador Immunization Program — Official Health Department", "submission": "Submit form completed by a physician or nurse practitioner to the school or public health nurse.", "renewal": "As indicated by the healthcare provider.", "authority": "Physician or Nurse Practitioner" }, "religious": { "available": true, "formUrl": "https://www.gov.nl.ca/hcs/", "formLabel": "Newfoundland and Labrador Immunization Program — Official Health Department", "submission": "Parent/guardian completes the form. Not required to be notarized. Submit to school or public health.", "renewal": "One-time submission.", "authority": "Parent/guardian" }, "philosophical": { "available": false } }, "relevantStatutes": "Newfoundland and Labrador Public Health Protection and Promotion Act", "notes": "NL allows medical and non-medical (conscience/religious) exemptions. Forms available through NL Health Services." }, { "id": "ns", "name": "Nova Scotia", "healthDept": "Nova Scotia Health Authority", "healthDeptUrl": "https://www.nshealth.ca/", "exemptions": { "medical": { "available": true, "formUrl": "https://www.nshealth.ca/", "formLabel": "Nova Scotia Immunization Program — Official Health Department", "submission": "Submit form completed by a physician or nurse practitioner to the school.", "renewal": "According to the healthcare provider's determination.", "authority": "Physician or Nurse Practitioner" }, "religious": { "available": true, "formUrl": "https://www.nshealth.ca/", "formLabel": "Nova Scotia Immunization Program — Official Health Department", "submission": "Parent/guardian completes the form. Not required to be notarized. Submit to school.", "renewal": "One-time submission.", "authority": "Parent/guardian" }, "philosophical": { "available": false } }, "relevantStatutes": "Nova Scotia Health Protection Act, Immunization Regulations", "notes": "Nova Scotia allows medical and non-medical (conscience/religious) exemptions." }, { "id": "nt", "name": "Northwest Territories", "healthDept": "NWT Health and Social Services", "healthDeptUrl": "https://www.hss.gov.nt.ca/", "exemptions": { "medical": { "available": true, "formUrl": "https://www.hss.gov.nt.ca/", "formLabel": "Northwest Territories Immunization Program — Official Health Department", "submission": "Submit form completed by a physician or nurse practitioner to the school or public health unit.", "renewal": "According to provider's direction.", "authority": "Physician or Nurse Practitioner" }, "religious": { "available": true, "formUrl": "https://www.hss.gov.nt.ca/", "formLabel": "Northwest Territories Immunization Program — Official Health Department", "submission": "Parent/guardian must submit a signed written statement to the school or local public health unit explaining the religious or conscientious objection. Contact the local public health unit for specific requirements.", "renewal": "Annually, at beginning of school year.", "authority": "Parent/guardian" }, "philosophical": { "available": false } }, "relevantStatutes": "NWT Public Health Act, Immunization Regulations", "notes": "NWT allows medical exemptions and religious/conscience exemptions. Contact the local public health unit for current forms and procedures." }, { "id": "nu", "name": "Nunavut", "healthDept": "Nunavut Department of Health", "healthDeptUrl": "https://www.gov.nu.ca/health", "exemptions": { "medical": { "available": true, "formUrl": "https://www.gov.nu.ca/health", "formLabel": "Nunavut Immunization Program — Official Health Department", "submission": "Submit a letter from a physician or nurse practitioner stating the medical contraindication to the school or community health centre.", "renewal": "According to the healthcare provider's direction.", "authority": "Physician or Nurse Practitioner" }, "religious": { "available": true, "formUrl": "https://www.gov.nu.ca/health", "formLabel": "Nunavut Immunization Program — Official Health Department", "submission": "Parent/guardian should contact the local community health centre or school for the current exemption procedure. A signed, dated written statement is typically required. Individual communities may have specific forms.", "renewal": "Annually.", "authority": "Parent/guardian" }, "philosophical": { "available": false } }, "relevantStatutes": "Nunavut Public Health Act", "notes": "Nunavut allows medical and non-medical exemptions. Contact your community health centre for current forms and requirements as procedures may vary by community." }, { "id": "on", "name": "Ontario", "healthDept": "Ontario Ministry of Health", "healthDeptUrl": "https://www.ontario.ca/page/ministry-health", "exemptions": { "medical": { "available": true, "formUrl": "https://www.ontario.ca/page/ministry-health", "formLabel": "Ontario Immunization Program — Official Health Department", "submission": "Submit Form 014-4897-64 signed by a physician or nurse practitioner to the school. The form must specify which vaccines are medically contraindicated and the reason.", "renewal": "Must be updated if the medical condition changes; does not require automatic annual renewal.", "authority": "Physician (MD) or Nurse Practitioner (NP)" }, "religious": { "available": true, "formUrl": "https://www.ontario.ca/page/ministry-health", "formLabel": "Ontario Immunization Program — Official Health Department", "submission": "Parent/guardian must complete the Statement of Conscience or Religious Belief form AND complete a vaccine education session. The education session must be completed before the exemption form is processed. After completing education, submit the notarized (or commissioner-signed) form to the school.", "renewal": "One-time for the student's time at that school level. Education session must be completed once.", "authority": "Parent/guardian (with notarization/commissioner, plus mandatory education session)" }, "philosophical": { "available": false, "notes": "Ontario does not offer a secular philosophical/personal belief exemption." } }, "relevantStatutes": "Immunization of School Pupils Act, R.S.O. 1990, c. I.1", "notes": "Ontario uniquely requires a mandatory vaccine education session for all non-medical exemptions. Once the education module is completed and the notarized form submitted, the exemption generally remains valid throughout the student's enrollment at that school level." }, { "id": "pe", "name": "Prince Edward Island", "healthDept": "Health PEI", "healthDeptUrl": "https://www.princeedwardisland.ca/en/topic/health-and-wellness", "exemptions": { "medical": { "available": true, "formUrl": "https://www.princeedwardisland.ca/en/topic/health-and-wellness", "formLabel": "Prince Edward Island Immunization Program — Official Health Department", "submission": "Submit a letter from a physician or nurse practitioner stating the medical contraindication. Contact Health PEI or the school for the most current procedures.", "renewal": "According to healthcare provider's direction.", "authority": "Physician or Nurse Practitioner" }, "religious": { "available": true, "formUrl": "https://www.princeedwardisland.ca/en/topic/health-and-wellness", "formLabel": "Prince Edward Island Immunization Program — Official Health Department", "submission": "Parent/guardian must submit a signed, dated written statement explaining the religious or conscientious objection to the school. Contact the school or Public Health Nursing office for current forms and procedures.", "renewal": "One-time submission typically.", "authority": "Parent/guardian" }, "philosophical": { "available": false } }, "relevantStatutes": "PEI Public Health Act, School Immunization Regulations", "notes": "PEI allows medical and non-medical (religious/conscience) exemptions. Contact Public Health Nursing for current forms." }, { "id": "qc", "name": "Quebec", "healthDept": "Ministère de la Santé et des Services sociaux", "healthDeptUrl": "https://www.msss.gouv.qc.ca/", "exemptions": { "medical": { "available": true, "formUrl": "https://www.msss.gouv.qc.ca/", "formLabel": "Quebec Immunization Program — Official Health Department", "submission": "Submit a medical certificate from a physician or specialized nurse practitioner stating the specific contraindication. Include with the child's vaccination record at the school or CLSC.", "renewal": "According to the healthcare provider's certification.", "authority": "Physician (MD) or Specialized Nurse Practitioner (IPS)" }, "religious": { "available": true, "formUrl": "https://www.msss.gouv.qc.ca/", "formLabel": "Quebec Immunization Program — Official Health Department", "submission": "Quebec does not have a standardized provincial exemption form for non-medical exemptions. Parent/guardian should provide a signed, dated written statement explaining the objection. The school/service de garde determines the sufficiency. Contact the local CLSC or school administration for current procedures.", "renewal": "Annually at school entry.", "authority": "Parent/guardian (statement reviewed by school administration)" }, "philosophical": { "available": false, "notes": "Quebec does not offer a secular philosophical exemption separate from religious/conscience." } }, "relevantStatutes": "Quebec Public Health Act, Loi sur la santé publique", "notes": "Quebec allows medical exemptions and non-medical (religious/conscience) exemptions. Procedures may vary by region (CLSC). Note: Quebec has periodically considered eliminating non-medical exemptions. Verify current status." }, { "id": "sk", "name": "Saskatchewan", "healthDept": "Saskatchewan Health Authority", "healthDeptUrl": "https://www.saskhealthauthority.ca/", "exemptions": { "medical": { "available": true, "formUrl": "https://www.saskhealthauthority.ca/", "formLabel": "Saskatchewan Immunization Program — Official Health Department", "submission": "Submit form completed by a physician or nurse practitioner. Submit to the school or public health office.", "renewal": "According to the healthcare provider's assessment.", "authority": "Physician or Nurse Practitioner" }, "religious": { "available": true, "formUrl": "https://www.saskhealthauthority.ca/", "formLabel": "Saskatchewan Immunization Program — Official Health Department", "submission": "Parent/guardian completes the form. Saskatchewan requires the form to be notarized or signed before a commissioner for oaths. Submit to school or public health.", "renewal": "One-time submission.", "authority": "Parent/guardian (with notarization/commissioner)" }, "philosophical": { "available": false } }, "relevantStatutes": "Saskatchewan Public Health Act, Immunization Regulations", "notes": "Saskatchewan allows medical and non-medical (conscience/religious) exemptions. Non-medical exemption requires notarization or commissioner for oaths." }, { "id": "yt", "name": "Yukon", "healthDept": "Yukon Health and Social Services", "healthDeptUrl": "https://yukon.ca/en/health-and-wellness", "exemptions": { "medical": { "available": true, "formUrl": "https://yukon.ca/en/health-and-wellness", "formLabel": "Yukon Immunization Program — Official Health Department", "submission": "Submit a letter from a physician or nurse practitioner stating the medical contraindication to the school or Yukon Communicable Disease Control.", "renewal": "According to the healthcare provider's direction.", "authority": "Physician or Nurse Practitioner" }, "religious": { "available": true, "formUrl": "https://yukon.ca/en/health-and-wellness", "formLabel": "Yukon Immunization Program — Official Health Department", "submission": "Parent/guardian must submit a signed, dated written statement to Yukon Communicable Disease Control (YCDC) or the school, stating the religious or conscientious objection. Contact YCDC at 867-667-8323 for current forms and procedures.", "renewal": "Annually.", "authority": "Parent/guardian" }, "philosophical": { "available": false } }, "relevantStatutes": "Yukon Public Health and Safety Act, Immunization Regulations", "notes": "Yukon allows medical and non-medical exemptions. Contact Yukon Communicable Disease Control for the most current forms and procedures." } ] }