Vaccine Exemptions

It is law in all US states that children be properly immunized before attending school. However, in addition to medical exemptions offered in each state, the vast majority of states allow for religious exemptions and various states allow personal belief exemptions for daycare and school.

School Exemption Laws by State

Some state laws specify religious in addition to personal belief exemptions; other state laws do not. However, in practice, states that offer personal belief exemptions also allow for religious exemptions as part of the personal belief exemption (Minnesota and Louisiana, for example).

Map updated from Immunization Action Coalition and National Conference of State Legislatures (NCSL).

Visit NCSL for more information on individual state exemption laws.

Selected Publications on School Exemption Laws

Seither R, Calhoun K, Knighton CL, Mellerson J, Meador S, Tippins A, Greby SM, Dietz V. Vaccination Coverage Among Children in Kindergarten – United States, 2014-15 School Year. MMWR Morb Mortal Wkly Rep 2015;64(33):897-904.
     Link to PubMed abstract | Link to article (may be restricted to subscribers)

Bradford WD, Mandich A. Some State Vaccination Laws Contribute To Greater Exemption Rates And Disease Outbreaks In The United States. Health Aff (Millwood) 2015;34(8):1383-90.
     Link to PubMed abstract | Link to article (may be restricted to subscribers)

Wang E, Clymer J, Davis-Hayes C, Buttenheim A. Nonmedical exemptions from school immunization requirements: a systematic review. Am J Public Health 2014;104(11):e62-84.
     Link to PubMed abstract | Link to article (may be restricted to subscribers)

Diekema DS. Personal belief exemptions from school vaccination requirements. Annu Rev Public Health 2014;35:275-92.
     Link to PubMed abstract | Link to article (may be restricted to subscribers)

Siddiqui M, Salmon DA, Omer SB. Epidemiology of vaccine hesitancy in the United States. Hum Vaccin Immunother 2013;9(12):2643-8.
     Link to PubMed abstract | Link to article (may be restricted to subscribers)

Ropeik D. How society should respond to the risk of vaccine rejection. Hum Vaccin Immunother 2013;9(8):1815-8.
     Link to PubMed abstract | Link to article (may be restricted to subscribers)

Salmon DA, Teret SP, MacIntyre CR, Salisbury D, Burgess MA, Halsey NA. Compulsory vaccination and conscientious or philosophical exemptions: past, present, and future. Lancet 2006;367(9508):436-42.
     Link to PubMed abstract | Link to article (may be restricted to subscribers)

Salmon DA, Omer SB, Moulton LH, Stokley S, Dehart MP, Lett S, Norman B, Teret S, Halsey NA. Exemptions to school immunization requirements: the role of school-level requirements, policies, and procedures. Am J Public Health 2005;95(3):436-40. Erratum in: Am J Public Health 2005;95(4):551.
     Link to PubMed abstract | Link to article (may be restricted to subscribers)

Calandrillo SP. Vanishing vaccinations: why are so many Americans opting out of vaccinating their children? Univ Mich J Law Reform 2004 Winter;37(2):353-440.
     Link to PubMed abstract