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Immunization

Alaska

Last Updated: 8/19/2010

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

Exemptions04 AAC 06.055 (2000) allows for exemption from immunization requirements under the following circumstances: (1) The child presents a statement signed by a doctor of medicine or osteopathy, physician assistant, or advanced nurse practitioner, stating that immunizations would, in that individual's professional opinion, be injurious to the health of the child or members of the child's family or household, or (2) The child presents an affidavit signed by his parent or guardian affirming that immunization conflicts with the tenets and practices of the church or religious denomination of which the applicant is a member.


Alabama

Last Updated: 8/19/2010

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

Exemptions:  Code of Alabama 16-30-3 (1973) allows for exemption from immunization requirements under the following circumstances: (1) In the absence of an epidemic or immediate threat, the parent or guardian of the child may object in writing on grounds that immunization or testing conflicts with his/her religious tenets and practices, or (2) If certification by a competent medical authority providing individual exemption from the required immunization is submitted to the admissions officer of the school.


Arkansas

Last Updated: 12/28/2013

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

Exemptions
: Code 6-18-702(d) allows exemption from immunization requirements under the following circumstances: (1) A licensed health officer provides a certificate stating that  the child has a physical disability which may contraindicate vaccination, or (2) The parents or legal guardian of the child object on the grounds that immunization conflicts with the religious tenets and practices of a recognized church or religious denomination of which the parent or guardian is an adherent or member.  In both cases, the parents or legal guardian of the child must complete an annual application for exemption with the department of health.  The application includes a notarized statement requesting a medical, religious or philosophical exemption from the department of health by the parents or legal guardians of the child, completion of an educational component on the risks and benefits of vaccination, a signed statement of refusal to vaccinate from the parents or guardian, and a signed statement agreeing to removal of the child from the school environment in case of a disease outbreak.


Arizona

Last Updated: 8/19/2010

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

Not included in the NNII database is State Board of Education Administrative Code R9-6-702 (2007) that requires students who are 11 years old and starting the sixth grade have one dose of meningococcal vaccine and one dose of Tdap - tetanus, diphtheria and pertussis. The Tdap requirement is in addition to the 4 required for kindergarten school entry, and is required if 5 years have passed since the child's last does of teatnus-diptheria containing vaccine and the child has not received Tdap. One teatnus-diptheria containing vaccine is required if 10 years have passed since the last dose of Tdap or teatnus-diptheria containing vaccine.

ExemptionsARS 15-873 (no date available) allows for exemption from immunization requirements under the following circumstances: (1) The parent or guardian of the pupil submits a signed statement to the school administrator stating that they have received information about immunization, understand the risks and benefits of immunization, the potential risks of non-immunizations, and that due to personal beliefs, they do not consent to immunization of the pupil, or (2) The parent or guardian submits a written certification, signed by a physician and the parent, to the school administrator stating that the required immunizations may be detrimental to the pupil's health and indicating the specific nature and probable duration of the medical condition or circumstances which precludes immunization.  In the case of an outbreak of a communicable immunization-preventable disease (as determined by the department of health services or local health department), students provided immunization exemptions shall not attend school.


California

Last Updated: 5/17/2011

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry." 

In addition to the vaccines listed, AB354 (2010) requires all students in grades 7-12 to provide evidence of having a TDAP booster on or before the 10th birthday.

Exemptions
California Code of Regulations Title 17, Division 1, Chapter 4, Subchapter 8, Article 3, 6051 (1986) allows exemption from immunization requirements under the following circumstances:  (1)  Submission to the governing authority of a written statement from a licensed physician stating that the physical condition of the pupil or medical circumstances relating to the pupil are such that immunization (for one or more vaccines) is permanently indicated, or (2) Submission of an affidavit from the pupil's parent, guardian, adult who has assumed responsibility for his or her care and custody or emancipated minor.  The affidavit must state that immunization is contrary to his or her beliefs.


Colorado

Last Updated: 8/19/2010

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

ExemptionsStatute 25-4-903 (1977) allows exemption from immunization requirements under the following circumstances: (1) Submission of certification from a licensed physician that the physical condition of the student is such that one or more immunizations would be life-endangering or medically contraindicated, or (2) Submission of a statement of exemption signed by one parent, an emancipated student or a student 18 years or older that the parent, guardian or student is an adherent to a religious belief whose teachings are opposed to immunizations or that they hold a belief that is opposed to immunizations.  In addition, the state board of health may provide, by regulation, further exemptions to immunization based upon sound medical practice.

Statute 25-4-908 (1977) states that in the case of danger of epidemic from any of the communicable diseases for which an immunization is required, no exemption or exception from immunization against such disease shall be recognized.  In this case, quarantine is authorized as a legal alternative to immunization.


Connecticut

Last Updated: 10/27/2011

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

ExemptionsPublic Health Code 10-204a-1 (2000) allows exemption from immunization requirements if a parent or guardian presents a statement that such immunization is contrary to the religious beliefs of the child.  Statute Chapter 169 Sec. 10-204a allows exemption from immunization requirements under the following circumstances: (1) Presentation of a certificate from a physician stating that such immunization is medically contraindicated because of the physical condition of such child, or (2) Presentation of a statement from the parents or guardian of the child that such immunization would be contrary to the religious beliefs of the child.


District of Columbia

Last Updated: 5/30/2013

Rule 5-E5300 (2008) requires each student to present valid written immunization certification documenting that the student has been successfully immunized in accordance with current Department of Health immunization requirements. All immunization requirements shall be established by the Department of Health, and distributed by the Public Schools, including as appropriate, advice published by public health officials and the Advisory Committee on Immunization Practice (ACIP). 

School officials shall maintain documentary proof of each student’s immunization certification, recorded in the student’s permanent school record. Schools must verify compliance with the immunization requirements at the following times: entry into Kindergarten, first grade, sixth grade, ninth grade; initial enrollment; and re-enrollment after more than one year’s absence from that school. 

The rule includes specific requirements schools must follow upon discovering that a student has not been properly immunized, along with guidelines for attendance for those who do not obtain the required immunizations.

The immunization requirements shall not apply to any student whose parent or guardian objects in writing to the immunization on grounds that the medical treatment or medical test is forbidden by their religion or religious beliefs and practices.
 
Exemptions: The immunization requirements of Rule 5-E5300 (2008) do not apply to any student whose parent or guardian objects in writing to the immunization on grounds that the medical treatment or medical test is forbidden by their religion or religious beliefs and practices.

Delaware

Last Updated: 8/19/2010

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

ExemptionsStatute 14: 131 (no date available) allows exemption from immunization requirements under the following circumstances: (1) Presentation of a written statement from a physician, i.e., medical doctor or doctor of osteopathy, stating that the student should not receive the prescribed immunizations because of the reasonable certainty of a reaction detrimental to that person (history of clinical illness of measles or rubella not acceptable as cause for exemption), or (2) Presentation of a notarized Affidavit of Religious Belief (outlined in statute) that states that the parents or legal guardians of the student reject the concept of immunization because of individual religious beliefs.  In the case of a vaccine preventable epidemic, any child enrolled in school who is exempt from the immunization program shall be temporarily excused from attendance at public school.


Florida

Last Updated: 4/24/2013

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry.

Exemptions:  Immunization exemptions for personal or philosophical reasons are not permitted under Florida law. Section 1003.22, Florida Statutes, stipulates that only  a county health department may issue a religious exemption for a child who is not immunized because of the family’s religious tenets or practices. This section of statute also provides for Temporary Medical Exemption as well as Permanent Medical Exemption. Rule 64D-3.046, Florida Administrative Code, specifies immunization documentation requirements as well as grade-level immunization requirements.


Georgia

Last Updated: 5/18/2011

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

ExemptionsCode 20-2-771 (2006) allows exemption from immunization requirements under the following circumstances: (1) A certificate is issued by the board of health or licensed physician stating that the student has a physical disability that makes immunization undesirable, or (2) The parent or guardian provides an affidavit stating that the immunization required conflicts with the religious beliefs of the parent or guardian.  During an epidemic or a threatened epidemic of any disease preventable by an immunization required by the Department of Human Resources, children who have not been immunized may be excluded from the school or facility until (1) they are immunized against the disease, unless they present valid evidence of prior disease, or (2) the epidemic or threat no longer constitutes a significant public health danger.


Hawaii

Last Updated: 5/18/2011

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

ExemptionsHRS 302A-1156 (1996) allows exemption from immunization requirements under the following circumstances: (1) A licensed physician certifies that the physical condition of the child is such that immunizations would endanger the child's life or health, or (2) A parent, custodian, guardian or any other person in loco parentis to a child objects to immunization in writing on the grounds that the immunization conflicts with that person's bonafide religious tenets and practices.  If at any time there is danger of an epidemic from any of the communicable diseases for which immunization is required under sections 302A-1154 (1996) to 302A-1163 (1996), no exemption from immunization against the disease will be recognized. Quarantine is considered be a legal alternative to immunization.


Iowa

Last Updated: 5/18/2011

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

Exemptions: Code 139A.8 and 641 IAC 7 allows exemption from immunization requirements under the following circumstances: (1) The student (if over 18) or the student's parent or guardian submits a signed statement from a licensed physician, advanced practice nurse practitioner, or physician assistant stating the required immunizations would be injurious to the health and well-being of the applicant or any member of the applicant's family, or  (2) The student (if over 18) or the student's parent or guardian submits a signed affidavit stating that immunization conflicts with the tenets and practices of a recognized religious denomination of which the applicant is an adherent or member.  Exemptions from immunization do not apply in times of emergency or epidemic as declared by the state board of health and the director of public health. 


Idaho

Last Updated: 2/28/2013

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information. Select your state from the drop down box under "Search for State Vaccine Requirements for School Entry."

Exemptions: Statute 39-4802 (no date available) allows exemption from immunization requirements under the following circumstances: (1) A parent or guardian submits to school officials a certificate signed by a licensed physician stating that the physical condition of the child is such that all or any of the required immunizations would endanger the life or health of the child, or (2) A parent submits a signed statement to school officials stating their objections to immunization on religious or other grounds.


Illinois

Last Updated: 5/18/2011

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

Exemptions410 ILCS 315/2 allows exemption from immunization requirements under the following circumstances: (1) The parent or guardian of the child objects to immunization requirements on the grounds that the administration of immunizing agents conflicts with his religious tenets or practices, or (2) A physician states that the physical condition of the child is such that the administration of one or more of the required immunizing agents would be detrimental to the health of the child.


Indiana

Last Updated: 7/1/2010

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information. Select your state from the drop down box under "Search for State Vaccine Requirements for School Entry."

Not included in the NNII database are the are the following statutes relating to HPV. Code 20-34-4-3 (2007) requires schools that enroll grade 6 female students to provide each parent of a female student who is entering grade 6 with information prescribed by the state department of health concerning the link between cervical cancer and the human papillomavirus (HPV) infection and that an immunization against the human papillomavirus (HPV) infection is available. Code 20-34-4-5.5 (2007) requires each school that enrolls grade 6 female students to require the parent of a female student entering grade 6 to furnish not later than the 20 school days after the first day of school a written statement prescribed by the state department of health stating that the parent has received the information required under 20-34-4-3 (2007) and that: (1) the student has received or is receiving the immunization; (2) the parent has decided not to have the student immunized; or (3) the parent chooses not to provide the information to the school concerning whether the student was immunized; against the human papillomavirus (HPV) infection.

Also not included in the NNII database are the following requirements. Code 20-34-4-2 gives authority to the State Department of Health to adopt rules requiring immunizations or modify existing schedules. Under this, the rules for 2011-12 school year include immunization of all 6-12 graders against menengitis and pertussis, in addition to a second varicella vaccine.

Exemptions: Codes 20-34-3-2 (2005) and 20-34-3-3 (2005) allow exemption from immunization requirements under the following circumstances: (1) A parent who objects to immunization on religious grounds must deliver a signed statement to the child’s teacher or to the individual who might order immunizations, or (2) A physician certifies that a particular required immunization(s) is or may be detrimental to the child’s health.


Kansas

Last Updated: 11/20/2011

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

ExemptionsStatute 72-5209 (1994) allows exemption from immunization requirements under the following circumstances: (1) An annual written statement signed by a licensed physician stating the physical condition of the child is such that the tests or vaccinations would seriously endanger the life or health of the child, or (2) A written statement signed by one parent or guardian that the child is an adherent of a religious denomination whose religious teachings are opposed to such tests or inoculations.


Kentucky

Last Updated: 5/23/2013

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

Exemptions: KRS 214.036 (2005) allows exemption from testing for tuberculosis or immunization under the following circumstances: (1) When, in the written opinion of an attending physician, immunization would be injurious to the child's health, or (2) The parents present a sworn statement objecting to the immunization of the childon religious grounds.  In the case of an epidemic, the Cabinet for Health Services may, by emergency regulation, require the immunization of all persons within the area of epidemic against the disease responsible for such epidemic.


Louisiana

Last Updated: 5/18/2011

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

ExemptionsR.S. 17:170 (1991) allows exemption from immunization requirements under the following circumstances: (1) The student or his parent or guardian submits a written statement from a physician stating that the vaccinations are contraindicated for medical reasons, or (2) The student or his parent or guardian presents a written dissent (philosophical or religious objections).  In the event of an outbreak of a vaccine-preventable disease at an educational institution, the administrators of that institution or facility are empowered, upon the recommendation of the office of public health, to exclude from attendance un-immunized students and clients until the appropriate disease incubation period has expired or the un-immunized person presents evidence of immunization.


Massachusetts

Last Updated: 5/18/2011

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

ExemptionsGeneral Law 76.15 (no date available) allows for medical exemption from immunization requirements upon certification by a physician that he has personally examined the child and that, in his opinion, their physical condition is such that his health would be endangered by immunizations. The certification must be submitted at the beginning of each school year to the physician in charge of the school health program. If the physician in charge of the school health program does not agree with the opinion of the child's physician, the matter shall be referred to the department of public health, whose decision will be final. General Law 76.15 (no date available) also allows for religious exemption.  In the absence of an emergency or epidemic of disease declared by the department of public health, no child whose parent or guardian states in writing that vaccination or immunization conflicts with his sincere religious beliefs shall be required to present a medical exemption certificate in order to be admitted to school.


Maryland

Last Updated: 5/18/2011

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

ExemptionsRegulation 10.06.04.04 (no date available) allows for a medical exemption from immunization requirements if a licensed physician or health officer provides a written statement stating that the student's immunization against a disease listed in Regulation 10.06.04.03.  The physician or health officer must indicate whether the contraindication is permanent or temporary.  If it is temporary, the physician or health officer must provide a statement estimating when the immunization may be obtained by the student, and the student's parent or guardian must provide the school evidence of the completion of the immunization.   Regulation 10.06.04.05 (no date available) allows for a religious exemption from immunization requirements if a student's parent or guardian submits a form provided by the Department of Health and Mental Hygiene stating that they object to immunization on the grounds that it conflicts with their bona fide religious beliefs and practices.  This exemption does not apply, however, when the Secretary declares an emergency or epidemic of disease.


Maine

Last Updated: 5/18/2011

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

Exemptions: 20-A 6355 (2001) allows exemption from immunization requirements under the following circumstances: (1) The parent or child provides a written statement from a physician stating that immunization against one or more of the diseases may be medically inadvisable, or (2) The parent provides a written declaration stating a sincere religious belief contrary to immunization requirements or opposition to immunizations for philosophical reasons.  When a public health official has reason to believe that the continued presence in a school of a student who has not been immunized against one or more diseases presents a clear danger to the health of others, the public health official will notify the chief administrative officer of the school. The chief administrative officer may excluded the student from attending school during the period of danger or until the student receives the necessary immunization.


Michigan

Last Updated: 12/20/2012

Required Immunizations for School Settings (2012) outlines the immunization requirements for pupils in Michigan Schools.

Exemptions: MCL 333.9215 (1978) allows for exemption from immunization requirements under the following circumstances:  (1) Certification from a physician that a specific immunization for any period of time is or may be detrimental to a child's health or is not appropriate, or (2) A written statement from a parent, guardian or person in loco parentis to the administrator of the child's school or operator of the group program that they hold religious convictions or other objections to immunization.


Minnesota

Last Updated: 5/18/2011

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

Exemptions: Statute 121A.15 (2005) allows for exemption from immunization requirements under the following circumstances: (1) A statement signed by a physician and submitted to the administrator or other supervisor of the school stating that an immunization is contraindicated for medical reasons or that laboratory confirmation of the presence of adequate immunity exists, or (2) Submission of a notarized declaration signed by the minor child's parent or guardian, or by an emancipated student, stating that the person has not been immunized because of conscientiously held beliefs of the parent or guardian or of the emancipated child.


Missouri

Last Updated: 5/18/2011

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  

Exemptions: 19 CSR 20-28.010 allows for medical exemption with certification by a doctor that either the immunization would danger the child's health or life or the child has documented immunity to the disease. Religious exemption is provided if the parent or guardian objects in writing to the school administrator that immunization of the child violates his/her religious believes.

 


Mississippi

Last Updated: 5/18/2011

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

Exemptions: Code 41-23-37 (1983) allows for medical exemption from immunization requirements upon presentation of a certificate from a licensed physician.  The certificate may be accepted the local health officer when, in his opinion, such exemption will not cause undue risk to the community.


Montana

Last Updated: 5/18/2011

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

Exemptions: Administrative Rule 37.114.715 (2005) allows for medical exemption from immunization requirements.  A person seeking to attend school (or their parent or guardian) must submit a written and signed statement from any physician that an immunization is medically contraindicated.  The statement must include which specific immunization is contraindicated, the period of time it is contraindicated and the reasons for medical contraindication.  Administrative Rule 37.114.716 (2005) allows for religious exemption from immunization requirements.  A person seeking to attend school (or their parent, guardian, responsible adult or emancipated minor) must submit a signed, written statement indicating that the proposed immunization interferes with the free exercise of the religious beliefs of the person signing the statement.  A claim of exemption from immunization requirements on religious grounds must be maintained on a form provided by the department and provided to the school prior to each school year by the parent, guardian or responsible adult of the pupil for whom a religious exemption is claimed.  If a pupil is 18 years of age or older or emancipated, the pupil may claim his or her own exemption.


North Carolina

Last Updated: 5/18/2011

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry." 

Statute 115C-47 (2007) requires local boards of education to ensure that schools provide parents and guardiansof students grades 5-12 with information about cervical cancer, cervical dysplasia, HPV and the vaccines available to prevent these diseases. The information must be provided at the beginning of the school year.

Exemptions: Statute 130A-156 (1999) allows for medical exemption if a licensed physician certifies that a required immunization is or may be detrimental to a person's health due to one of the contraindications adopted by the Commission for Health Services.  NC General Statute 130A-157 (2002) allows for religious exemption from immunization requirements if the bona fide religious beliefs of an adult, parent, guardian or person in loco parentis of a child are contrary to the immunization requirements.


North Dakota

Last Updated: 12/27/2011

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

Exemptions: Code 23-07-17.1 (no date available) allows for exemption from immunization requirements under the following circumstances: (1) Submission of a certificate from a licensed physician indicating that the physical condition of the child is such that immunization would endanger the life or health of the child, (2) Submission of a certificate signed by the child's parent or guardian whose religious, philosophical or moral beliefs are opposed to immunization, or (3) History of disease exemption. HB1136 (2007) also allows for the state health officer to authorize admission for children who have not been immunized if extenuating circumstances" exist making it difficult or impossible to comply with immunization requirements. Extenuating circumstances" include a vaccine shortage and other temporary circumstances.


Nebraska

Last Updated: 5/18/2011

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

Exemptions: Statute 79-221 (2005) allows for exemption from immunization requirements under the following circumstances: (1) Submission of a signed statement from a physician, physician assistant or advanced practice registered nurse stat that, in the health care provider's opinion, the immunizations required would be injurious to the health and well-being of the student or any member of the student's family or household, or (2) Submission of a signed affidavit by the student, or if he is a minor, by a legally authorized representative of the student, stating that the immunization conflicts with the tenets and practice of a recognized religious denomination of which the student is an adherent or member or that the immunization conflicts with the personal and sincere beliefs of the student.


New Hampshire

Last Updated: 5/18/2011

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

Exemptions: RSA 141-C:20-c (2002) allows for exemption from immunization requirements under the following circumstances: (1) Certification from a licensed physician that immunization against a particular disease may be detrimental to a child's health, or (2) Submission of a signed, notarized form stating that the child has not been immunized because of religious beliefs.  In the case of a medical exemption, the exemption shall exist only for the length of time, in the opinion of the physician, such immunization would be detrimental to the child.  An exemption from immunization from one disease shall not affect other required immunizations.


New Jersey

Last Updated: 1/23/2013

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under "Search for State Vaccine Requirements for School Entry.”  In addition to the immunization requirements listed, recent rules passed by the Public Health Council in 2007 require children attending childcare centers and preschools to receive annual influenza vaccinations and a pneumococcal vaccine beginning in 2008.  In addition, children enrolled in sixth grade or transferring into a New Jersey school from another state or country will be required to receive a booster dose of the diphtheria, tetanus, and pertussis vaccine as well as one dose of meningococcal vaccine. 

N.J.A.C. 6A:16-2.1 (a)1 requires each district board of education to develop and adopt written policies, procedures and mechanisms for the provision of health, safety and medical emergency services, including the annual review of immunization records for completeness pursuant to N.J.S.A. 8:57-4.1 through 4.20

Exemptions:  N.J.A.C. 8:57 –4.3 allows for exemptions to immunizations.  Objections to vaccination based on grounds which are not medical or religious in nature and which are of a philosophical, moral, secular, or more general nature are unacceptable.

Religious Exemptions:
N.J.S.A. 26:1A-9-1 provides an exemption for pupils from mandatory immunization "if the parent or guardian of the pupil objects thereto in a written statement signed by the parent or guardian upon the ground that the proposed immunization interferes with the free exercise of the pupil's religious rights.”  This exemption may be suspended by the State Commissioner of Health during the existence of an emergency as determined by the State Commissioner of Health.

All schools, childcare centers, and local health officers may be advised that the religious exemption extends to private, parochial, and public institutions.  Those children with religious exemptions may be excluded from school during a vaccine-preventable disease outbreak. 
 
Medical Exemptions: N.J.A.C. 8:57 – 4.3 allows for exemptions to immunizations which are medically contraindicated. A written statement shall be submitted to the school, preschool, or child care center from a physician licensed to practice medicine or osteopathy or an advanced practice nurse (certified registered nurse practitioner or clinical nurse specialist) indicating that an immunization is medically contraindicated for a specific period of time, and the reason(s) for the medical contraindication, based upon valid medical reasons as enumerated by the Advisory Committee on Immunization Practices (ACIP) or the American Academy of Pediatrics (AAP) guidelines.


New Mexico

Last Updated: 5/18/2011

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

Exemptions: NMSA 24-5-3 (2005) allows for medical exemption if a licensed physician certifies that the physical condition of the child is such that immunization would seriously endanger the life or health of the child.  NMSA 24-5-3 (2005) allows for religious exemption under the following circumstances: (1) Submission of an affidavit or written affirmation from an officer of a recognized religious denomination stating that the child's parents or guardians are bona fide members of a denomination whose religious teaching requires reliance upon prayer or spiritual means alone for healing, or (2) Submission of affidavits or written affirmation from a child's parents or guardians indicating that their religious beliefs, held either individually or jointly with others, do not permit the administration of vaccine or other immunizing agent.


Nevada

Last Updated: 5/18/2011

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

Exemptions: NRS 392.439 (1997) allows for medical exemption from immunization requirements with a written statement signed by a licensed physician and a parent or guardian stating that the medical condition of the child will not permit him to be immunized to the extent required by NRS 392.435 (1997).  NRS 392.437 (1997) allows for religious exemption from immunization requirements if the parent or guardian of the child submits a written statement indicating that their religious belief prohibits immunization of the child or ward.  The statement must be submitted to the board of trustees of the school district or governing board of the charter school in which the child has been accepted for enrollment.


New York

Last Updated: 5/18/2011

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

Exemptions: Public Health Law 2164 (no date available) allows for exemption from immunization requirements under the following circumstances: (1) Certification from a licensed physician that such immunization may be detrimental to a child's health, or (2) A child's parent, parents, or guardian hold genuine and sincere religious beliefs which are contrary to immunization practices.


Ohio

Last Updated: 5/18/2011

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

Exemptions: ORC 3313.671 (2005) allows for exemption from immunization requirements under the following circumstances: (1) Submission of a written statement from a child's physician indicating that immunization against any disease is medically contraindicated, or (2) Presentation of a written statement from the pupil's parent or guardian in which the parent or guardian objects to the immunization for good cause, including religious convictions.


Oklahoma

Last Updated: 5/18/2011

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

Exemptions: Oklahoma Statute 70.1210.192 (1998) allows for exemption from immunization requirements under the following circumstances: (1) Submission of a certificate from a licensed physician stating that the physical condition of the child is such that immunization would endanger the life or health of the child, or (2) Submission of a written statement by the parent, guardian or legal custodian of the child objecting to immunization of the child.


Oregon

Last Updated: 5/18/2011

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

Exemptions: ORS 433.267 (2005) allows for exemption from immunization requirements under the following circumstances: (1) Submission of a statement signed by a physician or representative of the local health department indicating that the child should be exempted from receiving specified immunizations because of an indicated medical diagnosis, or (2) Submission of a signed statement by the parent indicating that the child has not been immunized because the child is being reared as an adherent to a religion the teachings of which are opposed to such immunization.


Pennsylvania

Last Updated: 5/18/2011

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

Exemptions: 028 PA Code 23.84 (1997) allows for exemption from immunization requirements under the following circumstances: (1) Submission of a written statement from a physician or physician's designee indicating that immunization may be detrimental to the health of the child, or (2) Submission of a written statement from an emancipated child or a child's parent or guardian indicating objection to immunization on religious grounds or on the basis of a strong moral or ethical conviction similar to a religious belief.


Rhode Island

Last Updated: 2/13/2013

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry.

All Rhode Island students entering public or private preschools, elementary, middle, or high schools must have required immunizations. SeeSummary of Immunization Requirements & Guidelines for Granting Exemptions.

Exemptions: Statute 16-38-2 (1956) allows for exemption from immunization requirements under the following circumstances: (1) Certification from a licensed physician stating that a person is not a fit subject for immunization for medical reasons, or (2) Submission of a statement signed by the pupil (if over 18) or by the parent or guardian stating that immunization and/or testing for communicable diseases is contrary to that person's religious beliefs.


South Carolina

Last Updated: 5/18/2011

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

Exemptions: Code 44-29-180 (no date available) allows for exemption from immunization requirements upon presentation of a South Carolina Certificate of Medical or Religious Exemption.  Medical contraindication must be noted by an individual licensed to practice medicine or osteopathy on the South Carolina Certificate of Immunization. A Certificate of Religious Exemption may be granted to any student whose parents, parent, guardian, or person in loco parentis signs the appropriate section of the South Carolina Certificate of Religious Exemption stating that they are members of a recognized religious denomination in which the tenets and practices of the religious denomination conflict with immunizations.


South Dakota

Last Updated: 1/12/2013

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

Exemptions: Code 13-28-7.1 (2005) allows for exemption from immunization requirements under the following circumstances: (1) Certification from a licensed physician stating the physical condition of the child would be such that a test or immunization would endanger the child's life or health, or (2) Submission of a written statement signed by one parent or guardian indicating that the child is an adherent to a religious doctrine whose teachings are opposed to immunization.

 


Tennessee

Last Updated: 9/29/2011

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

Exemptions: Code 49-6-5001 (2007) allows for medical exemption from immunization requirements if a qualified physician certifies that administration of immunizations would be in any manner harmful to the child.  49-6-5001 (2007) and 37-10-402 (1993) allow for exemption from immunization requirements if a parent or guardian files with proper authorities a signed, written statement that such immunization and preventive measures conflict with the religious tenets and practices of the parent or guardian affirmed under penalties of perjury.


Texas

Last Updated: 5/18/2011

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

Exemptions: TAC 97.62 (2004) allows for medical exemption from immunization requirements if the child or student presents a statement signed by the child's licensed physician stating that, in the physician's opinion, the vaccine required is medically contraindicated or poses a significant risk to the health and well-being of the child or any member of the child's household.  Unless it is written in the statement that a lifelong condition exists, the exemption is valid for only one year from the date signed by the physician.  TAC 97.62 (2004) allows for exemption for reasons of conscience, including a religious belief.  A parent or guardian must present a signed affidavit stating that they decline immunization for reasons of conscience, including a religious belief.  The affidavit is valid for a two-year period.  A child who has not received required immunizations for reasons of conscience, including religious beliefs, may be excluded from school in times of emergency or epidemic declared by the commissioner of public health.


Utah

Last Updated: 5/18/2011

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

Exemptions: Code 53A-11-302 (1992) allows for medical exemption from immunization requirements with certification from a licensed physician stating that due to the physical condition of the student one or more specified immunizations would endanger the student's life or health.  Code 53A-11-302 (1992) and 53A-11-302.5 (1992) allows for personal belief exemption. In order to qualify for the exemption, a statement must be submitted indicating that a person has a personal belief opposed to immunizations or that they are a bona fide member of a specified, recognized religious organization whose teachings are contrary to immunization. The statement must be signed by one of the student's parents, guardian, a legal age sister or brother of a student who has no parent or guardian, or a student, if of legal age.


Virginia

Last Updated: 5/18/2011

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

Not included in the NNII database is Code 32.1.46 (2007) requiring three doses of properly spaced human papilloma virus (HPV) vaccines for females. The first dose must be administered before the student enters sixth grade. Code 32.1.46 (2007) allows a parent or guardian, at the parent's or guardian's sole discretion, to elect for the parent's or guardian's child not to receive the HPV vaccine, after having reviewed materials describing the link between the human papillomavirus and cervical cancer approved for such use by the Board.

Exemptions: 12VAC5-110-80 (1992) allows for medical exemption from immunization requirements.  The school has written certification on any of the documents specified under "documentary proof'' in 12VAC5-110-10 (1995) from a physician or a local health department that one or more of the required immunizations may be detrimental to the student's health. Such certification of medical exemption must specify the nature and probable duration of the medical condition or circumstance that contraindicates immunization. 12VAC5-110-80 (1992) allows for religious exemption from immunization requirements if the student or his parent or guardian submits a Certificate of Religious Exemption to the admitting official of the school to which the student is seeking admission. The Certificate of Religious Exemption is an affidavit stating that the administration of immunizing agents conflicts with the student's religious tenets or practices.

Code 32.1.46 (2007) allows a parent or guardian, at the parent's or guardian's sole discretion, to elect for the parent's or guardian's child not to receive the human papillomavirus vaccine, after having reviewed materials describing the link between the human papillomavirus and cervical cancer approved for such use by the Board.

If the pupil is a homeless child or youth and for that reason cannot furnish the immunization report or records required for enrollment, and the person seeking to enroll the pupil furnishes to the school division an affidavit so stating and also indicating that, to the best of his knowledge, such pupil is in good health and free from any communicable or contagious disease, the school division shall immediately refer the student to the local school division liaison, as described in the federal McKinney-Vento Homeless Education Assistance Improvements Act of 2001. The liasion is required to then assist the student in obtaining the necessary physical examination by the county or city health department or other clinic or physician's office and the student shall immediately be admitted to school.

Code 22.1-360 (2009) mandates that compacting states give children of military families 30 days from the date of enrollment to obtain any immunization(s) required by the receiving state. For a series of immunizations, initial vaccinations must be obtained within 30 days or within such time as is reasonable determined under the rules promulgated by the Interstate Commission.

Vermont

Last Updated: 5/18/2011

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

Exemptions: 18 VSA 1122 (1981) allows for exemption from immunization requirements under the following circumstances: (1) Written certification from a licensed physician stating that a specific vaccine is or may be detrimental to the person's health or is not appropriate, or (2) A written statement from a person, or if a minor, their parent or guardian, indicating that the person, parent or guardian holds religious beliefs or moral convictions opposed to immunization.  In addition, the health department may provide by rule for further exemptions to immunization based upon sound medical practice.


Washington

Last Updated: 5/18/2011

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

Code 28A.210.080 (2007) requires every public school to provide parents and guardians with information about human papillomavirus disease and its vaccine at the beginning of every school year beginning with students entering sixth grade.

Exemptions: 28A.210.090 (1979) allows for exemption from immunization requirements under the following circumstances: (1) Written certification from a licensed physician that a particular vaccine required by rule of the state board of health is, in his or her judgment, not advisable for the child, or (2) Written certification signed by any parent or legal guardian of the child or any adult in loco parentis to the child that the religious beliefs of the signator are contrary to the required immunization measures, or (3) Written certification signed by any parent or legal guardian of the child or any adult in loco parentis to the child that the signator has either a philosophical or personal objection to immunization of the child.  In the case of medical exemption, when it is determined that the immunization(s) named in the certification are no longer contraindicated, the child will be required to complete immunization.


Wisconsin

Last Updated: 12/13/2012

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

Exemptions: Statute 252.04 (2009) allows for exemption from immunization requirements if the student, adult or the students parent, guardian or legal custodian submits a written statement to the school, day care center or nursery school objecting to the immunization for reasons of health, religion or personal conviction.


West Virginia

Last Updated: 5/18/2011

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

State Board Policy 2423  policy reinforces new school enterer immunization requirements and entry into the WV Electronic Information System(WVEIS).  It also strongly recommends 6th and 9th grade adolescent immunizations.

Exemptions: Code 16-3-4 (no date available) allows for medical exemption from immunization requirements with a certificate from a reputable physician showing that immunization for any or all designated diseases is impossible or improper, or sufficient reason why any or all immunizations should not be done.


Wyoming

Last Updated: 5/18/2011

Detailed, current information about immunization requirements by state is maintained by the National Network for Immunization Information.  Select your state from the drop down box under Search for State Vaccine Requirements for School Entry."

Exemptions: Statute 21-4-309 (no date available) allows for exemption from immunization requirements upon submission of written evidence of religious objection or medical contraindication to the administration of any vaccine.  In the presence of vaccine preventable disease, school children for whom an exemption has been issued and who are not immunized against the occurring vaccine preventable disease shall be excluded from school attendance for a period of time determined by the state or county health authority.


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