All 50 states have adopted compulsory immunization laws for school children and also established some type of waiver, or exemption, for the immunizations. The types of waivers include: medical, religious, and philosophical or personal belief waivers. Medical waivers are typically granted upon the submission of a statement or certification from a health care provider that due to the student’s physical condition, the compulsory immunization would cause harm or pose a threat to the student’s health or life. Religious waivers are often based upon genuine religious beliefs or established religious doctrine while philosophical waivers are generally granted to those who hold a moral or sincere belief against immunizations.
Every state allows medical waivers while two states, West Virginia and Mississippi, allow medical waivers only. The remaining 48 states allow religious waivers and a number of states also allow philosophical waivers. Over the past few decades, the number of states allowing a philosophical waiver has varied from year to year as state legislatures either adopt or repeal such waivers. The current number of states allowing philosophical waivers is around 20.
This issue brief examines the elements of immunization waivers and provides examples of the various state waiver requirements.
Note: Some state requirements for waivers may have changed since this resource was developed.