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State School and Childcare Vaccination Laws

State vaccination laws include vaccination requirements for children in public and private schools and daycare settings; college/university students; and healthcare workers and patients in certain facilities. State laws also determine whether providing vaccinations to patients is within the scope of practice of certain healthcare professionals. The Public Health Law Program provides selected resources for public health practitioners and their legal counsel on state vaccination laws.

The Latest in Vaccine Policies: Selected Issues in School Vaccinations, Healthcare Worker Vaccinations, and Pharmacist Vaccination Authority Laws [PDF – 156KB]
This article identifies and discusses changes and trends in select state vaccine policy issues developing across the US that can affect rates of vaccination. Barraza L, Hoss A, Schmit C. Journal of Law, Medicine & Ethics 2017;45:16–9.

School Vaccination Laws [PDF – 594KB]
The Public Health Law Program is collecting state statutes and regulations regarding school vaccinations. This document summarizes state vaccination laws collected in February and March 2015 and updated in February 2017. The recent updates reflect feedback from state health department staff who reached out to PHLP; therefore, this document may not reflect all changes that have occurred since March 2015.

This document will be updated; to update relevant immunization laws from your state, please the Public Health Law Program at PHLawProgram@cdc.gov.

Polar Graph on State School Vaccination Exemptions Law

State law not only establishes exemptions for school vaccination requirements, but also establishes requirements regarding the exemption application process and the implications of an exemption in the event of an outbreak. This graph highlights nine attributes in school vaccination exemption laws.

States with laws that only allow for medical or religious exemptions: Alabama, Alaska, Arkansas, California, Connecticut, Delaware, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Kansas, Kentucky, Maryland, Massachusetts, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Rhode Island, South Carolina, South Dakota, Tennessee, Vermont, Virginia, West Virginia, Wyoming, and the District of Columbia. States with laws that expressly exclude philosophical exemptions: Delaware, Iowa, New Jersey, North Carolina, West Virginia. States with laws that allow for exempted student exclusion from school during an outbreak: Arizona, Arkansas, California, Colorado, Delaware, Florida, Georgia, Hawaii, Idaho, Kansas, Louisiana, Maine, Massachusetts, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New York, North Carolina, North Dakota, Ohio, Rhode Island, South Carolina, Texas, Utah, Virginia, Washington, Wisconsin, Wyoming, and the District of Columbia. States with laws that require parental acknowledgment during the exemption application process of exempted student exclusion during an outbreak: Arkansas, Montana, North Dakota, and Washington. States with laws that say that exemption might not be recognized during an outbreak: Alabama, Colorado, Georgia, Hawaii, Iowa, Kentucky, Maryland, Massachusetts, Nevada, North Dakota, and Tennessee. States with laws that require parental affidavit or notarization during the exemption application process: Alaska, Arizona, Delaware, Georgia, Iowa, Kentucky, Minnesota, Montana, Nebraska, New Hampshire, New Mexico, Tennessee, Texas, and Virginia. States with laws that require enhanced education during the exemption application process on the benefits of vaccinations and the risks of not being vaccinated: Arizona, Arkansas, Michigan, Oregon, Vermont, Utah, and Washington. States with laws that distinguish between temporary or permanent medical exemptions: Arizona, Arkansas, California, Connecticut, Florida, Georgia, Hawaii, Indiana, Iowa, Maryland, Michigan, Montana, New Jersey, New York, North Carolina, Pennsylvania, South Carolina, Virginia, Washington, and West Virginia. States with laws that require an annual or more frequent healthcare provider recertification for medical exemptions: Arkansas, Connecticut, Georgia, Kansas, Massachusetts, New Mexico, New York, Texas, and West Virginia. States with laws that only allow for medical or religious exemptions: Alabama, Alaska, Arkansas, California, Connecticut, Delaware, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Kansas, Kentucky, Maryland, Massachusetts, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Rhode Island, South Carolina, South Dakota, Tennessee, Vermont, Virginia, West Virginia, Wyoming, and the District of Columbia. States with laws that expressly exclude philosophical exemptions: Delaware, Iowa, New Jersey, North Carolina, West Virginia. States with laws that allow for exempted student exclusion from school during an outbreak: Arizona, Arkansas, California, Colorado, Delaware, Florida, Georgia, Hawaii, Idaho, Kansas, Louisiana, Maine, Massachusetts, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New York, North Carolina, North Dakota, Ohio, Rhode Island, South Carolina, Texas, Utah, Virginia, Washington, Wisconsin, Wyoming, and the District of Columbia. States with laws that require parental acknowledgment during the exemption application process of exempted student exclusion during an outbreak: Arkansas, Montana, North Dakota, and Washington. States with laws that say that exemption might not be recognized during an outbreak: Alabama, Colorado, Georgia, Hawaii, Iowa, Kentucky, Maryland, Massachusetts, Nevada, North Dakota, and Tennessee. States with laws that require parental affidavit or notarization during the exemption application process: Alaska, Arizona, Delaware, Georgia, Iowa, Kentucky, Minnesota, Montana, Nebraska, New Hampshire, New Mexico, Tennessee, Texas, and Virginia. States with laws that require enhanced education during the exemption application process on the benefits of vaccinations and the risks of not being vaccinated: Arizona, Arkansas, Michigan, Oregon, Vermont, Utah, and Washington. States with laws that distinguish between temporary or permanent medical exemptions: Arizona, Arkansas, California, Connecticut, Florida, Georgia, Hawaii, Indiana, Iowa, Maryland, Michigan, Montana, New Jersey, New York, North Carolina, Pennsylvania, South Carolina, Virginia, Washington, and West Virginia. States with laws that require an annual or more frequent healthcare provider recertification for medical exemptions: Arkansas, Connecticut, Georgia, Kansas, Massachusetts, New Mexico, New York, Texas, and West Virginia.

 

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