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Last week we reported on Connecticut’s 2021 removal of its K-12 vaccination religious exemption and the prospect of the US Supreme Court deciding whether this is allowed under the First Amendment. This week we survey the status of religious, conscientious, and personal exemptions around the USA, with a call to action on important pending legislation in Massachusetts, New York, and Alabama.

 

Religious and personal exemptions rolled back

 

As we noted last week, back in 2014 only Mississippi and West Virginia did not have a religious, conscientious, philosophical, or personal exemption for K-12 vaccine mandates. California lost its personal belief exemption in 2015.  Maine removed its religious and philosophical exemptions in 2019, and in the same year New York removed its religious exemption, and Washington removed its personal/philosophical exemption as to the measles, mumps and rubella vaccine only.  And as mentioned Connecticut’s religious exemption was removed in 2021. In response to a federal lawsuit in 2023 a federal court ordered Mississippi to add a religious exemption. West Virginia’s legislature recently voted to add a religious exemption, but this was vetoed in 2024.

 

Personal, conscientious, and religious exemptions

 

Personal belief exemptions are the broadest exemptions: if you don’t want your child vaccinated, you may decline to do so. Conscientious or philosophical exemptions are the next broadest and should include or subsume religious motivations for saying no to vaccines. Religious exemptions can be more challenging; while some states merely require a signed parent’s statement, most follow the minimum standards allowed by the US Supreme Court, which can require affirmatively showing a sincere religious belief against the vaccination at issue.

 

15 states have conscientious or personal exemptions

 

According to the National Council of State Legislators (NCSL), all 50 states have K-12 vaccine mandates and all grant exemptions for medical reasons. The strength of medical exemptions varies widely: In some states a doctor’s note must be accepted and essentially cannot be challenged. In other states such as California, medical boards have effectively prevented physicians from granting such exemptions. Regarding the religious exemptions, 45 states retain their religious exemption status.  NCSL reports that 15 states have personal, philosophical, or conscientious exemptions, and some of these states also specifically include a religious exemption. And even though some states, such as Minnesota, don’t have an explicit religious exemption, that state’s conscientious exemption should cover any religious objection to vaccination. NCSL’s list of exemptions by state is here, and the National Vaccine Information Center has a map showing each state’s exemptions here

Oppose Massachusetts H.604/S.1391: keep the religious exemption

 

In Massachusetts current law states that absent a declared emergency or epidemic, “no child whose parent or guardian states in writing that vaccination or immunization conflicts with his sincere religious beliefs shall be required to present said physician’s certificate in order to be admitted to school.” House Bill 604  and Senate Bill 1391 each would remove this religious exemption. These bills are pending at the Joint Committee on Public Health; the Committee indicates that they may be voted on anytime between now and December 2024.

 

Oppose Massachusetts S.1458/H.2151: “Community Immunity Act”

 

These bills make multiple complex changes to immunization policies purporting to improve and standardize immunization reporting, but they go well beyond this. In addition to unneeded additional tracking of vaccinations and other problematic elements, this Act would allow a minor of any age to consent to vaccination with parental knowledge. It also allows private preschools, K-12 schools, and institutes of higher education to exclude religious exemptions from their vaccine policies. These bills are also pending at the Joint Committee on Public Health. 

Support New York SB118/AB6676: reinstate religious exemption

 

New York’s SB118 and AB6676 state that K-12 vaccine mandate do not apply “to children whose parent, parents, or guardian  hold  genuine and sincere religious beliefs which are contrary to the practices herein required, and no certificate [of vaccination] shall  be  required as  a  prerequisite  to  such  children  being admitted or received into school or attending school.” These bills were referred to the Senate Health Committee and the Assembly Standing Committee on Health on January 3, 2024. 

Support Alabama SB246: state cannot question reason
for exemption request

 

In Alabama SB246 would remove any burden to prove the sincerity or applicability of any religious objection to K-12 vaccination. It states that a “written statement provided by a child’s parent or guardian to the local board of education declaring that he or she wishes to exempt his or her child from any vaccination or testing requirement pursuant to this subdivision shall constitute an exemption. The parent or guardian may not be required to explain the reason for the exemption, certify the exemption with any third party, or otherwise receive approval from the local board of education or any other entity.” SB246 has passed in the Senate, and it is now pending at the House Health Committee.