Vaccination Laws

CDC works closely with public health agencies and private partners to improve and sustain immunization coverage and to monitor the safety of vaccines. One tool used to maintain low rates of vaccine preventable disease is vaccination law. 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 affect access to vaccination services by determining 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.

State Healthcare Worker and Patient Vaccination Laws

Healthcare facilities across the country are increasingly requiring healthcare workers to be vaccinated for certain diseases in an effort to reduce outbreaks of vaccine-preventable diseases. In some instances, facilities are establishing these requirements due to mandates in state statutes and regulations. These PHLP menus examine state healthcare facility vaccination laws for the following vaccine-preventable diseases:

State School Vaccination Laws

All states require children to be vaccinated against certain communicable diseases as a condition for school attendance. In most instances, state school vaccination laws expressly apply to both public schools and private schools with identical immunization and exemption provisions. The Public Health Law Program has conducted an assessment of state statutes, regulations, and state health department policies (collectively referred to as “laws”) regarding school vaccinations. This assessment is a 2019 update of state vaccination laws originally collected in 2015 and updated previously in 2017.

View State School Immunization Requirements and Vaccine Exemption Laws pdf icon[PDF – 790 KB]

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. This graph, with 2019 data, highlights selected attributes of school vaccination exemption laws, which are reviewed in the Public Health Law Program’s assessment (linked above).

States with laws that permit medical exemptions only: California, Mississippi, New York, and West Virginia. States with laws that permit medical and religious exemptions: Alabama, Alaska, Connecticut, Delaware, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Kansas, Kentucky, Maryland, Massachusetts, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, North Carolina, Rhode Island, South Carolina, South Dakota, Tennessee, Vermont, Virginia, and Wyoming. States with laws that permit medical, religious, and philosophical exemptions: Arizona, Arkansas, Colorado, Idaho, Louisiana, Maine, Michigan, Minnesota, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Texas, Utah, Washington, and Wisconsin. States with laws that require parental acknowledgment during the exemption application process that exempted students can be excluded from school during outbreaks: Alaska, Arizona, Arkansas, Connecticut, Delaware, Georgia, Idaho, Illinois, Indiana, Iowa, Kentucky, Louisiana, Michigan, Minnesota, Missouri, Montana, New Hampshire, New Mexico, North Dakota, Ohio, Oklahoma, Oregon, Rhode Island, Utah, Vermont, Virginia, Washington, Wisconsin, and Wyoming. States with laws that establish that some exemptions might not be recognized in the event of an outbreak: Alabama, Colorado, Georgia, Hawaii, Iowa, Kentucky, Maryland, Massachusetts, Nevada, North Dakota, Tennessee, and Virginia. States with laws that require notarization of documents in the exemption application process: Alaska, Arkansas, Connecticut, Delaware, Georgia, Iowa, Kentucky, Minnesota, Montana, Nebraska, Nevada, New Hampshire, New Mexico, South Carolina, Texas, and Virginia. States with laws that require parental education on vaccinations in the exemption application process: Arizona, Arkansas, Illinois, Michigan, Oregon, Rhode Island, Utah, Vermont, and Washington. States with laws that expressly address the duration of medical exemptions (e.g., temporary or permanent): Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Michigan, Mississippi, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Oregon Pennsylvania, South Carolina, Texas, Utah, Vermont, Virginia, Washington, and West Virginia.
Additional Resource

The Latest in Vaccine Policies: Selected Issues in School Vaccinations, Healthcare Worker Vaccinations, and Pharmacist Vaccination Authority Lawsexternal icon
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.

Page last reviewed: February 16, 2022