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.