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Can You Opt Out of School Vaccines?
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Three line graphs display the dramatic decline in reported cases of diphtheria, polio, and measles in the United States from 1920 to 2019, each showing a sharp drop after the introduction of their respective vaccines. Diphtheria cases fell after 1921, polio after 1955, and measles after 1963, illustrating the impact of mass vaccination programs. An inset highlights an increase in measles cases after 2010. U.S. federal and state vaccine guidelines
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Three line graphs display the dramatic decline in reported cases of diphtheria, polio, and measles in the United States from 1920 to 2019, each showing a sharp drop after the introduction of their respective vaccines. Diphtheria cases fell after 1921, polio after 1955, and measles after 1963, illustrating the impact of mass vaccination programs. An inset highlights an increase in measles cases after 2010.
Historical mass vaccination programs in the United States In the United States, mass vaccination programs carried out against diphtheria, polio, and measles have almost eradicated these diseases from the population. The graphs indicate the years the vaccines were introduced. (Data source: U.S. Bureau of the Census, Historical Statistics of the United States: Colonial Times to 1970, CD-ROM ed. [1997].)

Can You Opt Out of School Vaccines?

Written by
Kara Rogers
Kara Rogers is the senior editor of biomedical sciences at Encyclopædia Britannica, where she oversees a range of content from medicine and genetics to microorganisms. She joined Britannica in 2006 and...
Kara Rogers
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Britannica Editors
Encyclopaedia Britannica's editors oversee subject areas in which they have extensive knowledge, whether from years of experience gained by working on that content or via study for an advanced degree....
Britannica Editors
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•History

In the United States all 50 states require certain vaccinations for public and private school entry, but exemptions are allowed for medical reasons in every state and for religious or personal beliefs in many states, though the rules vary. California, Connecticut, Maine, New York, and West Virginia, for example, do not allow nonmedical exemptions (based on religious or personal belief) to school vaccination requirements. Meanwhile, in 2025 officials in Florida announced plans to phase out all childhood vaccine mandates for public schools.

Exemptions

Medical exemptions are granted in certain instances. For example, some people may experience a severe allergic reaction (anaphylaxis) to vaccine components, such as gelatin or egg protein, making vaccination potentially life-threatening. A person with a weakened immune system, such as from chemotherapy, HIV infection, or immunosuppressive therapy, cannot safely receive live vaccines, nor can individuals who recently received a blood transfusion. Nonmedical exemptions are granted for reasons unrelated to health and are usually either religious or personal. Parents, for instance, may object to vaccines based on religious doctrine or because of personal, moral, or ethical beliefs, even if not tied to a specific religion, such as concerns about natural health or distrust of pharmaceuticals. Objection to vaccination may also be rooted in personal views of individual liberty or autonomy.

Global perspective

Some countries, such as China, mandate specific childhood vaccines with limited or no exemptions. Others, such as Japan, strongly recommend vaccination, making school entry less restrictive. In countries where vaccination is mandatory for schoolchildren, exemptions are often limited to strictly defined medical conditions, reflecting a balance between individual choice and public health protection.

School Vaccine Mandates and Exemptions Worldwide

  • United States
    • Vaccines required for school entry in all 50 states.
    • Exemptions: medical (all states), religious (most), personal/philosophical (some).
    • Several states, including California and New York, have eliminated religious and personal exemptions after outbreaks.
  • Canada
    • Requirements vary by province.
    • Exemptions: medical, religious, and sometimes philosophical.
    • Enforcement differs, as not all provinces require proof of vaccination.
  • Europe
    • Mixed approach: Some countries (Italy, France, Hungary) mandate vaccines; others (United Kingdom) only recommend them.
    • Exemptions: medical, with some countries allowing religious or personal.
    • Measles outbreaks have prompted stricter rules in Italy and France.
  • China
    • Vaccines provided through the Expanded Program on Immunization.
    • Exemptions: very limited, mostly medical.
    • Proof of vaccination needed for school entry, including such vaccines as those against polio, measles, and diphtheria.
  • Japan
    • Vaccines strongly recommended but not legally required for school since 1994.
    • No school-entry mandate, so exemptions are not applicable.
  • India
    • Universal Immunization Programme (1985–present) promotes routine childhood vaccination.
    • Vaccines not legally tied to school entry.
    • Coverage driven by public health campaigns rather than mandates.
  • South America (Brazil, Argentina, Chile)
    • Vaccines generally required or recommended for school enrollment.
    • Exemptions: very limited, primarily medical.
Kara Rogers