As you’re going over your child’s back-to-school list, there’s one thing you can cross off: vaccines.
You’ve probably seen Marcella Piper-Terry’s brilliant “NO SHOTS, NO SCHOOL … NOT TRUE!” campaign.  (Thank you, Marcella, for all your hard work. What a great idea!) And I, along with many others, have written about vaccine exemptions before. But at this time of year—and with the misinformation that’s out there—I believe it’s worth covering again. The bottom line is, your child does NOT have to be vaccinated to attend school.
KNOW YOUR RIGHTS
There is no federal law mandating vaccine exemptions. They are left up to individual states. Every state has at least one kind. Some have two or even three. All 50 states have a medical exemption. All states except Mississippi and West Virginia have religious exemptions. And 18 have philosophical exemptions.
To find out which exemptions are available in your state and how you go about getting one, visit the National Vaccine Information Center website.  Click on your state on the map. You will find a page of links that contain specific requirements and, in most cases, forms for each type. You can also Google your state’s name and “health department” for information.
A medical exemption has to come from a medical doctor.
I’ve told my personal story before, but I’ll tell it again for those who haven’t heard it. Early in 2009, my grandson, Jake, saw a homeopathic pediatrician who gave him a medical exemption for school. She filled in the Commonwealth of Virginia School Entrance Health Form, listing all the vaccines he had received since birth and their dates. In the Conditional Enrollment and Exemptions section, she wrote, “Jake is recovering from autism and is now a child with ADHD with residual autistic traits. Further vaccines may put him back into autism,” and signed and dated it. That fall, the school accepted it with no questions or comments. I’m pretty sure that medical exemptions cannot be revoked. At least I hope I’m right. If I sound hesitant and uncertain, it’s because my research has raised some doubts in my mind as to whether a medical exemption is the best option.
According to Barbara Loe Fisher, founder of NVIC, “… it is almost impossible to get an American doctor to write a medical exemption today because the medical conditions, which qualify for a medical contraindication have been severely narrowed by CDC and AAP so that very few medical conditions qualify as a contraindication to vaccination. Therefore, it follows that very few medical conditions officially qualify for a medical exemption to vaccination.” 
I don’t know which medical conditions qualify for an exemption or who oversees the exemptions, but I have heard that a medical exemption can be turned down by a state health department. With that in mind, it’s probably easier to get one of the following exemptions.
Requirements for religious exemptions vary by state. In most states, you don’t have to belong to a particular church (or any church), but some states require a letter from a “spiritual advisor” confirming that you are sincere about your beliefs. In other states (such as Virginia), you just need to sign a form saying vaccines violate your religious beliefs.
A philosophical exemption is based on a personal belief that doesn’t have to be religious. States currently accepting a philosophical exemption are Arizona, California, Colorado, Idaho, Louisiana, Maine, Michigan, Minnesota, New Mexico, North Dakota, Ohio, Oklahoma, Rhode Island, Texas, Utah, Vermont, Washington, and Wisconsin. Some of these states require the parent to sign the form at the local health department in front of a staff member.
Proof of Immunity
If you can show proof of immunity, you may be able to get an exemption. This requires submitting proof that your child has had a particular disease, that he has been vaccinated against the disease, or that his titers show immunity to the disease.
Back to my grandson. The same pediatrician who gave Jake a medical exemption offered to test his titers. He had been fully vaccinated between 1 day and 15 months, receiving 30 doses of vaccines. The results of his tests showed that he was still immune to measles, mumps, rubella, diphtheria, tetanus, and hepatitis B more than six years after his last vaccine.
My oldest daughter had a different experience. Her pediatrician told her that an insurance company wouldn’t pay for titer testing, which he said was expensive. He wasn’t willing to do it—even when she said she would pay for the tests. This is absolutely criminal on at least two counts. Titer testing should be covered by insurance. If you don’t have insurance, it should be free. After all, it’s ridiculously easy to get free vaccines. More important, the tests should be required by law after the first shot in any series. These tests could prevent many unnecessary vaccines for many children. The point I’m getting to here is, if you’re lucky enough to find a doctor who will give you a medical exemption, he would probably test your child’s titers, which would give you—and the school—proof of immunity.
A FEW EXAMPLES
Here are several states and their exemption laws. I have chosen these because they illustrate the wide range of specific requirements. Keep in mind that, in some states, legislators are being pressured to do away with different kinds of vaccine exemptions. So, the following information is subject to change at any time.
The Colorado Medical Exemption form includes options for children in child care through grade 5 and says that “The physical condition of the above named person is such that immunization would endanger life or health or is medically contraindicated due to other medical conditions.” The form must be signed by a medical doctor. 
In South Carolina, a licensed physician must submit a request in order to receive the medical exemption form. For a religious exemption, parents have to call the local health department and set up an appointment. 
The Virginia K–12 Religious Exemption form (which my family has used) states: “The administration of immunizing agents conflicts with the above named student’s/my religious tenets or practices.” Like most (if not all) exemptions, it also says, “I understand, that in the occurrence of an outbreak, potential epidemic or epidemic of a vaccine-preventable disease in my/my child’s school, the State Health Commissioner may order my/my child’s exclusion from school, for my/my child’s own protection, until the danger has passed.” The form has to be signed by the parent and notarized. 
The Montana Religious Exemption form says: “I, the undersigned, swear or affirm that immunization against diphtheria, pertussis (whooping cough), tetanus, polio, rubella, mumps and measles is contrary to my religious tenets and practices. I also understand that I am subject to the penalty for false swearing if I falsely claim a religious exemption for the above-named student [i.e. a fine of up to $500, up to 6 months in jail, or both (Sec. 45-7-202, MCA)].” A new form must be submitted each year, signed by the parent and the student (if 18 or older) and notarized. 
The Idaho Certificate of Immunization Exemption states that “As the parent/guardian of [student’s name], I am opposed to having my child receive the immunization(s) checked in Section 1 of this form for the following reason(s).” There is space to fill in the reason. 
In Texas, parents who want a philosophical exemption must sign an Affidavit Request for Exemption from Immunization for Reasons of Conscience. The form can be mailed, faxed, hand delivered, or filled in online. 
As you can see, the laws about exemptions vary from state to state. Some are as simple as checking a box and signing a form. Others require that you write a statement about your belief. Still others require that you or your doctor submit a request in order to receive the exemption form.
Whichever exemption you opt for, it’s vital that you learn what the laws are in your state and act quickly to do what you need to do before your child starts school. Some states are trying to take away religious and philosophical exemptions, and it’s becoming more and more difficult to get a medical exemption. The sooner you act, the better.
If your pediatrician won’t listen to your concerns and threatens to discharge your child as a patient if you refuse to vaccinate, find another doctor. You can ask friends for suggestions or Google “vaccine-friendly doctors” or “no-vax doctors” for a doctor who is open to an alternate schedule—or no schedule, if that’s your choice. Sometimes doctors in a family practice will accept unvaccinated children. Another option is to find a younger doctor. In a recent poll, about 15 percent of young doctors said they’re “starting to adopt a more individualized approach to vaccinations in direct response to the vaccine safety concerns of parents,” … “including delaying vaccinations or giving children fewer vaccines on the same day or continuing to provide medical care for those families, who decline use of one or more vaccines.”  It makes sense that a doctor who will accept a child who isn’t vaccinated according to the AAP schedule may also be amenable to writing a medical exemption—and/or testing your child’s titers.
If these efforts aren’t successful, talk to a lawyer who is knowledgeable about vaccine exemptions. Google “vaccine exemption lawyer,” or ask friends for suggestions. Especially in states that require personal belief statements, a lawyer can head off problems that may be difficult, if not impossible, to correct. For more information, I highly recommend that you listen to the conversation between Dr. Mayer Eisenstein and attorney Alan Phillips. 
I can think of two more ideas that, although they might not be a first choice, are possibilities. I personally know parents who have moved to a state with friendlier exemptions. I also know parents who end up homeschooling their children. For me, either option is preferable to letting a child have unnecessary, untested, and unsafe vaccines. Remember: We’re talking 49 doses of vaccines by age 4 to 6. And by the time a child has been through high school, we’re talking a total of approximately 70 doses. We’re talking lab-altered viruses and bacteria; aluminum; mercury; formaldehyde; phenoxyethanol; gluteraldehyde; sodium borate; sodium chloride; sodium acetate; monosodium glutamate (MSG); hydrochloric acid; hydrogen peroxide; lactose; gelatin; yeast protein; egg albumin; bovine and human serum albumin; antibiotics; and unidentified contaminants. 
DON’T “BUY” INTO THE BS
As usual, “the other side” is working hard to make sure kids stay vaccinated.
“Studies have shown that the harder it is to obtain an exemption, the less parents use it. Some are motivated by convenience. Others see the hurdles as a sign of how seriously society regards immunizations.” 
The gist of this article is to make exemptions more difficult to obtain by requiring parents to be counseled by their pediatricians on “the risks of vaccination versus leaving a child unprotected.” And—get this—requiring insurance and Medicaid to cover the counseling. After all, it’s effective. “About 85 percent of parents who had withheld vaccines changed their mind after group information sessions at the Vaccine Education Center at Children’s Hospital of Philadelphia.”
Why not call a spade a spade? A “group information session” is propaganda. More of the same. If parents can have a free counseling session with their pediatrician to convince them to have their children vaccinated—free if they can’t afford them—then let’s require insurance and Medicaid to pay for titer testing (and the visit) and make it free for uninsured patients.
ONE MORE TIME …
NO SHOTS, NO SCHOOL … NOT TRUE!