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States Seek to Expand, Relax Vaccine Requirements

Since Jan. 1, the Centers for Disease Control and Prevention has reported measles outbreaks have been reported in five states – California, Illinois, New York, Texas, and Washington. While the sudden outbreaks have turned many policymakers’ attention toward stemming future cases of preventable diseases, some states are advocating to relax vaccination requirements.

Forty-seven states and and Washington, D.C. have religious exemptions for children whose parents oppose vaccination. Seventeen states and D.C. also allow parents to exempt their children based on personal beliefs.

Mississippi and West Virginia have the most restrictive policies nationwide, with vaccination exemptions only permitted for medical reasons, which are subject to review.

Action to Change Exemption Requirements

A bill (H.B. 1638) under consideration in Washington state would remove the philosophical or “personal belief” exemption for the combined measles, mumps, and rubella vaccine.

Meanwhile, despite reported measles outbreaks in the state, New York legislators are considering bills to eliminate (A. 2371) and expand (S. 477) exemptions allowing parents to opt out of vaccines for their children.

A bill in Texas would prohibit the state from tracking vaccine exemptions altogether (H.B. 1490).

In a recent trend across states, lawmakers are considering “informed consent” legislation, which requires that providers offer more detailed information about vaccine ingredients. Eight states (Iowa, Maryland, Missouri, Oregon, Pennsylvania, Rhode Island, Texas, and Vermont) are considering legislation to establish or strengthen vaccine informed consent during their 2019 legislative sessions.

Contact Senior Director of Policy Erin O’Malley at or 202.585.0127 with questions.


About the Author

Kelcie Jimenez is a state policy analyst at America's Essential Hospitals.

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