What Is Vaccine Exemptions in College?

by Evan Thompson

Updated August 31, 2022 • 6 min read


College students have the right to request exemption from required immunizations, but approval isn't guaranteed. Here's what you need to know about vaccine exemptions.

Colleges and universities have long required students to get vaccinated against a long list of diseases, such as measles and mumps. The COVID-19 vaccine is the latest addition to that list.

But students might choose not to get vaccinated for medical, religious, or personal reasons. For this reason, schools allow students to request exemptions from required immunizations.

Most students have two options for exemption requests: medical and religious. Some schools allow exemptions for other reasons, including philosophical, right of conscience, or assumption of risk (meaning a student acknowledges the danger of not being vaccinated).

However, an exemption is not guaranteed. Students must meet certain criteria set by schools to be exempt from vaccines. According to attorney Andrew Lacy, flimsy requests won't hold up.

"College students generally are healthier than the rest of the population," Lacy said. "Medical exemptions will likely not be given out freely. The same applies for religious exemptions, and I'm sure that schools will be skeptical of requests."

While the rules for medical exemptions are fairly straightforward, religious and philosophical exemptions can be murky. If you need a vaccine exemption, here are a few questions you might be asking.

Questions About Vaccine Exemptions


What Are the Requirements for a Medical Exemption?

Students who have a medical reason for not receiving a vaccine usually need to provide a letter, affidavit, or certificate from their doctor. Such a document would state that a specific vaccine or vaccines would cause injury to the student's health and well-being.

What Are Some Examples of Medical Exemptions?

The Centers for Disease Control and Prevention (CDC) offers guidelines for exemptions to each type of commonly required vaccine, including polio, tetanus, and hepatitis B.

The reasons for medical exemptions differ for each vaccine and person, depending on their age, health conditions, and other factors.

Some people might qualify for exemption if they had a highly allergic reaction to a previous shot. Others have health ailments, such as a weakened immune system or a history of seizures, that make taking a vaccine risky.

It should be noted that COVID-19 is not included on the CDC's vaccine exemptions guideline list. Many health experts believe there is no reason for people not to get vaccinated for COVID-19.

For example, Art Krieg, a specialist in immune disorders, told Bloomberg that "there is no health condition where you should not get the vaccine."


Do I Need to Explain Why I'm Requesting a Religious Exemption?

Each school may have a different policy for addressing religious exemption requests. Because the laws surrounding religious exemptions are vague, each institution can handle it differently.

For example, students at James Madison University must sign a state-endorsed certificate that acknowledges a conflict between vaccines and religion. The certificate is then sent to the university's health center for review.

At Rush University Medical Center, a teaching hospital in Chicago, students must write in detail about their objection to immunization. A committee then reviews the application and determines if it will be granted.

What Does a "Sincerely Held Religious Belief" Mean?

You may see the phrase "sincerely held religious belief" if you're requesting a religious exemption. What does that mean?

In a 2002 court case in California, the requirements for a sincerely held religious belief included:

  • Addressing fundamental questions about deep and imponderable matters;
  • Being comprehensive in nature with a belief-system rather than isolated teaching; and
  • Being recognizable by the presence of certain formal and external signs.

Lacy believes schools will exercise caution when challenging sincerely held religious beliefs.

"It is difficult to make an opinion on whether someone's religious belief is legitimate," he said. "You do not want to deny someone's religious belief in violation of the First Amendment/Title VII."

Do Vaccine Requirements Interfere With Religious Freedom?

State courts have ruled in the past that vaccination requirements protect the public's health and do not prevent anyone from freely exercising their religion.

A recent court case reaffirmed that ruling. In April 2021, a New York court upheld a state law that required all children — aside from students who qualified for a medical exemption — to be vaccinated before entering school.


How Do Exemptions for Personal or Philosophical Reasons Work?

Some schools allow students to request an exemption for personal or philosophical reasons. For example, Anderson University requires students to explain their reasoning for a personal objection.

Other schools don't allow it, such as Teachers College, Columbia University, which states on its website that personal and philosophical reasons for not getting vaccinated "are insufficient, and requests of this nature will be denied."

State health law is also a factor. While most states allow medical and religious exemptions, only 15 accept philosophical objections.

In addition, some legal experts believe that philosophical objections will rarely be accepted due to undue hardship rules.


What Are Some Examples of Illegitimate Exemption Claims?

According to Lacy, some examples of illegitimate exemption claims include:

  • "The vaccine is against my religious beliefs" without stating that it is against the religion as a whole.
  • "I feel like the vaccine is dangerous to my health" without medical documentation.
  • "I think the vaccine is a government conspiracy."

If I'm Exempt, Will My School Require Me to Wear a Mask, Social Distance, or Quarantine?

Schools can require unvaccinated students to follow risk mitigation practices because they may put others they interact with at risk.

For example, exempt students at James Madison University must sign an "Assumption of Risk" form requiring them to wear masks, submit to screening tests, and isolate themselves off campus if they're infected or exposed to COVID-19.

Am I Automatically Exempt if I'm an Online-Only Student?

Some online-only students may be automatically exempt from getting the vaccine. For example, Pacific Lutheran University doesn't have a vaccination requirement for a select few students in an online master's program.

But it depends on the school. At the University of Washington, online students may still need to be vaccinated because most online students come to campus at some point, such as for graduation.

Recommended Reading

Many college students will be required to get vaccinated against COVID-19 before returning to campus this fall. But how can colleges require COVID-19 vaccines? The short answer: legal precedent.

COVID-19 vaccine requirements on college campuses remain an evolving issue. You'll want to check with your school for any updates about requirements and exemptions throughout the school year.

Portrait of Evan Thompson

Evan Thompson

Evan Thompson is a Washington-based writer for TBS covering higher education. He has bylines in the Seattle Times, Tacoma News Tribune, Everett Herald, and others from his past life as a newspaper reporter.

Header Image Credit: Edson Souza, Flavio Coelho | Getty Images

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