COVID Vaccination Exemptions

What Types of Exemptions Are Allowed In Each State And How To Process A Request

Curious about how vaccine exemptions work? Well if you weren’t before The White House released it’s Path Out Of The Pandemic, you likely are now.

Vaccination exemptions have always been a bit of a mystery, but with the highly anticipated ETS being issued by OSHA any day now, people against the COVID-19 vaccine are scrambling to figure out how they can get an exemption. In this article, we’ll be breaking down: 


As a citizen of the United States, there are a variety of vaccinations you are required to get. Most vaccination exemption conversations are centered around parents and children because most mandatory vaccinations are required between birth and the age of eighteen (i.e. vaccines against measles, mumps, polio, HPV, etc.). These vaccines have saved millions of lives in the U.S. by making children immune to highly communicable, deadly disease. Most vaccines administered before the age of eighteen will last throughout a person’s life. 

Up until this year, there were only two vaccinations the CDC strongly recommended be recurrently administered past the age of eighteen: tetanus and influenza (flu shot). The COVID-19 has recently been added to that list and has caused the exemption conversation to switch focus to employers and employees. The problem is that not everyone is quick to comply with the mandate due to not being exposed to accurate or factual information. This causes many employers to carry the burden of educating their employees on the facts about vaccines in an attempt to get them to comply with their mandatory vaccination policy.

Vaccination exemptions are permitted country-wide, but each individual state sets its own rules and regulations for what types of exemptions are allowed. Across the country, there are three types of exceptions:

  • Medical exemption: A medical exemption typically must be written by an MD or doctor of osteopathy (DO). However, some states allow other healthcare workers to certify that administering one or more of the state-mandated vaccinations would be detrimental to the individual’s health.
  • Religious exemption: A religious exemption is based on the First Amendment, the right to freely hold and exercise religious beliefs. However, if the state can provide a compelling reason for vaccination, the exemption can be withdrawn. One such reason would be to prevent the spread of serious communicable diseases (i.e. COVID-19)
  • Philosophical, conscientious, or personal belief exemption: This type of exemption must include ALL vaccinations, not just one. In some states, parents seeking this type of exemption must do so in collaboration with an MD or other state-designated health care worker. In addition, they may be required to complete a state-provided vaccine education program.

Currently, all fifty states and Washington D.C. allow medical exemptions for mandatory vaccines, but only forty-four of them allow exemptions for religious or philosophical/personal beliefs. The six states that do NOT allow religious or personal belief exemptions are:

  • New York
  • Maine
  • California 
  • Mississippi
  • West Virginia
  • Connecticut

Some states have made adjustments for the unique circumstances of the COVID vaccine. Both Maine and New York recently held court hearings to determine whether religious exemptions would be permitted regarding the COVID vaccine. A New York judge ruled to allow religious exemptions, while a judge in Maine ruled against allowing both religious and philosophical exemptions.

Freedom of religion is one of the most prominent aspects that gives the United States it’s democratic appeal, but it also leaves room for people to take advantage. Medical exemptions are much easier to prove, but when it comes to religious exemptions, employers kind of just have to take the employee’s word for it.


The table below displays the current status of vaccination exemptions regarding mandatory school immunizations. COVID exemptions are continuing to evolve as we approach the announcement of OSHA’s ETS.

Alabama --
Alaska --
California --
Colorado -- --
Delaware --
Washington D.C. --
Florida --
Georgia --
Hawaii --
Illinois --
Indiana --
Iowa --
Kansas --
Kentucky --
Maine -- --
Maryland --
Massachusetts --
Mississippi -- --
Missouri --
Montana --
Nebraska --
Nevada --
New Hampshire --
New Jersey --
New Mexico --
New York -- --
North Carolina --
North Dakota
Rhode Island --
South Carolina --
South Dakota --
Tennessee --
Vermont --
Virginia --
Washington --
West Virginia -- --
Wyoming --
Information recorded: 10/27/2021


As the employer, you are not required to provide official exemption request forms for employees to fill out, but it would certainly be useful to you when processing. There are multiple ways that employees can submit an exemption request, we’ve outlined them all in this guide for employees looking to learn how to write an exemption request. 

The most common way for an employee to submit a request is by filling out the form provided by their employer. If their employer does not provide a form, they can create their own or use a template. Employees can also write a statement and include letters from close friends, family members or members of the clergy for religious exemptions, although most employers do not require such letters in addition to an official request form. For medical exemptions, the employee would need documentation and confirmation from a certified medical professional.


Due to the recent government-issued mandate that would require companies with 100+ employees to fully vaccinate their entire workforce, many companies have been racing to figure out things like; how to implement a mandatory vaccination policy, facilitate vaccine and testing tracking and most tricky of all, how to handle exemption requests. Although the mandate will not officially go into effect until OSHA issues it’s Emergency Temporary Standard (ETS) (expected any day now), employers are still looking for answers and solutions to getting their entire workforce vaccinated.

Example of unreasonable accommodations include:

  • The accommodation is too costly
  • It would decrease workplace efficiency
  • The accommodation infringes on the rights of other employees
  • The accommodation would require other employees to do more than their share of hazardous or burdensome work
  • The proposed accommodation conflicts with another law or regulation
  • It compromises workplace safety
  • A key thing to consider when processing exemptions is the The Equal Employment Occupational Commission (EEOC) and Title VII of the Civil Rights Act of 1964, which ensures employees and people seeking employment protection against discrimination from employers with 15+ employees based on their race, color, sex, national origin and religion. The EEOC provides a very detailed guide for everything you need to know when it comes to processing an exemption request. Four factors that an employer should consider when determining the legitimacy of an employees exemption request identified by the EEOC are:

    • Whether the employee has acted in a way that is inconsistent with the claimed belief
    • Whether the employee is seeking a benefit or an exception that is likely to be sought for nonreligious reasons;
    • Whether the timing of the request is questionable (for example, because it follows closely on the heels of the same employee's request for the same benefit for different reasons); and
    • Whether the employer has other reasons to believe that the employee is seeking the benefit for secular reasons.

    Although employers have to assume each request received is sincere and thoroughly investigate and review the request before reaching a final decision, they do NOT have to accept any request. If a religious exemption request is denied, an employer must explore reasonable accommodations for that employee. If all possible accommodations are considered unreasonable, the employer is legally permitted to terminate the employee.

    Example of unreasonable accommodations include:

    • The accommodation is too costly
    • It would decrease workplace efficiency
    • The accommodation infringes on the rights of other employees
    • The accommodation would require other employees to do more than their share of hazardous or burdensome work
    • The proposed accommodation conflicts with another law or regulation
    • It compromises workplace safety

    In conclusion, yes, an employer must accept a vaccination exemption request for review, but no, they are not required to approve the request. Depending on a few factors like company culture, employee culture, location, etc. the volume of exemption requests you receive may be low and the probability of a request being accepted is extremely low. Even so, it’s important to know how to process a request should one get submitted.

    Overall, the main things to consider when deciding to approve or deny someone’s request are:

    • Is the request sincere? Or is it rooted in politics or misinformation about the vaccine?
    • Has this person’s behavior up to this point aligned with their claimed religious values?
    • If the person’s request is sincere and it is determined that taking the vaccine will conflict with their religion or medical needs, what can you as the employer do to accommodate this request?
    • If all options for accommodation are deemed unreasonable, make an effort to make sure the employee has been provided facts about the vaccine from reputable sources before escalating to disciplinary action or termination.

    We’ve attached a PDF at the bottom of this page for you to download and use as an all-encompassing guide when it comes to processing exemptions.

    Download our Shareable Guide for Processing Exemptions

    We'll email you the guide as a PDF, so that you can easily share the information with your team.

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