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Texas Vaccination Exemption Information

In 2003, the Texas legislature passed changes to the statutes expanding the reasons a parent can claim an exemption from vaccinations. The Texas Department of State Health Services (DSHS) outlines specific procedures for requesting an official affidavit and submitting it to the school and for completing a medical exemption. It is our hope that this page will answer your questions about the process.

Click Here to Fill out the DSHS Exemption Affidavit Request Form

How do I get an exemption for reasons of conscience, including a religious belief?

Requests for affidavit forms must be submitted to the DSHS Immunization Branch through one of the following methods:

  • The DSHS Immunization Branch website:
  • Written request through the United States Postal Service (or other commercial carrier) to the department at:
    DSHS Immunization Branch
    Mail Code 1946
    P.O. Box 149347
    Austin, TX 78714-9347
  • By facsimile at (512) 776-7544
  • By hand-delivery at the department’s physical address at 1100 West 49th Street, Austin, TX 78756. In-person requests can be made between 8am and 5pm Mondays through Fridays. Your affidavit forms for hand-delivered requests will be mailed to you via U.S. Postal Service.
  • Please note: telephone and email requests are not processed.

Source: Texas Administrative Code Rule §97.62

What information do I need to request an exemption?

If faxing, mailing or hand delivering a letter to request an affidavit, your letter must include the following information:

  • Full name of each child for whom a form is requested
  • Date of birth of each child for whom a form is requested
  • Parent or legal guardian’s complete return mailing address
  • Number of forms needed for each child*

* The state allows you to request a maximum of five forms per individual per request. We recommend that you request the maximum (five) per child. Exemption forms can be used for and may be needed at multiple locations and an original copy must be relinquished to each organization. Having extras on hand will prevent any delay in enrollment if a need for a form should arise. Clarifying Note: You may request up to 5 forms per child each time you request. There is not a limit to the number of times you may request forms.

Source: Texas Administrative Code Rule §97.62

I requested an affidavit. Is the state now tracking my family?

DSHS does not maintain a record of the names of individuals who request an affidavit and returns the original request (where applicable) with the forms requested. DSHS does report on the number of affidavit requests and zip code but no identifying information is maintained.

Source: Texas Administrative Code Rule §97.62

I have my affidavit/s. Now what?

When a facility requires the affidavit, go get one form per child notarized. Do not sign your form until you are in front of the notary.
Confirm that the facility requires an exemption form before you get your form notarize. Once notarized, the form must be turned in to the requesting facility within 90 days or it will become void.
Once notarized, the form is valid for 2 years.

Texas schools will accept only the official DSHS affidavit forms. No other forms, photocopies or reproductions are valid.

Any child who utilizes the affidavit may be excluded from school in times of emergency or epidemic declared by the commissioner of public health.

Do all K-12 schools have to accept the exemption form?

Texas public schools, including charter schools, are required to accept the exemption form. Private schools that accept state funding of any kind must also accept the exemption form.

Source: Education Code Section 1.001(a)

Do all childcare facilities/preschools have to accept the exemption form?

Current state law requires that childcare facilities and preschools that are licensed by the Texas Department of Family and Protective Services (DFPS) to accept the exemption form. However, TFVC has received reports from members across the state that some facilities are choosing not to abide by this law and instead are denying exemptions. Your best option is to fully vet a facility, either with a phone call or web page search, on their policies before enrollment or paying any sort of deposit or other fees. If your child has been denied enrollment due to vaccine exemption, the HHSC letter found here may be helpful when communicating with the childcare facility.

Source: Human Resources Code Sec. 42.043 and Texas Administrative Code Rule §746.615

Note: licensed daycares are required to maintain a health statement for every enrolled child. To satisfy this requirement, you must submit either:

1- a written statement, from a health care professional (HCP) who has examined the child within the past year, indicating the child is able to take part in the child-care program, or
2- a signed affidavit from the parent stating that medical diagnosis and treatment conflict with a deeply held belief.

Please note that the code does not indicate that the HCP must be an MD or DO. You may choose your own HCP. 

Source: Texas Administrative Rule §746.611

Does provisional enrollment in school apply to vaccinations?

Four vaccination-related provisional enrollment scenarios exist. All four scenarios allow for a 30 day temporary enrollment if vaccination evidence is not available. After 30 days, the school nurse/administrator will review the student’s vaccination status.

  1. a student who is homeless according to the federal McKinney-Vento Act
  2. a student who is in foster care
  3. a student who has received at least one dose of each specified age-appropriate vaccine required, and is on schedule to receive subsequent doses as rapidly as medically feasible. The student must not be overdue for next dose in series to be considered provisional.
  4. a student who transfers from one Texas school to another and is awaiting the transfer of the immunization record (Note: dependents of a person who is on active duty with the armed forces of the United States do not have to transfer from a Texas school to qualify for provisional enrollment.)

Source: Texas Administrative Code Rule §97.66/69

How do I enroll my child if I am selectively/delayed vaccinating?

In this instance, two different documents will be needed. 1- the official notarized affidavit indicating which vaccine/s the parent has chosen to forego, and 2- a valid immunization record indicating the date of administration of each chosen vaccine with appropriate validation by a physician.

What about Medical Exemptions?

To claim an exemption for medical reasons, the child or student must present a statement signed by the child’s physician (M.D. or D.O.), duly registered and licensed to practice medicine in the United States who has examined the child.

The statement must express that, in the physician’s opinion, the vaccine required is medically contraindicated or poses a significant risk to the health and well-being of the child or any member of the child’s household.

Unless it is written in the statement that a lifelong condition exists (the lifelong condition does not have to be named), the exemption statement is valid for only one year from the date signed by the physician.

Source: Texas Administrative Code Rule §97.62

Are titers accepted as exceptions to immunization requirements?

Serologic confirmations of immunity (ie titers) to measles, rubella, mumps, hepatitis A, hepatitis B, and/or varicella are acceptable. Evidence of measles, rubella, mumps, hepatitis A, or hepatitis B, and/or varicella illnesses must consist of a valid laboratory report that indicates confirmation of either immunity or infection.

For varicella (chickenpox), a written statement from a parent or guardian, school nurse, or physician attesting to a student’s positive history of varicella disease or of varicella immunity, is acceptable in lieu of a vaccine record for that disease (see form at

Source: Texas Administrative Code Rule §97.65

Are vaccination requirements different for active-duty military?

Persons who can prove that they are serving on active duty with the armed forces of the United States are exempt from school vaccination requirements. Armed forces exclusions apply to active-duty military only. Dependents of service members are not excluded from Texas vaccination requirements.

Source: Texas Administrative Code Rule §97.62

What if my child changes schools?

The affidavit is part of the child’s school records and should be sent to the new school with other school records.

Can an expectant parent request an exemption affidavit form for an unborn child?

No. The child’s name and date of birth is required when the exemption affidavit form is requested. Expectant parents must wait until after the child is born to request the vaccine exemption affidavit form.

What is ImmTrac and how do I remove myself/my children?

ImmTrac, the Texas Immunization Registry, is a no-cost service offered by the Texas Department of State Health Services (DSHS). ImmTrac stores immunization information from multiple sources electronically in one centralized system. Texas law requires written consent for ImmTrac participation and limits access to the registry to only those individuals who have been authorized by law. Each participant’s immunization information is consolidated into one electronic record.

You can remove yourself and your children from ImmTrac by using the ImmTrac Withdrawal Form/Withdrawal of Consent and Confirmation Form. Download, print, fill out and mail a form for each person you wish to remove.

If you do not wish to have your newborn participate in ImmTrac, you can deny your baby’s registration by marking “I DENY consent for registration.” on the ImmTrac Newborn Registration Form provided by the birth registrar at the hospital.

Despite the fact that ImmTrac is an opt-in (consent required) immunization registry system, we consistently receive reports from individuals that they or their children have been added to this tracking system without their consent. The number of reports we are receiving has recently skyrocketed, and we are hearing from people who not only denied consent in writing on the state’s consent form but also from people who never even saw a consent form.

To find out if you are in the ImmTrac system, you can call the DSHS at (800) 252-9152.

If you or your child has been added to the ImmTrac system without your knowledge or consent or DSHS has failed to remove your records after you request they do so, please file a complaint with the Department of State Health Services. You can file a complaint by e-mail to the attention of Manager, Immunization Branch at [email protected]

Texas law requires DSHS to keep record of these complaints and to report them to the Governor & House of Representatives by September of every even-numbered year. The last report claimed that no complaints had been received, which was surprising to us considering the number of complaints TFVC receives from Texas citizens.

You can find  more ways to file a complaint and more information on the complaint-reporting process here.

What about the meningitis vaccination to live on campus at college?

If you are enrolling in a public junior college or a community college, you can create your own exemption form using this website: After entering all the requested information, print the form, sign and date it, and submit the form when registering for courses. Some public junior colleges and community colleges may require students to use this option.

If you are enrolling in any public or private four-year college, university, or other institution of higher education, you can submit an exemption affidavit for meningococcal vaccination by requesting the official Texas DSHS affidavit form by following the steps outlined above.

Source: Texas Administrative Code Rule Rule §21.614

Are vaccines required for Medicaid/TANF?

According to statute, vaccines for TANF are not required. In fact, the code says that only “a statement by the caretaker or parent that the requirement violates the caretaker’s or parent’s religious beliefs or conscience” is required. It is TFVC’s recommendation, however, that you submit the official exemption affidavit when applying since some might not be familiar with the law. Moreover, you are encouraged to print the code to show in the event of any pushback. You can order exemptions here:

In the 2023 Legislative Session, TFVC was successful in getting a significant Medicaid/CHIP reform measure passed. As of September 1, 2023, doctors who contract with Medicaid/CHIP are no longer allowed to refuse to see Medicaid/CHIP patients based on vaccination status. Read the new law here.

Source: Texas Administrative Code Rule §372.1154(c)

I work in a childcare facility. Can I be exempt?

All DFPS-licensed childcare facilities must have a policy that includes procedures for a facility employee to be exempt from the required vaccines for both medical reasons and reasons of conscience, including a religious belief.

If you choose to be exempt, you may be required to use protective equipment such as gloves or masks.

Source: Human Resources Code Section 42.04305.

I am enrolling in a health-related field in college. Can I be exempt?

Students enrolled in (non-veterinary) health-related, higher education courses which will involve direct patient contact with potential exposure to blood or bodily fluids can be exempt from the immunization requirements if the student can properly demonstrate proof of serological confirmation (ie titers) of immunity. Serologic confirmations (via a valid laboratory report that indicates confirmation of either immunity or infection) to measles, rubella, mumps, hepatitis A, hepatitis B, or varicella, are acceptable. Varicella can also be confirmed via a written statement from a parent/guardian, school nurse, or physician attesting to the student’s positive history of varicella.

Source: Texas Administrative Code Rule §97.64/65

work in a healthcare facility. Can I be exempt from my employer’s vaccine policies?

Texas law requires every healthcare facility to develop and implement its own vaccine policy. The policy MUST require employees to receive specific vaccines based on their level of risk (assessed by the amount of exposure to patients) and MUST include procedures for employees to be exempt from the required vaccines for medical reasons. The law further states that employees who are exempt may be required to use protective medical equipment, such as gloves and masks, based on their level of risk (assessed by the amount of exposure to patients). Employees who are medically exempt may not be discriminated or retaliated against. Protective medical equipment, such as gloves and masks, are not considered retaliatory action.

The law further states that healthcare facility vaccine policies MAY include procedures for employees to be exempt from the required vaccines based on reasons of conscience, including a religious belief.

If you are a healthcare worker who desires to forgo some or all vaccines a potential employer is requiring, you are strongly advised to review all employment conditions prior to signing any employment agreement, as medical exemptions can be difficult to obtain and religious exemption options may or may not be available. 

Source: Texas Administrative Code Rule 1.702


What is the status of COVID vaccine mandates in Texas?

We had several laws pass during the 88th Legislative Session that expanded protections against COVID vaccine mandates in Texas.

SB 29 prohibits implementation or enforcement of a vaccine mandate, mask requirement, or private business or school closure to prevent the spread of COVID-19. SB 29 also prohibits public school children and college students from being mandated to get the COVID shot or wear a mask for COVID.

SB 7 has been signed into law by Governor Greg Abbott and will take effect on February 6, 2024. Anyone under the direction of a private employer (including paid employees, contractors, medical students, volunteers getting credit hours, unpaid interns, and others who perform duties in exchange for a benefit), as well as applicants, will be shielded from COVID vaccine mandates. There is no need to submit an exemption in order to be protected by this legislation.

Once the bill takes effect, Texans will need to contact the Texas Workforce Commission if they feel they are being wrongfully denied employment, benefits or accommodations by an employer due to their COVID vaccination status. TWC is the state agency tasked with investigating complaints and enforcing the $50,000 fine against companies found to be in violation of the law.

What do the family codes say about not vaccinating in terms of CPS involvement?

There are 3 places in the family code that specifically address this issue. The codes make it clear that not vaccinating does NOT qualify as neglect, is NOT grounds for removing the child from the home, and is NOT grounds for terminating parental rights.

Source: Family Codes 161.001(c), 261.001(4), and 262.116(a)

My child has been admitted to a state-run facility. Can he/she still be exempt?

Any child admitted to a facility of the Department of Aging and Disability Services, Department of State Health Services, the Texas Department of Criminal Justice, or the Texas Youth Commission is eligible for any of the vaccination exemptions.

Source: Texas Administrative Code Rule § 97.102

I work or live in a nursing home. Can I refuse vaccinations?

Licensed nursing homes that serve elderly residents offer vaccines for both pneumococcal and influenza. Residents have the right to refuse either or both. Additionally, employees of these facilities also have the right to refuse the influenza vaccine.

Source: Texas Administrative Code Rule § 97.202

Tell me more about the Hepatitis B vaccine given to newborns.

In 1991, the American Academy of Pediatrics recommended that all newborns be given a Hepatitis B shot within 12 hours of birth. However, there is no legal federal or state requirement in the U.S. or Texas that newborns receive a Hepatitis B shot at birth. While none of the below information should be construed as legal advice, we hope to help you navigate refusing this vaccine if that is your desire.

Many private medical facilities have their own internal policies in place, which direct staff to routinely give newborn infants a Hepatitis B shot before discharge. Private hospitals and birthing facilities have a legal right to refuse to allow you to give birth in their medical facility if you do not agree to abide by their policies in advance. Therefore, if you do not want your newborn to get a Hepatitis B shot at birth, you should evaluate your birthing options well in advance of your due date to find a location that has a more flexible policy about allowing exceptions to this vaccine.

Newborn vaccination policies may be hard to find because they are often included under “Standard of Care” language in policy manuals. Additionally, many hospitals and birthing centers, as a routine matter, administer the Hepatitis B vaccine on the basis of what is known as “standing orders”. Find a pediatrician who respects your choice to delay or forego this vaccination and ask him/her to write the “standing orders” for your baby accordingly. You may ask for copies to share with the hospital or birthing center at the time of admission for labor and delivery.

Please carefully read all your admission paperwork. If you wish to decline a newborn vaccination, be sure to review all hospital forms, policies and procedures before signing. You might also want to consider a written birthing plan and newborn care plan that includes the understanding by staff that no Hepatitis B vaccine should be given to your newborn before discharge.

It is also a good idea to keep your newborn with you at all times in the hospital, or have a trusted family member stay with your infant while you are napping, to ensure that your baby is not vaccinated without your knowledge or consent before discharge.

If you find yourself being threatened by hospital staff with charges of child neglect or abuse for not giving your child this vaccine, immediately find an attorney who can advise you about whether or not your parental rights are being violated and evaluate your legal options.

Can you opt out of health screenings at school?

Despite communication from schools regarding various health screenings being “required,” state law provides for exemptions. For those who choose to obtain these screenings outside of school, we hope you find these exemption affidavits helpful:

Acanthosis Nigricans
Vision & Hearing Exemption (Note: Two options – one for daycare and one for school – are included. Make a copy, delete the one that does not apply to you, and then print.)

Nowhere in state law does it require that children using exemptions submit records from an outside screening.
Nowhere in state law does it require these affidavits be notarized.
These links are for informational purposes to empower you with your choices. TFVC supports all parents regardless of where you obtain these health screenings.

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