Conscientious Exemptions in Texas
Amy Schlabach, Immunization Compliance CoordinatorImmunization BranchNovember 1, 2010
Conscientious Exemption Legislation
78th Legislature 2003 Regular Session House Bill 2292 Effective September 1, 2003
Summarizing Legislation Key Provisions of HB 2292
Allows exemption for reasons of conscience, including a religious belief
Applies to child-care facilities, elementary or secondary schools and institutions of higher education
May be excluded from school in times of emergency or epidemic
Requires affidavit Prohibits maintaining a record of names of
individuals requesting the form
Summarizing LegislationKey Provisions of HB 2292
The affidavit form: Must contain a seal or other security device to prevent
reproduction. Must contain a statement indicating the person
“understands the benefits and risks of immunizations and the benefits and risks of not being immunized.”
Must be obtained by submitting a written request to the department.
Must be signed by the person claiming the exemption or, if a minor, signed by the parent.
Must be submitted within 90 days from date notarized.
Changes to Rules
2003 Texas began allowing exemptions from immunizations based on reasons of conscience, including religious beliefs. Exemptions requested from September 2003 through April 2004,
were valid for five years. In April 2004, the former Texas Board of Health ruled exemptions
to be valid for two years. The approved rules allowed parents to fax their requests for the
affidavit form In December 2007, the Executive Commissioner of the Health &
Human Services Commission approved changes to the exemption rule allowing parents or guardians to request via the Internet that an affidavit form be mailed to them.
Conscientious Exemption
Requires written requests for affidavit, incl. facsimiles and internet
Requires full name and date of birth of child Allows request for up to five forms per child Allows exemption for one or more vaccines Affidavit form is valid for two years
Conscientious Exemption
Original requests are returned with forms Affidavit forms are pre-printed with child’s
name and date of birth Benefits and Risks of Vaccination fact
sheet is included with forms.
Sources for Conscientious Exemption Data
Number of affidavit forms requested Number of requests Number of children for whom exemptions are
requested Number of affidavit forms per child
Number of exemptions reported via school surveys & child-care audits
Yearly Comparison of the Number of Individuals Requesting Conscientious Exemptions, 2004 - 2010
0
1000
2000
3000
4000
5000
6000
7000
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov DecMonth
Num
ber
2004
2005
2006
2008
2009
2009
2010
2009-10 Annual Report of Immunization Status: Kindergarten Conscientious Exemptions
Kindergarten Conscientious Exemptions
Vaccine Category (%)
DTP/DTaP 0.53
Hepatitis B 0.47
MMR 2 0.54
Polio 0.53
Varicella 0.58
Hepatitis A 0.53
2009-10 Annual Report of Immunization Status: 7th Grade Conscientious Exemptions
7th Grade Conscientious Exemptions
Vaccine Category (%)
Tdap 0.35
Hepatitis B 0.24
MMR 0.24
Polio 0.25
Varicella 0.35
Meningococcal 0.37
Annual Report of Immunization Status: Total Number of Conscientious Exemptions Reported, School Year 2003-2010
SchoolYear
Number of Students Enrolled with a Conscientious Exemption
Percent of Students Enrolled with a Conscientious Exemption
2003-04 2,314 0.08%
2004-05 2,722 0.09%
2005-06 6,991 0.15%
2006-07 9,606 0.21%
2007-08 10,404 0.23%
2008-09 12,633 0.28%
2009-10 19,050 0.39%
2,722
6,991
10,404
12,633
19,050
2,314
9,606
1,000
3,000
5,000
7,000
9,000
11,000
13,000
15,000
17,000
19,000
21,000
2003-04 2004-05 2005-06 2006-07 2007-08 2008-09 2009-10
School Year
Nu
mb
er
of E
xem
ptio
ns
Annual School Report: Total Number of Conscientious Exemptions Reported, School Year 2003-2010
Questions?
Amy Schlabach Immunization Compliance Coordinator
Immunization Branch
800-252-9152512-458-7111 ext 6470
Vaccine Coverage Sources
Texas Immunization Branch – Coverage Levels http://www.dshs.state.tx.us/immunize/coverage/default.shtm
National Immunization Survey – Child, 19-35 months http://www.cdc.gov/vaccines/stats-surv/imz-coverage.htm#nis
National Immunization Survey – Teen http://www.cdc.gov/vaccines/stats-surv/imz-coverage.htm#nisteen
Texas County Retrospective Immunization School Survey (TCRISS) http://www.dshs.state.tx.us/immunize/coverage/tcriss.shtm
Texas School Immunization Validation Survey http://www.dshs.state.tx.us/immunize/coverage/validation.shtm
Texas Childcare Immunization Assessment http://www.dshs.state.tx.us/immunize/coverage/childcare.shtm
The Annual Survey of Immunization Status http://www.dshs.state.tx.us/immunize/coverage/schools.shtm
The Behavioral Risk Factor Surveillance System (BRFSS) http://www.dshs.state.tx.us/chs/brfss/query/brfss_form.shtm