In general, the answer to this question is no, you don’t have to give your child vaccines. We don’t know of any law that requires you to give your child vaccines or risk having your child taken away from you for neglect. We have seen circumstances where a failure to vaccinate a child has become an issue in custody cases or in adoption proceedings. However, in general, the state will not interfere with your medical decisions for your child.
On the other hand, all states require that a child be vaccinated before attending school. Different states may have slightly different requirements, but most closely follow the CDC recommendations. So if you want your child to attend school (or preschool or day care in some states), you need to either vaccinate your child or obtain some sort of exemption.
All states allow medical exemptions. A medical exemption is when a doctor writes a letter explaining the medical reason a vaccine or vaccines should not be given. Most medical exemptions are usually narrowly based and only cover some vaccines. There are very rare medical circumstances where no vaccines should be given, but you don’t want your child to be sick enough to justify that.
In addition to medical exemptions, there are also religious and personal exemptions, in which parents write a letter explaining their religious or personal beliefs that preclude the use of all or some vaccines. As of September 2008, forty-eight states allowed religious exemptions for vaccines. The two states that do not allow religious exemptions to vaccines are Mississippi and West Virginia. The most common example of a religion that opposes vaccines is the First Church of Christ, Scientist, otherwise known as the Christian Scientists.
Twenty-one states allow exemptions from vaccines based on an individual’s or a parent’s personal beliefs only, without regard to religious beliefs. This gives parents the option to pick and choose the vaccines they feel are best suited for their children, instead of following all the national recommendations. As of the fall of 2008, the twenty-one states that allow personal exemptions are Arkansas, Arizona, California, Colorado, Idaho, Louisiana, Maine, Michigan, Minnesota, New Hampshire, New Mexico, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Texas, Utah, Vermont, Washington, and Wisconsin. (For more information on vaccine exemptions for day cares and schools in various states, visit http://www.vaccinesafety.edu/)
Note that most people consider the religious exemption an all-or-nothing exemption. It is hard to argue that a given religion opposes some vaccinations but not others. This makes it difficult for parents in states with only a religious exemption to pick and choose vaccines based on their personal beliefs. In our practice in New York, a state that allows a religious but not a personal exemption, most families who choose not to vaccinate either request a religious exemption or homeschool their children.