What is a Medical Exemption?
A Medical Exemption is an exception to compulsory school immunization laws, based upon a medical condition. According to the Centers for Disease Control and Prevention (CDC), all 50 states allow school children to be exempted from vaccination requirements for medical reasons. WV does not grant non-medical exemptions, or exemptions based upon non-medical reasons. Non-medical exemptions have been associated with increased occurrence of serious diseases spread by sick school children. Some states, like California and Oregon, have changed their non-medical exemption laws after seeing more school-based disease outbreaks.
Is it difficult to get a Medical Exemption in West Virginia?
The American Medical Association (AMA) published data in American Medical News indicating the ease of obtaining medical exemptions across the United States. WV and 17 other states are listed as “Medium Difficulty.” The classification of states’ medical exemption processes can be found here
WV's School Compulsory Immunization Requirements have been challenged in the State and Federal courts. WV's law has been upheld at each level. School immunization is a public health issue, much like drinking and driving and public smoking laws. Because noncompliance with the law has an impact on the entire population, it is not a personal freedom or parental rights issue.
What Medical Exemption requests are typically granted in West Virginia?
• Weakened immune system due to a permanent or temporary condition e.g. certain diseases, medications,
cancer, chemotherapy, radiation treatment, etc.
• Severe allergy to a vaccine component
• Serious adverse event associated with a previous vaccination
What Medical Exemption requests are typically denied?
• Vaccine-hesitant and for reasons not supported by current medical or safety standards
• Use of experimental or unlicensed products to provide immunization
• Family has history of vaccine reactions
• Philosophical and religious objections to immunization
• Common side effect to a previous vaccination
How would parents or legal guardians request a Medical Exemption for their child?
1. The student’s Primary Care physician sends a written request to the County Health Department/Local Health
Officer in the county where the child will attend school.
2. The physician lists on the Medical Exemption Statement the specific contraindications and/or precautions which
are the basis for the request.
3. The Request is reviewed by the Local Health Officer.
4. If the Local Health Officer does not receive complete information, the review must be delayed until all needed
information is provided.
5. If the Local Health Officer determines the request is complete and justified, the request is approved.
6. If the Local Health Officer does not find the request medically valid, it is denied.
7. Notification of the decision should be made within 30 days after all necessary records are received.
8. The Local Health Officer sends notification of his/her decision to the Primary Care provider, the school, the
parents (or legal guardians), and the Bureau for Public Health.
If a child is denied a Medical Exemption, how can the parents or legal guardians appeal that decision?
A parent or legal guardian has the right to appeal a denial of exemption to the Bureau for Public Health.
To request an appeal, the parent or legal guardian should:
1. Submit a written request to the Bureau for Public Health Commissioner's Office indicating their desire to
appeal a vaccine medical exemption decision. (Request for Appeal Form
2. Sign a medical records release with the child's primary care physician requesting that the child's medical
information/records regarding the medical reasons for the exemption be sent directly to the Commissioner's
Office at 350 Capitol Street, Room 702, Charleston, WV 25301. The information may also be e-mailed to
or faxed to (304) 558-1035
3. Respond to Bureau for Public Health requests for additional medical information, if requested.
What is the Bureau for Public Health’s process for ruling on a denied medical exemption?
1. After the written request and all the necessary medical information has been received, the parent or legal
guardian will be notified and the review process begins.
2. The medical documentation will be reviewed. Any needed consultations with the treating physician or with
medical or national authorities will be obtained. Then a decision will be issued. Both the Local Health Officer
and the parent or legal guardian will be notified of the decision in writing.
3. If the necessary medical records are requested by the parent or legal guardian but not received by the
Bureau for Public Health no action can be taken until the requested information is in hand.
How will the parents or legal guardians know the results of the appeal?
The parents or legal guardians will be notified by mail of the decision. If a request is granted, the child may be issued either a temporary or permanent exemption, depending on whether their medical condition is temporary or permanent. If the appeal is denied, the child will need to be vaccinated in order to attend school in West Virginia.
A Frequently Asked Questions document
regarding Medical Exemptions in West Virginia may be found here.
For more information and questions about vaccine safety, visit the CDC’s Vaccine Safety website at www.cdc.gov/vaccinesafety