Medical Exemptions In California

Medical Exemptions In California

Below are the general guidelines on medical exemption in California for vaccines.  Read the new laws of SB 276 and SB714 Guidelines as of August 2019 for California schools. You must have the professional counsel of a medical doctor knowledgeable in the new  California laws in order to obtain  legal medical exemptions in California for vaccines.

About Medical Exemptions In California:  SB 277 Medical Exemption Criteria
per CDPH at

  • IMPORTANT NOTE: Do NOT submit any medical exemptions dated 2020 or before to any electronic or other database.
    If you have a medical exemption on file or put one on file before January 1, 2021, file a notarized privacy notice with it at
  • Medical exemptions, under SB277 are at the discretion of the physician (MD or DO), and can be given if they determine the physical condition of the child is such, or medical circumstances relating to the child are such, that immunization is not considered safe, including, but not limited to, family medical history.
  • Medical exemptions filed BEFORE JULY 1, 2019 must consist
    of a written statement from a licensed physician (MD or DO)
    which states:
    • That the physical condition or medical circumstances of
    the child are such that the required immunization(s) is not
    • Which vaccines are being exempted.
    • Whether the medical exemption is permanent or temporary.
    • The expiration date, if the exemption is temporary.
  • Medical exemptions filed JULY 1, 2019 TO DECEMBER 1, 2020
    must consist of a signed, written statement from a physician (MD or DO) licensed in California which states:
    • The specific nature of the physical condition or medical
    circumstance of the child for which a licensed physician does
    not recommend immunization.
    • Each specific required vaccine that is being exempted.
    • Whether the medical exemption is permanent or temporary.
    • If the exemption is temporary, an expiration date no more than
    12 calendar months from the date of signing.
  • Note: If the medical exemption is written by a physician who has been subject to disciplinary action by the Medical Board or the
    Osteopathic Medical Board of California, then the exemption will be revoked. Your physician’s primary status should be active and their secondary status should be N/A

Medical exemptions in California filed AFTER JANUARY 1, 2021, under SB276/SB714 must meet the CDC, ACIP, or AAP criteria for appropriate medical exemptions.

  • Note: These do not exist. Only CDC, ACIP, or AAP vaccination guidelines exist.
  • Therefore either CDPH will use the guidelines or one of these organizations will create medical exemption criteria before January 1, 2021.
  • If information other than what is included in the vaccination guidelines is used, it is at the medical discretion of the CDPH staff member whether or not they accepta medical exemption that is based on other contraindications or precautions, including consideration of family medical history, if the issuing physician and surgeon provides written documentation to support the medical exemption that is consistent with the relevant standard of care.
  • Medical exemptions filed AFTER JANUARY 1, 2021 must be transmitted directly to the department’s California Immunization Registry (CAIR) by a physician (MD or DO) licensed in California using the electronic, standardized, statewide medical exemption certification form. The form should be printed, signed, and submitted directly to the school or institution at which the child will attend, submitted directly to the governing authority of the school or institution, or submitted to that governing authority through the CAIR where applicable. The form will include:
    • The name, California medical license number, business address, and telephone number of the physician and surgeon who issued the medical exemption, and of the primary care physician of the child, if different from the
      physician and surgeon who issued the medical exemption.
    • The name of the child for whom the exemption is sought, the name and address of the child’s parent or guardian, and the name and address of the child’s school or other institution.
    • A statement certifying that the physician and surgeon has conducted a physical examination and evaluation of the child consistent with the relevant standard of care and complied with all applicable requirements of this section.
    • Whether the physician and surgeon who issued the medical exemption is the child’s primary care physician. If the issuing physician and surgeon is not the child’s primary care physician, the issuing physician and surgeon shall also provide an explanation as to why the issuing physician and not the primary care physician is filling out the medical exemption form.
    • How long the physician and surgeon has been treating the child.
    • A description of the medical basis for which the exemption for each individual immunization is sought. Each specific immunization shall be listed separately and space on the form shall be provided to allow for the inclusion of descriptive information for each immunization.
    • Whether the medical exemption is permanent or temporary, including the date upon which a temporary medical exemption will expire. A temporary exemption shall not exceed one year. All medical exemptions shall not extend beyond the grade span (i.e. will need to be renewed at TK/Kindergarten and 7th grade).
    • An authorization for the department to contact the issuing physician and surgeon for purposes of this section and for the release of records related to the medical exemption to the department, the Medical Board of California, and the Osteopathic Medical Board of California.
    • A certification by the issuing physician and surgeon that the statements.


Listed below were allowed before August 2019 and before the new laws of SB 276 and SB714 were passed

Prior to August 2019 Allowed: Historical Information About Medical Exemptions In California Under The OLD SB276 Law

  • Medical exemptions are not guaranteed.
  • Many doctors will required genetic testing, for example for the presence of the MTHFR mutations and other SNP’s to write a medical exemption. Read more about MTHFR here.
  • Read “Genetic Basis for Adverse Events Following Smallpox Vaccination” here:
  • The general guide is that a family will need a minimum of 4 people in the family with the qualifying diseases and/or conditions to qualify for a medical exemption.
  • Family members must be blood related to the person seeking the medical exemption.
  • For consideration for a medical exemption, up to 4 generations can be considered.
  • To get a medical exemption, more than 4 people will be needed if the diseases are less severe, for example like in eczema.

Blood Titers  As A Basis For Medical Exemptions In California

  • Exemptions can be written to specific vaccines  if blood titers (IgG blood levels) are documented and show that there is already adequate immunity.

Prior to August 2019 Allowed: Autoimmune, Neurological Issues and Vaccine Reaction History As A Basis For Medical Exemptions In California:

  • If there is an autoimmune disease in the person and it is severe, then the doctor writing the medical exemption may make an exception.
  • Neurological issues and developmental delays may qualify for temporary exemption if the condition is worsening or still being diagnosed and defined.  In general these will NOT qualify if the condition is stable.
  • A well-documented severe reaction to a vaccine in the person seeking exemption or immediate relative (parent, sibling) is grounds for an exemption.

Prior to August 2019 Allowed: General Documentation Required For  Medical Exemptions In California For Vaccination(s)

  • Documentation is required for a medical exemption to be written by your physician, in accordance with SB277 law.
  • Supporting documentation can include:
    • death certificates if disease is listed on it
    • Emails or letters from family members about their diseases in cases of destruction of records or death of family member can collaborate but are not used as the sole documentation.
    • official medical records and summaries
    • pictures of specific medication with family member’s name on it, (i.e.  Epi-pen or Lupus specific medication).
    • screenshots of patient portals
    • VAERS report
    • Thyroid medicine and diabetes medicine are too nonspecific to be accepted.
    • Note: Thyroid medicine and diabetes medicine are too non-specific to be accepted.

Prior to August 2019 Allowed: List Of Prior Qualifying Diseases And Conditions For A Medical Exemption:

(Prior to August 2019) Autoimmune Conditions, including but not limited to:

  • Antiphospholipid antibody
  • Celiac Disease
  • Crohn’s Disease
  • Eosinophilic esophagitis
  • Hashimoto or Graves Thyroiditis – does not include not hypothyroid or low thyroid. Documentation of the antibody results or the actual name of the disease noted in medical records is required.
  • Lupus
  • Mixed Connective Tissue Disease
  • Multiple Sclerosis
  • Psoriasis
  • Rheumatoid Arthritis (NOT old age or arthritis from overuse)
  • Sjogren’s Syndrome
  • Scleroderma
  • Type 1 Diabetes (child type)
  • Ulcerative Colitis
  • Vitiligo
  • Vasculitis
  • Wegener’s Granulomatosis

(Prior to August 2019) Hyper Immune Conditions – Including, But Not Limited To:

  • Asthma
  • Allergies to food, bee stings, medicines that include hives/swelling/wheezing (hay fever does not count)
  • Eczema
  • Hives

(Prior to August 2019) Immune Cancers – Including, But Not Limited To:

  • Lymphoma
  • Leukemia
  • Multiple myeloma
  • Other rare cancers

(Prior to August 2019) Immune Deficiencies Including, But Not Limited To:

  • Agammaglobulinemia
  • SCID

(Prior to August 2019) Genetic Mutations or SNP’s That May Qualify – MTHFR, Etc.

  • Genetic SNP’s are associated with increased vaccine reaction risk.
  • Studies are pending, but include MTHFR,  and some HLA subtypes.
  • These genetic mutations will only count once in the family as a contributing factor, not per person who has it.
  • They don’t count as much as a family member with an actual disease.

(Prior to August 2019) Vaccine Reactions That May Qualify For A Medical Exemptions

  • Vaccine reactions must be related to the vaccine within about a week and not caused by anything else.
  • These reactions include but are not limited to:
    • Anaphylaxis
    • Coma
    • Difficulty breathing
    • Encephalitis, including high-pitched cry and developmental regression (must be well documented within a short time of the shot)
    • Fevers over 104
    • Leg swelling causing hospitalization
    • Seizures
    • Severe lethargy

(Prior to August 2019) Medical Conditions That Do NOT Qualify For  Medical Exemption

  • Chronic Fatigue Syndrome
  • Endometriosis
  • Fibromyalgia
  • Lyme Disease

(Prior to August 2019) Non-Qualifying Cancers
None Of These  Cancers Will Qualify For A Medical Exemption

  • Colon
  • Breast
  • Lung
  • Skin

(Prior to August 2019) Non-Qualifying Diseases and Conditions
None Of These Will Qualify For A Medical Exemption

  • Adult onset diabetes
  • Anxiety
  • Asperger’s
  • Autism
  • Behavior issues
  • Bipolar Disorder
  • Depression
  • Epilepsy
  • Heart disease
  • Hypertension
  • Kidney disease
  • Liver disease
  • Migraines
  • Neurological Diseases
  • Psychiatric Diseases
  • Schizophrenia
  • Seizures
  • Strokes
  • Schizophrenia

(Prior to August 2019) Vaccine Reactions That Will NOT Qualify For A Medical Exemption

  • Feeling cranky
  • Fevers under 104
  • Getting ear infections after vaccination(s)
  • Getting sick often after vaccination(s)
  • Getting asthma after vaccination(s)
  • Getting other infections right after vaccination(s)
  • Having allergies after vaccination(s)
  • Sore leg

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