1. Can I still get a religious exemption? What are the religious exemption application elements, and why are they included in this bill?

Yes. The Community Immunity Act maintains religious exemptions. The Act also standardizes and centralizes the process for obtaining a religious exemption from immunization requirements for covered programs, including:

  • Standardized application forms: The Act requires all parents and caregivers seeking religious exemptions to complete the same religious exemption application form, created by DPH. The Act also instructs DPH to state on the application form the Department’s position that refusing to vaccinate is against public health policy and may endanger the health or safety of their children or others. These statements are similar to statements already in use in more than a dozen other states. The completed form must be submitted to DPH for processing.

  • Provider signature: Religious exemption application forms must be signed by a child’s healthcare provider ONLY to acknowledge receipt of a copy of the application. This signature is not an evaluation or endorsement of the religious exemption. The purpose of this signature is to promote open dialogue between providers and parents who do not vaccinate. The Community Immunity Act instructs DPH to provide an alternate process for program participants who do not have a primary care provider.

  • DPH approval: The Act explicitly states, in paragraph 5(i), that DPH “shall approve all validly and accurately completed religious exemption applications.” In other words, DPH does not have authorization to reject properly completed religious exemption application forms. Forms will be processed through DPH to better ensure we have accurate statewide data on the number of exemptions granted in Massachusetts. DPH will not evaluate anyone’s religious beliefs.

  • Religious privacy: The Community Immunity Act does not ask any participant to disclose their particular religious beliefs. The Act specifically forbids DPH from inquiring into the nature of any individual’s religion. Participants  must only certify they have a sincere religious belief preventing immunization, consistent with existing law. The Act does not require any evidence or verification of this belief other than the statement itself.

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2. Will medical exemptions be harder to obtain?

No. The Community Immunity Act intentionally gives providers more flexibility in determining eligibility for a medical exemption by expressly stating that healthcare providers may consider a child’s complete medical circumstances, rather than limiting medical exemption availability only to those children with conditions falling squarely within immunization contraindications established by the Centers for Disease Control and Prevention (CDC). Consistent with its treatment of religious exemptions, the Act also standardizes and centralizes the medical exemption process and requires DPH to approve all validly and accurately completed medical exemption forms.

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3. What happens for children who need to “catch up” and aren’t currently fully vaccinated according to the schedule?

Children who are behind on the recommended vaccination schedule for whatever reason but whose medical records indicate an effort to catch up to the schedule will not be excluded from covered programs. No exemption is required, pursuant to paragraph (b) of the Act.

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4. What is the mature minor rule and does the bill drastically change it?

The mature minor rule allows capable young people to consent to standard medical treatment. The rule is already in practice in Massachusetts, as set forth in Baird v. Attorney General (1977). The Community Immunity Act partially codifies this practice, by amending existing medical treatment of minor statutes to include preventive care measures. Mature minors routinely consent to standard medical care every day. For example, minors who attend routine medical check ups without a parent present regularly consent to physical examinations, mental health screenings, or minor medical procedures. It is important to note that most minors involve their parents and caregivers in their health care; this provision protects the few minors who cannot do so because of abuse, abandonment, or other circumstances.

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5. How will my child’s privacy be maintained, given the data publication components of
this bill?

Personal information is protected by several existing privacy laws, and the Community Immunity Act does not change those laws. In fact, the Act specifically states that publication of immunization data “shall not be required if it would result in disclosure of personally identifying information … or otherwise violate applicable privacy laws.” See paragraphs (m) and (n). The Act requires covered programs and DPH to publish immunization data annually, consistent with these privacy requirements. DPH currently publishes this data for programs that respond to the Department’s voluntary immunization survey.[1] No personally identifying information will be published, consistent with current practice.[2] Similarly, any outreach for an elevated risk program (a covered program with immunization rates below herd immunity for at least one infectious disease) is for everyone involved with the program; no one’s personal vaccination status will be disclosed.



[2] For example, DPH does not publish immunization information for programs with 30 or fewer students, as such publication might unintentionally reveal personally identifying information.

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