Pediatrics

AAP calls for end to nonmedical vaccine exemptions in schools

July 30, 2025

In its updated 2025 policy statement, American Academy of Pediatrics (AAP) reaffirmed its strong support for eliminating nonmedical vaccine exemptions for school and child care attendance. While AAP has maintained this position since 2016, the latest statement emphasizes the need for consistent enforcement, equitable access, and transparency in immunization practices. The update also reflects growing concern over persistent exemption loopholes and their impact on public health.

Key recommendations:

• Mandate immunization for attendance. Require all students to be fully vaccinated for entry into childcare and schools to protect all students and staff.
• Ensure equitable access. Strengthen vaccine access through medical homes, public health, and school-based programs to prevent exclusion due to systemic barriers.
• Limit exemptions to medical need. Only grant exemptions when medically justified, with regular recertification.
• Eliminate nonmedical exemptions. Urge all states and territories to remove religious and philosophical exemptions.
• Discourage provider involvement in nonmedical exemptions. Pediatricians shouldn’t endorse or process nonmedical exemption requests.
• Enforce documentation. Require accurate immunization and exemption records; ensure uniform enforcement by state agencies.
• Promote transparency. Public health authorities should report immunization rates by school or center to identify outbreak risks and inform families.

Source:

Hackell JM, et al; Committee on Practice and Ambulatory Medicine; Committee on Infectious Diseases; Committee on State Government Affairs; Council on School Health. (2025, July 28). Pediatrics. Medical vs Nonmedical Immunization Exemptions for Child Care and School Attendance: Policy Statement. https://pubmed.ncbi.nlm.nih.gov/40716772/