NVIC Vaccine News

College Bound - Navigating Vaccine Choices

By Theresa Wrangham
Published February 01, 2011 in Government

Recently, I responded to one of our reader’s vaccination choice concerns regarding college bound young adults and many of these young adults will soon be deciding which college to attend in the fall. I have these concerns myself now, as my youngest is also off to college this year. As a parent, I have learned that the informed consent movement that NVIC founded and the values we in turn have taken into our home really transfer to our college bound daughter. It is not easy to step aside, but as we do, we are empowering our daughter to ask the right questions as she decides which college to attend.

This article will address concerns held by families and young adults who are college bound and choose to alternatively vaccinate, or do not vaccinate at all. As they enter college, they will face pressure to receive vaccines for meningitis, HPV, and influenza, among others. Whatever decisions our sons and daughters make in this respect, make no mistake - it is their decision to make and defend.

Although parents are no longer directly involved with these healthcare decisions, parents can help their sons and daughters find accurate information and resources regarding:

  1. the risks of the vaccine they are being asked by the college to receive;
  2. the risks of the disease for which they are considering vaccination;
  3. and their rights to informed consent in the vaccine decision-making process.

For reliable facts helpful in evaluating the risks discussed in the first two points above, our webpage on diseases and vaccines is an excellent resource and should be recommended to prospective college students. When a decision is made to decline a vaccine, it is crucial for the incoming college student to understand what the legal and policy requirements are in order for them to be able to continue to be enrolled and meet their program requirements.

College Vaccination – What is Required?

Understanding college vaccination policies and state exemption laws are a critical part of the information gathering process. Having taken calls from parents of students suspended from attending college until their vaccinations are up to date, we are not leaving admission to our daughter’s dream college to chance. We have personally found it helpful to proactively:  

  1. ask the admissions officer for the school’s vaccination policy in writing (should be on the institution’s letterhead);
  2. and research the state’s exemption laws when considering colleges.

In general, college vaccination policies must comply with the legal exemptions to vaccination outlined in each state's public health laws. Unforeseen trouble may come up later if the student is going into a health profession that requires clinical practice during their course of study. In that instance, the facility providing the clinical experience necessary for graduation requirements could have vaccination requirements for students, who are in direct contact with patients. It is better to have this information in advance. There are times when exceptions are made for medical contraindications and/or proof of existing antibodies, but these exceptions are on a case-by-case basis and policies governing vaccination could change before graduation. 

Helpful Tips for Gathering Information

Below are guidelines to assist families in gathering information that empowers their college bound student’s understanding of the vaccination landscape in their state. Much of the information below can be found on our website under FAQs and although NVIC continually updates our website, state laws and rules change frequently and the website content may not reflect all recent changes to laws.  

  • Research the state exemption laws for colleges under consideration. Le gal requirements of vaccination laws differ state to state. Recognized legal exemptions are medical, religious and conscientious, philosophical or personal belief exemptions. Wording and scope of exemptions can differ from state to state, so do your homework!
  • State laws that govern exemptions sometimes don’t extend to private schools, which can institute any vaccine requirements they deem appropriate. Exemptions differ state to state and are dependent on the laws of each state.
  • Be aware of the difference between a legal requirement and a recommendation. For example, while vaccine policymakers at the Centers for Disease Control (CDC) have included the meningitis vaccine in their recommendations for first year college students living in dormitories, the state of Alaska requires only that college students receive information on the disease, vaccine and their increased risk of contracting meningitis if living in student housing. In this example the student must either agree to be vaccinated for meningitis, or sign a waiver verifying that they received the information and have waived vaccination.
  • Some states allow exemption from vaccination, or revaccination, if there is proof of existing antibodies. These antibodies can sometimes be determined by a private laboratory with a blood test to check titers. Titer tests are not available for all diseases for which a vaccine is available and acceptance of titer test results vary state to state. Again, check with the public health laws governing the state in question to determine what titer tests are acceptable.
  • Stay up-to-date on state exemptions and vaccination issues in the state of attendance, as requirements can change! NVIC maintains a webpage updated with state-by-state exemption information. NVIC has also recently launched its State Advocacy Portal and individuals can sign up to receive free eNewsletters on vaccine policy and law changes underway in their state, as well as tips for protecting your legal right to obtain an exemption to vaccination.

There are three types of vaccination exemptions:

  • Philosophical Exemption: There are 18 states which allow exemption to vaccination based on philosophical, personal or conscientiously held beliefs. In many of these states, individuals must object to all vaccines, not just a particular vaccine in order to use the philosophical, conscientious or personal belief exemption.  This type of exemption is being threatened in some state legislatures due to pressure from government health officials, drug company lobbyists and medical organizations to revoke this exemption.
  • Religious Exemption: All states except Mississippi and West Virginia allow for a religious exemption to vaccination. The religious exemption is intended for people who hold a sincere religious belief opposing vaccination but those beliefs can be personally held and church membership or adherence to an organized religion is not required. However, you should be able to articulate in your own words why your sincerely held religious or spiritual beliefs do not allow you to vaccinate yourself or your child with one or more vaccines. Sometimes obtaining a letter from your pastor or spiritual advisor attesting to the sincerity of your religious beliefs about vaccination is helpful, as well. Some religious exemptions are broadly defined and similar to philosophical or conscientious belief exemptions.
  • Medical Exemptions: All 50 states allow medical exemption to vaccination. Proof of medical exemption must take the form of a signed statement by a medical doctor, or doctor of osteopathy that the administering of one or more vaccines would be detrimental to the health of an individual. Some states will accept a private physician's written exemption without question. Other states allow the state health department to review the doctor's exemption and revoke it if health department officials do not think the exemption is justified.

My advice to our readers is to take the time to research the vaccination laws of the state in question, the specific policies of the college and program being considered and empower your student with information well in advance of selecting the college of their dreams and beginning their journey into adulthood.

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9 Responses to "College Bound - Navigating Vaccine Choices"
Commenter Name
Healthy Child
Posted: 2/3/2011 12:00:31 PM
Thanks so much for this valuable information. My daughter will be off to college in the next couple of years. She's been vaccine-free for 16 years and extremely healthy. It disturbs me that there's a possibility of her being vaccinated now with college. She understands about vaccines, but who knows what kind of pressure she'll be under. She wants to be a doctor so will have the clinical requirements to deal with as well. So great to have this information and I am very grateful for the work you do! - Jane
Commenter Name
Posted: 2/3/2011 4:08:14 PM
Stay up-to-date on state exemptions and vaccination issues in the state of attendance, as requirements can change! NVIC maintains a 'webpage' updated with state-by-state exemption information. The NVIC webpage 'link' referred to above has a problem.
Commenter Name
Posted: 2/3/2011 9:34:17 PM
When my daughter went out of state to college back east, we found out that the school would only accept a religious or medical exemption. Here in CO, we have all 3 exemptions, so we opted to utilize the religious exemption. When the health clinic rep asked me what our religion was, I stated that we don't have a 'religion' per se, but a religious belief opposed to injecting neuro-toxic and carcinogenic poisons. He then asked again, and I said it is not necessary to have a formal religion, and he finally relented. He then shared w/me that his childhood friend had been damaged by vaccines and was now in his early 20's confined to a bed 24/7 and brain damaged. He said he personally did not believe in vaccines knowing the damage they confer and the clinic's medical director, an M.D., also did not believe in them. What a nice surprise to know that an actual medical doctor was open-minded and supportive of vaccine exemptions.
Commenter Name
Theresa Wrangham
Posted: 2/4/2011 10:44:56 AM
To name withheld - thank you for catching my error. Those links are now working! Theresa
Commenter Name
Lawrence B. Palevsky, MD
Posted: 2/4/2011 11:53:11 AM
There is a common misconception in our society that if we don't see a specific disease in the community, like meningitis, we are led to believe that the germ that causes that disease is either not present in the body, or not present in the environment. This is unfortunate thinking, because it is incorrect. The surfaces of our bodies are filled with trillions of bacteria lining the skin, nose, sinuses, mouth, throat, ear canals, intestines, and airway. Where do they come from to inhabit our bodies? From the air. And, where do the 4 Neisseria meningitidis bacteria exist in the environment, that are then used to make the meningitis vaccine? In the air. And, where do these bacteria exist in our bodies because we breathe in the air? In the nose, sinuses, mouth, throats, and ear canals of our children, and in us. And what's the likelihood that children, by the time they are vaccinated with the meningitis vaccine at 11 or 17 years of age, have breathed in these 4 bacteria that then become a natural part of the multitude of bacteria that line their noses, sinuses, throats, mouths and ear canals? Extremely likely. Think about it. Children are exposed to trillions of bacteria that line the surfaces of their bodies without these bacteria causing any diseases, and we're saying that because the children haven't yet had meningitis from these 4 bacteria, they somehow haven't been exposed to them by the time the vaccine is given? Unlikely. It stands to reason then, that from a statistical perspective, children are more than likely to have been exposed to these 4 bacteria, perhaps long before they are vaccinated between the ages of 11 and 17, along with the trillions of other bacteria lining their bodies, and somehow they have managed to not get sick from them. Somehow, the immune systems lining their upper airways don't perceive that these bacteria are a threat by their presence, or by the presence of the trillions of other organisms lining the upper airway. It is silly to think that the 4 bacteria in the Neisseria meningitidis family that are included in the meningitis vaccine are the only 4 bacteria in the environment that children have somehow found a way not to be exposed to by the time they go to college, despite there being a colonization of trillions of bacteria along the surfaces of their bodies that make their way into the body just by breathing and living. So, if meningitis is to occur, it's not going to happen because children are suddenly exposed to these 4 bacteria. It takes more than the exposure to bacteria to cause disease. There are multiple other factors, that have nothing to do with the presence of these bacteria, that make children susceptible to developing meningitis. Another unfortunate misconception is that the injection of these 4 Neisseria bacteria into our children's bodies will somehow protect them from getting meningitis by helping them to produce antibodies to the bacteria. It won't necessarily. And, here's why: Antibodies are not the only way in which our immune systems are protected from bacterial diseases. Think about the trillions of bacteria that are lining the surfaces of our body. We co-exist with these bacteria. Our immune systems are in constant contact with these bacteria. Yet, we don't produce antibodies to every one of the trillions of bacteria that are on the surfaces of our bodies, and we seem to be protected from getting sick from them. That's right. We are covered in trillions of bacteria, lining the surfaces of our bodies, and we are protected by them without having antibodies to maintain that protection. How is it then, that our bodies are not threatened by these bacteria? How is it that we don't get immediate or frequent diseases from exposure to these bacteria? As it turns out, we have a protective immune system along the surfaces of our bodies that can protect us from disease, without the need for antibodies to perform this protective role. There are aspects of the communication between our immune systems and the trillions of the bacteria we are exposed to, that identify the bacteria as "friendly," and signal the immune system to recognize them and be protected by them at the same time......without the need for antibodies to fulfill this protective role. Antibodies are not the be-all and end-all of protection from diseases. To inject these bacteria, with the thinking that the production of antibodies against them is going to be the best means by which we are protected from them, is short-sighted and lacking in understanding of how our immune systems work. So, just because the vaccine catalyzes the immune systems in our children to produce antibodies, doesn't fully mean that our children are going to be protected from getting the disease. Lastly, the lack of safety studies re: this vaccine is a huge concern, not to mention the increased incidence of neurological complications, such as Guillan-Barre syndrome in adolescents and adults who receive this vaccine. And, where are the safety profiles of what happens to the immune systems of our children when they are injected with the vaccine ingredients? They are non-existent, and all efforts are made to divert attention from these scientific questions by the system that manufactures, recommends, and sells these vaccines to the public. It's simply a vaccine that doesn't make medical sense.
Commenter Name
Medical student
Posted: 6/9/2015 10:26:04 AM
I will be entering medical school in the fall and have never been vaccinated. The school requires that students be fully compliant with the CDC immunization requirements in order to engage in clinical experiences. I have a lot of reservations about being immunized and need to make a decision soon. Any advice would be helpful
Commenter Name
Posted: 10/11/2015 11:24:55 AM
My son will be going away to college next fall. We live in NJ and he is planning on attending a school in NJ. He has not been vaccinated since he was 5 years old, before I was smart enough to research all the effects. My first question is their a difference in a state school/private school with their requirements and being able to be exempt? I am so torn with the meningitis vaccination. It is the only one I would consider, because you an die from it. I would not consider any other one. I have searched the web...can anyone give me long term effects, or anything else? Can you get one required vaccination and be exempt from the others??? HELP!!!!!
Commenter Name
Posted: 6/22/2016 8:56:17 PM
I live in Florida and just got approved into the Respiratory Therapy program at the community college. My daughters both have a religous exemption. Is there anyway that I can get away with trying to get a religous exemption for myself? I have asked before at the health dept (think that is where I had gotten the forms) but the lady told me i was too old to have one. I know that Hepatitis B is one of the shots and then when school starts I believe the flu shot is also a main one that is required. What can I do? Please help!!!!!! I havent had any vaccines since i was around 5 years old and had a reaction to DTap
Commenter Name
Posted: 6/24/2016 4:09:43 PM
A nurse at Mt Nittany Medical Center in State College, PA has sued the hospital because she refuses all immunizations and was told she would be removed from her job. Please support her and know you can file legal action as well.

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