State Regulations

Each state regulates the practice of immunization within the state, so vaccination requirements often vary from one state to another. Some vaccinations are required by law, while others are only recommended. Your state might only require measles and rubella immunization, for example, even though the American Academy of Pediatrics and the Centers for Disease Control and Prevention recommend both of those plus a mumps vaccine. In that case, you could legally refuse a mumps vaccine without penalty, although your pediatrician or family practice doctor might disagree and try to convince you to give your child all three vaccines.

Exemptions

Even in states where vaccines are legally required, your child can be exempted from vaccination if you can prove she already has immunity to a disease, such as whooping cough or measles. Laboratory tests can show if your child already has enough antibodies in her system to prove she is immune to the disease. You may have to pay for the test, which might cost $55 or more, according to the National Vaccine Information Center. Other states may allow vaccine refusal based on religious or philosophical beliefs. Each state is different, however, so check the requirements in your state.

If You Refuse

States have what is considered a “compelling state interest” in preventing the spread of communicable diseases. If you choose to forgo vaccinations for your child, you may wind up in court. Your county or state health department may require you to provide proof to back up your decision. If you have made your decision based on your religious beliefs, for example, you may need to present evidence of your church’s teachings or provide a supporting letter from your minster, priest or rabbi. Most states will accept your physician's written exemption if your refusal is for health reasons. On the other hand, some states will require the health department to review the case.

Pediatricians and Vaccinations

The American Academy of Pediatrics strongly recommends that all pediatricians discuss vaccination with parents. The AAP notes, however, that in 2011, 13 percent of parents who had children between 6 months and 6 years of age refused or delayed certain vaccines, and 17 percent refused vaccination entirely. Should a parent refuse, the AAP recommends the pediatrician spend extra time in education. When parents maintain their refusal to vaccinate, the AAP notes that the pediatrician should have the parent sign a refusal to vaccinate form and document the refusal in the patient’s chart.