RELATING TO HEALTH.

SB2472

THE SENATE

S.B. NO.

2472

THIRTY-THIRD LEGISLATURE, 2026

STATE OF HAWAII

A BILL FOR AN ACT

RELATING
TO HEALTH
.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

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SECTION 1.
�
The
legislature recognizes that forty-five states, including Hawaii, honor the First
Amendment of the United States Constitution by granting religious exemptions
from vaccinations.
�
The legislature
believes that these exemptions help ensure continued school attendance.

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The legislature also recognizes, however,
that current state law, when in providing religious exemptions from medical
examinations, immunizations, vaccinations, and revaccinations, requires those
exemptions to be based on "religious tenets of an established church".
�
The legislature believes that the exemptions
should be amended to also accommodate people of faith who might not attend
established churches.

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Accordingly, the purpose of this Act is to expand
statutory provisions that provide for religious exemptions from medical
examinations, immunizations, vaccinations, and revaccinations to protect parents
and other persons with bona fide religious tenets and practices.

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SECTION
2
.
�
Section 302A-1156, Hawaii Revised Statutes,
is amended to read as follows:

����
"
�302A-1156
�
Exemptions.
�
A child [
may
]
shall
be exempted
from the required immunizations:

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(1)
�
If
a licensed physician, physician assistant, or advanced practice registered
nurse certifies that the physical condition of the child is such that
immunizations would endanger the child's life or health; or

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(2)
�
If
any parent, custodian, guardian, or any other person in loco parentis to a
child objects to immunization in writing on the grounds that the immunization
conflicts with that person's bona

fide
religious tenets and practices.
�
Upon
showing the appropriate school official satisfactory evidence of the exemption,
no certificate or other evidence of immunization shall be required for entry
into school."

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SECTION
3
.
�
Section 321-11, Hawaii Revised Statutes, is
amended to read as follows:

����
"
�321-11
�
Subjects of health rules, generally.
�
The department of health pursuant to chapter
91 may adopt rules that it deems necessary for the public health and safety
respecting:

����
(1)
�
Nuisances,
foul or noxious odors, gases, vapors, waters in which mosquitoes breed or may
breed, sources of filth, and causes of sickness or disease, within the
respective districts of the State, and on board any vessel;

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(2)
�
Adulteration
and misbranding of food or drugs;

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(3)
�
Location,
air space, ventilation, sanitation, drainage, sewage disposal, and other health
conditions of buildings, courts, construction projects, excavations, pools,
watercourses, areas, and alleys.
�
For
purposes of this paragraph, "pool" means a watertight artificial
structure containing a body of water that does not exchange water with any
other body of water, either naturally or mechanically, and is used for
swimming, diving, recreational bathing, or therapy by humans;

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(4)
�
Privy
vaults and cesspools;

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(5)
�
Fish
and fishing;

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(6)
�
Interments
and dead bodies;

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(7)
�
Disinterments
of dead human bodies, including the exposing, disturbing, or removing of these
bodies from their place of burial, or the opening, removing, or disturbing
after due interment of any receptacle, coffin, or container holding human
remains or a dead human body or a part thereof and the issuance and terms of
permits for the aforesaid disinterments of dead human bodies;

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(8)
�
Cemeteries
and burying grounds;

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(9)
�
Laundries,
and the laundering, sanitation, and sterilization of articles including linen
and uniforms used by or in the following businesses and professions:
�
barber shops, manicure shops, beauty parlors,
electrology shops, restaurants, soda fountains, hotels, rooming and boarding
houses, bakeries, butcher shops, public bathhouses, midwives, masseurs, and
others in similar calling, public or private hospitals, and canneries and
bottling works where foods or beverages are canned or bottled for public consumption
or sale; provided that nothing in this chapter shall be construed as
authorizing the prohibiting of laundering, sanitation, and sterilization by
those conducting any of these businesses or professions where the laundering or
sterilization is done in an efficient and sanitary manner;

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(10)
�
Hospitals,
freestanding surgical outpatient facilities, skilled nursing facilities,
intermediate care facilities, adult residential care homes, adult foster homes,
assisted living facilities, special treatment facilities and programs, home
health agencies, home care agencies, hospices, freestanding birthing
facilities, adult day health centers, independent group residences, and
therapeutic living programs, but excluding youth shelter facilities unless
clinical treatment of mental, emotional, or physical disease or handicap is a
part of the routine program or constitutes the main purpose of the facility, as
defined in section 346-16 under "child caring institution".
�
For the purpose of this paragraph, "adult
foster home" has the same meaning as provided in section 321-11.2;

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(11)
�
Hotels,
rooming houses, lodging houses, apartment houses, tenements, and residences for
persons with developmental disabilities including those built under federal
funding;

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(12)
�
Laboratories;

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(13)
�
Any
place or building where noisome or noxious trades or manufacturing is carried
on, or intended to be carried on;

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(14)
�
Milk;

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(15)
�
Poisons
and hazardous substances, the latter term including any substance or mixture of
substances that:

���������
(A)
�
Is
corrosive;

���������
(B)
�
Is
an irritant;

���������
(C)
�
Is
a strong sensitizer;

���������
(D)
�
Is
inflammable; or

���������
(E)
�
Generates
pressure through decomposition, heat, or other means,

���������
if the substance or mixture of
substances may cause substantial personal injury or substantial illness during
or as a proximate result of any customary or reasonably foreseeable handling or
use, including reasonably foreseeable ingestion by children;

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(16)
�
Pig
and duck ranches;

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(17)
�
Places
of business, industry, employment, and commerce, and the processes, materials,
tools, machinery, and methods of work done therein; and places of public
gathering, recreation, or entertainment;

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(18)
�
Any
restaurant, theater, market, stand, shop, store, factory, building, wagon,
vehicle, or place where any food, drug, or cosmetic is manufactured,
compounded, processed, extracted, prepared, stored, distributed, sold, offered
for sale, or offered for human consumption or use;

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(19)
�
Foods,
drugs, and cosmetics, and the manufacture, compounding, processing, extracting,
preparing, storing, selling, and offering for sale, consumption, or use of any
food, drug, or cosmetic;

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(20)
�
Device
as defined in section 328-1;

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(21)
�
Sources
of ionizing radiation;

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(22)
�
Medical
examination, vaccination, revaccination, and immunization of school
children.
�
No child shall be subjected to
medical examination, vaccination, revaccination, or immunization, whose parent
or guardian objects in writing thereto on grounds that the [
requirements are
not in accordance
]
medical examination, vaccination, revaccination, or
immunization conflicts
with the
parent's bona fide
religious tenets [
of
an established church of which the parent or guardian is a member or adherent,
but no objection shall be recognized when, in the opinion of the department,
there is danger of an epidemic from any communicable disease;
]
and
practices;

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(23)
�
Disinsectization
of aircraft entering or within the State as may be necessary to prevent the
introduction, transmission, or spread of disease or the introduction or spread
of any insect or other vector of significance to health;

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(24)
�
Fumigation,
including the process by which substances emit or liberate gases, fumes, or
vapors that may be used for the destruction or control of insects, vermin,
rodents, or other pests, which, in the opinion of the department, may be
lethal, poisonous, noxious, or dangerous to human life;

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(25)
�
Ambulances
and ambulance equipment;

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(26)
�
Development,
review, approval, or disapproval of management plans submitted pursuant to the
Asbestos Hazard Emergency Response Act of 1986, Public Law 99‑519; and

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(27)
�
Development,
review, approval, or disapproval of an accreditation program for specially
trained persons pursuant to the Residential Lead-Based Paint Hazard Reduction
Act of 1992, Public Law 102-550.

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The department of health may require any
certificates, permits, or licenses that it may deem necessary to adequately
regulate the conditions or businesses referred to in this section."

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SECTION
4
.
�
Section 325-34, Hawaii Revised Statutes, is
amended to read as follows:

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"
�325-34
�
Exemptions.
�
(a)
�

Section 325-32 shall be construed not to require the vaccination or
immunization of any person for three months after a duly licensed physician,
a

physician assistant,
an
advanced practice registered nurse, or an
authorized representative of the department of health has signed two copies of
a certificate stating the name and address of the person and that because of a
stated cause the health of the person would be endangered by the vaccination or
immunization, and has forwarded the original copy of the certificate to the
person or, if the person is a minor or under guardianship, to the person's
parent or guardian, and has forwarded the duplicate copy of the certificate to
the department for its files.

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[
No
]
(b)
�
Except as required under section 302A-1154,
no
person shall be subjected to vaccination, revaccination
,
or
immunization, who shall in writing object [
thereto
] on the grounds that
the [
requirements are not in accordance
]
vaccination, revaccination,
or immunization conflicts
with the
person's bona fide
religious
tenets [
of an established church of which the person is a member or
adherent,
]
and practices,
or, if the person is a minor or under
guardianship, whose parent or guardian shall in writing object [
thereto
]

based
on [
such grounds, but
]
the parent or guardian's bona fide
religious tenets and practices; provided that
no objection shall be
recognized when, in the opinion of the director of health, there is danger of
an epidemic from any communicable disease."

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SECTION 5.
�

Statutory material to be repealed is bracketed and stricken.
�
New statutory material is underscored.

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SECTION 6.
�

This Act shall take effect upon its approval.

INTRODUCED BY:

_____________________________

Report Title:

Health;
Medical Examinations; Vaccinations; Religious Exemptions

Description:

Expands
statutory provisions that provide for religious exemptions from medical
examinations, immunizations, vaccinations, and revaccinations to protect parents
and other persons with bona fide religious tenets and practices.

The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.