Prohibit use of an exemption to immunization due to conscientiously held beliefs

A bill for an act

relating to education; prohibiting use of an exemption to immunization due to

conscientiously held beliefs; modifying immunization schedules; prohibiting use

of a substitute immunization statement; amending Minnesota Statutes 2024, sections

121A.15, subdivisions 1, 3, 3a, 10, 12, by adding a subdivision; 135A.14,

subdivisions 3, 7; Minnesota Statutes 2025 Supplement, section 121A.15,

subdivision 8; repealing Minnesota Statutes 2024, section 121A.15, subdivision

4.

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

Section 1.

Minnesota Statutes 2024, section 121A.15, subdivision 1, is amended to read:

Subdivision 1.

School and child care facility immunization requirements.

Except as

provided in subdivisions 3
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, 4,
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and 10, no person over two months old may be allowed to

enroll or remain enrolled in any elementary or secondary school or child care facility in this

state until the person has submitted to the administrator or other person having general

control and supervision of the school or child care facility, one of the following statements:

(1) a statement from a physician or a public clinic which provides immunizations stating

that the person has received immunization, consistent with medically acceptable standards,

against measles after having attained the age of 12 months, rubella, diphtheria, tetanus,

pertussis, polio, mumps, haemophilus influenzae type b, and hepatitis B; or

(2) a statement from a physician or a public clinic which provides immunizations stating

that the person has received immunizations, consistent with medically acceptable standards,

against measles after having attained the age of 12 months, rubella, mumps, and haemophilus

influenzae type b and that the person has commenced a schedule of immunizations for

diphtheria, tetanus, pertussis, polio, and hepatitis B and which indicates the month and year

of each immunization received.

Sec. 2.

Minnesota Statutes 2024, section 121A.15, subdivision 3, is amended to read:

Subd. 3.

Exemptions from immunizations.

(a) If a person is at least seven years old

and has not been immunized against pertussis, the person must not be required to be

immunized against pertussis.

(b) If a person is at least 18 years old and has not completed a series of immunizations

against poliomyelitis, the person must not be required to be immunized against poliomyelitis.

(c) If a statement, signed by a physician, is submitted to the administrator or other person

having general control and supervision of the school or child care facility stating that an

immunization is contraindicated for medical reasons or that laboratory confirmation of the

presence of adequate immunity exists, the immunization specified in the statement need

not be required.

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(d) If a notarized statement signed by the minor child's parent or guardian or by the

emancipated person is submitted to the administrator or other person having general control

and supervision of the school or child care facility stating that the person has not been

immunized as prescribed in subdivision 1 because of the conscientiously held beliefs of the

parent or guardian of the minor child or of the emancipated person, the immunizations

specified in the statement shall not be required. This statement must also be forwarded to

the commissioner of the Department of Health. This paragraph does not apply to a child

enrolling or enrolled in a child care center or family child care program that adopts a policy

under subdivision 3b.

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(e)
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(d)
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If the person is under 15 months, the person is not required to be immunized

against measles, rubella, or mumps.

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(f)
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(e)
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If a person is at least five years old and has not been immunized against

haemophilus influenzae type b, the person is not required to be immunized against

haemophilus influenzae type b.

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(g)
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(f)
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If a person who is not a Minnesota resident enrolls in a Minnesota school online

learning course or program that delivers instruction to the person only by computer and

does not provide any teacher or instructor contact time or require classroom attendance, the

person is not subject to the immunization, statement, and other requirements of this section.

Sec. 3.

Minnesota Statutes 2024, section 121A.15, subdivision 3a, is amended to read:

Subd. 3a.

Disclosures required.

(a) This paragraph applies to any written information

about immunization requirements for enrollment in a school or child care facility that:

(1) is provided to a person to be immunized or enrolling or enrolled in a school or child

care facility, or to the person's parent or guardian if the person is under 18 years of age and

not emancipated; and

(2) is provided by the Department of Health; the Department of Education; the

Department of Children, Youth, and Families; an immunization provider; or a school or

child care facility.

Such written information must describe the exemptions from immunizations permitted under

subdivision 3,
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paragraphs
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paragraph
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(c)
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and (d)
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. The information on exemptions from

immunizations provided according to this paragraph must be in a font size at least equal to

the font size of the immunization requirements, in the same font style as the immunization

requirements, and on the same page of the written document as the immunization

requirements.

(b) Before immunizing a person, an immunization provider must provide the person, or

the person's parent or guardian if the person is under 18 years of age and not emancipated,

with the following information in writing:

(1) a list of the immunizations required for enrollment in a school or child care facility;

(2) a description of the exemptions from immunizations permitted under subdivision 3,
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paragraphs
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paragraph
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(c)
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and (d)
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;

(3) a list of additional immunizations currently recommended by the commissioner; and

(4) in accordance with federal law, a copy of the vaccine information sheet from the

federal Department of Health and Human Services that lists possible adverse reactions to

the immunization to be provided.

(c) The commissioner will continue the educational campaign to providers and hospitals

on vaccine safety including, but not limited to, information on the vaccine adverse events

reporting system (VAERS), the federal vaccine information statements (VIS), and medical

precautions and contraindications to immunizations.

(d) The commissioner will encourage providers to provide the vaccine information

statements at multiple visits and in anticipation of subsequent immunizations.

(e) The commissioner will encourage providers to use existing screening for immunization

precautions and contraindication materials and make proper use of the vaccine adverse

events reporting system (VAERS).

(f) In consultation with groups and people identified in subdivision 12, paragraph (a),

clause (1), the commissioner will continue to develop and make available patient education

materials on immunizations including, but not limited to, contraindications and precautions

regarding vaccines.

(g) The commissioner will encourage health care providers to use thimerosal-free vaccines

when available.

Sec. 4.

Minnesota Statutes 2025 Supplement, section 121A.15, subdivision 8, is amended

to read:

Subd. 8.

Report.

The administrator or other person having general control and supervision

of the elementary or secondary school shall file a report with the commissioner on all persons

enrolled in the school. The superintendent of each district shall file a report with the

commissioner for all persons within the district receiving instruction in a home school in

compliance with sections
120A.22
and
120A.24
. The parent of persons receiving instruction

in a home school shall submit the statements as required by subdivisions 1, 2, 3,
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4,
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and 12

to the superintendent of the district in which the person resides by October 1 of the first

year of their homeschooling in Minnesota and the grade 7 year. The school report must be

prepared on forms developed jointly by the commissioner of health and the commissioner

of education and be distributed to the local districts by the commissioner of health. The

school report must state the number of persons attending the school, the number of persons

who have not been immunized according to subdivision 1 or 2, and the number of persons

who received an exemption under subdivision 3, paragraph (c)
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or (d)
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. The school report

must be filed with the commissioner of education within 60 days of the commencement of

each new school term. Upon request, a district must be given a 60-day extension for filing

the school report. The commissioner of education shall forward the report, or a copy thereof,

to the commissioner of health who shall provide summary reports to community health

boards as defined in section
145A.02, subdivision 5
. The administrator or other person

having general control and supervision of the child care facility shall file a report with the

commissioner of children, youth, and families on all persons enrolled in the child care

facility. The child care facility report must be prepared on forms developed jointly by the

commissioner of health and the commissioner of children, youth, and families and be

distributed to child care facilities by the commissioner of health. The child care facility

report must state the number of persons enrolled in the facility, the number of persons with

no immunizations, the number of persons who received an exemption under subdivision 3,

paragraph (c)
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or (d)
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, and the number of persons with partial or full immunization histories.

The child care facility report must be filed with the commissioner of children, youth, and

families by November 1 of each year. The commissioner of children, youth, and families

shall forward the report, or a copy thereof, to the commissioner of health who shall provide

summary reports to community health boards as defined in section
145A.02, subdivision

5
. The report required by this subdivision is not required of a family child care or group

family child care facility, for prekindergarten children enrolled in any elementary or

secondary school provided services according to sections
125A.03
and
125A.06
, nor for

child care facilities in which at least 75 percent of children in the facility participate on a

onetime only or occasional basis to a maximum of 45 hours per child, per month.

Sec. 5.

Minnesota Statutes 2024, section 121A.15, is amended by adding a subdivision to

read:

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Subd. 8a.

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Statement required for participation in an extracurricular activity.

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If a

parent of a person receiving instruction in a home school fails to comply with the requirement

in subdivision 8 to submit statements as required by subdivisions 1, 2, 3, and 12 to the

superintendent of the district in which the person resides, the superintendent must prohibit

the person from participating in an extracurricular activity until all requirements are met.

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Sec. 6.

Minnesota Statutes 2024, section 121A.15, subdivision 10, is amended to read:

Subd. 10.

Requirements for immunization statements.

(a) A statement required to be

submitted under subdivisions 1
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,
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and
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2
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, and 4
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to document evidence of immunization shall

include month, day, and year for immunizations administered after January 1, 1990.

(b) A person who has received at least three doses of tetanus and diphtheria toxoids,

with the most recent dose given after age six and before age 11, is not required to have

additional immunization against diphtheria and tetanus until ten years have elapsed from

the person's most recent dose of tetanus and diphtheria toxoid.

(c) The requirement for hepatitis B vaccination shall apply to persons enrolling in

kindergarten beginning with the 2000-2001 school term.

(d) The requirement for hepatitis B vaccination shall apply to persons enrolling in grade

7 beginning with the 2001-2002 school term.

Sec. 7.

Minnesota Statutes 2024, section 121A.15, subdivision 12, is amended to read:

Subd. 12.

Modifications to schedule.

(a) The commissioner of health may adopt

modifications to the immunization requirements of this section. A proposed modification

made under this subdivision must be part of the current immunization recommendations of

each of the following organizations:
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the United States Public Health Service's Advisory

Committee on Immunization Practices,
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the American Academy of Family Physicians
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,
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and

the American Academy of Pediatrics. In proposing a modification to the immunization

schedule, the commissioner must:

(1) consult with (i) the commissioner of education
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;
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and
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the commissioner of children,

youth, and families
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; the chancellor of the Minnesota State Colleges and Universities; and

the president of the University of Minnesota
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; and (ii)
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the Minnesota Natural Health Coalition,

Vaccine Awareness Minnesota, Biological Education for Autism Treatment (BEAT),
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the

Minnesota Academy of Family Physicians
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,
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and
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the American Academy of

Pediatrics-Minnesota Chapter
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, and the Minnesota Nurses Association
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; and

(2) consider the following criteria: the epidemiology of the disease, the morbidity and

mortality rates for the disease, the safety and efficacy of the vaccine, the cost of a vaccination

program, the cost of enforcing vaccination requirements, and a cost-benefit analysis of the

vaccination.

(b) Before a proposed modification may be adopted, the commissioner must notify the

chairs of the house of representatives and senate committees with jurisdiction over health

policy issues. If the chairs of the relevant standing committees determine a public hearing

regarding the proposed modifications is in order, the hearing must be scheduled within 60

days of receiving notice from the commissioner. If a hearing is scheduled, the commissioner

may not adopt any proposed modifications until after the hearing is held.

(c) The commissioner shall comply with the requirements of chapter 14 regarding the

adoption of any proposed modifications to the immunization schedule.

(d) In addition to the publication requirements of chapter 14, the commissioner of health

must inform all immunization providers of any adopted modifications to the immunization

schedule in a timely manner.

Sec. 8.

Minnesota Statutes 2024, section 135A.14, subdivision 3, is amended to read:

Subd. 3.

Exemptions from immunization.

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(a)
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An immunization listed in subdivision

2 is not required if the student submits to the administrator a statement signed by a physician

that shows:

(1) that, for medical reasons, the student did not receive an immunization;

(2) that the student has experienced the natural disease against which the immunization

protects; or

(3) that a laboratory has confirmed the presence of adequate immunity.

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(b) If the student submits a notarized statement that the student has not been immunized

as required in subdivision 2 because of the student's conscientiously held beliefs, the

immunizations described in subdivision 2 are not required. The institution shall forward

this statement to the commissioner of health.

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Sec. 9.

Minnesota Statutes 2024, section 135A.14, subdivision 7, is amended to read:

Subd. 7.

Modifications to schedule.

(a) The commissioner of health may adopt

modifications to the immunization requirements of this section. A proposed modification

made under this subdivision must be part of the current immunization recommendations of

each of the following organizations:
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the United States Public Health Service's Advisory

Committee on Immunization Practices,
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the American Academy of Family Physicians
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,
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and

the American Academy of Pediatrics. In proposing a modification to the immunization

schedule, the commissioner must:

(1) consult with the commissioner of education; the commissioner of human services;

the chancellor of the Minnesota State Colleges and Universities; and the president of the

University of Minnesota; and

(2) consider the following criteria: the epidemiology of the disease, the morbidity and

mortality rates for the disease, the safety and efficacy of the vaccine, the cost of a vaccination

program, the cost of enforcing vaccination requirements, and a cost-benefit analysis of the

vaccination.

(b) Before a proposed modification may be adopted, the commissioner must notify the

chairs of the house of representatives and senate committees with jurisdiction over health

policy issues. If the chairs of the relevant standing committees determine a public hearing

regarding the proposed modifications is in order, the hearing must be scheduled within 60

days of receiving notice from the commissioner. If a hearing is scheduled, the commissioner

may not adopt any proposed modifications until after the hearing is held.

(c) The commissioner shall comply with the requirements of chapter 14 regarding the

adoption of any proposed modifications to the immunization schedule.

(d) In addition to the publication requirements of chapter 14, the commissioner of health

must inform all immunization providers of any adopted modifications to the immunization

schedule in a timely manner.

Sec. 10.
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REPEALER.
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Minnesota Statutes 2024, section 121A.15, subdivision 4,

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is repealed.

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APPENDIX

Repealed Minnesota Statutes: 26-07516

121A.15 HEALTH STANDARDS; IMMUNIZATIONS; SCHOOL CHILDREN.

Subd. 4.

Substitute immunization statement.

(a) A person who is enrolling or enrolled in an elementary or secondary school or child care facility may substitute a statement from the emancipated person or a parent or guardian if the person is a minor child in lieu of the statement from a physician or public clinic which provides immunizations. If the statement is from a parent or guardian or emancipated person, the statement must indicate the month and year of each immunization given.

(b) In order for the statement to be acceptable for a person who is enrolling in an elementary school and who is six years of age or younger, it must indicate that the following was given: no less than one dose of vaccine each for measles, mumps, and rubella given separately or in combination; no less than four doses of vaccine for poliomyelitis, unless the third dose was given after the fourth birthday, then three doses are minimum; no less than five doses of vaccine for diphtheria, tetanus, and pertussis, unless the fourth dose was given after the fourth birthday, then four doses are minimum; and no less than three doses of vaccine for hepatitis B.

(c) In order for the statement to be consistent with subdivision 10 and acceptable for a person who is enrolling in an elementary or secondary school and is age seven through age 19, the statement must indicate that the person has received no less than one dose of vaccine each for measles, mumps, and rubella given separately or in combination, and no less than three doses of vaccine for poliomyelitis, diphtheria, tetanus, and hepatitis B.

(d) In order for the statement to be acceptable for a person who is enrolling in a secondary school, and who was born after 1956 and is 20 years of age or older, the statement must indicate that the person has received no less than one dose of vaccine each for measles, mumps, and rubella given separately or in combination, and no less than one dose of vaccine for diphtheria and tetanus within the preceding ten years.

(e) In order for the statement to be acceptable for a person who is enrolling in a child care facility and who is at least 15 months old but who has not reached five years of age, it must indicate that the following were given: no less than one dose of vaccine each for measles, mumps, and rubella given separately or in combination; no less than one dose of vaccine for haemophilus influenzae type b; no less than four doses of vaccine for diphtheria, tetanus, and pertussis; and no less than three doses of vaccine for poliomyelitis.

(f) In order for the statement to be acceptable for a person who is enrolling in a child care facility and who is five or six years of age, it must indicate that the following was given: no less than one dose of vaccine each for measles, mumps, and rubella given separately or in combination; no less than four doses of vaccine for diphtheria, tetanus, and pertussis; and no less than three doses of vaccine for poliomyelitis.

(g) In order for the statement to be acceptable for a person who is enrolling in a child care facility and who is seven years of age or older, the statement must indicate that the person has received no less than one dose of vaccine each for measles, mumps, and rubella given separately or in combination and consistent with subdivision 10, and no less than three doses of vaccine for poliomyelitis, diphtheria, and tetanus.

(h) The commissioner of health, on finding that any of the above requirements are not necessary to protect the public's health, may suspend for one year that requirement.