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NC Department of Health and Human Services
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North Carolina Immunization Branch

N.C. Exemptions

North Carolina law provides for two types of exemptions from required immunizations. They are medical and religious.

Medical Exemption

G.S.130A-156. Medical exemption.

The Commission for Public Health shall adopt by rule medical contraindications to immunizations required by G.S. 130A-152. If a physician licensed to practice medicine in this State certifies that a required immunization is or may be detrimental to a person's health due to the presence of one of the contraindications adopted by the Commission, the person is not required to receive the specified immunization as long as the contraindication persists. The State Health Director may, upon request by a physician licensed to practice medicine in this State, grant a medical exemption to a required immunization for a contraindication not on the list adopted by the Commission.

Medical exemptions can only be requested by a physician licensed to practice medicine in North Carolina. If a physician determines the need to request a medical exemption from a required immunization for a patient and needs assistance, they should contact the North Carolina Immunization Branch at (919) 707-5550.

Use this form for true contraindications, i.e. those recognized by the Commission for Public Health.

Use this form for contraindications not recognized by the Commission for Public Health.

Religious Exemption

G.S.130A-157. Religious exemption

If the bona fide religious beliefs of an adult or the parent, guardian or person in loco parentis of a child are contrary to the immunization requirements contained in this Part, the adult or the child shall be exempt from the requirements. Upon submission of a written statement of the bona fide religious beliefs and opposition to the immunization requirements, the person may attend the college, university, school or facility without presenting a certificate of immunization.

There is no form for requesting religious exemptions in North Carolina. To claim a religious exemption, the parent or person requesting the exemption must write a statement of their religious objection to immunization, including the name and date of birth of the person for whom the exemption is being requested. This statement would then be provided to schools, child care programs, camps, etc. in place of an immunization record. If a family is requesting a religious exemption for more than one child, a separate statement should be prepared for each child. Statements of religious objection to immunization do not need to be notarized, signed by a religious leader, or prepared by an attorney. They do not need to be submitted to the state for review or approval.

Personal Belief

10A NCAC 41A .0403 Non-Religious Personal Belief No Exemption: 

Except as provided in G.S. 130A-156 and G.S. 130A-157, and 10A NCAC 41A .0404 and .0405, no child shall be exempt from the requirements of 10A NCAC 41 .0401; there is no exception to these requirements for the case of a personal belief or philosophy of a parent or guardian not founded upon a religious belief.


Additional text from North Carolina rules and laws on immunizations, including text suitable for printing, can be found on our N.C. Rules and Laws page.



Updated: August 5, 2020