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Immunization Exemption Guidance

Vaccination programs are an important part of military public health and deployment readiness. However, sometimes a particular vaccination is not indicated for an individual to receive. There are 2 main types of exemptions from immunizations: medical and administrative. A medical exemption is a function that can only be validated by a health care professional. An administrative exemption is a non-medical function that is usually controlled by the individual's unit commander.

Where can I get more information?

For exact guidance please see page 6 of the Joint Instruction (AR 40-562, BUMEDINST 6230.15B, AFI 48-110_IP, CG COMDTINST M6230.4G) Immunizations and Chemoprophylaxis for Prevention of Infectious Disease.

Healthcare professionals are available for consultation regarding exemption recommendations. Both healthcare professionals and service members are encouraged to contact the Worldwide DHA Immunization Healthcare Support Center for vaccine medical exemption guidance.

What are the different types of military exemptions?

Medical

  • Temporary Exemptions may be granted for up to 365 days based on:
    • Temporary contraindications to vaccines (e.g., pregnancy, acute illness, treatments causing immune suppression)
    • Pending completion of an ongoing medical evaluation
    • Medical Supply exemption: lack of vaccine supply
  • Permanent Exemptions may be granted indefinitely based on one of the following**:
    • HIV infection, prolonged or permanent immune suppression
    • Determination by a medical provider that further vaccination will seriously endanger patient's health
    • Medical, Reactive exemption: Previously severe reaction after specific vaccine (e.g., anaphylaxis)
    • Medical, Immune exemption: Evidence of existing immunity (e.g., by serologic antibody test, documentation of previous infection or natural infection presumed)

**Indefinite or permanent exemptions may be reversed if an alternate form of prophylaxis is not available, if a medical condition or vaccination guideline changes, or if a provider experienced in vaccine adverse-event management determines that the risk of acquiring the disease is greater than the risk of vaccine exposure. 

Administrative

  • Separation or retirement within 180 days provided the following conditions are met:
    • Service member is not assigned, deployed or scheduled to perform duties in an area where specific immunization is indicated
    • The commander has not directed immunization because of overriding mission requirements
  • Separation of civilian employees and contractor personnel within 30 days
  • Religious:
    • Granted according to Service-specific policies
    • Command decision made with medical and chaplain consultation

How is an exemption documented?

Electronic and paper health records should annotate temporary and/or permanent medical exemptions.

Can I get a second opinion on a vaccination exemption recommendation?

Individuals who disagree with a provider's exemption recommendation may be referred for a second opinion to providers experienced in vaccine adverse-event management, such as the Worldwide DHA Immunization Healthcare Support Center.

Where can I find information about exemptions for beneficiaries?

Beneficiaries not in the military should contact their local state health department for state laws.

Exemption Codes

Find codes for medical and administrative exemptions, as well as exemption codes for smallpox vaccine.

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MILPERSMAN 6320-010 Immunization Exemptions

Policy
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