How to Get a Medical Vaccine Exemption in New York

To get a medical vaccine exemption in New York, you need a New York-licensed physician to certify in writing that a specific immunization would be detrimental to your health or your child’s health because of a recognized medical contraindication. For a K-12 student, that certification goes on state form DOH-5077 and is submitted to the school. For a job, there is no state form; the physician’s letter supports a reasonable accommodation request to the employer. Since New York repealed the religious exemption for schools in June 2019, a medical exemption is the only lawful way for a child to attend school in New York without the required vaccines.

Who Can Sign the Exemption

For a child in kindergarten through 12th grade, only a physician licensed to practice medicine in New York State can certify the exemption. That means an MD or a DO. A nurse practitioner or physician assistant cannot sign the K-12 form, even if that provider is your child’s regular clinician.¹

For a college or other post-secondary student, Public Health Law Section 2165 lets either a licensed physician or a nurse practitioner certify that immunization is medically contraindicated.²

For a job, the credentialing rules come from the employer’s own policy and any applicable workplace regulations, not from a single statute. A letter from a licensed physician is the standard supporting document.

What Actually Qualifies as a Medical Reason

The physician cannot simply write that you or your child would prefer to skip a vaccine. The certification must identify a specific contraindication or precaution to a specific vaccine, consistent with guidance from the Advisory Committee on Immunization Practices (ACIP) or another nationally recognized evidence-based standard of care.³

The recognized categories are narrower than many families expect. They include a documented severe allergic reaction (anaphylaxis) to a previous dose or to a vaccine component; severe immunodeficiency, such as certain cancers, congenital immunodeficiency, long-term immunosuppressive therapy, or severe HIV, which generally rules out live vaccines; specific neurological conditions, for example encephalopathy within seven days of a previous DTaP dose, or a progressive neurological disorder that has not stabilized; and vaccine-specific contraindications, such as a history of intussusception or severe combined immunodeficiency before rotavirus vaccine.⁴

A family history of vaccine reactions, mild illness, or a general concern about side effects does not qualify. The physician has to tie the exemption to a recognized medical reason in current accepted medical practice.

The K-12 Process: Form DOH-5077

New York uses one specific form for school immunization exemptions: the DOH-5077, “Immunization Requirements for School Attendance / Medical Exemption Statement for Children 0-18 Years of Age,” available on the Department of Health website.⁵

The physician completes and signs the form. It asks for the child’s name, date of birth, and address; a checkbox for each vaccine the exemption covers (MMR, DTaP, polio, hepatitis B, varicella, meningococcal, and others); a written description of the child’s contraindication or precaution and why immunization is medically inadvisable; the date the exemption ends, or an open-ended entry if the condition is permanent or the duration is unknown; and the physician’s printed name, New York medical license number, address, phone number, and signature.

You submit the signed original to your child’s school, usually to the school nurse or building administrator. Keep a copy.¹

How Schools Review the Request

Turning in the form is not the same as approval. The school’s principal or person in charge makes the final decision on whether the documentation meets the regulatory requirements, and can ask the physician for additional supporting information.⁶ For schools outside New York City, the NYSDOH Bureau of School Immunizations reviews exemptions and evaluates whether the stated contraindication is valid under ACIP or another nationally recognized standard. If it doesn’t meet those criteria, the school can deny it.³

Two rules apply no matter what condition is involved. First, the exemption has to be reissued every year, even when the underlying condition is permanent. Your physician provides a fresh signed form each school year.⁶ Second, a child cannot attend school for more than 14 calendar days without proof of immunization or an accepted exemption. Students transferring from out of state or another country who show a good-faith effort to get their records can be given up to 30 days.⁷

If the school finds the form insufficient, it can keep the child out of attendance until the paperwork issue is resolved. Start the process well before the school year begins.

College and University Students

Post-secondary students born on or after January 1, 1957, must show immunity to measles, mumps, and rubella under Public Health Law Section 2165. The scope is narrower than for K-12: three diseases, not the full childhood schedule.²

Two practical differences from the K-12 process. A nurse practitioner can sign the exemption, not just an MD or DO. And there is no state-issued form comparable to the DOH-5077; each institution sets its own documentation. The certifying provider states that the immunization is medically contraindicated or detrimental to health, and the exemption stays in effect until the condition changes. Individual colleges may add requirements beyond the state minimum, particularly for students in campus housing, so check with the school’s health services office.²

Employer Exemptions

Employment vaccine exemptions do not run on a single state form or a single process. Which vaccines, which employer, and which industry all matter.

General Employment

When a job requires vaccination, an employee with a medical contraindication can request a reasonable accommodation. The usual supporting document is a letter from a licensed physician that identifies the employee, the physician’s credentials, the specific medical condition, the vaccines covered, and why vaccination is medically inadvisable.

After receiving that documentation, the employer should engage in a cooperative dialogue to figure out whether a reasonable accommodation is available without an undue hardship on the business or a direct threat to the health of others. Possibilities include masking, remote work, regular testing, or reassignment. An employer can deny the request if no workable option exists, but the decision has to rest on an individualized assessment rather than a blanket rule.

Healthcare Workers

Healthcare workers face broader mandates. New York requires that personnel at hospitals, nursing homes, diagnostic and treatment centers, home health agencies, and hospices demonstrate immunity to measles and rubella. Facilities licensed under Article 28 or Article 36 of the Public Health Law also have to document each employee’s influenza vaccination status every year, and unvaccinated staff must wear a surgical mask in patient areas during flu season. Long-term care facilities, adult homes, and adult day healthcare programs must provide or arrange for annual influenza vaccination and pneumococcal vaccination where recommended by ACIP.⁸

A healthcare worker seeking an exemption should route the request through the facility’s occupational health or human resources office. When an exemption is granted, the facility usually imposes alternative infection-control measures like masking or added screening.

An Approved Exemption Doesn’t Guarantee Attendance During Outbreaks

New York regulations allow schools to exclude unvaccinated students during an outbreak of a vaccine-preventable disease, even when those students hold valid medical exemptions. If a case of measles or chickenpox appears at your child’s school, expect that a medically exempt child may be sent home until the outbreak is declared over. The length of the exclusion turns on the disease’s incubation period and the local health department’s assessment.

Religious Exemptions for Schools No Longer Exist

On June 13, 2019, New York repealed the religious exemption from school vaccination requirements.⁹ Subdivision 9 of Public Health Law Section 2164, which had provided that exemption, was eliminated.¹⁰ For K-12, a medical exemption is now the only legal path. Religious exemptions still exist for college students under Section 2165. For employment, religious accommodation requests remain available through anti-discrimination law.

If the Exemption Is Denied

A denial is not the end of the road, but the appeal path depends on the setting.

School Denials

For schools outside New York City, a parent has 30 days from receiving the school’s written denial to file a Section 310 appeal with the New York State Commissioner of Education. Filing instructions are on the State Education Department’s website, and SED Student Support Services can be reached at 518-486-6090. For schools in New York City, appeals go through the Office of School Health at (718) 391-8383.³

Once administrative appeals are exhausted, a parent can file an Article 78 proceeding in New York State Supreme Court, which asks a judge to review whether the administrative decision was arbitrary, an abuse of discretion, or made in violation of lawful procedure. The filing fee is $210.¹¹

Employment Denials

An employee whose exemption request was improperly denied can file a disability discrimination complaint with the New York State Division of Human Rights. Filing is free and does not require an attorney. For discriminatory acts on or after February 15, 2024, the deadline is three years from the most recent act. The starting point is a call to (844) 697-3471, where an agent walks you through the report. The Division then reviews whether the situation falls under the state Human Rights Law, formalizes the complaint if it does, and investigates. Investigations run several months at minimum, sometimes longer.¹²

1
New York State Department of Health. Immunization-Related Medical Exemptions for School-Aged Children
2
New York State Senate. New York Public Health Law 2165 – Immunization of Certain Post-Secondary Students
3
New York State Department of Health. Medical Exemption Review Procedures for Schools Outside New York City
4
Centers for Disease Control and Prevention. Contraindications and Precautions – Vaccines and Immunizations
5
New York State Department of Health. Immunization Requirements for School Attendance – Medical Exemption Statement for Children 0-18 Years of Age
6
New York Codes, Rules and Regulations. New York Codes, Rules and Regulations Title 10, Section 66-1.3 – Requirements for School Admission
7
New York State Department of Health. Dear Superintendent/Principal/School Nurse Regarding Public Health Law 2164(7)(a)
8
New York State Department of Health. Health Care Personnel
9
New York State Department of Health. Statement on Legislation Removing Non-Medical Exemption
10
New York State Senate. New York Public Health Law 2164 – Immunization Requirements
11
New York State Unified Court System. Commencement of Cases
12
Division of Human Rights. Report Discrimination