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Immunization Exemption

Vaccination programs are important to military public health and readiness. Sometimes, however, an individual may be considered exempt from a particular vaccination. There are two general types of vaccine exemptions: medical and administrative. A medical exemption must be validated by a DOD or USCG health care professional. An administrative exemption is a non-medical function that may be considered by an individual's command or employer.

What are the different types of immunization exemptions in the military?

Note: The following descriptions and terminology apply to immunization requirements for military service members and federal civilian employees who support the military. Although the principles of immunization exemption may apply to other vaccine requirements (e.g., schools or other employment), please consult your organization’s specific policies on this topic.

There are two types of exemptions from immunization: medical and administrative. Reviewing medical exemptions is a medical function; and reviewing administrative exemptions is a personnel function. Supporting documentation for medical exemptions will be maintained within the medical records, and supporting documentation for administrative exemptions in personnel records.

Medical

  • A medical exemption includes any medical contraindication relevant to a specific vaccine or other medication. Health care providers will determine a medical exemption based on the health of the vaccine candidate and the nature of the immunization under consideration
  • Clinicians may obtain consultation with a specialist when assessing the appropriateness of a medical exemption

Administrative

  • Planned separation or retirement within 180 days, service personnel may be exempt from deployment (mobility) immunizations provided the following conditions are met:
    • Service personnel is not currently 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
  • Thirty days or fewer of service remaining, civilian employees and contractor personnel who will leave a permanent (other than OCONUS deployments) assignment subject to immunization within 30 days or fewer
  • Other administrative exemptions as described in Appendix C (Joint Instruction (AR 40-562, BUMEDINST 6230.15B, AFI 48-110_IP, CG COMDTINST M6230.4G) Immunizations and Chemoprophylaxis for the Prevention of Infectious Diseases)
  • Religious:
    • Granted according to service-specific policies
    • Command decisions may be made with medical, judge advocate and/or chaplain consultation

Reference: Joint Instruction (AR 40-562, BUMEDINST 6230.15B, AFI 48-110_IP, CG COMDTINST M6230.4G) Immunizations and Chemoprophylaxis for the Prevention of Infectious Diseases.

How is an exemption documented?

Electronic and paper health records must annotate medical exemptions.

All exemptions, administrative or medical, must be documented in the immunization section and clinical notes of individual medical records. For military members, exemptions must also be documented in readiness systems (Navy/Marine Corps/Coast Guard Medical Readiness Reporting System, Army Medical Protection System, or Air Force Aeromedical Services Information Management System).

What happens when patients disagree with an exemption decision?

Military members should follow guidance from their chain of command for appealing an exemption decision. Federal civilian employees should work within their respective commands to appeal decisions about vaccine exemption. Healthcare providers who have clinical questions about whether or when to authorize medical exemptions from vaccination may consult directly with specialists.

Exemption Codes

Find codes for medical and administrative exemptions.

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Last Updated: January 23, 2025
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