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Pennsylvania State Exemption Page
VacLib.org & VaccineTruth.net Exemption Page

Statutes/Laws
Link to state law.
National Vaccine Information Center:
Link to state law.


For additional help with exemptions, birth plan,etc questions:
Non_Vaccinating_Physicians

Check our Vaccination Liberation State Chapter and other resource organizations page for help in your state.

If your state specific help is not available, Contact us.


Available Exemptions
Medical  &  Religious


Religious exemption. Children need not be immunized if the parent, guardian or emancipated child objects in writing to the immunization on religious grounds or on the basis of a strong moral or ethical conviction similar to a religious belief.

PDF documents (.pdf)

A PDF reader is required for PDF Files:
Free Foxit Reader 12 MB file size.

Or Free Download of Acrobat Reader: [Adobe. 43 MB file size]



NewBorn Birthing Plan and Birth Exemptions
BirthExemptions  |   Birthing_Plans  |   Vitamin_K  |   Hepatitis_B  |   Eyedrops  |   Newborn_Screening

Birth Exemptions:
Religious Exemption from Newborn Screening Allowed...
For those who are planning a hospital birth but want to evade invasive routine post natal procedures such as a Hep B shot, vitamin K injection, newborn screening, or the application of silver nitrate in the newborn's eyes, a very specific birthing plan must be submitted to the hospital in advance of the birth. Hospital staff must be informed, in advance, of your needs, wants and desires where your baby and birthing experience are concerned. The same applies to midwives.

Steps:
  • Create the Birthplan. Or modify one of our ours to fit your state laws and any other personal circumstances. (see below)

  • Sign the birthplan in front of a Notary.

  • Submit the birth plan to your hospital or midwife. Keep a couple extra copies in case plans change.

  • Make sure affected parties (doctors, nurses, etc) understand your requirements and wishes.
  • .
  • Plan on having one or two trusted persons stay with the mother and child to watch the child at all times while in the hospital, so no unwanted injections are given the baby.

  • The birth plan arrangements and letter should be turned in before delivery date.

  • The "Refusal to Permit Medical Treatment" form below is optional.

Birth Plans (To be used with hospitals and/or midwives)
(Links to model birth plan letters)

Model Birth Plan Letter for Hospital Births. You can attach an exemption from immunizations. In some states, there are religious exemptions from newborn screening tests such as PKU, etc...

Information on the Dangers of Hospital Birth and the Benefits of Home Birth from gentlebirth.org

Our best and most itemized birthplan:
Word-Document (.doc) birthplan-itemized.doc  |   PDF-Document (.pdf) birthplan-itemized.pdf

(HTML) BirthPlan-Itemized for reading on screen. Includes handy small dictionary of terms in the document.

Word-Document (.doc) Model Letter for Hospital Births (Model11425.doc)

Model Birth Plan Letter for Hospital Births. This one is more detailed.

Word-Document (.doc) Model letter for hospital births 2.doc (11426)

Model Birth Plan Letter for Hospital Births for an adopted child...
Model letter for hospital births for adoptions -- Dear Doctor and Medical Staff.doc (11427)
Word-Document (.doc) Model letter for hospital births for adoptions.doc


The birth plan arrangements and letter should be turned in before delivery date.
This "Refusal to Permit Medical Treatment" form below is optional.

"Refusal to Permit Medical Treatment" form
A generic form.
PDF-file (.pdf) letters/refusal_treatment.pdf

It would be good idea to use the AFFIDAVIT below AND a model birth plan letter from above.
Affidavit - Birth Exemptions
HTML (simple text) Affidavit to modify.

AFFIDAVIT in Microsoft Word Word-Document (.doc) format. (may be modified)

Replace the paragraph (near bottom of page 1) of the generic AFFIDAVIT above with your state law as follows: [Make sure you replace with your name, status, and name of child.]

(We / I) {First and Last name(s)}, as the {(parent (s) / guardian(s)} of ______________________(name of newborn child) are exercising (our/my) rights under the US Constitution, PA. CODE § 23.84, PA. CODE § 28.12(b) and PA. CODE §27.98(b) to receive Religious Exemption from Vaccination, ALL injections, prophylaxis, & testing.

If your Title and Paragraph number of your state law is not pasted above, click here for the link to your state law.

Vitamin K Injection...

The prescribing information on Vitamin K shot states that fatalities are an adverse reaction according to the Merck pharmaceutical package insert.
http://fdb.rxlist.com/drugs/drug-9003-Aqua-Mephyton+Inj.aspx?drugid=9003&drugname=Aqua-Mephyton+Inj
"The injectable form of vitamin K can rarely cause severe (sometimes fatal) allergic reactions when given by injection into a muscle or vein. Therefore, vitamin K should be injected into a muscle or vein only when it cannot be given by injection under the skin or taken by mouth, or when your doctor has judged that the benefit is greater than the risk. Seek immediate medical attention if you experience symptoms of an allergic reaction such as rash, itching, swelling, dizziness, or trouble breathing."
Potential exists for the newborn to experience hypersensitivity to any component of this medication.
Each milliliter contains: Phytonadione ............. 2 mg or 10 mg
Inactive ingredients:
Polyoxyethylated fatty acid derivative ................... 70 mg
Dextrose...................................................................... 37.5 mg
Water for Injection, q.s. .................................................. 1 mL
Added as preservative: Benzyl alcohol ...................... 0.9%

Links to prescribing information for Vitamin K:
http://vaclib.org/chapter/inserts.htm#vitK

Archive: Year 2002 Merck Vitamin K Package Insert - Aquamephyton PI | posted on Scribd

Alternatives to Vitamin K Prophylaxis...

Although oral vitamin K is not licensed for use as a drug by the FDA, drops for oral administration are available. Typically, one drop contains 2 mg. of vitamin K. Contact a midwife in your area, or a birthing supply company (such as birthwithlove.com), or Scientific Botanicals (206 527-5521) where your health care provider can order liquid vitamin K directly.

Here's another much safer alternative that your chiropractor or naturopath can order for you. Or order directly from Amazon.com

Biotics Research, Bio-K Mulsion - 1 fl oz

A good organic whole food diet along with lots of leafy green vegetables is all that is necessary to prevent vitamin K deficiency in newborns.


Pennsylvania: Hepatitis B Vaccine

§ 27.99. Prenatal examination for hepatitis B.
(a) A physician who attends, treats or examines a pregnant woman for conditions relating to pregnancy during the period of gestation or delivery, shall inform the woman that the physician intends to take or cause to be taken, unless the woman objects, a sample of her blood at the time of the first examination (including the initial visit when a pregnancy test is positive) or within 15 days thereafter, but no later than the time of delivery, and shall submit the sample to a clinical laboratory approved by the Department to conduct immunologic testing.

(b) When a pregnant woman tests positive for hepatitis B surface antigen, a physician shall provide the appropriate prophylactic treatment to the newborn within 12 hours after birth. If the parent or guardian of the newborn child objects on the ground that the prophylactic treatment conflicts with the parent’s or guardian’s religious beliefs or practices, prophylactic treatment shall be withheld, and an entry in the child’s hospital record indicating the reason for withholding treatment shall be made and signed by the attending physician and the parent or guardian.

http://www.pacode.com/secure/data/028/chapter27/chap27toc.html#27.99.

§ 23.84. Exemption from immunization. [28 PA. CODE CH.23]
(b) Religious exemption. Children need not be immunized if the parent, guardian or emancipated child objects in writing to the immunization on religious grounds or on the basis of a strong moral or ethical conviction similar to a religious belief.


General Information: Hepatitis B Vaccine
Most states now require the Hepatitis B vaccine for newborns. Many parents are also cornered by emergency room personnel during accident visits. Hospitals nationally are under pressure to utilize every opportunity to score a "hit." If your pediatrician understands your views, get him involved with the hospital. As a last resort, protect your right to receive quality care in by asking hospital personal to sign the following waiver. Usually, you'll never find anybody in the hospital to sign this simple form, but you well get relief from demands to vaccinate your child.

"I certify that the (Name of Vaccine)________ vaccine being administered to (Name of Child)_________ is free from all known and yet unknown zoonotic or human viruses or viral fragments and will not cause acute or chronic illness in the recipient due to viral contamination or as a reaction to the components of this vaccine. (Signature of Physician and Date)_________."

If you do get a signature, hold on to the form.

See Birth Plans for more information on avoiding Hep B Vaccination at birth

Eyedrops:
Pennsylvania: See Screening, below, for religious exemption.

Eyedrops [General]
Some states require Prophylaxis against Gonococcal OPHTHALMIA NEONATORUM.

A discussion of medical and legal issues regarding Silver Nitrate in the eyes of the newborn is here:
PDF file: Statutory Law USA: Requiring Silver Nitrate in Eyes of Newborns at: http://www.rbs2.com/SilvNitr.pdf
Written by Dr. Ronald B. Standler, attorney in Massachusetts and consultant

Blog type discussion of pros and cons of eyedrops for newborn is here: http://answers.google.com/answers/threadview/id/20050.html


New Born Screening
Religious Exemption from Newborn Screening Allowed...

New Born Screening
§ 28.12. Religious objections
.
(a) A health care provider may not collect or cause to be collected, a specimen from a newborn child if the parent or guardian of the newborn child objects on the ground that the specimen collection conflicts with religious beliefs or practices held by the parent or guardian.

(b) If the parent or guardian of the newborn child objects to the collection of the specimen for screening on the ground that the specimen collection conflicts with religious beliefs or practices held by the parent or guardian, the health care provider shall ensure that the recorded objection of the parent or guardian is entered into the medical record of the newborn child. The entry shall include a written statement of the objection signed by the parent or guardian.

http://www.pacode.com/secure/data/028/chapter28/s28.12.html

(.pdf) Entire CHAPTER 28. SCREENING AND FOLLOW-UP FOR DISEASES OFTHE NEWBORN

Eye Prophyalaxis...

§ 27.98. Prophylactic treatment of newborns.

(a) Physicians and midwives attending women in childbirth shall instill in each eye of the newborn child, as soon as practicable after birth, either a 1% silver nitrate solution, or erythromycin ophthalmic ointment or solution as a single application in both conjunctival sacs, or appropriate medication approved by the Department.

(b) If the parent or guardian of the newborn child objects on the ground that the prophylactic treatment conflicts with the parent’s or guardian’s religious beliefs or practices, or if in the opinion of the attending physician treatment is not advisable, prophylactic treatment shall be withheld.

(c) An entry in the child’s hospital record indicating the reason for withholding treatment shall be made and signed by the attending physician and the parent or guardian.

http://www.pacode.com/secure/data/028/chapter27/chap27toc.html#27.98.

§ 501.49. Newborn infant care policies and procedures.

(2) Medication approved by the Department in § 27.98. (relating to prophylactic treatment of newborns), shall be instilled in the eyes of the newborn infant according to statute. If the parent or guardian of the newborn child objects on the ground that the prophylactic treatment conflicts with the parent's religious beliefs or practices, prophylactic treatment will be withheld, and an entry in the child's record indicating the reason for withholding treatment shall be made and signed by the Physician Director of Medical Affairs and the parent or guardian of the newborn infant.

(4) The birth center shall explain to the mother the purpose and nature of the screening tests for diseases of the newborn, required by Chapter 28 (relating to screening and follow-up for diseases of the newborn), give her an informational pamphlet provided by the Department, inform her of her right to refuse the tests because of religious beliefs or practices, and see that the recorded written objection is entered into the medical record of the newborn child and signed by the parent or guardian, if screening is refused.

http://www.pacode.com/secure/data/028/chapter501/s501.49.html

General Information for USA: New Born Screening
U.S. states now require screening of newborn babies for specific diseases.

Conditions and legal status of "requirement" of newborn to be screened for each state:
National Newborn Screening Status Report - http://genes-r-us.uthscsa.edu/sites/genes-r-us/files/nbsdisorders.pdf

Newborn Genetic Screening Privacy Laws
(includes links to laws for various states)
Archived Copy: http://web.archive.org/web/20130603035608/http://www.ncsl.org/issues-research/health/newborn-genetic-and-metabolic-screening-laws.aspx

Newborn screening From Wikipedia, the free encyclopedia
http://en.wikipedia.org/wiki/Newborn_screening

Federal NewBorn Screening Law (from Families of Spinal Muscular Atrophy)
http://www.fsma.org


Waivers - Take Care In Signing
If you take your new baby to an MD as opposed to a naturopath and/or chiropractor, please be aware of and careful of any forms you sign.

Our WARNING below is about signing (some) state approved and AAP created forms. See this letter from our director, Ingri Cassel, before you consider signing waiver forms.

WARNING!

Dear VacLib Members and Friends -

Wanted to give you all a heads up on state issued exemption forms. I haven't had to deal with this personally for several years, and I always crossed out sentences or clauses, and often adding some of my own, before signing their exemption of medical release type of forms. When Donna Carrillo began to diligently search out existing exemption forms and posting them, I read over a couple of them and encouraged people to make up their own whenever possible. After having a "closer encounter" with such a form - a form provided to the state of Idaho by the American Academy of Pediatrics and the Centers for Disease Control and Prevention and used by licensed Idaho daycares, I was shocked into the VERY REAL danger of signing these forms without changing them significantly.

Any form one affixes their initials to, dates and affixes their signature to at the end is a LEGAL document. All statements prior to your signature you must agree to fully OR restrict your signature to say that you are signing under TDC - threat, duress, and coercion. The form that my daughter was told she needed to fill out for this daycare is posted here: ChildCareExemptForm.pdf. On this form, she crossed out all the "nots" and in her personal statement she further clarified that she understands fully the risks of vaccinating her child.

I have since found out that most public schools and daycares in other states also use a similar form. Basically, by initialing and signing this form as is, you are admitting to understanding that "vaccine preventable" diseases are extremely deadly and ALSO admitting to negligence for willfully denying your son/daughter the life saving protection that vaccines offer. These forms are MEANT to not only be intimidating but to catch the legally ignorant off guard. This is very serious to me since all states have adopted the federally funded Child Abuse Prevention and Treatment Act which gives states the right to literally steal your children for up to 48 hours -- the time they have to prove child neglect OR abuse.

If it were ME, I would insist that they accept a form that I provide them since it satisfies the law. If there are any problems or they insist on me using their form, I would cite the law and ask the school or daycare provider where it actually says in state statute that this particular form is the only form that will satisfy the law. Since your parental rights are at stake here, it is best to be vigilant and err on the side of being overly cautious.


A modified AAP form is posted here that you may wish to use with your doctor: AAPmodified.htm

AAPmodified.doc MSWord .DOC file  |   AAPmodified.pdf PDF file, best for printing.

Not all State employees are aware of the law and many exhibit the Hitler Complex. Take a firm stand. Some individuals have had difficulty getting the required forms. Such arrogance on the part of State employees should be reported to the Director of your state Department of Health.

See:   AnaiRhoads.org Why Signing a Waiver to Avoid Vaccines Can Be Considered Abuse
She is referring to the Refusal To Vaccinate Form developed by The American Academy of Pediatrics, not a regular religious or conscientious exemption letter or form.



Letters Forms Affidavits
Links to Model birth plan letters (above).

Link to Refusal to Permit Medical Treatment form

Links to Affidavit - Birth

An Adult Affidavit, with Christian beliefs, is here. (MSDOC file) Feel free to modify as needed.


Dr. Tenpenny has the following forms on her web site. The forms are generic and may be used in any state.

Affidavit for Parents Participating in International Adoption (Word) (pdf)
Hep B vaccine in hospital for newborn refusal, sample (pdf)
OSHA Declination Statement Form (also, pdf)
Religious exemption letter that was approved in Florida (Word) (pdf)
School Vaccine Exemption Form, sample (Word) (pdf)
TB testing refusal, sample (pdf)
Childcare and School Immunization Requirements

http://drtenpenny.com/forms/

Sample Vaccine Letters. from www.vaccines.bizland.com/letters.htm archived on VacLib.org/letters/doctor.htm

Short Sample Vaccine Letter

Most states now require the Hepatitis B vaccine for newborns. Many parents are also cornered by emergency room personnel during accident visits. Hospitals nationally are under pressure to utilize every opportunity to score a "hit." If your pediatrician understands your views, get him involved with the hospital. As a last resort, protect your right to receive quality care in the following manner. (Usually, you'll never find anybody in the hospital to sign this simple form):

"I certify that the (Name of Vaccine)________ vaccine being administered to (Name of Child)_________ is free from all known and yet unknown zoonotic or human viruses or viral fragments and will not cause acute or chronic illness in the recipient due to viral contamination or as a reaction to the components of this vaccine. (Signature of Physician and Date)_________."

If you do get a signature, hold on to the form.

The ACCEPTANCE OF RESPONSIBILITY is imperative in exercising your rights for legal exemptions from forced medical experimentation and legalized bioterrorism. DO be prepared to fight for your baby's rights!
An index page to various Acceptance of Responsibility) forms is here:
. http://www.vaclib.org/legal/accept.htm

Religious exemption forms will be listed below under Daycare Schools Colleges

Did not find your state exemption form on our site?
Then try this link to forms for all 50 states and D. of Columbia.
http://experimentalvaccines.org/vaccine-exemption-forms/



DayCare - Preschool - Schools - Colleges
DayCare-Preschool-K-12-Colleges
DayCare  |   Preschool  |   K thru 12  |   Colleges



Kindergarten & Schools
See Pennsylvania forms information below.

Homeschool
The following is a version of the medical exemption form one can file with their affidavit instead of filing other more specific medical forms. The version below is from The Pennsylvania Home Education Handbook by Diana Baseman, with permission from the author.

Available here in 3 file formats for offline reading or printing. Everyone should be able to view at least one of them.
Rich Text Format: (.rtf) http://www.phen.org/medexemp.rtf
Microsoft Word: (.doc) http://www.phen.org/medexemp.doc
PDF: (.pdf) http://www.phen.org/medexemp.pdf

PHEN- home education affidavit... http://www.phen.org/affidavit.html
Available here in 3 file formats for offline reading or printing. Everyone should be able to view at least one of them.
affidavit in .pdf (Adobe Acrobat) format. (.pdf) http://www.phen.org/affidavit.pdf
affidavit in .doc (Word for Windows) format. (.doc) http://www.phen.org/affidavit.doc
affidavit in .rtf (rich text) format. (.rtf) http://www.phen.org/affidavit.rtf
Your notarized affidavit should include an outline of proposed education objectives by subject area and be accompanied by your medical papers or exemption. Objectives... http://www.phen.org/objectives.html
Pennsylvania Home Education Network: http://www.phen.org/


Pennsylvania Forms
State Form Required: No, just a written statement from parent, or so says the law. The law also specifies: "All certificates of immunization shall be issued in accordance with the rules and regulations promulgated by the Secretary of Health..." And the The Certificate of Immunization has spaces for both the religious and medical exemption on the bottom. See Public Schools, below.

§ 23.45. Objections to examination on religious grounds.
(a) School children or school employes may be excused from regular or special medical or dental examinations on presentation of written evidence to the school administrator that the examinations are contrary to the religious beliefs of the parent or guardian of the child or of the employee.

(b) Exemption from medical or dental examinations will not be granted if the Department of Health finds that facts exist under which the exemption constitutes a present substantial menace to the health of other persons exposed to contact with the unexamined person.

§ 23.84. Exemption from immunization. [28 PA. CODE CH.23]
(b) Religious exemption. Children need not be immunized if the parent, guardian or emancipated child objects in writing to the immunization on religious grounds or on the basis of a strong moral or ethical conviction similar to a religious belief.


Use one of the exemption letters below...

§ 23.45. Objections to examination on religious grounds.
(a) School children or school employes may be excused from regular or special medical or dental examinations on presentation of written evidence to the school administrator that the examinations are contrary to the religious beliefs of the parent or guardian of the child or of the employee.

(b) Exemption from medical or dental examinations will not be granted if the Department of Health finds that facts exist under which the exemption constitutes a present substantial menace to the health of other persons exposed to contact with the unexamined person.

§ 23.84. Exemption from immunization. [28 PA. CODE CH.23]
(b) Religious exemption. Children need not be immunized if the parent, guardian or emancipated child objects in writing to the immunization on religious grounds or on the basis of a strong moral or ethical conviction similar to a religious belief.


And see Pennsylvania code 23.45 regarding Objections to examination on religious grounds. http://www.pacode.com/secure/data/028/chapter23/chap23toc.html#23.45.

Also see TB testing requirements

Public schools:
STATE Form:
The state has, The Certificate of Immunization, which has room for both the medical and religious exemption on the bottom of the page.

A single page PDF with the exemption form is here:
sainthilaryschool.com/aboutourschool/Forms/PA%20Dept%20of%20Health%20-%20Certificate%20of%20Immunization.pdf

You may also obtain the exemption form by printing the page labeled Appendix B, page 21 in the PDF obtained here:
(Because of the cover page, my PDF reader said it was page 22)
http://www.portal.state.pa.us/portal/server.pt/document/1086393/2011_immunization_school_procedure_manual_pdf

If you take a religious exemption, apparently you must fill in the form and state your reason for exempting. The medical exemption requires a doctors signature.

If you need ideas for your religious exemption, here are older letters/forms to choose from...
PA Hepatitis B vaccine exemption letter.
(.doc) VaccineTruth.net/letters/PennsylvaniaHebB10985.doc

PA Religious Exemption Letter for all vaccines.
(.doc) VaccineTruth.net/letters/Pennsylvania10986.doc

Statement Of Religious Objection To Immunization in Pennsylvania.doc (with scriptures).
(.doc) VaccineTruth.net/letters/PennsylvaniaStatement10987.doc

An old Pennsylvania Exemption Form...
http://www.unhinderedliving.com/Vaccine.jpg

Here is a sample form that can be used from http://www.marysherbs.com/Miscellaneous/v-e-formP.htm

Colleges/Universities
Pennsylvania colleges and university on-campus housing
1. ... required to provide information on meningococcal disease and vaccine.
2. Non-vaccinated students are prohibited from living in University-owned house unless a waiver is sign.
3. ...can sign an exception waiver stating that the information was received and reviewed, and that the vaccination was declined for religious or other reasons. The University may permit the student to then reside in on-campus housing accommodations once the waiver is received.
Source: http://www.hfs.psu.edu/Altoona/HousingContracts/terms-and-conditions.cfm/#11

Widener University...
Religious Exemption
If you are requesting an exemption from fulfilling the university required vaccines based upon religious reasons, you must provide a letter from your church, which states that it is the belief (or doctrine) of that church to recommend against medical vaccinations, and that you are an active member of the church in good standing. The designated religious leader of your church must write the letter on your place of worship's letterhead, which should include his/her address and telephone number.
You must also complete a Religious Exemption Form, which will be sent to a student upon request. Call Student Health Services Department at 610-499-1183.
Rev. 5/02

See AFFIDAVIT and good religious reasons below...

DeSales University
2755 Station Avenue
Center Valley, PA 18034
(610) 282-1100
DeSales University Meningitis Vaccine Waiver Form
(.pdf) http://www.desales.edu/assets/desales/MeningitisWaiver.pdf

Seton Hill University | One Seton Hill Drive | Greensburg, PA | 15601
Statement of Exception to College and University Student Vaccination Act
(.pdf) http://old.setonhill.edu/forms/wc_exemption_form1.pdf

University of Pennsylvania Immunization Requirements and Exemptions.
http://www.vpul.upenn.edu/shs/immunization.php

Student Health Services
Gannon University
109 University Square
Erie, PA 16541-0001
Information Website
(.PDF) http://www.gannon.edu/
University-owned housing: Students may sign a waiver and request an exemption from this mandate if the student (or parent, if the student is a minor) provides a signature as to the reason (i.e., religious or medical reason).

Student Health Service
University of Pennsylvania Immunization Requirements and Exemptions.
http://www.vpul.upenn.edu/shs/immunization.php
Includes links to Meningococcal requirement and waiver. Also TB requirements.
Meningococcal waiver.
http://www.vpul.upenn.edu/shs/files/meningwaiver2011.pdf

Only targeted TB testing for University of Pennsylvania http://www.vpul.upenn.edu/shs/tuberculosis.php

Penn State University:

Penn State University Meningococcal Waivers:
Must be filled in online: http://studentaffairs.psu.edu/health/myUHS/

Penn State University Meningococcal Waiver (The Milton S. Hershey Medical Center, The College of Medicine) http://www.hfs.psu.edu/HFS/Vaccine/index.cfm
To comply with this law, the student must submit his/her acknowledgement of this requirement online through University Health Services. The student will certify that he/she has received the meningococcal vaccination or is requesting a waiver to the requirement.

Penn State University - other vaccines. (d) Individuals requesting exemptions for medical or religious reasons will need approval by the Director of University Health Services. No downloadable exemption forms available for other vaccines. You'll have to write your exemption for the other vaccines.


Good religious reasons...

These constitute good reasons when a school or college asks for your religious reason on a form that says, state your reason here, attach rationale, or state why a particular vaccination is contrary to your religious beliefs, etc...

Often you will be requested to state your rationale for your vaccination exemption petition. What follows is what is used for public schools, parochial schools, private colleges, and public universities.

Q: What constitutes a religious conflict with vaccination?

A: All vaccines are made in violation of God’s Word. Vaccines are made with toxic chemicals that are injected into the bloodstream by vaccination. All vaccines are made with foreign proteins (viruses and bacteria), and some vaccines are made with genetically engineered viral and bacterial materials.

A conflict arises if you believe that man is made in God’s image and the injection of toxic chemicals and foreign proteins into the bloodstream is a violation of God’s directive to keep the body/temple holy and free from impurities.

Vaccines are produced in animal tissues. A conflict arises if you accept God’s warning not to mix the blood of man with the blood of animals. Some vaccines are produced in aborted fetal tissue.

A conflict arises if your religious convictions are predicated on the belief that all life is sacred. God’s commandment “Thou Shall Not Kill” applies to the practice of abortion. When it is believed that the practice of abortion should not be encouraged or supported in any manner, a conflict may arise with vaccines produced in aborted fetal tissue even though you didn’t have anything to do with the abortions from which the vaccines are made from.

The Hepatitis-A vaccine containing MRC-5 is obtained from human babies that were electively aborted. WI-38 was created from the tissue of an aborted fetus and is used for the rubella portion of the MMR-II vaccine. RA 273 was created from the tissue of an aborted fetus, and is used for MMR-II vaccine. A conflict arises because my religious convictions are predicated on the belief that all life is sacred. God's commandment "Thou Shall Not Kill" applies to the practice of abortion. The acceptance of this/these vaccine(s) promotes/promote abortion and violates the Sixth Commandment of "Thou Shall Not Kill".

The Chickenpox (Varivax) vaccine containing MRC-5 and RA 273, is obtained from human babies that were electively aborted. The acceptance of this vaccine promotes abortion and violates the Sixth Commandment of "Thou Shall Not Kill".

The Hepatitis-B vaccine protects against a disease that is only transmitted through multiple sexual partners or street IV drug users. The acceptance of this vaccine promotes sexual promiscuity and immoral behavior in direct contradiction to the teachings of my faith.

For a child under age 18, where parent has to make the statement, concerning Hep B vaccine...
The Hepatitis-B vaccine protects against a disease that is only transmitted through multiple sexual partners or street IV drug users and therefore usurps my parental authority to condemn such activity in my child. The acceptance of this vaccine promotes sexual promiscuity and immoral behavior in direct contradiction to the teachings of our faith.

”I believe that inherent in each individual is an innate intelligence, provided by God, which will protect the host environment and provide homeostasis.” “Life and physical health are precious gifts entrusted to us by God. We must take reasonable care of them…” [2288 – Catechism of the Catholic Church 1994]

“The virtue of temperance disposes us to avoid every kind of excess: the abuse of … medicine.” [2290 – Catechism of the Catholic Church 1994]

(Indicate rationale and attach statement from clergy or other authority.)
You do not need to belong to a church or religious organization to claim religious exemption from vaccines.

Applicable law has been interpreted to mean that a religious belief is subject to protection even though no religious group espouses such beliefs or the fact that the religious group to which the individual professes to belong may not advocate or require such belief. Title VII of the Civil Rights Act of 1964 as amended Nov. 1, 1980; Part 1605.1-Guidelines on Discrimination Because of Religion.

Our legal rights are guaranteed by the free exercise clause of the First Amendment to the U.S. Constitution. Recent court decisions have upheld the rights of individuals seeking exemptions from immunizations based upon personal and religious reasons. On the U.S. Supreme Court level in Frazee V. Illinois Dept. of Security, 489 U.S. 829, it was found that a state may not deny an exemption simply because a person is not a member of a formal religious organization.


An Adult Affidavit, with Christian beliefs, is here. (MSDOC file) Feel free to modify as needed.


OptOutRegistry for Vaccines
and various other Opt-Outs
Vaccine Registry Opt-Outs:

KNOW YOUR RIGHTS
Confidentiality of Your Child’s Vaccination Records
FERPA: The Family Educational Rights and Privacy Act
http://www.vaxchoicevt.com

     - - - - Other Opt-Outs - - - -:

Birth Certificate and Marriage License Opt-Out:

Did you know that you can REFUSE to sign the hospital birth certificates and that there is no law that requires you to do so?
See: Marriage Licenses, Birth Certificates & #SSNs

Military Recruiters:

STUDENT OPT OUT FORM regarding the
RELEASE OF NAME, ADDRESS, AND TELEPHONE NUMBER TO MILITARY RECRUITERS
(.pdf) (.pdf) Archived letter from www.militaryfreeschools.org

UNDERGROUND ACTION ALLIANCE STUDENT OPT OUT FORM
Word-Document (.doc) Archived on VacLib.org: http://veterans4peace.org/opt_out.doc

SAMPLE ENGLISH - BILINGUAL FORMS FOR OPTING OUT
Act to Protect Your Privacy from Military Recruiters
Information links and forms at AFSC site

STUDENT OPT-OUT - Google Search

STUDENT OPT-OUT NOTICE regarding the instruction of sexuality to children:
STUDENT OPT-OUT NOTICE Valid in all 50 states
PDF-file (.pdf) http://www.catholiccitizens.org/content/img/f26422/opt%20out%20notice.pdf

STUDENT OPT-OUT NOTICE - Google Search



Employment
Suggestions for dealing with Employer Mandates.

OSHA
Standard Interpretations
09/23/1997 - The Bloodborne Pathogen Standard and the Enforcement Procedures for TB.
"Finally, be aware that participation in the employer's skin testing program is voluntary on the part of the employee. OSHA does not require that employees participate in TB skin testing, only that the employer make such skin testing available to employees."
See TB Testing for more information.

US Fish and Wildlife Service Form 3-2283
Hepatitis B Immunization Consent/Refusal Form
PDF-file (.pdf) http://www.fws.gov/forms/3-2283.pdf

Click here for an Affidavit for Adult (college & employment religious exemption) ... Edit as needed...



TB and/or Lead Testing

§ 23.9. Tuberculosis tests.

 (a)  Pupils to be tested. A test for tuberculosis shall be administered upon original entry into school, and in grade nine by a tuberculin test.

 (b)  Testing methods. The tuberculin test may be administered by either the multiple puncture method or by the Mantoux test using intermediate strength tuberculin (PPD 0.0001 mg.).

 (c)  All tuberculin reactors. Tuberculin reactors shall be X-rayed. Chest X-rays of tuberculin reactors may be provided by local public or private health agencies. Arrangements for the examinations are the responsibility of the local school authorities.

 (d)  Tuberculin testing programs. A school board or joint school board which finds that individual schools within the school district or jointure have significant differences in the reactor rate may implement tuberculin testing programs for individual schools in accordance with the following:

   (1)  A test for tuberculosis shall be done annually on original entry into school and in the ninth grade by a tuberculin test in schools with a prior tuberculin reactor rate of 0.5% or above in these grades.

   (2)  A test for tuberculosis shall be done every third year upon original entry into school and in the ninth grade by a tuberculin test in those schools with a tuberculin reactor rate below 0.5% in these grades. A school which subsequently shows an increase to a level above 0.5% shall renew the annual testing program until the reactor rate descends below 0.5% again.

Source

   The provisions of this §  23.9 amended July 22, 1971, effective July 23, 1971, 1 Pa.B. 2163.
Source: http://www.pacode.com/secure/data/028/chapter23/s23.9.html

TB-Links/Exemptions

Generic letter for Exemption to TB Testing:
HTML (text): Exemption-tb-test.html

MS Doc file: Exemption-tb-test.doc

OSHA
Standard Interpretations
09/23/1997 - The Bloodborne Pathogen Standard and the Enforcement Procedures for TB.

"Finally, be aware that participation in the employer's skin testing program is voluntary on the part of the employee. OSHA does not require that employees participate in TB skin testing, only that the employer make such skin testing available to employees."
TB and Lead Testing Links:
F L Y E R    LETTER    Exemption_Letters    OSHA_and_TB_test    Tubersol    Treatment    TB_Screening    Alternatives/QuantiFERON_TB_Gold_testimony

The above TB and Lead exemption letters are courtesy of Deirdre DeVane of Wash DC. Thank you Deirdre!
The adult TB letters were edited by Sherri Tenpenny. Thank you Sherri!

TB can be detected by biofeedback machines that are hooked up to a computer, such as the QXCI, Best BioMeridian MSAS (Meridian Stress Assessment) or Electro Dermal Screening, Quantum Life System, and the F-Scan. You will need to ask specifically for a pathogen scan, especially TB. You will also need to request a printout with the results.

See QXCI-BioMeridian Providers, etc below


Misc Info - Sponsors - Etc.
Global Quantum Quest; Worldwide EPFX Resource Centre
General link for QXCI practitioners in Canada, USA, Africa and The Netherlands. http://theqxci.com/practitioners.php

Here are some of the practitioners for Pennsylvania

Pennsylvania BEST™ BioMeridian Practitioners:

Please call contact below to find BioMeridian practitioners in your area or closeby.

Oksana Gorodetsky
Marketing/Administrative Coordinator
BioMeridian International
12411 South 265 West, Suite F
Draper, UT 84020
T 801-501-7517
F 801-501-7518
Toll Free 888-224-2337
ogorodetsky@biomeridian.com

Pennsylvania QXCI Practitioners:

The Herb Barn
Stan Doublosky
Specializes with herbal medicinal herbs, ph testing, cleansing, detox, and dietary coaching
Nazareth, Pa 18604
610-746-9969
theherbbarn@rcn.com

For information on purchase or lease of the new Quantum Life BioFeedback L.I.F.E. System, please email Donna and leave your name, mailing address, phone number and email. If you're inquiring for another interested individual or practitioner, please leave their information. The company will then send information and contact the interested parties.
Or you may call 1-407-672-6144.

WHOLEFOOD
http://www.wholefoodfarmacy.com/
FARMACY

For assistance with Vaccine Exemptions in Pennsylvania:
Vaccine Information and Liberation - Pennsylvania Chapter