Childhood Vaccines: The Recommended Schedule, What's Given at Birth & How to Get a Religious Exemption for School

Vaccines are one of the most personal and sensitive decisions a parent makes, and in today's climate it can be hard to find clear, balanced information. This guide is written to be judgment-free. My goal is simply to lay out the facts: what the recommended schedule is, what is given at birth, whether you can opt out, and how to claim a religious exemption for school and day care if that is the path you choose — including which states allow it and which do not.

Let's start with the recommended schedule. The Centers for Disease Control and Prevention (CDC) publishes the standard childhood immunization schedule, endorsed by the American Academy of Pediatrics. It is designed to protect children at the ages when they are most vulnerable and when each vaccine is most likely to be effective. The core schedule, in plain terms, looks like this:

At birth (before leaving the hospital): Hepatitis B dose #1. This is the only vaccine routinely given to a newborn before discharge. Within 1–2 months: Hepatitis B dose #2. At 2 months: RV (rotavirus), DTaP (diphtheria, tetanus, pertussis), Hib, PCV (pneumococcal), and IPV (polio). At 4 months: the same set is repeated. At 6 months: another round, plus a yearly flu shot starting at 6 months. At 12–15 months: MMR (measles, mumps, rubella), Varicella (chickenpox), Hepatitis A, and boosters for Hib and PCV. At 4–6 years: DTaP, IPV, MMR, and Varicella boosters before kindergarten. At 11–12 years: Tdap and HPV, plus a meningococcal vaccine. At 16 years: a meningococcal booster.

So what is given immediately when a child is born? The Hepatitis B vaccine is the one routinely administered in the hospital within the first 24 hours of life. The reason is that Hepatitis B can be transmitted from mother to baby during birth, and infants who become infected have a very high risk of chronic infection. Some hospitals will ask for your consent before giving it; others include it as part of standard newborn care. You always have the right to ask questions and to decline any single vaccine, including this one.

Can a parent opt out of vaccines? Yes — every state allows some form of exemption, but the rules vary dramatically. There are three types of exemptions recognized in the U.S.: medical exemptions (for children with a documented medical reason, such as a severe allergic reaction or a compromised immune system), religious exemptions (for families whose sincerely held religious beliefs prohibit vaccination), and personal-belief or philosophical exemptions (for families with non-religious objections). Medical exemptions are allowed in all 50 states. Religious exemptions are allowed in most but not all states. Personal-belief exemptions are allowed in only a minority of states.

How do you get a religious exemption for school or day care? The process is set by your state, not the federal government, so the exact steps and forms differ. Generally, you must complete and submit a religious exemption form to your child's school or day care, and in some states you must also have the form notarized, attend an educational briefing, or have it signed by a healthcare provider. The key resources are your state's Department of Health and Department of Education. You can also call the CDC's immunization hotline at 1-800-CDC-INFO (1-800-232-4636) for general guidance, and find your state's specific requirements through the CDC state immunization web portal at cdc.gov/vaccines/programs.

Which states allow religious exemptions for school? As of the most recent updates, the following states allow a religious exemption for school and day care entry: Alabama, Alaska, Arizona, Arkansas, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine (limited), Maryland, Massachusetts, Michigan, Minnesota, Mississippi (limited, recent change), Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Utah, Vermont, Virginia, Washington, West Virginia (limited), Wisconsin, and Wyoming. Florida is a notable example: it allows religious exemptions for both public and private schools and day care, and the process is a simple signed form available through the Florida Department of Health.

Which states do NOT allow religious exemptions? These states have removed the religious exemption, meaning that — with the exception of a documented medical exemption — children must be fully vaccinated to attend both public and private schools and day care: California, New York, Maine, Connecticut (for non-medical), Mississippi, West Virginia (no non-medical exemptions), and Texas. Texas is the example I am asked about most often: Texas does not accept a religious exemption for vaccines in the way many parents expect. Texas allows a religious exemption only for private schools and day care facilities that do not receive state funding, and even then the rules are narrow. For public schools and most licensed day care centers in Texas, only a medical exemption is accepted. The same is true in California and New York, where both personal-belief and religious exemptions were eliminated after measles outbreaks.

What are the options for parents in Texas and similar states who want to avoid one or more vaccines? First, you can request a medical exemption if your child has a genuine medical contraindication — this is the only universally accepted exemption. Second, you may homeschool your child, which removes the school-entry vaccine requirement entirely in most states, including Texas. Third, some private faith-based schools that do not accept state funding may have more flexibility, but you must confirm directly with the school. Fourth, you can pursue a modified or delayed schedule with your pediatrician — choosing to spread vaccines out or decline specific ones while still meeting the minimum your state requires. Fifth, if your employer offers it, you can explore faith-based health sharing programs, but note that these do not change school vaccine requirements.

Here is a quick-reference list. States that DO allow religious exemptions (in most cases): AL, AK, AZ, AR, CO, DE, FL, GA, ID, IL, IN, IA, KS, KY, LA, MD, MA, MI, MN, MO, MT, NE, NV, NH, NJ, NM, NC, ND, OH, OK, OR, PA, RI, SC, SD, TN, UT, VT, VA, WA, WI, WY. States that DO NOT allow religious exemptions (medical only): CA, CT, ME, MS, NY, WV, TX (public schools and most day care).

A few important notes. First, exemption rules change frequently — states have tightened or loosened requirements after disease outbreaks, so always verify the current rule with your state's Department of Health before relying on an exemption. Second, having an exemption does not mean a child cannot be excluded from school during an outbreak — many states reserve the right to temporarily exclude unvaccinated children if a vaccine-preventable disease appears in the school. Third, this article is informational only and not legal or medical advice; talk with your pediatrician and check your state's official forms.

If you have questions about how vaccines, well-child visits, and your health insurance work together — for example, which plans cover the full CDC schedule at no cost-sharing under the ACA, or how to make sure your newborn's pediatric care is covered during those first 60 days — I can help. As an independent licensed insurance broker, I help families across 28 states understand their coverage so they can make the choices that are right for them. Reach me at (407) 815-0820 or book a free consultation through the link below.