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Vaccine Waiver

Michigan Opposing Mandatory Vaccines

Vaccine waiver forms are used in situations where proof of vaccination must be submitted. Vaccines that Michigan requires a waiver for are:

  • Diphtheria
  • Tetanus
  • Pertussis
  • Polio
  • Hepatitis B
  • Measles
  • Mumps
  • Rubella
  • Haemophilus influenzae type b (pre-school child care programs only)
  • Varicella

These mandates apply to:

  • Children attending licensed daycare (any group of 6 or more, as defined in Michigan)
  • Children attending public or private school
  • Many summer camps
  • Some colleges and universities

If you live in Michigan, you may use one of the following waiver forms:

  1. M.O.M. Vaccination Exemption Form pdfsmall
  2. The State of Michigan Immunization Waiver Form pdfsmall

Note: If you are unable to open the files above directly from the link, save first to your computer, then open using Acrobat Reader.

Feel free to adapt it to meet your needs; for example, you may want to write in “Hepatitis B” as an exempt vaccine.

Contact us: info@momvaccines.org or 586-447-2418.
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