Waivers in Michigan
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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 influenza type b and Pneumococcal Conjugate (pre-school child care programs only), and 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:
M.O.M. Vaccination Exemption Form
The State of Michigan Immunization Waiver Form
College/Employment Waiver Form
In 2007, the Attorney General of Michigan stated in AG opinion No. 7205 opinion that a local health department can decide which waiver form a parent may use for exercising the right to exempt their child from vaccination. Specifically, “It is my opinion that a local health department has authority to adopt regulations to require a parent to use a specific immunization exemption form in order to claim an exemption from vaccination requirements…” (p. 8 of Opinion No. 7205). The Attorney General further stated that the local health department could not deny the reason given by the parent for claiming the “other” exemption to vaccinations. Specifically, “…the “approval” contemplated in the county regulation does not call upon the county to exercise a subjective judgment about the adequacy of the exemption; rather, it contemplates a ministerial review that is “necessary or appropriate” to confirm that the exemption claimed meets the requirements of MCL 333.9215 (2).”
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.
M.O.M. Forms
M.O.M. Membership Form

M.O.M. Vaccination
Exemption Form

The State of Michigan
Immunization Waiver Form

College/Employment
Waiver Form

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