Frequently asked questions
Why can’t my student use a religious or
philosophical exemption anymore?
Maine passed a law (LD 798, Public Law
Ch. 154) in the spring of 2019 removing all non-medical exemptions for students.
This new law goes into effect on September 1, 2021. Click here to view the statute.
Do positive titers qualify as proof of immunity
if my child doesn’t have all required doses of immunizations? My doctor has told me
they are not willing to order a titer test and/or that they are not valid for all
Yes, if a student has proof of
sufficient immunity to a disease via blood titer testing, that will satisfy the
requirement for immunity for school attendance under the law. Additionally, the
student will not be required to stay home during any outbreak of that disease at the
Per state law, proof of immunity using a blood titer test is perfectly acceptable
in lieu of vaccination. In fact, Maine’s only medical school, the University of
New England, REQUIRES
proof of immunity for certain vaccinations, even
with proof of vaccination dosages that qualify as being considered fully
In addition, it is standard for healthcare employees to be given a titer test
upon employment in a hospital, THEN vaccinated if an employee does not have
sufficient titers (proof of immunity) for the disease. Unfortunately, Laura
Blaisdell MD, Vice President of the Maine AAP, recently provided training for
physicians on the new law, misrepresenting the use of titer testing in
determining proof of immunity, and stated that a student that had a recent
dose of MMR with a subsequent positive titer was not “fully immunized” against
MMR. Certainly if Maine’s only medical school can use this
same titer test to determine immunity for
medical students who were likely vaccinated close to 20 years ago, Maine’s
children can use this titer test to determine immunity from a recent dosage of
How do you get titer testing?
Titers (proof of immunity to a disease shown by blood testing) can be ordered by
the primary care provider and drawn at any hospital or outpatient lab. The
provider must order a titer for each disease, and insurance usually covers a
portion of the blood work just like any other lab work.
Which shots & how many doses of each are
required for my child to attend daycare? K-12 school? College?
For Children in Daycare: Please see the
following immunization chart that the Maine CDC has
created. The required vaccines are listed below and all but 2 require multiple
doses that are to be administered at specific ages starting at 3 months through 43
months of age.
DTaP (Diphtheria, Tetanus & Pertussis) - 4 doses
Hib (Haemophilus influenzae type B) - 3 doses
Polio - 3 doses
MMR (Measles, Mumps & Rubella) - 1 doses
Varicella (Chickenpox) -1 dose
Hepatitis A - 2 doses
Hepatitis B - 3 doses
PCV (Pneumococcal Disease) - 4 doses
For Pre K - grade 12 the proposed
rules (as of 7/7/21) are as follows:
For pre-kindergarten students only, four doses of
DPT/DTaP are required. The third and fourth dose must be
separated by at least six months.
For students ages six years old and younger in
kindergarten or grades above, a total of five
doses of DPT/DTaP are required, except that, if
the fourth dose was administered on or after the
child’s fourth birthday, then only four doses are
For students seven years of age and older, a
minimum of three doses of DPT/DTaP with the
last dose administered on or after the
child’s fourth birthday is required. A
student who did not complete their primary
DTP/DTaP immunization series or who has an
unknown vaccine history, requires a single
dose of Tdap followed by either Tdap or Td
until three doses have been achieved.
In addition to receiving the required
doses for DPT/DTaP, one dose of Tdap
vaccine is required for students
entering grade 7. Any valid dose of
Tdap after age seven satisfies the
requirement for 7th grade entry.
For pre-kindergarten students
only, one dose of MMR vaccine is
All students in grades
kindergarten through 12 must
have been immunized against
measles, mumps, and rubella
with two doses of MMR
vaccine, provided the first
dose is administered no
sooner than 12 months of age
and at least four weeks
separate the two doses.
For students in
three doses of IPV or
OPV or a combination
of both are required.
The first dose must be
administered at least
six weeks after birth,
with subsequent doses
given at least four
For students in
kindergarten – 12,
four doses of
vaccine (IPV) or
oral polio vaccine
both are required.
The first dose
least six weeks
after birth, with
given at least
four weeks apart.
The fourth dose is
not needed if the
third dose is
given on or after
One dose of
Does the law apply to private schools?
Parochial? Charter? Fully online schools?
law applies to all schools (public, private,
charter, and online) except that students who are completely online and do not
attend any classes in person
may not be required to meet the
immunization requirements. The recently proposed revisions in the rules provide a
new exception for fully online students in prek-12 schools.
Can homeschool students participate in school
sports or other extracurriculars if they don't meet the new vaccine
Maine law has always allowed
homeschooled students to participate in extracurriculars and academic classes, so
long as they meet the vaccination requirements of students enrolled in Maine
schools. This means that, once the new law is implemented on Sept. 1, 2021,
homeschooled students can no longer participate in extracurriculars unless they are
fully vaccinated or have a medical exemption.
Do pre-k students abide by vaccinations
required for daycare or kindergarten entry?
The current proposed rules state that there are slightly different immunization
requirements for pre-kindergarten students. *Note: These are subject to change as
the rules are not yet finalized. Pre-K students are required to have 4 doses of
DPT or DTaP (Diphtheria, Pertussis, Tetanus), 1 dose of MMR (Measles, Mumps,
Rubella) and 3 doses of Polio (note that the 4th dose of Polio is not needed for
Kindergarten entry if the 3rd dose is given after the student’s 4th birthday).
Does the new law affect all daycares, even
small in-home daycares or unlicensed daycares?
All children who attend a child care center, child care facility, small child care
facility, home daycare, public preschool program, nursery school, pre-k program,
early kindergarten, 4 year old program or any child development program under the
control of the State Department of Education or under the control of the Office of
Child Care and Head Start must be vaccinated in accordance with the “
Day Care Immunization Standards” as indicated by
the Maine Department of Health and Human Services effective September 1, 2021.
Can students who have an IEP still use a
philosophical or religious exemption?
YES. Students who have an IEP in place
prior to September 1, 2021 AND filed a religious or philosophical exemption on or
before September 1, 2021 are eligible to continue attending school with a religious
or philosophical exemption in addition to a
statement from a medical provider.
Under the new law, the parent/guardian of a student with an IEP (or student if
they are over 18) must provide a statement to the school from a licensed
physician, nurse practitioner, or physician assistant that the medical provider
has consulted with the parent (or student, if they are 18 or older) and has made
the parent/guardian aware of the risks and benefits associated with the choice to
Do students with an existing IEP who are
submitting a non-medical exemption need a doctor’s note that the student/parent has
been counseled on the risks and benefits associated with vaccination choice?
YES. The parent, guardian or student age 18 or older who has an IEP in place prior
to September 1st, 2021 must receive counseling from a licensed physician, nurse
practitioner, or physician’s assistant about the risks and benefits associated
with the choice to vaccinate and provide written proof of that counseling to the
*Please note that a philosophical or religious exemption MUST be submitted to the
student’s school on or before September 1, 2021.
If my child loses their IEP will their
non-medical exemption be eliminated?
According to the new law, so long as the student has an IEP on 9/1/21 and elected
a religious or philosophical exemption on or before 9/1/21, the student can
continue in school under that exemption. The amended rules, however, state that if
the child loses their IEP AND loses their protection under FAPE (Free and
Appropriate Public Education), they lose the ability to use the grandfathered
non-medical exemption. We advise families to ensure their children keep needed
IEPs as long as possible, and to advocate to step down to 504 plans to ensure FAPE
protection when they are no longer eligible for an IEP.
What about grandfathering? Will my child's
non-medical exemption be grandfathered since it was on file before this law was
No, there is no grandfathering of non-medical exemptions except for students who
have an IEP on 9/1/21.
Have any lawsuits been initiated to challenge
the removal of the religious exemption?
There have not been any lawsuits filed yet in Maine challenging the removal of
religious exemptions to vaccination.
What will happen if I send my student to school
without being fully vaccinated?
We can not speak for any school administration as to the process that
will occur in this situation. The rules state that unless a student is exempt, no
superintendent may permit any student to be enrolled in or to attend school without a
certificate of vaccination for each disease or other acceptable evidence of required
immunization or immunity against each disease. How the superintendent/school enforces
this will be different for each school. It is important to note that schools are
authorized to accept:
- A one-time written assurance from the parent/guardian or adult student (age 18 or
older) that the student will be immunized by private effort within ninety days of
enrollment (officially registering) in school or of the student first attending,
whichever date is the earliest.
- A medical exemption provided by a licensed physician, nurse practitioner, or
physician's assistant that indicates that in that medical provider’s professional
judgment, immunization is not medically advisable.
- A parent’s/guardian’s written consent for the child to be vaccinated by a public
health officer, physician, nurse or other authorized person in their employ, or
acting as an agent of the school, where such immunization programs are in effect.
- A philosophical or religious exemption so long as the student has, on or before
September 1, 2021, an IEP and has submitted a philosophical or religious exemption
to vaccination to the student’s school. Written documentation, from a licensed
physician, nurse practitioner, or physician’s assistant, assuring that the parent,
guardian, or adult student has received counseling on the risks and benefits of
vaccination, must also be submitted to the student’s school. If a student with an
IEP has a non-medical exemption for vaccination, the student will be able to
maintain that exemption after dismissal from special education services and will be
considered exempt until the child is no longer eligible for free, appropriate public
- The student may be enrolled in a distance education program offered by a school,
if the student does not physically attend any classes or programs at the school or a
Can we get non-medical exemptions back?
Yes, but it would require the State Legislature to change the law. State and
federal elections really matter. It is imperative that any person in the state of
Maine that is concerned about the right to make their own medical decisions gets
involved politically. Ways that you can do this is are:
Help in the 2022 Election for Governor. Governor Mills was heavily in favor of
the passing of the new vaccine law and is unlikely to support any effort to
reverse it. Make sure that future candidates are hearing from you on why you
support medical freedom. If they are willing to support your beliefs, find out
ways that you can help them get elected (make phone calls, go door to door,
and donate financially).
Find out who your
state representative is and find out
their stance on medical freedom.
Find out who your
state senator is and find out
their stance on medical freedom.
Attend local school board meetings and consider running for
upcoming seats so your voice can be heard.
Are medical exemptions still allowed?
Yes. Medical exemptions are still allowed from a licensed physician, nurse
practitioner, or physician assistant. Under the law, they are given FULL
discretion to determine the risk and benefit of vaccination for their patients and
may write a medical exemption based on their clinical judgement. There is no
specific form that is required to be used, a simple written statement from the
provider is all that is required.
Where can I find a doctor that will write a
The primary care provider, or whoever knows the child’s health history best,
should be the one to write the medical exemption. If there is a specialist that
the child sees for a health issue which impacts their ability to receive vaccines,
then that specialist can also write the exemption.
Similarly, if the child’s sibling or other close family member sees a specialist
for an issue that impacts close family members being able to receive vaccines,
then that specialist may also write the exemption. For example, if a child is
undergoing chemotherapy and their sibling(s) should not receive live virus
vaccines, then the parent should ask the specialist treating the sibling for an
exemption, which might require coordination with the sibling’s PCP, or some other
plan of coordination or communication between providers to obtain an exemption for
the child in order to protect their sibling.
Do you have a list of doctors that will see an
No, we do not maintain a list of providers for several reasons.
First, most practitioners are connected to large medical practices that must
follow the corporate policies of the major hospitals with which they are
affiliated, so even a provider who is personally supportive of a parent’s right to
choose which vaccines their child does and does not receive will be limited in how
they practice because of their employer’s policies.
Secondly, a provider who is labeled as “friendly” to vaccine choice will be
subjected to personal and professional attacks, as we have seen in other
states and as providers in Maine experienced during the People’s Veto effort
of LD 798.
The best way to locate a provider who is supportive of delayed and
selective vaccine schedules is to start with those in private practice and
not affiliated with a hospital system, as they will typically have a
greater ability to put the individual needs of their patients ahead of
corporate, money-driven practice policies. Additionally, call and ask the
office staff if
1) the provider is accepting new patients, and
2) what the office policy is on selective vaccination or unvaccinated
These two questions are quick and easy, they do not reveal a
family’s own stance on vaccine choice, and they can help to rule out
whether or not a practice might be a good fit for the family. You
can also ask for a free consultation with the doctor and find out
directly from that provider if he/she is a good fit for your
What information is required on a medical
A medical exemption must contain a
statement from a licensed physician, nurse practitioner, or physician assistant
indicating that in that medical provider’s professional judgment, vaccination
against one or more of the diseases may be medically inadvisable. There is not a
specific form or document that is required to be submitted as a medical exemption.
For your convenience we have a sample form here
(based on a draft previously made available on the Maine DOE website until it was
removed in late March of 2021) that may be used, copied, or altered as desired.
In April of 2021 the Maine Chapter of the American Academy of Pediatrics, Maine
Medical Association and Maine Osteopathic Association jointly released a
medical exemption form that
grossly misrepresents medical exemption
requirements per state law.
If a provider insists that they must use that form, direct them to the
state law (see below):
Medical exemption. The parent or the child provides a written statement
from a licensed physician, nurse practitioner or physician assistant that,
in the licensed physician's, nurse practitioner's or physician assistant's
professional judgment, immunization against one or more of the diseases
may be medically inadvisable.
[PL 2019, c. 154, §1 (AMD).]
Does the medical reason for exemption need to
be listed on the medical exemption?
No, there is no law that requires the parent, student, or medical provider to
state the medical reason(s) for the exemption to immunizations on the written
medical exemption. We advise against providing additional information beyond state
Who can write/provide a medical
A medical exemption must be provided
by any licensed physician, nurse practitioner or physician assistant. Under the
previous laws regarding vaccination, only a licensed physician could write a medical
Who sees a medical exemption/does it get turned
into a state department or stay at my child’s school(s)?
Medical exemptions are kept in the student’s school health record and maintained
by the nurse or superintendent. They are subject not to HIPAA laws, but to FERPA
(school privacy) laws. According to the recent draft of the Maine DOE rules, the
state and local health officials can inspect the child’s vaccination record and
medical exemption to ensure compliance with immunization and documentation.
Additionally, all school nurses and/or superintendents are required to maintain a
list of unvaccinated students and report vaccination and exemption status to the
My college/university/post-secondary school
requires vaccinations that are not required by state law. What can I do?
If your child is being required to get a vaccine that isn’t required by state law
you can request that they allow a non-medical exemption, which they have the
authority to allow so long as the vaccine they require is NOT required by law.
They may or may not honor such a request, however the best option is for students
to push back on requirements that go beyond state law.
In addition, if you or your child will be attending post-secondary school out of
state, it is important to determine the exemption laws in the state, as well as the
policy for the institution. Many state vaccination rules for college are determined
outside of state law, and this is highly important to research ahead of time.
You can start your research by going to the
National Vaccine Information Center to learn more.
Doing your homework prior to reaching out to the school will be very helpful in
understanding what rights that your child has and the proper way to move forward.
If my child uses a religious or medical
exemption for covid vaccine in college, will they be discriminated against (special
dorm, wear a mask, separate transportation). Is there any legal path to fight
It is unclear at this point if those that use exemptions will be given different
accommodations from those that are vaccinated for COVID-19. Most colleges and
universities are updating their websites with details so it is best to continually
monitor the information that is posted. It is suggested that you keep any
documentation from correspondence with your child’s school.
I am moving to Maine and my child is not
up-to-date on vaccinations. How can I enroll them in school?
According to the draft of the proposed
DOE rules, families moving into Maine or enrolling in school for the first time will
have a 90-day grace period from the first date of enrollment in school to get their
children caught up on vaccinations.
Are there resources for someone that is new to
There are some facebook pages including
HOME (Homeschoolers of Maine), and many other
local and regional resources online for parents getting started with
homeschooling. Additionally, many local libraries and churches have homeschooling
resources and groups that meet on a weekly basis. We encourage families to connect
with others in their area.