More than 3,500 Alabama students attend school despite not having Certificate of Immunizations, utilizing a law that allows parents to file for an exemption based on religious objections.

Students in both public and private schools in Alabama are required present documentation proving they’ve received vaccinations for diphtheria, pertussis, tetanus, polio, measles, mumps, rubella and varicella. Almost every state, however, allows for some type of exemption, with Alabama permitting exceptions for those who object to vaccinations on religious or medical reasons. Some states also allow for personal/conscientious belief objections.

The Certificate of Religious Exemption – presented like the Certificate of Immunization – can only be issued by the county health department. Applicants must submit a written objection and watch a video on the importance of vaccinations before the certificate is issued. Alabama law does allow school districts to keep children with religious exemptions out of school if an outbreak occurs.

Parents are not required to prove membership of a church that objects to vaccinations.

Such exemptions are drawing increased scrutiny, however, amid a recent outbreak of measles. The Centers for Disease Control and Prevention has confirmed 626 cases of measles this year, the highest number since the virus was eliminated from the U.S. in 2000. Twenty states have reported measles cases, most are centered in New York and Washington state.

The American Medical Association has been vocal in its opposition to exemptions except in the rarest of cases.

“The reductions we have seen in vaccination coverage threaten to erase many years of progress as nearly eliminated and preventable diseases return, resulting in illness, disability and death. To protect our communities’ health, it is vital that individuals not be permitted to opt out of immunizations solely as a matter of convenience or misinformation…” said AMA President Barbara L. McAneny, M.D. “The AMA strongly supports legislation that eliminates non-medical exemptions from immunizations, and we will continue to actively urge policymakers to eliminate non-medical exemptions from immunizations.”

Religious exemption rates

Statewide, 3,587 students applied for vaccine exemptions based on religious reasons in the 2017-2018 school year, according to the most recent tracking by the Alabama Department of Public Health. That figure is up from 3,325 and 3,066 in the previous two school years.

Only two counties have religious exemption rates above 1 percent of total student population: Cullman (1.28 percent) and Baldwin (1.15 percent). The remainder fall below 1 percent.

Three-hundred and 21 students received medical exemptions for vaccinations in 2017-2018.

Religious exemption rates for schools by county:

Here’s a look at religious exemption numbers for public and private schools by county. The figures do not include numbers from those those who sought religious exemptions for certain vaccines while presenting blue cards for others.

Autauga - 58

Baldwin - 396

Barbour - 5

Bibb - 17

Blount - 41

Bullock - N/A

Butler - 0

Calhoun - 80

Chambers - 6

Cherokee - 14

Chilton - 35

Choctaw - 0

Clarke - 2

Clay - 5

Cleburne - N/A

Coffee - 38

Colbert - 24

Conecuh - 0

Coosa - 0

Covington - 15

Crenshaw - 2

Cullman - 131

Dale - 19

Dallas - 7

DeKalb - 96

Elmore - 54

Escambia - 11

Etowah - 85

Fayette - 1

Franklin - 16

Geneva - 12

Greene - 0

Hale - 0

Henry - 17

Houston - 87

Jackson - 75

Jefferson - 398

Lamar - 4

Lauderdale - 77

Lawrence - 8

Lee - 68

Limestone - 52

Lowndes - 68

Macon - N/A

Madison - 420

Marengo - 3

Marion - 19

Marshall - 80

Mobile - 221

Monroe - 14

Montgomery - 73

Morgan - 69

Perry - 0

Pickens - 1

Pike - 10

Randolph - 18

Russell - 13

Shelby - 328

St. Clair - 63

Sumter - 1

Talladega - 27

Tallapoosa - 29

Tuscaloosa - 135

Walker - 18

Washington - 1

Wilcox - 1

Winston - 19