Table 3.

Legislative Changes from 2011 to 2016 That Impacted Nonmedical Exemption Ease Classifications

State	Year of Change	Previous Classification	New Classification	Description
California	2011	Easy	Difficult	New law requires signature from healthcare provider and counseling about vaccine benefits before exemption is granted
Alaska	2013	Medium	Difficult	New law requires notarization of exemption form, and yearly recertification
Oregon	2014	Easy	Difficult	New law requires education from healthcare provider or through online portal to receive exemption forms
Illinois	2015	Medium	Difficult	Signature of healthcare provider is required on exemption form, with a parent personal statement
Connecticut	2015	Medium	Difficult	Exemption form requires notarization
Missouri	2015	Easy	Medium	Exemption form can only be obtained in person at the county or district health department
Michigan	2015	Medium	Difficult	New law requires parent or guardian to attend education session at health department before exemption waiver is granted