State	Education mandate start	Source	Type	Education mandate content
Alabama	2009	Alabama Department of Health	Website	The parent or legal guardian must submit a written objection and receive education on the consequences of not immunizing their child.24
Arizona	2013	AZ Rev Stat § 15–873 (2016)	Legislation	The parent or guardian of the pupil submits a signed statement to the school administrator stating that the parent or guardian has received information about immunizations provided by the department of health services and understands the risks and benefits of immunizations and the potential risks of nonimmunization and that due to personal beliefs, the parent or guardian does not consent to the immunization of the pupil.25
Arkansas	2013	AR Code § 6–60-504 (2016)	Legislation	Completion of an educational component developed by the department that includes information on the risks and benefits of vaccination26
Delaware	2011	14 DE Code § 131 (2016)	Legislation	(We) acknowledge that (I) (we) have been given the opportunity to receive from the school district information regarding the medical benefits and risks in choosing whether to have the child participate in the immunization program, and if (I) (we) have not taken that opportunity, it is hereby waived.27
Illinois	2015	105 ILCS 5/27–8.1 (2016)	Legislation	The certificate must also be signed by the authorized examining health care provider responsible for the performance of the child’s health examination confirming that the provider provided education to the parent or legal guardian on the benefits of immunization and the health risks to the student and to the community of the communicable diseases for which immunization is required in this State … Those receiving immunizations required under this Code shall be provided with the relevant vaccine information statements that are required to be disseminated by the federal National Childhood Vaccine Injury Act of 1986, which may contain information on circumstances when a vaccine should not be administered, prior to administering a vaccine.28
Michigan	2015	Michigan R 325.176 (2014)	Rule	Each nonmedical exemption filed at the child’s school or group program of a child entering a program after December 31, 2014 shall be certified by the local health department that the individual received education on the risks of not receiving the vaccines being waived and the benefits of vaccination to the individual and the community.29
New Mexico	2013	New Mexico Department of Health	Form	I HAVE READ THE ‘COMPULSORY IMMUNIZATION REGULATIONS’ AND UNDERSTAND THE RISK OF NON-IMMUNIZATION FOR MY CHILD.30
Oregon	2014	OR Rev Stat § 433.267 (2015)	Legislation	(i) A signature from a health care practitioner verifying that the health care practitioner has reviewed with the parent information about the risks and benefits of immunization that is consistent with information published by the Centers for Disease Control and Prevention and the contents of the vaccine educational module approved by the authority pursuant to rules adopted under ORS 433.273; or (ii) A certificate verifying that the parent has completed a vaccine educational module approved by the authority pursuant to rules adopted under ORS 433.273.31
Rhode Island	2015	Rhode Island Department of Health	Form	I have received and read the educational materials explaining the disease(s) and vaccine (s) checked above and: I understand the benefits and the risks of the vaccine(s). I understand the risk of contracting the disease(s) that the vaccine(s) prevent. I understand the risk of transmitting the disease(s) to others. I understand that, if an outbreak of vaccine-preventable disease should occur, an exempt student will be excluded from school by the school administrative head for a period of time as determined by the Health Department based on a case-by-case analysis of public health risk.32
Vermont	2013	18 V.S.A. § 1122 (2016)	Legislation	(3) If the person or, in the case of a minor, the person’s parent or guardian annually provides a signed statement to the school or child care facility on a form created by the Department that the person, parent, or guardian: (A) holds religious beliefs opposed to immunization; and (B) has reviewed evidence-based educational material provided by the Department regarding immunizations, including: (i) information about the risks of adverse reactions to immunization; (ii) information that failure to complete the required vaccination schedule increases risk to the person and others of contracting or carrying a vaccine-preventable infectious disease; and (iii) information that there are persons with special health needs attending schools and child care facilities who are unable to be vaccinated or who are at heightened risk of contracting a vaccine-preventable communicable disease and for whom such a disease could be life-threatening.33
Washington	2011	WA Rev Code § 28A.210.090 (2016)	Legislation	(2)(a) The form presented on or after July 22, 2011, must include a statement to be signed by a health care practitioner stating that he or she provided the signator with information about the benefits and risks of immunization to the child. The form may be signed by a health care practitioner at any time prior to the enrollment of the child in a school or licensed day care. Photocopies of the signed form or a letter from the health care practitioner referencing the child’s name shall be accepted in lieu of the original form.