West Independent School District

The law allows physicians to write a statement stating that the vaccine(s) required would be medically harmful or injurious to the health and well-being of the child. The written statement by the physician must be submitted to the school nurse. Unless it is written in the statement that a lifelong condition exists, the exemption statement is valid for only one year from the date signed by the physician.

The law allows parents/guardians to choose an exemption from immunization requirements for reasons of conscience, including a religious belief. The completed and returned form from the Texas DSHS must be submitted to the school nurse for the student to be admitted. The school will accept only the original official affidavit forms developed and issued by the Texas DSHS. The affidavit will be valid for two years.

• Please note: In the case of an outbreak, an unimmunized child may be prohibited from school attendance.
• Any form presented for conscientious objection to immunization must be presented before the student may start school and must be updated every two years by the anniversary date.
• If the Affidavit is not current, the student will not be allowed to stay in school.

Affidavits may be requested via the Immunization Section Affidavit Request website. It is recommended individuals use the Microsoft Edge web browser when submitting a vaccine exemption request online. Other web browsers may not function properly.

A written request for an affidavit may be sent through the United States Postal Service (or another commercial carrier).  Print and then mail the Request for Exemption from Immunizations for Reasons of Conscience to:

Texas Department of State Health Services

Immunization Section, Mail Code 1946

P.O. Box 149347

Austin, Texas 78714-9347

Print and then fax the Request for Exemption from Immunizations for Reasons of Conscience to: (512) 776-7544.

NOTE: No requests will be filled at the time of hand-delivery of a request. All affidavit forms will be mailed to you via U.S. Postal Service.

The Vaccines for Children (VFC) Program helps provide vaccines to children whose parents or guardians may not be able to afford them. This helps ensure that all children have a better chance of getting their recommended vaccinations on schedule. Vaccines available through the VFC Program are those recommended by the Advisory Committee on Immunization Practices (ACIP). These vaccines protect babies, young children, and adolescents from 16 diseases.

Funding for the VFC program is approved by the Office of Management and Budget (OMB) and allocated through the Centers for Medicare & Medicaid Services (CMS) to the Centers for Disease Control and Prevention (CDC). CDC buys vaccines at a discount and distributes them to grantees—i.e., state health departments and certain local and territorial public health agencies—which in turn distribute them at no charge to those private physicians’ offices and public health clinics registered as VFC providers.

A child is eligible for the VFC Program if he or she is younger than 19 years of age and is one of the following:

• Medicaid-eligible
• Uninsured
• Underinsured [Click]
• American Indian or Alaska Native

Children whose health insurance covers the cost of vaccinations are not eligible for VFC vaccines, even when a claim for the cost of the vaccine and its administration would be denied for payment by the insurance carrier because the plan’s deductible had not been met.

Nationwide, there are over 44,000 doctors (nearly 40,000 sites) doctors enrolled in the VFC Program. Each state’s VFC Coordinator can provide a list of doctors enrolled in the VFC Program. Other places that provide vaccinations are

• Public Health Clinic
• Federally Qualified Health Center (FQHC)
• Rural Health Clinic (RHC)