Exemption or Declination from UC's Immunization Requirements

Students seeking an Exemption, Declination, or Remote Learning request must submit a request via the Student Health Patient Portal no later than their appropriate compliance deadline dates. Please follow the directions for completion and submission below.

In the event of a Vaccine Preventable Disease outbreak, students with approved exemptions or declinations may be excluded from the site of the outbreak or subject to additional Non-Pharmaceutical Interventions or Vaccine Education in compliance with County Public Health orders and to protect the health and safety of others on campus.

Medical Exemptions

For students with medical conditions which may be contraindications for the following required vaccines:

  • MMR
  • Varicella
  • Tetanus/Pertussis
  • Meningococcal ACWY

 

The form below is to be used to request a Medical Exemption.

 

PLEASE NOTE: The Medical Board of California has stated that a physician who grants a vaccine MEDICAL EXEMPTION without conducting an appropriate prior exam and without a finding of a legitimate medical reason supporting such an exemption within the standard of care may be subjecting their license to disciplinary action.

The Medical Board of California encourages the public to REPORT such providers to the Board if they feel that a physician is granting exemptions inappropriately.

Remote Learning

For students who are currently doing coursework remotely off campus and will not be back on campus for any reason, including work or meetings.

  • The list of enrolled courses is required, and confirmation may be requested by the Registrar or Academic Department.
  • Once a student returns to UCI for on-site learning, requirements will be reinstated, and non-compliant students may have their registrations held.
  • New forms must be submitted for each quarter while remote.

 

The form below is to be used to request a Remote Learning extension.

Flu and COVID Vaccination Declination

May be submitted without the need for a Medical Exemption/Religious Exception request.

To submit a declination for Flu and/or COVID vaccination:

    1. Log into My Student Chart
      • Click on “My Compliances”
    2. Scroll down to Clearance Exemptions
      • Click on “Request an Exemption”
    3. Follow prompts to complete your declination request
Religious Exceptions

For students with justified religious beliefs which may be contraindications for the following required vaccines:

  • MMR
  • Varicella
  • Tetanus/Pertussis
  • Meningococcal ACWY

 

The form below is to be used to request a Religious Exception:

    1. Download the UCI Religious Exception Request Form (also available in the My Student Chart)
    2. Carefully read the form and answer the questions completely.
      • IMPORTANT: Please fill in all the sections of the form:
        • Questions 1 and 2 are required
        • Checking boxes, signature and dates are required
        • Question 3 is optional
      • UCI will rely on what you submit in making its determination on your request, so please be clear and thoughtful with answers.
      • Upload the form through the My Student Chart.
        • Click on “Upload Images/Clearance Forms”
        • Find the “Religious Exception” section of the Downloadable Forms page
        • Click “Upload” and attach your completed request form
        • Click “SAVE” at the BOTTOM or all work will be lost. ***see the image at the bottom as a visual reference

IF YOU HAVE ALREADY SUBMITTED YOUR RELIGIOUS EXCEPTION REQUEST, and have additional questions or concerns regarding your status or the decision made, please:

1. Re-Download the UCI Religious Exception Request Form
2. Enter your question/concerns under Question 3
3. Re-Upload the form through the My Student Chart.
4. Your question/concerns will be reviewed by the Committee

PLEASE NOTE: While your request is pending (and if granted) you must comply with all applicable non-pharmaceutical (i.e., behavioral) interventions (i.e., masking or distancing) and vaccine education as specified by UCI or applicable public health directives as a condition of your Physical Presence at any University Location/Facility or Program.

In the event of a disease outbreak, you may be excluded from the site of the outbreak or subject to additional Non-Pharmaceutical Interventions or Vaccine Education to protect the health and safety of yourself and others.