Vaccination Exemption Information

All students who are enrolling in school have to provide Form 122 from the Mississippi Department of Health (MSDH). This form is proof of vaccinations. Mississippi now allows parents to request religious exemptions from the required vaccinations. This must be done through MSDH. Please see their instructions below.  

  • To request a religious exemption from one or more required vaccinations for Mississippi school entry, the parent or guardian must complete the MSDH Religious Exemption Request (Form 139-R) and submit to the County Health Department (appointment is required: 855-767-0170). 

  • A review of all religious exemption requests for completeness will be conducted at MSDH.  

  • Complete religious exemption requests submitted per MSDH policy will be accepted and signed by the State Epidemiologist or Deputy State Epidemiologist. 

  • Once the request is reviewed and accepted, a Certificate of Medical/Religious Exemption (Form 122) will be issued.  

  • Only the Certificate of Medical/Religious Exemption (Form 122) signed and dated by the State Epidemiologist or Deputy State Epidemiologist provides official, documented proof that a child has been issued a medical/religious exemption by MSDH.  


The process for schools and K-12 vaccinations and exemptions has not changed. Each child with a medical or religious exemption must have a completed and signed 122 Form from the MSDH to be enrolled. There has been no change to the way schools collect, retain and report vaccination status on all students