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Vaccination Exemptions
West Virginia
State Exemption Page & Exemption Page

Statutes/L A W S
West Virginia State specific information

Link to state law.
National Vaccine Information Center:
NVIC link to state law.

For additional help with exemptions, birth plan, etc questions:
Check our Vaccination Liberation State Chapter and other resource organizations located in your state.

If your state specific help is not available, Contact us.

- - - Available Exemptions - - -
Medical Only for schools

See Daycare for religious exemption for children in daycare.

"A certificate from a reputable physician showing that an immunization for any or all designated diseases, is impossible or improper or sufficient reason why any or all immunizations should not be done."


No Recent Updates to Report

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Table of State Vaccination Exemptions for Children Entering Public Schools

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Begin New Born Birthing Plan and Birth Exemptions
West Virginia State specific New Born Exemption Information.
None at this time.


BirthExemptions  |   Birthing_Plans  |   Vitamin_K  |   Hepatitis_B  |   Eyedrops  |   Newborn_Screening

Birth Exemptions:

For those who are planning a hospital birth but want to evade invasive routine post natal procedures such as a Hep B shot, vitamin K injection, newborn screening, or the application of silver nitrate in the newborn's eyes, a very specific birthing plan must be submitted to the hospital in advance of the birth. Hospital staff must be informed, in advance, of your needs, wants and desires where your baby and birthing experience are concerned. The same applies to midwives.


  • Create the Birthplan. Or modify one of our ours to fit your state laws and any other personal circumstances. (see below)
  • Sign the birthplan in front of a Notary.
  • Submit the birth plan to your hospital or midwife. Keep a couple extra copies in case plans change.
  • Make sure affected parties (doctors, nurses, etc) understand your requirements and wishes.
  • Plan on having one or two trusted persons stay with the mother and child to watch the child at all times while in the hospital, so no unwanted injections are given the baby.
  • The birth plan arrangements and letter should be turned in before delivery date.
  • The "Refusal to Permit Medical Treatment" form below is optional.
  • The "Refusal to Register Live Birth" form below is also optional.

West Virginia State specific information Birth Plans
None at this time.

(To be used with hospitals and/or midwives)

(Links to model birth plan letters)

Model Birth Plan Letter for Hospital Births. You can attach an exemption from immunizations. In some states, there are religious exemptions from newborn screening tests such as PKU, etc...

Information on the Dangers of Hospital Birth and the Benefits of Home Birth from

Our best and most itemized birthplan:
Word-Document (.doc) birthplan-itemized.doc  |   PDF-Document (.pdf) birthplan-itemized.pdf

(HTML) BirthPlan-Itemized for reading on screen. Includes handy small dictionary of terms in the document.

Word-Document (.doc) Model Letter for Hospital Births (Model11425.doc)

Model Birth Plan Letter for Hospital Births. This one is more detailed.

Word-Document (.doc) Model letter for hospital births 2.doc (11426)

Model Birth Plan Letter for Hospital Births for an adopted child...
Model letter for hospital births for adoptions -- Dear Doctor and Medical Staff.doc (11427)
Word-Document (.doc) Model letter for hospital births for adoptions.doc

The birth plan arrangements and letter should be turned in before delivery date.
This "Refusal to Permit Medical Treatment" form below is optional.

West Virginia State specific information Medical Treatment Refusal
None at this time.

GENERAL INFORMATION (Medical Refusal Forms and Affidavit)

"Refusal to Permit Medical Treatment" form
A generic form.
PDF-file (.pdf) letters/refusal_treatment.pdf

It would be good idea to use the AFFIDAVIT below AND a model birth plan letter from above above.
Affidavit - Birth Exemptions
HTML (simple text) Affidavit to modify.

AFFIDAVIT in Microsoft Word Word-Document (.doc) format. (may be modified)

If your Title and Paragraph number of your state law is not pasted to the left, click here for the link to your state law.

Affidavit: Definition and some terms.

West Virginia State specific information Vitamin K
None at this time.


1. Make an informed choice as far ahead of birth as possible.

2. See the Black box warning in the FDA Package Insert for the Injection.

3. Know your options: Pre-Birth Diet, Oral Vitamin K, or synthetic Vitamin K Injection.

Vitamin K

Vitamin K Injection...

The Question of Vitamin K for Newborns
"Essentially all human infants are born with very low blood levels of vitamin K and, since low amounts of vitamin K crosses into breast milk, levels remain low for several weeks after birth in breastfed babies. The purpose of this natural, universal experience of low vitamin K levels in newborns is not known. ..."
"Mouse and epidemiologic studies indicate that the neonatal “deficiency” of vitamin K, which promotes cell turnover, may actually protect the developing fetus from damaging substances that “escape the primary placental screen.”
Read the rest of the article here:

The prescribing information on Vitamin K shot states that fatalities are an adverse reaction according to the Merck pharmaceutical package insert.


"The injectable form of vitamin K can rarely cause severe (sometimes fatal) allergic reactions when given by injection into a muscle or vein. Therefore, vitamin K should be injected into a muscle or vein only when it cannot be given by injection under the skin or taken by mouth, or when your doctor has judged that the benefit is greater than the risk. Seek immediate medical attention if you experience symptoms of an allergic reaction such as rash, itching, swelling, dizziness, or trouble breathing."
Potential exists for the newborn to experience hypersensitivity to any component of this medication.
Each milliliter contains: Phytonadione .. 2 mg or 10 mg
Inactive ingredients:
Polyoxyethylated fatty acid derivative .... 70 mg
Dextrose................................... 37.5 mg
Water for Injection, q.s. .................. 1 mL
Added as preservative: Benzyl alcohol .... 0.9%

Links to prescribing information for Vitamin K:

Archive: Year 2002 Merck Vitamin K Package Insert - Aquamephyton PI | posted on Scribd

My daughter's Vitamin K injection injury Chairwoman and all ...
One Woman's experience: [PDF]

Alternatives to Vitamin K Prophylaxis...

Although oral vitamin K is not licensed for use as a drug by the FDA, drops for oral administration are available. Typically, one drop contains 2 mg. of vitamin K. Contact a midwife in your area, or a birthing supply company (such as, or Scientific Botanicals (206 527-5521) where your health care provider can order liquid vitamin K directly.

Here's another much safer alternative that your chiropractor or naturopath can order for you.


Or buy direct from

Good article with links to sources of oral and natural vitamin K

A good organic whole food diet along with lots of leafy green vegetables is all that is necessary to prevent vitamin K deficiency in newborns.

More Information:
Daily Med - Package Insert:

VRM: First Strike – The Dark Side of The Vitamin K Shot

Informed Consent Defense (2020 Pilot Survey)
Wonderful Graphs comparing various unvaccinated vs vaccinated disease rates for vaccines and Vitamin K at birth PDF 4.8MB

West Virginia State specific information Hepatitis B
None at this time.

Hepatitis B Vaccine

Most states now require the Hepatitis B vaccine for newborns. Many parents are also cornered by emergency room personnel during accident visits. Hospitals nationally are under pressure to utilize every opportunity to score a "hit." If your pediatrician understands your views, get him involved with the hospital. As a last resort, protect your right to receive quality care in by asking hospital personal to sign the following waiver. Usually, you'll never find anybody in the hospital to sign this simple form, but you well get relief from demands to vaccinate your child.

"I certify that the (Name of Vaccine)________ vaccine being administered to (Name of Child)_________ is free from all known and yet unknown zoonotic or human viruses or viral fragments and will not cause acute or chronic illness in the recipient due to viral contamination or as a reaction to the components of this vaccine. (Signature of Physician and Date)_________."

If you do get a signature, hold on to the form.

See Birth Plans for more information on avoiding Hep B Vaccination at birth

West Virginia State specific information Eyedrops

West Virginia: §16-3-10.  Inflammation of eyes of newborn -- Use of an appropriate medication as prophylactic.

§16-3-10.   It shall be unlawful for any physician, nurse-midwife or midwife, practicing midwifery, or other health care professional to neglect or otherwise fail to instill or have instilled, immediately upon its birth, in the eyes of the newborn babe, the contents of a single-use tube of an ophthalmic ointment containing one percent tetracycline or one half of one percent erythromycin or the equivalent dosage of such medications or other appropriate medication approved by the director for prevention of inflammation of the eyes of the newborn. Every physician, nurse-midwife or midwife or other health care professional shall, in making a report of a birth, state the name of the appropriate medication which was instilled into the eyes of said infant. The director shall establish a list of appropriate medications for prevention of inflammation of the eyes of the newborn. The list shall be kept current and distributed to appropriate health care facilities and such other sources as the director may determine to be necessary.

Eyedrops: General

Some states require Prophylaxis against Gonococcal OPHTHALMIA NEONATORUM.

A discussion of medical and legal issues regarding Silver Nitrate in the eyes of the newborn is here:
PDF file: Statutory Law USA: Requiring Silver Nitrate in Eyes of Newborns at:
Written by Dr. Ronald B. Standler, attorney in Massachusetts and consultant

Blog type discussion of pros and cons of eyedrops for newborn is here:

West Virginia State specific information New Born Screening
Says is mandatory. See below.

Main Webpage of West Virginia Code

Chapter 16. 4E - Uniform Maternal Screening Act"

Mandatory Newborn Screening Code
West Virginia -- Universal Newborn Hearing Screening Legislation
§16-22A-1. Testing required.

The physician or midwife in attendance at, or present immediately after, a live birth shall perform, or cause to be performed, a test for hearing loss in the infant unless the infant's parents refuse under subsection (c), section three of this article to have the testing performed. For any infant delivered at a nonlicensed facility, including home births, the physician or other health care provider shall inform the parents of the need to obtain testing within the first month of life. The director of the division of health shall prescribe the test or tests to be administered in accordance with this article.

See §16-24-4. When Screening is Required.

New Born Screening: General

U.S. states now require screening of newborn babies for specific diseases.

Conditions and legal status of "requirement" of newborn to be screened for each state:
National Newborn Screening Status Report

Newborn Genetic Screening Privacy Laws
(includes links to laws for various states)
Archived Copy:

Newborn screening From Wikipedia, the free encyclopedia

Federal NewBorn Screening Law

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Waivers: Read - Modify or Do Not Sign
West Virginia State specific information Waivers
None at this time.

Waivers - Take Care In Signing
If you take your new baby to an MD as opposed to a naturopath and/or chiropractor, please be aware of and careful of any forms you sign.

Our WARNING below is about signing (some) state approved and AAP created forms. See this letter from our director, Ingri Cassel, before you consider signing waiver forms.


To ALL who choose to partially vaccinate or NOT vaccinate their children:

We (here in Idaho) are hearing more reports of schools and daycares across our state not honoring legal and valid vaccine exemptions. The following article contains very important information as to why you do NOT want to sign AAP's (state adopted) exemption form: ...

Filing a NO Vaccination Notice – for patients, employees and students (Your_Choice)

Older letter regarding exemptions in Idaho (similar to many states today)

Dear VacLib Members and Friends -

Wanted to give you all a heads up on state issued exemption forms. I haven't had to deal with this personally for several years, and I always crossed out sentences or clauses, and often adding some of my own, before signing their exemption of medical release type of forms. When Donna Carrillo began to diligently search out existing exemption forms and posting them, I read over a couple of them and encouraged people to make up their own whenever possible. After having a "closer encounter" with such a form - a form provided to the state of Idaho by the American Academy of Pediatrics and the Centers for Disease Control and Prevention and used by licensed Idaho daycares, I was shocked into the VERY REAL danger of signing these forms without changing them significantly.

Any form one affixes their initials to, dates and affixes their signature to at the end is a LEGAL document. All statements prior to your signature you must agree to fully OR restrict your signature to say that you are signing under TDC - threat, duress, and coercion. The form that my daughter was told she needed to fill out for this daycare is posted here: ChildCareExemptForm.pdf. On this form, she crossed out all the "nots" and in her personal statement she further clarified that she understands fully the risks of vaccinating her child.

I have since found out that most public schools and daycares in other states also use a similar form. Basically, by initialing and signing this form as is, you are admitting to understanding that "vaccine preventable" diseases are extremely deadly and ALSO admitting to negligence for willfully denying your son/daughter the life saving protection that vaccines offer. These forms are MEANT to not only be intimidating but to catch the legally ignorant off guard. This is very serious to me since all states have adopted the federally funded Child Abuse Prevention and Treatment Act which gives states the right to literally steal your children for up to 48 hours -- the time they have to prove child neglect OR abuse.

If it were ME, I would insist that they accept a form that I provide them since it satisfies the law. If there are any problems or they insist on me using their form, I would cite the law and ask the school or daycare provider where it actually says in state statute that this particular form is the only form that will satisfy the law. Since your parental rights are at stake here, it is best to be vigilant and err on the side of being overly cautious.

A modified AAP form is posted here that you may wish to use with your doctor: AAPmodified.htm

AAPmodified.doc MSWord .DOC file  |   AAPmodified.pdf PDF file, best for printing.

Not all State employees are aware of the law and many exhibit the Hitler Complex. Take a firm stand. Some individuals have had difficulty getting the required forms. Such arrogance on the part of State employees should be reported to the Director of your state Department of Health.

See: [archive] Why Signing a Waiver to Avoid Vaccines Can Be Considered Abuse
She is referring to the Refusal To Vaccinate From developed by The American Academy of Pediatrics, not a regular religious or conscientious exemption letter or form.

Black's Law Dictionary - Sixth Edition - the definition of Affidavit. This is the dictionary used by the American Bar Association and all judges/magistrates/attorneys.

Affidavit - A written or printed declaration or statement of facts, made voluntarily, and confirmed by oath or affirmation of the party making it, taken before a person having authority to administer such oath or affirmation. [notary]

Warning: Any affidavit we supply is a suggestion or template for you to modify to fit your beliefs or understanding of facts. The "facts" are those of the person signing the affidavit.
Some definitions for terms on AFFIDAVIT:

Further Affiant Saith Not

Affiant: a person who makes an affidavit.

Saith: A third person singular present tense of say.

Sui Juris: having full legal capacity to act on one's own behalf : not subject to the authority of another

Propria Persona: In ones own proper person.

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West Virginia State specific information LETTERS FORMS AFFIDAVITS
None at this time.

Letters Forms Affidavits (General)

Affidavit Index for all Ages: Affidavit Index

Links to Model birth plan letters (above).

Link to Refusal to Permit Medical Treatment form

Links to Affidavit - Birth

An Adult Affidavit, with Christian beliefs, is here. (MSDOC file) Feel free to modify as needed.

Dr. Tenpenny had the following forms on her web site. (Now Archived) The forms are generic and may be used in any state. Check any references that might need updating.

Affidavit for Parents Participating in International Adoption (Word) (pdf)
Hep B vaccine in hospital for newborn refusal, sample (pdf)
OSHA Declination Statement Form (also, pdf)
Religious exemption letter that was approved in Florida (Word) (pdf)
School Vaccine Exemption Form, sample (Word) (pdf)
TB testing refusal, sample (pdf)
Childcare and School Immunization Requirements

Sample Vaccine Letters. from archived on

Short Sample Vaccine Letter

Most states now require the Hepatitis B vaccine for newborns. Many parents are also cornered by emergency room personnel during accident visits. Hospitals nationally are under pressure to utilize every opportunity to score a "hit." If your pediatrician understands your views, get him involved with the hospital. As a last resort, protect your right to receive quality care in the following manner. (Usually, you'll never find anybody in the hospital to sign this simple form):

"I certify that the (Name of Vaccine)________ vaccine being administered to (Name of Child)_________ is free from all known and yet unknown zoonotic or human viruses or viral fragments and will not cause acute or chronic illness in the recipient due to viral contamination or as a reaction to the components of this vaccine. (Signature of Physician and Date)_________."

If you do get a signature, hold on to the form.

The ACCEPTANCE OF RESPONSIBILITY is imperative in exercising your rights for legal exemptions from forced medical experimentation and legalized bioterrorism. DO be prepared to fight for your baby's rights!
An index page to various Acceptance of Responsibility) forms is here:

Religious exemption forms will be listed below under Daycare Schools Colleges

Did not find your state exemption form on our site?
Then try this link to forms for all 50 states and D. of Columbia.

Page Navigation Links

DayCare - Preschool - Schools - Colleges
West Virginia State specific information
DayCare  |   Preschool  |   K thru 12  |   Colleges


Note: Only a medical exemption is available for school children.

Facility Licensing Requirement - West Virginia Department of HEALTH AND HUMAN RESOURCES
However: §78-18-6. Administration of the Family Child Care Facility.
"6.4.f.3. If a facility’s policy permits, exemptions from immunization requirements shall be available for parents who provide written documentation of religious objections to immunizations. "


Medical Exemption from your medical doctor (MD or DO)

Kindergarten & Schools

LETTER OF REQUEST FOR MEDICAL EXEMPTION (To Health Care Provider from parent or guardian)
Filable PDF form

WVMER-2012 Revised June 2015 (form used by Primary Care Provider)
Uses CDC Recognized Contraindications and Precautions
Request for Medical Exemption From Compulsory Immunization

Medical Exemption from your medical doctor (MD or DO)

COVID-19 Vaccination Religious Exemption Request Form [may not be in current use]
WVUHS provides reasonable accommodations

University of Charleston
Medical Immunization Exemption Certificate
Exemption Certificate

Affidavit Index

An Adult Affidavit, with Christian beliefs, is Downloadable here. (MSDOC file) Feel free to modify as needed.

Index of Letters/Affidavit files.

West Virginia State specific information for various Opt-Outs
Not at this time

OptOutRegistry for Vaccines
and various other Opt-Outs

Vaccine Registry Opt-Outs:

Confidentiality of Your Child’s Vaccination Records
FERPA: The Family Educational Rights and Privacy Act

     - - - - Other Opt-Outs - - - -:

Birth Certificate and Marriage License Opt-Out:

Did you know that you can REFUSE to sign the hospital birth certificates and that there is no law that requires you to do so?
See: Marriage Licenses, Birth Certificates & #SSNs

Military Recruiters:
Opt-Out For Children in public schools to to have information withheld from military recruiters.

STUDENT OPT OUT FORM regarding the
pdf file (.pdf) Archived letter from

Word-Document (.doc) Archived on

Act to Protect Your Privacy from Military Recruiters
Information links and booklets at AFSC site

STUDENT OPT-OUT NOTICE regarding the instruction of sexuality to children:
STUDENT OPT-OUT NOTICE Valid in all 50 states
PDF-file (.pdf)


West Virginia State specific information Employment

West Virginia Department of Health and Human Resources
Office of Environmental Health Services
Public Health Sanitation Division
Body Piercing Technician - Hepatitis B Declination Statement

General Employment

Suggestions for dealing with Employer Mandates.

Standard Interpretations
09/23/1997 - The Bloodborne Pathogen Standard and the Enforcement Procedures for TB.
"Finally, be aware that participation in the employer's skin testing program is voluntary on the part of the employee. OSHA does not require that employees participate in TB skin testing, only that the employer make such skin testing available to employees."
See TB Testing for more information.

US Fish and Wildlife Service Form 3-2283
Hepatitis B Immunization Consent/Refusal Form
PDF-file (.pdf) ARCHIVED:

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West Virginia State specific information TB Testing

TB Test:
§16-3D-3.  Compulsory testing for tuberculosis of school children and school personnel; Commissioner to approve the test; X-rays required for reactors; suspension from school or employment for pupils and personnel found to have tuberculosis.

(a) All students transferring from a school located outside this state or enrolling for the first time from outside the state shall furnish a certification from a licensed physician stating that a tuberculin skin test, approved by the Commissioner, has been made within four months prior to the beginning of the school year. If the student cannot produce certification from a physician as required by this section then the student shall have an approved tuberculin skin test done with the result read and evaluated prior to admittance to school.
(b) Test results must be recorded on the certification required by subsection (a) of this section. Positive reactors to the skin test must be immediately evaluated by a physician and, if medically indicated, X-rayed, and receive periodic X-rays thereafter, when medically indicated. Pupils found to have tuberculosis shall be temporarily removed from school while their case is reviewed and evaluated by their physician and the local health officer. Pupils shall return to school when the local health officer indicates that it is safe and appropriate for them to return.
(c) Notwithstanding any other provision of this code to the contrary, all school personnel shall have one approved tuberculin skin test at the time of employment performed by the local health department or the person's physician. Additional tuberculosis skin tests or other medical screens may be required by the local health department or Commissioner, if medically indicated. Positive reactors and those with previous positive skin tests are to be immediately referred to a physician for evaluation and treatment or further studies. School personnel found to have tuberculosis shall have their employment suspended until the local health officer, in consultation with the Commissioner, approves a return to work. School personnel who have not had the required examination will be suspended from employment until reports of examination are confirmed by the local health officer.
(d) The local health officer shall be responsible for arranging proper follow-up of school personnel and students who are unable to obtain physician evaluation for a positive tuberculin skin test.
(e) The Commissioner shall have the authority to require selective testing of students and school personnel for tuberculosis when there is reason to believe that they may have been exposed to the tuberculosis organism. School nurses shall identify and refer any students or school personnel to the local health officer in instances where they have reason to suspect that the individual has been exposed to tuberculosis or has symptoms indicative of the disease.

General Information: TB and/or Lead Testing

Standard Interpretations
09/23/1997 - The Bloodborne Pathogen Standard and the Enforcement Procedures for TB.
"Finally, be aware that participation in the employer's skin testing program is voluntary on the part of the employee. OSHA does not require that employees participate in TB skin testing, only that the employer make such skin testing available to employees."
Generic letter for Exemption to TB Testing:
HTML (text): Exemption-tb-test.html

MS Doc file: Exemption-tb-test.doc

TB and Lead Testing Links:
F L Y E R    LETTER    Exemption_Letters    OSHA_and_TB_test    Tubersol    Treatment    TB_Screening    Alternatives/Additional_Information

The above TB and Lead exemption letters are courtesy of Deirdre DeVane of Wash DC. Thank you Deirdre!
The adult TB letters were edited by Sherri Tenpenny. Thank you Sherri!

TB can be detected by biofeedback machines that are hooked up to a computer, such as the QXCI, Best BioMeridian MSAS (Meridian Stress Assessment) or Electro Dermal Screening, Quantum Life System, and the F-Scan. You will need to ask specifically for a pathogen scan, especially TB. You will also need to request a printout with the results.

Next (below) in Misc are some QXCI and other practitioners. (If known.)

Misc Info and explanation of QXCI - Etc.


(The SCIO and the EPFX are the same device.
It is known as the EPFX in the USA and the SCIO world wide.)
Source: [Now inactive]

National (USA) search on business site for EPFX (QXCI) / SCIO Practitioners.

Use Google or other search engine to find a BioMeridian Practitioner in your area.

If you do not find a practitioner, you can contact the current device manufacturer for the practitioner in your area.

West Virginia specific information Misc/QXCI

QXCI and BioMeridian providers in West Virginia

West Virginia BEST™ BioMeridian Practitioners:

Worldwide Chiropractic & Sports Medicine
7717 Sissonville Drive
Charleston, WV 25320
(304) 988-1922

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