Does NC have vaccine exemptions? The law amid state’s 1st measles case

The first case of measles in North Carolina this year was reported last month, and doctors say an outbreak in the state is expected due to low vaccination rates in some parts of the state.

Nearly 93% of kindergarten students in North Carolina were up to date on their vaccinations during the 2023 school year, according to the N.C. Department of Health and Human Services.

North Carolina law requires that all children get immunized against several illnesses, including measles — but there are exemptions in place for certain groups.

The overhaul of certain programs by U.S. Secretary of Health and Human Services (HHS) Robert F. Kennedy Jr. has also led to increased vaccine hesitancy, according to The Center for American Progress.

Here’s what to know about those exemption laws, and how Robert F. Kennedy Jr.’s vaccine policies have impacted North Carolina.

Vaccine exemptions NC

There are two types of exemptions for required immunizations, according to the N.C. Department of Health and Human Services:

• The state’s medical exemption says if a licensed doctor determines that a vaccine would be detrimental to a person’s health, they can be exempt from it.

• There is also a religious exemption that allows those with religious beliefs that prevent them from getting immunizations to skip them, The News & Observer previously reported.

Vaccination rates by state

Vaccination rates tend to be lower in states that allow more exemptions, especially non-medical exemptions for personal or religious beliefs, data show.

For example, in the 2023–24 school year, about 12% of kindergartners in Idaho had at least one exemption, The Washington Post reported. Only around 81% were up to date with the measles, mumps and rubella vaccine — well below the herd immunity threshold of 95%.

However, California, Connecticut, Maine and New York eliminated both religious and personal exemptions, KFF Health News reported. They typically report exemption rates below 1% and achieve near-universal vaccination coverage.

Vaccine changes RFK Jr.

Sweeping changes to vaccine policy by HHS Secretary Kennedy, such as removing COVID vaccine policy requirements for healthy children and pregnant women, and overhaul of the CDC’s vaccine advisory committee could be contributing to the public’s distrust of vaccines, The Washington Post reported.

One of the ways North Carolina healthcare workers have tried to combat this is by getting people to understand the risks of not taking them, Dr. David Wohl, an infectious disease specialist at UNC Health, told The Charlotte Observer.

He pointed out that uptake rates for COVID vaccines were considerably higher among older populations because they understood the virus was affecting people in their age group.

“They knew they were at risk,” said Wohl. “I also think they appreciate being older in a time period where we didn’t have as many vaccines and we had more sickness.”

How to avoid measles

Wohl said another way to lessen the resistance against vaccines is to keep them readily accessible.

“One of the good things we have in our country is that people get vaccines at their local pharmacies,” Wohl said. “I think that’s incredibly innovative and important, and something we take for granted, but that you can walk into your CVS or Walmart or Walgreens and get your shots really makes a big difference.”

“I’m an infectious disease specialist, these vaccines prevent diseases that I don’t want to see,” he added. “You know, people say all the time, ‘well, how many measles cases have you seen?’ I’ve seen no measles cases because we’ve had an effective vaccine that most everyone in the country took. And that’s the way it should be.”

This story was originally published July 23, 2025 at 12:55 PM with the headline "Does NC have vaccine exemptions? The law amid state’s 1st measles case."

Evan Moore

The Charlotte Observer

Evan Moore is a service journalism reporter for the Charlotte Observer. He grew up in Denver, North Carolina, where he previously worked as a reporter for the Denver Citizen, and is a UNC Charlotte graduate.