sample vaccine exemption letter

Sample Vaccine Exemption Letter for Personal or Medical Reasons

If you need to request an exemption from COVID-19 vaccination due to personal or medical reasons, here is a sample vaccine exemption letter to use as a guide.

Dear [Employer/School Administration],

I am writing to request an exemption from the COVID-19 vaccination requirement for personal/medical reasons. I understand the importance of vaccination in preventing the spread of the virus, but due to [insert personal/medical reason], I am unable to receive the vaccine at this time.

[If personal reason] As an individual, I strongly value my autonomy and personal beliefs. While I respect the company/school’s decision to require vaccination, I believe that this decision should ultimately be left to each individual. I am aware that my decision not to receive the vaccine may impact my ability to participate in certain activities, but I am willing to take appropriate precautions to protect myself and others.

[If medical reason] I have consulted with my healthcare provider and have been advised against receiving the COVID-19 vaccine due to [insert medical reason]. While I understand the risks associated with not receiving the vaccine, I believe that this decision is in the best interest of my health.

I am willing to comply with any alternative measures that may be necessary to ensure the safety of myself and others, such as wearing a mask or undergoing regular testing. I also understand that my exemption may be subject to review as the situation evolves.

Thank you for your understanding and consideration.


[Your Name]

Please note that this letter is intended as a guide only and should be customized to fit your specific situation. It is recommended that you consult with legal or medical professionals for advice on how to proceed.

sample vaccine exemption letter


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