Meningococcal Vaccine - Request a waiver for exemption by submitting form UM55
Residence Life has a form available on their website for obtaining this waiver.
MISSOURI WESTERN STATE COLLEGE
Esry Student Health Center

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[Archived] http://www.mwsc.edu/healthserv/pdf/ImmExempt.pdf

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[Archived] Second Link

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[Archived] Third Link
I request exemption from immunization requirements based on the following:
My religious/cultural beliefs prohibit immunizations. (Indicate rationale and attach statement from clergy or other authority.)
Good religious reasons...
These constitute good reasons when a school or college asks for your religious reason on a form that says, state your reason here or attach rationale.
Oftentimes, you will be requested to state your rationale for your vaccination exemption petition. What follows is what is used for public schools, parochial schools, private colleges, and public universities.
Q: What constitutes a religious conflict with vaccination?
A: All vaccines are made in violation of God’s Word. Vaccines are made with toxic chemicals that are injected into the bloodstream by vaccination. All vaccines are made with foreign proteins (viruses and bacteria), and some vaccines are made with genetically engineered viral and bacterial materials.
A conflict arises if you believe that man is made in God’s image and the injection of toxic chemicals and foreign proteins into the bloodstream is a violation of God’s directive to keep the body/temple holy and free from impurities.
Vaccines are produced in animal tissues. A conflict arises if you accept God’s warning not to mix the blood of man with the blood of animals. Some vaccines are produced in aborted fetal tissue.
A conflict arises if your religious convictions are predicated on the belief that all life is sacred. God’s commandment “Thou Shall Not Kill” applies to the practice of abortion. When it is believed that the practice of abortion should not be encouraged or supported in any manner, a conflict may arise with vaccines produced in aborted fetal tissue even though you didn’t have anything to do with the abortions from which the vaccines are made from.
The
Hepatitis-A vaccine containing
MRC-5 is obtained from human babies that were electively aborted.
WI-38 was created from the tissue of an aborted fetus and is used for the rubella portion of the
MMR-II vaccine.
RA 273 was created from the tissue of an aborted fetus, and is used for
MMR-II vaccine. A conflict arises because my religious convictions are predicated on the belief that all life is sacred. God's commandment
"Thou Shall Not Kill" applies to the practice of abortion.
The acceptance of this/these vaccine(s) promotes/promote abortion and violates the Sixth Commandment of "Thou Shall Not Kill".
The
Chickenpox (Varivax) vaccine containing
MRC-5 and
RA 273, is obtained from human babies that were electively aborted.
The acceptance of this vaccine promotes abortion and violates the Sixth Commandment of "Thou Shall Not Kill".
The
Hepatitis-B vaccine protects against a disease that is only transmitted through multiple sexual partners or street IV drug users.
The acceptance of this vaccine promotes sexual promiscuity and immoral behavior in direct contradiction to the teachings of my faith.
For a child under age 18, where parent has to make the statement, concerning Hep B vaccine...
The
Hepatitis-B vaccine protects against a disease that is only transmitted through multiple sexual partners or street IV drug users and
therefore usurps my parental authority to condemn such activity in my child. The acceptance of this vaccine promotes sexual promiscuity and immoral behavior in direct contradiction to the teachings of our faith.
”I believe that inherent in each individual is an innate intelligence, provided by God, which will protect the host environment and provide homeostasis.” “Life and physical health are precious gifts entrusted to us by God. We must take reasonable care of them…” [2288 – Catechism of the Catholic Church 1994]
“The virtue of temperance disposes us to avoid every kind of excess: the abuse of … medicine.” [2290 – Catechism of the Catholic Church 1994]
(Indicate rationale and attach statement from clergy or other authority.)
You do not need to belong to a church or religious organization to claim religious exemption from vaccines.
Applicable law has been interpreted to mean that a religious belief is subject to protection even though no religious group espouses such beliefs or the fact that the religious group to which the individual professes to belong may not advocate or require such belief.
Title VII of the Civil Rights Act of 1964 as amended Nov. 1, 1980; Part 1605.1-Guidelines on Discrimination Because of Religion.
Our legal rights are guaranteed by the free exercise clause of the
First Amendment to the U.S. Constitution. Recent court decisions have upheld the rights of individuals seeking exemptions from immunizations based upon personal and religious reasons. On the
U.S. Supreme Court level in Frazee V. Illinois Dept. of Security, 489 U.S. 829, it was found that a state may not deny an exemption simply because a person is not a member of a formal religious organization.
UNIVERSITY OF MISSOURI - COLUMBIA SCHOOL OF MEDICINE
Exemption on page 2
EXEMPTION FOR RELIGIOUS/PHILOSPHICAL REASONS
This is to certify that I,________________________________________________________
Student Name (print or type)
Object to receiving measles and/or rubella immunizations for religious or philosophical reasons. I understand that I am subject to exclusion from the University campus when outbreaks of
measles and/or rubella occur.
[Archived document.]

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http://www.muhealth.org/~medicine/src/APP_LCME_Revised.doc
Meningococcal Vaccination Policy Compliance Form
Section 2 Waivers (complete part A or B)
To be completed by students 18 years of age or older
A. I do not choose to get the meningococcal vaccine at this time.
For students under the age of 18:
B. I do not want _______________________________to get the meningococcal vaccine at this time.

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http://www.umsystem.edu/media/fa/management/records/forms/other/um55.pdf