TITLE 25. HEALTH SERVICES
PART 1. DEPARTMENT OF STATE HEALTH SERVICES
CHAPTER 97. COMMUNICABLE DISEASES
SUBCHAPTER
B.
The executive commissioner of the Texas Health and Human Services Commission (HHSC), on behalf of the Department of State Health Services (DSHS), adopts amendments to §97.62, concerning Exclusions from Compliance and §97.64, concerning Required Vaccinations and Exclusions for Students Enrolled in Health-related and Veterinary Courses in Institutions of Higher Education.
Section 97.62 is adopted with changes to the proposed text as published in the August 15, 2025, issue of the Texas Register (50 TexReg 5300). This rule will be republished.
Section 97.64 is adopted without changes to the proposed text as published in the August 15, 2025, issue of the Texas Register (50 TexReg 5300). This rule will not be republished.
BACKGROUND AND JUSTIFICATION
The amendments are necessary to comply with Texas Health and Safety Code §161.0041, as amended by House Bill (HB) 1586, 89th Legislature, Regular Session, which requires the department to develop a blank affidavit form to be used by a person claiming an exemption from a required immunization and make the affidavit form available on the DSHS website. DSHS has posted a blank affidavit form on the website for a person to download and submit to their child-care facility, school, or institution of higher education, including students enrolled in health-related and veterinary courses.
The amendments allow individuals to print these documents themselves (or request that DSHS send them a blank affidavit, which does not need to be printed on the security sealed paper).
To comply with HB 1586 implementation guidelines beginning with the 2025-2026 school year, a proposal was published in the July 4, 2025, issue of the Texas Register (50 TexReg 3854). DSHS withdrew that rule proposal to ensure the language from HB 1586 and related statutes were properly reflected in the Texas Administrative Code. The notice stating the withdrawal was published in the July 25, 2025, issue of the Texas Register (50 TexReg 4411). A revised proposal was published in the August 15, 2025, issue of the Texas Register (50 TexReg 5300). DSHS now adopts these amendments.
COMMENTS
The 14-day comment period ended August 29, 2025.
During this period, DSHS received comments from 96 commenters regarding the proposed rule amendments, including one from The Immunization Partnership (TIP), two from Texans for Vaccine Choice (TFVC), one from Ector County Health Department, one from Andrews County Health Department, two from Pfizer, one from American Samoa Government Department of Health, two from Cherokee County Public Health, one from District Nurse at Sabinal Independent School District (ISD), one from Elementary School Nurse at Cypress-Fairbanks ISD, one from ProAction/Immunize El Paso, one from Houston Health Department, and 82 from individuals. A summary of comments relating to §97.62 and §97.64 and DSHS's responses follows.
Comment: Concerning §97.62, 71 commenters requested DSHS to require parents and individuals aged 18 years and older to acknowledge viewing a clear and fact-based information web page about the risks of not vaccinating before they can download the exemption form.
Response: DSHS has reviewed the comments and has decided not to incorporate such an amendment at this time. DSHS provides a Benefits and Risks of Vaccination information sheet with the blank exemption affidavit form. Parents, legal guardians, or individuals aged 18 years and older sign the exemption affidavit stating they have read and understand the Benefits and Risks of Vaccination information sheet. No change was made as a result of this comment.
Comment: Concerning §97.62(2)(A), one commenter requested DSHS to require parents and individuals aged 18 years and older to acknowledge viewing a clear and fact-based information web page about the risks of not vaccinating before they can download the exemption form. The stakeholder requests DSHS limit the visibility of the exemption affidavit link and ensure the fact-based information page is included with the link. The stakeholder requests DSHS facilitates education and outreach to health-related and veterinary courses stakeholders.
Response: DSHS has reviewed the comment and has decided not to incorporate such an amendment at this time. DSHS provides a Benefits and Risks of Vaccination information sheet with the blank exemption affidavit form. Parents, legal guardians, or individuals aged 18 years and older sign the exemption affidavit stating they have read and understand the Benefits and Risks of Vaccination information sheet. No change was made as a result of this comment.
Comment: Concerning §97.62, one commenter believes childhood disease is putting the health of the country at risk.
Response: The amendments are necessary to comply with Texas Health and Safety Code §161.0041, as amended by HB 1586, 89th Legislature, Regular Session. No change was made as a result of this comment.
Comment: Concerning §97.62, one commenter requested DSHS to keep vaccine policies.
Response: The amendments are necessary to comply with Texas Health and Safety Code §161.0041, as amended by HB 1586, 89th Legislature, Regular Session. No change was made as a result of this comment.
Comment: Concerning §97.62, one commenter requested DSHS to require a more rigorous process.
Response: DSHS has reviewed the comment and has decided not to incorporate such an amendment at this time. DSHS provides a Benefits and Risks of Vaccination information sheet with the blank exemption affidavit form. Parents, legal guardians, or individuals aged 18 years and older sign the exemption affidavit stating they have read and understand the Benefits and Risks of Vaccination information sheet. No change was made as a result of this comment.
Comment: Concerning §97.62, one commenter requested DSHS to require school vaccines.
Response: The amendments are necessary to comply with Texas Health and Safety Code §161.0041, as amended by HB 1586, 89th Legislature, Regular Session. No change was made as a result of this comment.
Comment: Concerning §97.62, one commenter stated parents are using the exemption form for convenience of missing one vaccine rather than conscience. The stakeholder requests DSHS to require parents and individuals aged 18 years and older to acknowledge viewing a clear and fact-based information web page about the risks of not vaccinating before they can download the exemption form.
Response: DSHS has reviewed the comment and has decided not to incorporate such an amendment at this time. The amendments are necessary to comply with Texas Health and Safety Code §161.0041, as amended by HB 1586, 89th Legislature, Regular Session. DSHS provides a Benefits and Risks of Vaccination information sheet with the blank exemption affidavit form. Parents, legal guardians, or individuals aged 18 years and older sign the exemption affidavit stating they have read and understand the Benefits and Risks of Vaccination information sheet. No change was made as a result of this comment.
Comment: Concerning §97.62, one commenter stated requiring a name and telephone number exceeds the requirement and legislative intent of HB 1586.
Response: DSHS has reviewed the comment and has amended language to clarify that required information only pertains to requests for a mailed form submitted via online, fax, mail, or hand-delivered. The amendments are necessary for DSHS to contact requestors who have issues with their address or if the mailed packet gets returned via USPS. DSHS removes the information once the request is processed.
Comment: Concerning §97.62, five commenters neither supported nor opposed the rules; however, they emphasized support for immunization policies.
Response: The amendments are necessary to comply with Texas Health and Safety Code §161.0041, as amended by HB 1586, 89th Legislature, Regular Session. No changes were made as a result of these comments.
Comment: Concerning §97.62, one commenter neither supported nor opposed the rules; however, they emphasized their support for school vaccination requirements and requested DSHS provide vaccine education.
Response: The amendments are necessary to comply with Texas Health and Safety Code §161.0041, as amended by HB 1586, 89th Legislature, Regular Session. No change was made as a result of this comment.
Comment: Concerning §97.62, eight commenters supported the new language.
Response: DSHS has reviewed the comment. No changes were made as a result of these comments.
Comment: Concerning House Bill 1586, two commenters requested DSHS reject HB 1586.
Response: The amendments are necessary to comply with Texas Health and Safety Code §161.0041, as amended by HB 1586, 89th Legislature, Regular Session. No changes were made as a result of these comments.
Comment: Concerning the proposed rules, one commenter submitted a statement that they were interested in submitting a comment.
Response: No response. No comment was received.
Comment: Concerning vaccinating kids, one commenter submitted a statement in the subject line "vaccinate kids."
Response: No response. No comment was received.
STATUTORY AUTHORITY
The amendments are adopted under Texas Health and Safety Code §161.004 and §161.0041, which authorize the executive commissioner to adopt rules necessary to administer statewide immunization of children and exceptions; and Texas Government Code §524.0151 and Texas Health and Safety Code §1001.075, which authorize the executive commissioner of HHSC to adopt rules for the operation and provision of health and human services by DSHS and for the administration of Texas Health and Safety Code Chapter 1001.
§97.62.
Exclusions from compliance are allowable on an individual basis for medical contraindications, reasons of conscience, including a religious belief, and active duty with the armed forces of the United States. Children and students seeking enrollment in schools, child-care facilities, or institutions of higher education, including students enrolled in health-related and veterinary courses, must submit evidence for exclusion from compliance as specified in the Health and Safety Code §161.004(d), Health and Safety Code §161.0041, Education Code Chapter 38, Education Code §51.933(d), Human Resources Code Chapter 42, and §97.64 of this subchapter (relating to Required Vaccinations and Exclusions for Students Enrolled in Health-related and Veterinary Courses in Institutions of Higher Education).
(1) To claim an exclusion for medical reasons, the child or student must present an exemption statement to the school or child-care facility, dated and signed by a physician (M.D. or D.O.), properly licensed and in good standing in any state in the United States who has examined the child or student. The statement must state that, in the physician's opinion, the vaccine required is medically contraindicated or poses a significant risk to the health and well-being of the child or student or any member of the child's or student's household. Unless it is written in the statement that a lifelong condition exists, the exemption statement is valid for only one year from the date signed by the physician.
(2) To claim an exclusion for reasons of conscience, including a religious belief, the child's parent, legal guardian, or a student 18 years of age or older must present to the school or child-care facility a completed, signed, and notarized affidavit on a form provided by the department stating that the child's parent, legal guardian, or the student declines vaccinations for reasons of conscience, including because of the person's religious beliefs. The affidavit will be valid for a two-year period from the date of notarization. A child or student, who has not received the required immunizations for reasons of conscience, including religious beliefs, may be excluded from school in times of emergency or epidemic declared by the commissioner of the department.
(A) A person claiming exclusion for reasons of conscience, including a religious belief, from a required immunization may only obtain the affidavit form from the department by:
(i) downloading the affidavit form from the department's internet website, or
(ii) submitting a request (via online, fax, mail, or hand-delivery) to the department.
(B) A request for a mailed affidavit submitted online, fax, mail, or hand-delivery must include the following information:
(i) complete mailing address, including name, address, and telephone number; and
(ii) number of requested affidavit forms.
(C) Requests for mailed affidavit forms must be submitted to the department through one of the following methods:
(i) written request through the United States Postal Service (or other commercial carrier) to the department at: DSHS Immunization Branch, Mail Code 1946, P.O. Box 149347, Austin, Texas 78714-9347;
(ii) by fax to (512) 776-7544;
(iii) by hand-delivery to the department's physical address at 1100 West 49th Street, Austin, Texas 78756; or
(iv) via the department's Immunization program website (at www.ImmunizeTexas.com).
(D) The department will mail the requested affidavit forms to the specified mailing address.
(E) The department may not maintain a record of the personally identifiable information of individuals who request an affidavit and must return the original documents (when applicable) with the requested affidavit forms.
(3) To claim an exclusion for armed forces, persons who can prove active duty service with the armed forces of the United States are exempted from the requirements in these sections.
The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on September 18, 2025.
TRD-202503297
Cynthia Hernandez
General Counsel
Department of State Health Services
Effective date: October 8, 2025
Proposal publication date: August 15, 2025
For further information, please call: (512) 776-6319