On page 2, after line 21, insert the following:
     "The form for a certificate of exemption under (c) of this subsection must include a box that may be checked if the reason for requesting the exemption is that the risk of permanent disability from the vaccine may be greater than the risk of permanent disability from the disease if (A) data has not conclusively established that the risk of permanent injury from the disease that a particular vaccine is administered to prevent is greater than the risk of permanent injury from the vaccine or (B) the number of deaths attributed to the particular vaccine reported in the vaccine adverse event reporting system database exceeds the number of deaths attributed to the disease according to statistics of the centers for disease control."