Washington State

House of Representatives

Office of Program Research



Health Care & Wellness Committee

HB 1638

This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent.

Brief Description: Promoting immunity against vaccine preventable diseases.

Sponsors: Representatives Harris, Stonier, Robinson, Macri, Jinkins, Cody, Thai, Davis, Appleton, Doglio, Frame, Stanford, Bergquist, Santos and Tarleton.

Brief Summary of Bill

  • Removes the philosophical or personal objection exemption for the measles, mumps, and rubella vaccine.

  • Allows proof of disease immunity through laboratory evidence or history of disease to substitute for immunization.

Hearing Date: 2/8/19

Staff: Jim Morishima (786-7191).


A child is prohibited from attending a school or licensed day care center unless one of the following is presented prior to the child's first day: (1) proof of full immunization; (2) proof of the initiation and compliance with a schedule of immunization; or (3) a certificate of exemption. Full immunization includes vaccines for chickenpox, diphtheria, measles, German measles, haemophilus influenza type B disease, hepatitis B, mumps, pneumococcal disease, polio, tetanus, and whooping cough. The certificate of immunization status form published by the Department of Health allows laboratory evidence of immunity (titer) to substitute for the required immunization. The form also allows a verified history of chickenpox to substitute for the chickenpox vaccine.

In order for a child to be exempt from all or part of the immunization requirement, one of the following must be presented:

An exemption form must also include a statement signed by a health care practitioner stating that he or she provided the signator with information about the benefits and risks of immunization, unless the parent or guardian demonstrates membership in a religious body or church in which the religious beliefs or teachings preclude a health care practitioner from providing medical treatment to the child. "Health care practitioner" is defined as a licensed allopathic or osteopathic physician, naturopath, physician assistant, or advanced registered nurse practitioner.

Summary of Bill:

A philosophical or personal objection may not be used to exempt a child from the measles, mumps, and rubella vaccine.

Proof of disease immunity through documentation of laboratory evidence of antibody titer or a health care provider's attestation of a child's history of a disease sufficient to provide immunity against that disease constitutes proof of immunization for that specific disease.

Appropriation: None.

Fiscal Note: Requested January 31, 2019.

Effective Date: The bill takes effect 90 days after adjournment of the session in which the bill is passed.