18 STATES HAVE RABIES MEDICAL EXEMPTIONS: Alabama, California, Colorado, Connecticut, Florida, Illinois, Maine, Massachusetts, Maryland, New Hampshire, New Jersey, Nevada, New York, Oregon, Pennsylvania, Vermont, Virginia, Wisconsin
(1) ALABAMA Alabama Code Alabama Code Title 3 Section 7A-2
(c)(1) Notwithstanding the other provisions of this chapter, the State Board of Health by rule may establish procedures and qualifications for an exemption from the requirement for a vaccination for an animal if a rabies vaccination would be injurious to the animal's health.
(2) An animal exempted under subdivision (1) shall be considered unvaccinated by the State Board of Health in the event of the animal's exposure to a confirmed or suspected rabid animal.
(2) CALIFORNIA https://leginfo.legislature.ca.gov/faces/codes_displayText.xhtml?lawCode=HSC&division=105.&title&part=6.&chapter=1.&article
Health and Safety Code Section 121690 (2) A request for an exemption from the requirements of this subdivision shall be submitted on an approved form developed by the department and shall include a signed statement by the veterinarian explaining the inadvisability of the vaccination and a signed statement by the dog owner affirming that the owner understands the consequences and accepts all liability associated with owning a dog that has not received the canine antirabies vaccine. The request shall be submitted to the local health officer, who may issue an exemption from the canine antirabies vaccine.
(3) The local health officer shall report exemptions issued pursuant to this subdivision to the department.
(4) A dog that is exempt from the vaccination requirements of this section shall be considered unvaccinated.
(5) A dog that is exempt from the vaccination requirements of this section shall, at the discretion of the local public health officer or the officer's designee, be confined to the premises of the owner, keeper, or harborer and, when off the premises, shall be on a leash the length of which shall not exceed six feet and shall be under the direct physical control of an adult. A dog that is exempt from the provisions of this section shall not have contact with a dog or cat that is not currently vaccinated against rabies.
A veterinarian licensed in Colorado may issue a written waiver as provided in this section exempting an animal from a rabies vaccination order if the veterinarian, in his or her professional opinion, determines the rabies inoculation is contraindicated due to the animal's medical condition. The terms "waiver" and "exemption" as used in this section are interchangeable. A veterinarian may issue a waiver if:
1. The animal to be exempted has a medical condition defined as "a disease, illness, or other pathological state" for which, in the opinion of the exempting veterinarian, a rabies inoculation is contraindicated;
2. A valid veterinary-client-patient relationship, as definied under C.R.S. Section 12-64-103 (15.5), has been established between the veterinarian, owner and animal to be exempted from rabies inoculation;
3. The veterinarian completes and signs the veterinary section of the Exemption from Rabies Vaccination form provided by the department.
4. The animal owner signs the informed consent section of the Exemption from Rabies Vaccination form;
5. The veterinarian maintains the signed exemption as part of the animal's medical record and provides a copy to the owner;
6. The exemption issued is limited to the anticipated duration of the animal's medical condition that precludes inoculation; and
7. The veterinarian provides a copy of the exemption form to the department, the local health department or animal control agency when requested.
C. A waiver may not exceed a period of three years from the date of issuance. If the medical condition persists beyond a three year period and, in the professional opinion of a veterinarian licensed in the State of Colorado the exemption continues to be appropriate, a new waiver may be issued.
D. Upon receiving a complaint regarding the validity of a rabies inoculation exemption, the executive direction or his/her designee(s) may review Exemption from Rabies Vaccination forms and examine the veterinary records pertaining to the medical condition to determine if the medical condition legitimately contraindicates rabies inoculation. If appropriate, the executive director or his/her designee(s) may refer the case to the State Board of Veterinary Medicine.
(b) The State Veterinarian or the Commissioner of Agriculture, or the commissioner's designee, may grant an exemption from vaccination against rabies for a dog or cat if a licensed veterinarian has examined such animal and determined that a rabies vaccination would endanger the animal's life due to disease or other medical considerations. Such exemption may be granted for an individual animal only after the veterinarian has consulted with the State Veterinarian, the Commissioner of Agriculture, or the commissioner's designee, and completed and submitted to the department an application for exemption from rabies vaccination on a form approved by the Department of Agriculture. After approval of such exemption, the department shall issue a rabies vaccination exemption certificate, copies of which shall be provided to the veterinarian, the owner of the dog or cat exempted from rabies vaccination and the animal control officer of the municipality in which the owner of the dog or cat resides. Certification that a dog or cat is exempt from rabies vaccination shall be valid for one year, after which time the animal shall be vaccinated against rabies or the application for exemption shall be renewed.
(c) Any veterinarian aggrieved by a denial of a request for an exemption from rabies vaccination by the State Veterinarian, the Commissioner of Agriculture or the commissioner's designee may appeal such denial as provided in the Uniform Administrative Procedure Act, sections 4-166 to 4-189, inclusive.
(2) A dog, cat, or ferret is exempt from vaccination against rabies if a licensed veterinarian has examined the animal and has certified in writing that at the time vaccination would endanger the animal's health because of its age, infirmity, disability, illness, or other medical considerations. An exempt animal must be vaccinated against rabies as soon as its health permits.
If a licensed veterinarian determines in writing that a rabies inoculation would compromise an animal's health, then the animal shall be exempt from the rabies shot requirement, but the owner must still be responsible for the fees.
A. A letter of exemption from vaccination may be submitted for licensure, if a medical reason exists that precludes the vaccination of the dog. Qualifying letters must be in the form of a written statement, signed by a licensed veterinarian, that includes a description of the dog, and the medical reason that precludes vaccination. If the medical reason is temporary, the letter shall indicate a time of expiration of the exemption.
B. A dog exempted under the provisions of paragraph 5 A, above, shall be considered unvaccinated, for the purposes of 10-144 C.M.R. Ch.251, Section 7(B)(1), (Rules Governing Rabies Management) in the case of said dog’s exposure to a confirmed or suspect rabid animal.
(3) The Public Health Veterinarian may delay temporarily or indefinitely the rabies vaccination requirement for certain dogs, cats, or ferrets in the interest of public safety or for medical determinations or research.
In order for a dog or cat to be accepted at an animal hospital, veterinarian's office or boarding facility an owner or keeper of such animal shall show proof of current vaccination against rabies; provided however, that if a dog or cat has not been so vaccinated or such owner or keeper fails to show such proof the animal shall be vaccinated against rabies prior to being discharged if the animal's medical condition permits.
Massachusetts General Laws, Chapter 140, Section 137
§ 137. Registration and licenses
A person who at the commencement of a license period is, or who during any license period becomes, the owner or keeper of a dog six months old or over which is not duly licensed, and the owner or keeper of a dog when it becomes six months old during a license period, shall cause it to be registered, numbered, described and licensed until the end of such license period, and the owner or keeper of a dog so registered, numbered, described and licensed during any license period, in order to own or keep such dog after the beginning of the succeeding license period, shall, before the beginning thereof, cause it to be registered, numbered, described and licensed for such period. The registering, numbering, describing and licensing of a dog, if kept in Boston shall be in the office of the police commissioner or if kept in any other town in the office of the clerk thereof.
No town clerk or, in Boston, the police commissioner, shall grant such license for any dog unless the owner thereof provides such town clerk or, in Boston, the police commissioner, either a veterinarian's certification that such dog has been vaccinated in accordance with the provisions of section one hundred and forty-five B, or has been certified exempt from such provision as hereinafter provided, or a notarized letter from a veterinarian that a certification was issued or a metal rabies tag bearing an expiration date indicating that such certification is still in effect.
A dog licensing official may grant an exemption from the provisions of section one hundred and forty-five B for any dog which has not yet attained the age of six months, any dog which the local board of health, for a specified period of time, declared exempt upon presentation of a veterinarian's certificate stating that because of an infirmity, other physical condition or regimen of therapy, that inoculation is thereby deemed inadvisable, or any dog in transit, or dog brought into the commonwealth, temporarily, for the sole purpose of showing in dog shows or exhibition.
(10) NEVADA Medical Exemption:
4. A licensed veterinarian may exempt a dog, cat or ferret from vaccination for health reasons. The veterinarian shall record the reasons for the exemption and a specific description of the dog, cat or ferret, including the name, age, sex, breed and color on a rabies vaccination certificate which must bear the owner’s name and address. The veterinarian shall record whether the reason for the exemption is permanent and, if it is not, the date the exemption expires.
(11) NEW HAMPSHIRE
II. A rabies immunization exemption may be issued, where illness or a veterinary medical condition warrants, by the local rabies control authority upon the written recommendation of a veterinarian licensed under RSA 332-B. The recommendation shall also be signed by an American College of Veterinary Internal Medicine diplomate and the state veterinarian. The exempted animal shall be maintained in strict rabies isolation, under conditions that are at the discretion of the local rabies control authority, until such time as the medical condition has been resolved and the animal can be immunized against rabies. Exempted animals shall not be allowed outdoors without being on a leash and shall be under the direct physical control of an adult owner at all times. In addition, when the animal is outdoors, it shall be muzzled in a manner approved by the local rabies control authority.
Source. 1985, 72:1. 1992, 250:3. 1995, 202:4, eff. June 12, 1995. 2007, 79:1, eff. Jan. 1, 2008.
(12) NEW JERSEY
The State Department of Health shall promulgate regulations providing for the recognized duration of immunity, interval of inoculation, certificate of vaccination, certificate of exemption, and such other matters related to this act.
Medical exemption form
(13) NEW YORK Exemptions The vaccination requirements shall not apply to any dog, cat, domesticated ferret if .... a licensed veterinarian has determined that the vaccination will adversely affect the animal's health....
NY Medical exemption form
(1) Except where specifically exempt, all dogs at least three months old shall be immunized against rabies by the age of six months.
(b) Dogs for which rabies immunization is contraindicated for health reasons, as determined by a licensed veterinarian subsequent to an examination. The reasons for the exemption and a specific description of the dog, including name, age, sex, breed, and color, shall be recorded by the examining veterinarian on a Rabies Vaccination Certificate, which shall bear the owner's name and address. The veterinarian shall also record whether the exemption is permanent, and if it is not, the date the exemption ends;
(15) PENNSYLVANIA unanimously passed a rabies medical exemption bill, SB 155, which was signed into law by Governor Corbett on July 9, 2013 to be effective in 60 days (September 7, 2013).
SB 155 text
The Rabies Prevention and Control in Domestic Animals and Wildlife Act Section 8 Subsection (f) :
(1) An exemption from vaccination against rabies for a dog or cat under subsection (a) may be granted if a licensed veterinarian examines the dog or cat and determinesthat it would be medically contraindicated to vaccinate.
(2) An exemption statement must be completed and signed by the veterinarian and dog or cat owner and must contain the following information in order to be valid:
(i) the signature of the veterinarian and the veterinarian's license number; (ii) the date; (iii) the name and address of the veterinarypractice, office or clinic; (iv) an explanation of the medical reason contraindicating vaccination against rabies; and (v) a description of the dog or cat that includes: (A) breed; (B) sex; (C) age; (D) color and markings; (E) whether the dog or cat is intact, neutered or spayed; and (F) the current license number of the dog that includes any permanent identification, if applicable. (vi) The signature of the owner of the dog or cat and the address of the owner. If there is more than one owner, and the owners are living at separate locations where the dog or cat may be housed, the signature and address of both owners is required.
(3) An exemption from vaccination against rabies is valid for a period of up to one calendar year , after which the dog or cat shall be reexamined. At the reexamination, the dog or cat shall either be vaccinated against rabies or, if exemption status still applies, a new certificate of exemption shall be issued.
2.C.4.D. Rabies vaccination must be administered to domestic pets and wolf/hybrids prior to the age of 4 months unless in the judgment of the veterinarian the animal's medical condition would prevent the development of adequate immunity to rabies. Animals so exempted must be inoculated against rabies as soon as their medical condition permits.
(17) VIRGINIA § 3.2-6521. (enacted March 29, 2010)
D. The Board of Health shall, by regulation, provide an exemption to the requirements of subsection A if an animal suffers from an underlying medical condition that is likely to result in a life-threatening condition in response to vaccination and such exemption would not risk public health and safety. For the purposes of § 3.2-6522, such exemption shall mean that the animal is considered not currently vaccinated for rabies. For the purposes of §§ 3.2-5902, 3.2-6526, and 3.2-6527, such exemption shall be considered in place of a current certificate of vaccination.
(d) A city, village, or town may exempt the owner of a dog from the requirement to have the dog vaccinated against rabies for a year based on a letter from a veterinarian stating that vaccination
is inadvisable because of a reaction to a previous vaccination, a physical condition, or a regimen of therapy that the dog is undergoing. The city, village, or town shall require the owner to providea new letter for each year in which the owner seeks an exemption under this paragraph.
States with Medical Exemptions in Lieu of Rabies Vaccination
Rabies Exemptions and Waivers
Rabies vaccination is required by law. In some instances, it is possible to secure a written waiver for exemption from rabies booster vaccination. A letter justifying the medical reason for such exemption needs to be obtained from your primary care veterinarian. When seeking a waiver, a rabies serum antibody titer should be performed. Adequate serum rabies titers in the USA are at least 0.1 IU/ml (formerly stated as a 1:5 dilution) by the RFFIT method. The international World Health Organization standard for export or in other countries is 0. 5 IU/ml). Waiver requests are not generally accepted based on serum antibody titers alone, but may be granted on a case-by-case basis with justification. Waivers are not granted as a matter of personal preference or advanced pet age, and localities may not permit waivers and exemptions regardless of the justification.