Effective May 17, 2021, institutions of education must give an exemption for students with a medical condition or religious belief that is contrary to vaccination (SB 267 signed 5/17/21). Previously, effective November 4, 2021 through May 1, 2023, employers were required to allow employees to claim an exemption from COVID-19 vaccination for medical reasons or sincerely held religious beliefs (SB 9 signed 11/4/21).
Alaska
There is no requirement to provide exemptions for COVID-19 vaccines.
Arizona
Effective June 30, 2021, employers are required to provide reasonable accommodation to employees with sincerely held religious beliefs, practices, or observances that prevent the employee from recieving the COVID-19 vaccination unless the accommodation would pose an undue hardship to the operation of the employer's business (SB 1824 signed 6/30/21).
Arkansas
Effective October 13, 2021 through July 31, 2023, employers must allow their employees to claim an exemption from COVID-19 vaccination if they show proof of immunity or undergo weekly testing (SB 739 enacted 10/13/21).
California
There is no requirement to provide exemptions for COVID-19 vaccines.
Colorado
There is no requirement to provide exemptions for COVID-19 vaccines.
Connecticut
There is no requirement to provide exemptions for COVID-19 vaccines.
Delaware
There is no requirement to provide exemptions for COVID-19 vaccines.
District of Columbia
There is no requirement to provide exemptions for COVID-19 vaccines.
Florida
Effective June 1, 2023, business entities must provide exemptions to any vaccine requirement based on religious and medical reasons (SB 252 enacted 5/12/23).
Georgia
There is no requirement to provide exemptions for COVID-19 vaccines.
Hawaii
There is no requirement to provide exemptions for COVID-19 vaccines.
Idaho
There is no requirement to provide exemptions for COVID-19 vaccines.
Illinois
There is no requirement to provide exemptions for COVID-19 vaccines.
Indiana
Effective March 3, 2022, employers must allow employees to opt out of a vaccine requirement based on medical or religious reasons or immunity based on a prior COVID-19 infection (HB 1001 passed 3/3/22).
Iowa
Effective October 29, 2021, employers must allow their employees to claim an exemption from COVID-19 vaccination for medical or religious reasons (HF 902 signed 10/29/21).
Kansas
Effective November 22, 2021, employers who impose COVID-19 vaccine requirements are required to allow for medical and religious exemptions. (HB 2001 signed 11/22/21)
Kentucky
There is no requirement to provide exemptions for COVID-19 vaccines.
Louisiana
There is no requirement to provide exemptions for COVID-19 vaccines.
Maine
There is no requirement to provide exemptions for COVID-19 vaccines.
Maryland
There is no requirement to provide exemptions for COVID-19 vaccines.
Massachusetts
There is no requirement to provide exemptions for COVID-19 vaccines.
Michigan
There is no requirement to provide exemptions for COVID-19 vaccines.
Minnesota
There is no requirement to provide exemptions for COVID-19 vaccines.
Mississippi
Effective April 21, 2022, employers must exempt COVID-19 vaccination as a condition of employment for any employee who has a sincerely held religious objection (HB 1509 signed 4/21/22).
Missouri
Effective October 28, 2021, state agencies are prohibited from compelling an individual to receive a COVID-19 vaccine or penalizing a business for noncompliance with federal vaccine mandates where such individual objects due to religious belief or for medical reasons (EO 2021-10 issued 10/28/22).
Montana
There is no requirement to provide exemptions for COVID-19 vaccines.
Nebraska
Effective February 28, 2022, employers must allow for exemptions from a COVID-19 vaccine requirement based on medical or religious reasons (LB 906 passed 2/28/22).
Nevada
There is no requirement to provide exemptions for COVID-19 vaccines.
New Hampshire
Effective August 23, 2022, state hospitals and medical facilities are required to grant religious and medical exemptions from vaccination requirements (HB 1604 signed 6/29/22).
New Jersey
There is no requirement to provide exemptions for COVID-19 vaccines.
New Mexico
Effective July 1, 2023, a child's parent or guardian may file an immunization exemption based on medical or religious reasons. A certificate, affidavit, or written affirmation may be obtained from a physician, physician assistant, certified nurse practitioner, an officer of a recognized religious denomination, or the child's parent or legal guardian. Upon filing and approval, the child is exempt from the immunization requirement for a period of up to nine months (SB 81 enacted 4/4/23).
New York
There is no requirement to provide exemptions for COVID-19 vaccines.
North Carolina
There is no requirement to provide exemptions for COVID-19 vaccines.
North Dakota
Effective November 12, 2021 through August 1, 2023, individuals are allowed to be exempt from any employer vaccination requirement if they submit proof of COVID-19 antibodies, have a medical condition, have a religious, philosophical, or moral belief opposing immunization, or submit to periodic COVID-19 testing (HB 1511 signed 11/12/21).
Ohio
There is no requirement to provide exemptions for COVID-19 vaccines.
Oklahoma
There is no requirement to provide exemptions for COVID-19 vaccines.
Oregon
There is no requirement to provide exemptions for COVID-19 vaccines.
Pennsylvania
There is no requirement to provide exemptions for COVID-19 vaccines.
Rhode Island
There is no requirement to provide exemptions for COVID-19 vaccines.
South Carolina
Employers must provide an exemption to COVID-19 vaccine mandates based on medical or religious reasons. A medical exemption may include the presence of antibodies, a prior positive COVID-19 test, or pregnancy (H 3126 is effective 4/25/22 through 12/31/23).
South Dakota
There is no requirement to provide exemptions for COVID-19 vaccines.
Tennessee
Effective March 15, 2022, employers with a mandatory COVID-19 vaccination policy are required to grant exemptions based on medical or religious reasons (SB 1823 passed 3/15/22).
Texas
Effective October 11, 2021, all entities, including private businesses, must exempt COVID-19 vaccination for any individual, including an employee or a consumer, who objects to such vaccination for any reason of personal conscience, based on a religious belief, or for medical reasons, including prior recovery from COVID-19 (EO-GA-40 issued 10/11/21).
Utah
Effective March 22, 2022, employers must exempt employees from a vaccine requirement for medical reasons, sincerely held religious or personal beliefs, or previous COVID-19 infection (HB 63 passed 3/22/22). Effective November 16, 2021, businesses that mandate a COVID-19 vaccine are required to grant an exemption (1) if receiving the vaccine would be injurious to the health and wellbeing of the employee and (2) if receiving the vaccine would conflict with a sincerely held religious belief (SB 2004 signed 1/16/21).
Vermont
There is no requirement to provide exemptions for COVID-19 vaccines.
Virginia
There is no requirement to provide exemptions for COVID-19 vaccines.
Washington
There is no requirement to provide exemptions for COVID-19 vaccines.
West Virginia
Effective October 20, 2021, public and private employers must exempt employees from a COVID-19 vaccine requirement for religious or medical reasons (HB 335 signed 10/20/21).
Wisconsin
There is no requirement to provide exemptions for COVID-19 vaccines.
Wyoming
There is no requirement to provide exemptions for COVID-19 vaccines.
Meat From Animals Vaccinated With mRNA Vaccines May Soon Make Its Way Into the US Food Supply
A growing list of food sources, including shrimp, pigs, and beef, are being targeted by mRNA gene therapy technology, and the risks are entirely unknown.
(Kateryna Kon/Shutterstock)
Shrimp have become the latest addition to a growing list of food sources targeted by mRNA gene therapy technology. An Israeli company seeking to bring mRNA vaccines to shrimp farming has raised $8.25 million from a group of venture capitalists to promote and improve animal health in marine species through its orally administered RNA-particle platform.
ViAqua, a biotechnology company, created an RNA-based vaccine product that uses ribonucleic acid interference (RNAi) to manipulate gene expression in shrimp. RNAi is a biological process where RNA molecules are used to inhibit gene expression or translation by neutralizing targeted mRNA molecules.
The vaccine comes in the form of a coated feed supplement designed to enhance resistance to white spot syndrome virus (WSSV)—a viral infection that causes an annual loss of about $3 billion and a 15 percent reduction in global shrimp production. ViAqua suggests RNA molecules can inhibit the expression of genes that cause disease with every meal containing its coated product.
According to a 2022 proof-of-concept study, the nanovaccine was roughly 80 percent effective in a lethal WSSV challenge model and exhibited excellent in vivo safety profiles. Yet the risks of altering gene expression in shrimp and the effects of consuming vaccinated shrimp are unknown.
"Oral delivery is the holy grail of aquaculture health development due to both the impossibility of vaccinating individual shrimp and its ability to substantially bring down the operational costs of disease management while improving outcomes," said Shai Ufaz, CEO of ViAqua in a press release. "We are excited to bring this technology to market to address the need for affordable disease solutions in aquaculture."
ViAqua plans to begin production in India in 2024 and believes its technology has numerous applications in aquaculture and beyond, according to their press release.
mRNA Vaccines Are Already Used in Pigs
The aquaculture industry is not the only market being targeted with mRNA vaccines. Genvax Technologies, a startup creating mRNA vaccines for animals, in 2022 secured $6.5 million in funding to develop a self-amplifying mRNA (saRNA) platform that allows for rapid development of a herd or flock-specific vaccine matched 100 percent to the circulating variant at the root of a disease outbreak.
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Genvax's technology involves inserting a specific transgene or "gene of interest" matched to the variant strain into the platform. The saRNA then generates an antibody response without requiring the whole pathogen to be matched to the circulating strain.
In April 2022, Genvax was awarded a $145,000 grant by the Foundation for Food and Agriculture Research to develop an saRNA vaccine for African swine flu (ASF) in collaboration with the U.S. Department of Agriculture. ASF is a highly contagious virus with a 100 percent swine mortality rate but has never occurred in the United States.
According to a 2022 paper published in eClinicalMedicine, saRNA technology uses lipid nanoparticles (LNPs) to encapsulate saRNA. When injected as a vaccine, the LNP encapsulation facilitates "endosomal uptake and release into the cytoplasm of target cells in vivo." This novel technology has "significant and previously untested potential" to be used in drugs and vaccines.
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Genvax isn't the first company to harness mRNA technology in pigs. Merck, in 2018, introduced SEQUIVITY, a "revolutionary swine vaccine platform" that uses RNA particle technology to create "customized prescription vaccines against strains of influenza A virus in swine, porcine circovirus (PCV), rotavirus and beyond."
SEQUIVITY uses electronic gene sequencing to generate RNA particles that, when injected into an animal, provide instructions to immune cells to translate the sequence into proteins that act as antigens, similar to how the COVID-19 vaccine causes the body to generate spike proteins. The idea is that the animal's immune system, when challenged with the actual live pathogen, will recognize the antigen and elicit an immune response.
According to Merck, their RNA participle technology allows for the development of a "safe and flexible" custom swine flu vaccine in only eight to 12 weeks compared to traditional vaccines that take years to develop.
Although it is claimed vaccines utilizing RNA technology are safe and effective, studies appear to be scarce with little to no research to determine what effects consuming pork from vaccinated pigs may have on the human body.
mRNA Vaccines in Cattle Raise Concerns Among Producers
According to the National Cattlemen's Beef Association, mRNA vaccines are currently not licensed for use in U.S. beef cattle. The vaccines are being developed to treat and prevent diseases in cattle, whose meat could make its way to the dinner table.
Ranchers-Cattlemen Action Legal Fund United Stockgrowers of America (R-CALF USA), a national, non-profit organization with more than 5,000 members dedicated to ensuring the continued profitability and viability of the U.S. cattle industry, has raised concerns over using mRNA vaccines in cattle.
In April 2023, R-CALF USA met with medical doctors and a molecular biologist regarding the status of mRNA injections in the global protein supply chain. Veterinarian Max Thornsberry reported that some researchers have found that mRNA and its coded virus could pass to humans who have consumed dairy or meat products from an mRNA-injected animal.
Mr. Thornsberry raised concerns about the full impact and unknown long-term effects of consuming meat from animals injected with mRNA vaccines and called for more extensive research. Although the United States has not yet approved an mRNA vaccine for use in cattle, the country is increasing imports of beef from other countries that either vaccinate cattle with mRNA vaccines or plan to.
"This points to the urgent need for MCOOL (mandatory country of origin labeling)," Mr. Thonsberry said. "Consumers deserve the right to choose whether to consume beef from a country where mRNA injections are being given to cattle, and the only way they can have that choice is if Congress passes MCOOL for beef."
R-CALF USA plans to develop a policy direction for the organization at an upcoming meeting, but "strongly reinforces the need for mandatory country of origin labeling" of beef immediately so that American consumers will know if the beef they are buying comes from a country that is using the controversial mRNA technology in their cattle.
In an op-ed posted on its website, R-CALF USA CEO Bill Bullard said the organization has been attacked for its position and accused by pharmaceutical-backed publications of "fearmongering and misinformation."
"Iowa State University researchers submitted a multi-year research project to the U.S. Department of Agriculture to test a cattle mRNA vaccine system for bovine respiratory syncytial virus (RSV) infection," Mr. Bullard said.
"According to the submission, researchers planned to test the mRNA on cattle during the second year of the project with a completion date of 2026. It would be naïve not to assume that such a research project signals an effort to obtain approval for mRNA injections in U.S. cattle," he added.
Mr. Bullard encouraged others not to "simply trust the pharmaceutical companies and the government" and says his organization "intends to learn the truth by continuing to disclose differing scientific findings, seeking more research into the long-term effects of mRNA injections for cattle, and demanding more transparency from pharmaceutical companies and the government."
Meanwhile, the organization has stated it believes people have a right to know whether the meat they consume has come from animals injected with mRNA technology.
Several states have already drafted or proposed legislation seeking to require the labeling of products derived from animals administered mRNA vaccines, including Tennessee, Idaho, Arizona, Texas, and Missouri.
The COVID-19 vaccine has gotten a lot of attention lately. And for good reason: It may keep people from getting the virus or becoming very sick from it. But at the same time, people are avoiding other important vaccinations. In fact, 47 percent of adults have put off or canceled health care services, such as getting vaccines, during the pandemic.1
That can be a mistake, experts say. You should not postpone certain medical visits or procedures. Routine vaccinations for adults are high on that list. (The same goes for getting emergency care for symptoms such as chest pain or difficulty breathing.) "Vaccines are meant to protect public health and prevent disease," says Hiten Patel, MD, MPH. He's an assistant professor of family medicine at the Ohio State University Wexner Medical Center. And they do a good job of protecting people. But only if you get them when you should.
Below are the vaccines adults should have. Of course, it depends on your age and other key factors. To find out if you're overdue for any on the list, check your vaccination record. It includes a history of all the vaccines you got as a child and adult. Can't find it? Your doctor may have a vaccine history in your medical records. Your state health department may also have registries that include adult vaccines. The Centers for Disease Control and Prevention (CDC) has a list of registry contacts and websites. If you still can't find your record, your doctor can share the right vaccination schedule.
Influenza (flu): Everyone over the age of six months should have a flu shot each year, ideally in September or October.2 "It reduces the likelihood of getting influenza. And if you do get it, you're less likely to get seriously ill," Dr. Patel says. People aged 65 or older have a greater chance of catching the flu and developing complications. So they should get a high-dose version. It has four times as much antigen as the regular shot.3,4
Tdap: This vaccine can protect you from three illnesses: tetanus (lockjaw), diphtheria and whooping cough (pertussis). Diphtheria is a serious bacterial infection. It can cause breathing trouble and heart failure.5 People usually get their first dose of Tdap at age 11 or 12. After age 19, you should have one dose of Tdap, then a Tdap or Td shot every 10 years. Also, women should get a Tdap dose during each pregnancy.6 Never got it? You should have it as soon as possible.
MMR: You usually get the measles-mumps-rubella (MMR) vaccine as a child. It can prevent all three of these contagious diseases. The first dose happens at 12 to 15 months. You'll get the second dose at 4 to 6 years of age.7 Once you've had the full series of vaccines, there's no need to update them, Dr. Patel says. Immunity may wane in some people, though. Your doctor may check antibody levels. If you're low for MMR, you may need a repeat vaccine.
Adults who've never had the MMR vaccine should get at least one shot. There are a few exceptions. For instance, pregnant women should wait until after they've given birth.8 Your doctor can tell you if it's right for you.
Varicella: You might not have heard of the varicella-zoster virus, but you've heard of what it causes ‒ chickenpox. It's highly contagious. But we have a strong defense against it. Two doses of the varicella vaccine are about 90 percent effective. Doctors give it during childhood, usually by age 6. If you are over age 13 and have never had chickenpox or the shot, the Centers for Disease Control and Prevention suggests getting it when you can.9
Shingles: This condition is a reactivation of the same virus that causes chickenpox.10 It comes with a painful rash and blisters, usually on one side of your torso.11 The shot can prevent shingles and complications such as long-lasting nerve pain. The newest vaccine (Shingrix) has two doses. It's given two to six months apart to adults 50 and older. After that, you're protected for life.
"If you got the older shingles vaccine before 2017, you're still eligible for Shingrix, which is much more effective," Dr. Patel says. Keep in mind: It may have side effects. These might include body aches, fever and fatigue that last one to two days.
Pneumococcal: This bacterium can cause pneumonia and meningitis. These infections can be especially harmful at older ages. That's why adults age 65 and older should get the PPSV23 vaccine. (In some cases, a doctor may also suggest a second vaccine, PCV13.) "Adults under 65 should get it if they have a history of diabetes, cardiovascular disease, hypertension, lung disease, alcoholism, immunocompromising conditions (such as HIV) or chronic hepatitis," Dr. Patel says.
Meningococcal: These days, kids are ages 11 to 12 when they get the first dose of this vaccine. Then a booster at age 16.12 It helps prevent meningococcal disease. Most adults don't need it, Dr. Patel says. But it may be a good idea if you're traveling to a part of the world where bacterial meningitis occurs more often.
HPV: The human papillomavirus (HPV) is a leading cause of cervical, throat and rectal cancer. The CDC recommends that anyone between the ages of 11 to 26 get a series of HPV vaccines. That's two doses for 11- to 14-year-olds and three doses starting at age 15. Recently, the CDC approved the vaccine for adults ages 27 to 45.13 If that's you, ask your doctor if you should get the vaccine. It may be especially important if you're dating or have multiple sexual partners.
Finally, if you haven't gotten the COVID-19 vaccine, talk to your doctor about whether you should get it. And if you need more than one vaccine, ask your doctor about the best ways to space them out. You can create a vaccination schedule together. That way you can get the biggest immune-building bang from each one.
This material is for informational purposes only and is not medical advice. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. Contact a health care professional with any questions or concerns about specific health care needs. Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna is not a provider of health care services and, therefore, cannot guarantee any results or outcomes. The availability of any particular provider cannot be guaranteed and is subject to change. Information is believed to be accurate as of the production date; however, it is subject to change. For more information about Aetna plans, refer to our website.
