The exemption is one of three conditions allowed in K-12 public schools and accepted by all three districts.
How it works
All three districts follow the Texas Department of State Health Services’ list of required vaccinations for K-12 students.
State law allows students to receive vaccine exemptions through DSHS for medical reasons, reasons of conscience due to religious or personal beliefs, or those in the military.
The law does not allow exemptions out of “inconvenience,” such as lost or incomplete medical records.
Reason of conscience exemptions must be notarized and are valid for two years, while medical exemptions must include a statement from the student’s physician and can be valid for life, LTISD lead nurse Jamie Ennis said.
Medical exemptions tend to not be common at her school but do pop up, EISD Bridgepoint Elementary nurse Leslie Boldrick said.
“I've had a student that has had an allergic reaction to the first [measles vaccine dose]; I've had a student on chemotherapy, so it was delayed,” Boldrick said. “I've had students that came in from other countries and they needed to start the series, but [their physician] didn't want to do all of them at the same time.”
Diving in deeper
In EISD, reason of conscience exemptions increased from 62 in the 2019-20 school year against an enrollment of 8,139 to 285 in 2024-25 against an enrollment of 7,595. Medical exemptions increased from 6 to 53.
Ennis said she has also seen an increase in LTISD reason of conscience exemptions after the COVID-19 pandemic, with exemptions increasing from 255 in 2019-20 against an enrollment of 11,805 to 700 exemptions in 2024-25 against an enrollment of 11,010.
“One thing I don’t think parents realize about exemptions is if we have an outbreak like the measles, ... then everyone who is not immunized for the measles would be required to stay out of school for 21 days,” Ennis said.
Measles and varicella, or chickenpox, vaccines have been some of the most commonly exempted vaccines in LISD over the past five school years.
Over the five-year period, enrollment has stayed between 40,355—its lowest in 2020-21—and 42,593, its highest in 2023-24.
LISD also follows the state’s “exclusion day” protocol where once a month students who are not compliant—either vaccinated or exempted, with the correct records submitted—are excluded from school until they reach compliance, said Cristin Wicketts, LISD’s director of health services.
“We want kids in school; we want them learning,” Wicketts said. “... There's a lot of frustration that comes from the family when their kid has to be excluded, but again, our hands are tied. ... This isn't a Leander ISD law.”
Offering input
Increasing access to affordable vaccine clinics is a priority in all three districts.
In LTISD, officials are working to provide a mobile vaccine clinic to students before the 2025-26 school year begins.
“There are a lot of communities surrounding Austin, and we just don’t have the mobile clinics out here,” Ennis said. “... I would love to see more help from Austin Public Health with that, maybe then being able to provide some of those clinics to not just Lake Travis, but other school districts as well.”
EISD and LISD officials said they also work to have clear communication with families about what is required, and provide local pediatricians to answer immunization questions.
“My thought process is, let’s just talk,” Boldrick said. “Let’s figure out what you need and how we can get it together.”
Quote of note
“We know moving can be overwhelming, and knowing the laws of vaccinations in public education depending on the school district or state that you're in can get a little cumbersome," Wicketts said. "But my nurses are here to support and help and answer any questions.”
