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Parents can ask for an exemption based on genuine religious beliefs or a physician’s medical advice. North Carolina does not recognize a philosophical objection to vaccinations; parents with those concerns typically claim a religious objection, officials said. Nearly all states – except California, Mississippi and West Virginia – offer religious exemptions, while only 19 offer philosophical exemptions. Children who do not have an exemption or the required vaccinations can be suspended after 30 days and return to school after their parents get an exemption or proof they were vaccinated. Emerson Waldorf School outside Chapel Hill reported Orange County’s lowest immunization rate – 62.2 percent of the K-12 students are immunized. The school, which has had previous outbreaks of pertussis and measles, reported 84 out of 222 students had religious exemptions. The school’s policy is to meet all state requirements, Emerson Waldorf administrator Christina Wise said. A number of families have made a different choice, she said, and the school chooses to respect their decisions. “We consider it a private matter for the family to make decisions, and then we observe all North Carolina laws regarding it,” Wise said. Emerson Waldorf’s immunization rate lowered the overall rate for six local private schools to 93.2 percent, health officials reported. Those schools reported 96 religious and two medical exemptions. Two charter schools – Orange Charter and Expedition School – had a 95.8 percent vaccination rate. Those schools reported 22 religious exemptions and none for medical reasons. The Orange County Schools district led the county with the most vaccinated students at 99.2 percent, reports show, followed by the Chapel Hill-Carrboro City Schools with 98.78 percent. The county schools reported five medical and 57 religious exemptions, compared with 15 medical and 127 religious exemptions in the city schools. Exemptions bill The state Senate considered a bill this year that would have ended religious exemptions; it’s still in the Committee on Health Care. Chapel Hill-Carrboro schools also attempted to eliminate the religious exemption a few years ago, said Judy Butler, the Health Department’s public health nursing supervisor. “They found out legally that they probably could not do that,” she said. “The concern about having the legislature do away with religious exemptions ... was that it might backfire, and they may actually pass a law that allows personal exemptions, which a lot of states have done.”