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Exemption, Exception or Deferral from UC's Immunization Requirements Including COVID-19


The UC COVID-19 Vaccination Policy provides students with the opportunity to request a medical exemption, disability exception, religious belief exception or deferral during pregnancy. Students seeking an Exemption, Exception or Deferral must submit a request via the Student Health Patient Portal no later than the published compliance deadline dates that were included in the Provost's campus message announcing the policy. While a request is pending, the student must, as a condition of Physical Presence on campus, observe the non-pharmaceutical interventions (NPI's) as defined by UCI consistent with applicable public health directives and the guidelines in Appendix A: COVID-19 Prevention Strategies.

A student who meets the definition of a "Non-Covered Individual" as defined by the policy may submit a form to the Student Health Patient Portal on which they self-attest that they are not subject to the policy. If you believe that the COVID-19 Vaccination Policy does not apply to you, then you must submit a self-attestation that under no circumstances will you be physically present, even for a moment, on the UCI campus or at any other UC location or event for the duration of the 2021 Fall Quarter, including Finals Week. The attestation form is available below under the "Forms" section of this webpage. A student who self-attests by completing, signing and uploading the form will no longer be considered "non-compliant" with the policy.  However, attestations are subject to audit and a new attestation form must be submitted for each term in which you meet the definition as a "non-covered individual".

Below is a summary of current UC mandatory Immunization Requirements:

  • New, incoming students must obtain four (4) required vaccines (aka "4-Vax" requirement) or demonstrate compliance through upload of vaccination records online via the Student Health Patient Portal . In addition, incoming students must complete a TB Risk Screening Form on the portal.  For detailed information, visit the TB and Immunization Requirements webpage. Incoming medical students have additional requirements and should visit the School of Medicine's webpage for incoming medical students here for detailed information.
  • All students, including continuing education students, must obtain a COVID-19 vaccination for which compliance is verified through upload of records to the portal. Reference: UC COVID Policy.
  • Note that the FDA has approved the Pfizer-BioNTech COVID-19 Vaccine for individuals ages 16 and older. Visit the FDA website here for more information.
  • Flu Vaccination: The official UC Flu Vaccination Policy has not been announced. However, it is anticipated that flu vaccination will be mandatory in AY 2021-22 for all students. Compliance will be verified through upload of records to the portal. Visit the Flu Vaccination webpage for updates.

Submitting a Request for Exemption, Exception or Deferral

If you intend to submit a request, please click on the form below that corresponds to the specific exemption, exception or deferral that you are requesting. The submission of a request is completed online via the Student Health Patient PortalClick here for step-by-step instructions

Below is a brief overview of the "Exemptions" process:

Submission of Exemption Request Form

  1. Student downloads the fillable request form. Links to the forms appear below on this webpage and they are also available on the Student Health Patient Portal.
  2. Note that the same form is used to request a medical exemption or disability exception. Separate forms are used for a religious belief exception and a deferral during pregnancy exception.
  3. Student completes and signs the applicable form. Note that the medical exemption-disability exception form must be completed and signed by your health care provider.
  4. Student uploads the completed form to the Student Health Patient Portal for inclusion in the student's electronic health record.

Review of Exemption Requests

  1. Medical Exemptions will be reviewed by the SHC Medical Director.
  2. Disability Exceptions will be jointly reviewed by SHC Medical Director and Disability Services Director.
  3. Religious Belief Exceptions will be reviewed by the campus Religious Exception Committee.
  4. Deferrals for the duration of pregnancy will be reviewed by the SHC Medical Director. A student with an approved deferral will become non-compliant upon expiration of the deferral/birth.
  5. It is anticipated that most reviews will be completed within seven (7) business days. However, certain reviews may take longer. We will strive to complete reviews and respond to the students in as timely a manner as possible. Thank you for your patience.

Confirmation of Approval/Denial of Request

  1. SHC will send a secure message to the student via the portal indicating approval or denial of the request.
  2. If approved, student must acknowledge/sign the approval form and upload to the portal for inclusion in the student's electronic health record. 
  3. The student's portal will reflect compliance for approved exemptions.
  4. If the request is denied, student will be expected to promptly become Fully Vaccinated or could be denied Physical Presence at the relevant campus location(s) or program(s). 

Submitting an Attestation as a Non-Covered Individual

A Covered Individual under the SARS-CoV-2 Vaccination Program Policy includes Students or Trainees under the Policy who physically accesses a University Facility or Program in connection with their education/training.  All Covered Individuals must comply with the Policy.  You are a Covered Individual, and must comply with the Policy, even if you will be physically present on campus or at a UC program only for a moment. To verify that you are not a Covered Individual, please download the attestation form below. Scan and upload the completed and signed form to the Student Health Patient PortalClick here for step-by-step instructions. Please note that you must initial each of the statements and sign and date the form.  Attestations of Non-Covered Individual status are valid until the end of the academic term and are subject to audit.  UCI will check course registrations, facility access documents and other records to verify your answers on this form.


  • For questions regarding the exemptions process, please send a secure message on the Student Health Patient Portal to "Immunization Exemption/Deferral Request Inquiry". A SHC nurse will respond to your inquiry within 3-5 business days.
  • For questions regarding the attestation as a non-covered individual, please send a secure message on the Student Health Patient Portal to "Inquiries Related to Attestation of Non-Covered Individual Status - Students Only" or call the Student Health Center at 949-824-3505.


Medical Exemption, Disability Exception or Deferral Due to Pregnancy

The form below is to be used to request a medical exemption, disability exception or deferral due to pregnancy. Please download the form; present to your health care provider to complete and sign; and then upload the form to the portal. 

Religious Belief Exception

To request an exception for a sincerely held religious belief, please download, complete, sign and upload the form below to the portal. 

Attestation as a Non-Covered Individual -  Student Only

Students who wish to self-attest that they are not Covered Individuals under UC's SARS-CoV-2 Vaccine Program Policy should download, complete, sign, scan and upload this form (or image) to the Student Health Patient Portal.