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Exemption or Declination from UC's Immunization Requirements


Students seeking an Exemption or Declination 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. Exemption requests are unnecessary for the flu and COVID vaccines as students may submit a declination letter. 

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 .
  • 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
  • Covered individuals who choose to decline COVID-19 vaccination must complete a Vaccine Declination form (see below) and submit it prior to the start of the quarter (or semester for Law students) in which they are first entering UCI.
  • Flu Vaccination: Visit the Flu Vaccination webpage for the UC policy and any updates.

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

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. 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.
  3. 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. 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. The student's portal will reflect compliance for approved exemptions.
  3. 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). 


  • 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.

Covered Individuals who choose to decline COVID-19 vaccination must complete a Vaccine Declination form and submit it prior to the start of the quarter (or semester for Law students) in which they are first entering UCI.  

Students should upload the Vaccine Declination Letter to the Student Health Patient PortalMEDICAL CLEARANCES page by following DIRECTIONS HERE.

To decline a flu vaccination, please download, complete and sign the UC Flu Vaccination Declination Letter and then upload it to the Student Health Patient Portal.