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TN Vaccination and Minor Consent Laws

COERCION ILLEGAL IN TN

As of July 1, 2024, it is illegal in TN for a healthcare provider to:

(1) Coerce a person, including a person who has legal authority to make healthcare decisions for a child, to consent to a vaccination;
(2) Mislead or misrepresent that a vaccination is required by state law, when state law provides an exemption; or
(3) Mislead or misrepresent that a newborn screening test is required by state law, when state law does not require such screening without providing an exemption to such requirement.

FAQs

WHAT VACCINES ARE REQUIRED FOR CHILD CARE, K-12, COLLEGE?

WHAT EXEMPTIONS ARE AVAILABLE BY LAW?

Find the full TN Code and Search for Specific Codes at TN Courts Lexis Law https://www.tncourts.gov/Tennessee Code

  • Medical and Religious exemptions are available for every vaccination requirement in the state, public and private, through either state law, rule, or federal civil rights protections.
  • For children in any school, nursery school, kindergarten, preschool or child care facility of this state see Tenn. Code Ann. § 49-6-5001
  • For students enrolled in higher education: Medical and religious exemptions are provided by state law (exemptions provided in the Jacob-Nunley Act for the meningococcal vaccine – Tenn. Code Ann. § 49-7-124 ). All other higher education vaccination requirements and exemptions have come from Department of Health Rules. (https://publications.tnsosfiles.com/rules/1200/1200-14/1200-14-01.20191013.pdf)
  • Schools must tell parents about exemptions. State law says: “Any communication provided to students or parents” by the school “must include information” about exemptions and “The exemption information and immunization requirements must be: (1) Provided in the same font size and style; and (2) Located on the same page of the written or digital communication.” Tenn. Code Ann. § 49-6-5001 and for Higher Education Tenn. Code Ann. § 49-7-175.
  • The state has no vaccine requirements for adults outside of higher education settings. For requirements set by employers and other private entities, medical and religious exemptions are protected through religious rights secured under Title VII or medical rights under Americans with Disabilities Act (ADA).

WHAT IS THE PROCESS TO FILE A RELIGIOUS EXEMPTION?

  • Daycare/K-12 Students: A parent or guardian simply files with their minor child’s school “a signed written statement that the immunization and other preventive measures conflict with the parent’s or guardian’s religious tenets and practices”. The parent or guardian can simply repeat the exact language of the law in their statement. Tenn. Code Ann. § 49-6-5001
  • Higher Education Students: The same process as for K-12 (submit a letter). The rules state:  “Where a parent or guardian, or in the case of an adult student, the student, provides to the school a written statement, affirmed under penalties of perjury, that vaccination conflicts with the religious tenets and practices of the parent or guardian, or in the case of an adult student, the student”.  https://publications.tnsosfiles.com/rules/1200/1200-14/1200-14-01.20191013.pdf

WHO CAN ADD VACCINES TO DAYCARE AND SCHOOL REQUIREMENTS?

  • The Commissioner of Health is authorized to designate diseases against which children must be immunized prior to attendance at any school, nursery school, kindergarten, preschool or child care facility of this state. Tenn. Code Ann. § 49-6-5001
  • The General Assembly can pass legislation to add vaccine requirements (the Jacob-Nunley act added the meningococcal vaccine to college requirements for certain situations)
  • The TN Department of Health (TDH), through the rulemaking process, has added vaccine requirements for Higher Education (colleges and universities).
  • Rulemaking by Universities has been attempted.
  • All Rulemaking must get approval from the Government Operations Committee of the General Assembly.

ARE THERE VACCINATION REQUIREMENTS FOR FOSTER OR ADOPTIVE FAMILIES ?

  • Immunization is not required of families adopting (Tenn. Code Ann. § 36-1-148) or fostering (Tenn. Code Ann. § 37-2-419) children, unless the child is under eighteen (18) months of age or has significant documented medical needs; however, a 2024 law now provides religious or moral conviction exemptions. Families that file exemptions, therefore, are not required to be immunized, regardless of the foster or adoptive child’s age or medical status. https://publications.tnsosfiles.com/acts/113/pub/pc0699.pdf
  • For a child in foster care, or a child in the process of adoption, the legal parent or legal guardian has the right to make vaccination decisions.

ARE THERE VACCINE REQUIREMENTS FOR FAMILIES FIRST (TANF) BENEFITS?

  • Possibly for some, but religious exemptions are provided. The federal (TANF) program does not have immunization requirements, but it does suggest the immunization of household children for what a state could include in a recipient’s “individual responsibility plan”. This plan is developed in consultation with the individual. See: https://www.tn.gov/humanservices/for-families/families-first-tanf/families-first-eligibility-information.html
  • Religious exemption: RULES OF TENNESSEE DEPARTMENT OF HUMAN SERVICES FAMILY ASSISTANCE DIVISION CHAPTER 1240-01-47 NON-FINANCIAL ELIGIBILITY REQUIREMENTS FAMILIES FIRST PROGRAM states “Good Cause for failure to meet an immunization or health screening schedule includes a verified illness that resulted in inability to make or keep an appointment, or religious beliefs as a part of the caretaker’s stated faith that prohibits such immunizations and/or health screenings” https://publications.tnsosfiles.com/rules/1240/1240-01/1240-01-47.20161227.pdf

CAN YOUR EMPLOYER MANDATE YOU GET A VACCINE?

  • Tenn. Code Ann. § 50-3-106. Employees’ rights and duties. “Nothing in this chapter or this section shall be deemed to authorize or require medical examination, immunization or treatment for those who object to the medical examination, immunization or treatment on religious grounds, except where the medical examination, immunization or treatment is necessary for the protection of the health or safety of others; . . .”
  • Any immunization incapable of preventing transmission is for personal protection only and not capable of protecting “the health or safety of others”.
  • For requirements set by employers and other private entities, medical and religious exemptions are protected through religious rights secured under Title VII or medical rights under Americans with Disabilities Act (ADA).

WHAT HEALTH CARE CAN MINORS CONSENT TO ON THEIR OWN IN TN?

In 2024, the Families’ Rights and Responsibilities Act was passed.  The full law can be read here:  https://publications.tnsosfiles.com/acts/113/pub/pc1061.pdf    Please read this law carefully.  The impact of this law is still unknown.

-For vaccination, a 2023 law clarified that minors cannot be vaccinated without parental knowledge and consent. This new law acknowledged that the mature minor exception, guided by the “Rule of Sevens,” is part of Tennessee common law, but only in the context of tort law and jury considerations, and not the general rule requiring parental consent for the medical treatment of minors. Tenn. Code Ann. § 63-1-165

-While other medical treatments were not named in the 2023 law, because it clarified the meaning of the Mature Minor Exception in TN, moving forward it should impact other medical situations unless a law exists that specifically names an age for which a minor can receive a specific medical treatment.

– For sexually transmitted diseases: “Any state, district, county or municipal health officer or any physician may examine, diagnose and treat minors infected with STDs without the knowledge or consent of the parents of the minors, and shall incur no civil or criminal liability in connection with the examination, diagnosis or treatment, except for negligence.” T.C.A. 68-10-104.

– For mental health: Minors in TN cannot be given gender-affirming medical procedures, hormones, or puberty blockers. Tenn. Code Ann. § 68-33

Minors 16 years and older “with serious emotional disturbance or mental illness has the same rights as an adult with respect to outpatient and inpatient mental health treatment, medication decisions, confidential information, and participation in conflict resolution procedures”. Tenn. Code Ann. § 33-8-202.

— In 2024, a new law gave parents access to their minor child’s prescription records, with some exceptions, even if the minor acquired the prescription legally without parental knowledge or consent. (https://publications.tnsosfiles.com/acts/113/pub/pc0761.pdf)

– For birth control: The law is so broad it allows access to contraceptive supplies and information for virtually all minors. Tenn. Code Ann. § 68-34-107.

– For pregnancy: Minors can receive prenatal and peripartum care without parental consent. § 63-6-223.

WHAT ARE THE LAWS REGARDING COVID-19 VACCINES AND MASKS?

Tenn. Code Ann. § 14 is dedicated to COVID-19 and includes laws about vaccination and masks.

In Summary:

  • COVID-19 vaccines cannot be mandated by any governmental entity for anyone or for childcare or school attendance.
  • “A private business, governmental entity, school, or local education agency shall not compel or otherwise take an adverse action against a person to compel the person to provide proof of vaccination if the person objects to receiving a COVID-19 vaccine for any reason.”
  • Those with acquired (natural) immunity must be treated the same as the vaccinated.
  • Masks cannot be required by governmental entities. . .except when they can. See the full law.

COVID LAWS

14-1-101. Definitions.
As used in this title, unless the context otherwise requires:
(1) “Acquired immunity” means an acquired specific immune system response to the SARS-CoV-2 virus that is:
(A) Acquired naturally as a result of an individual’s prior infection with SARS-CoV-2 virus; and
(B) Verified by:
(i) A letter from a licensed physician; or
(ii) Documentation of a laboratory test showing antibody, memory cell, or T cell immunity;
(2) “Adverse action” means to:
(A) Discriminate against a person by denying the person employment, privileges, credit, insurance, access, products, services, or other benefits; or
(B) Discharge, threaten, or otherwise discriminate against an employee in any manner that affects the employee’s employment, including compensation, terms, conditions, locations, rights, immunities, promotions, or privileges;
(3) “Applicant” means a person who has applied for employment with an employer;
(4) “Arising from COVID-19” means caused by or resulting from the actual, alleged, or possible exposure to or contraction of COVID-19, or caused by or resulting from services, treatment, or other actions in response to COVID-19, including, but not limited to:
(A) Implementing policies and procedures to prevent or minimize the spread of COVID-19; however, “arising from COVID-19” does not include implementing policies and procedures that violate this title;
(B) Testing;
(C) Monitoring, collecting, reporting, tracking, tracing, disclosing, or investigating COVID-19 exposure or other COVID-19-related information;
(D) Using, designing, manufacturing, providing, donating, or servicing precautionary, diagnostic, collection, or other health equipment or supplies, such as personal protective equipment;
(E) Closing or partially closing to prevent or minimize the spread of COVID-19;
(F) Delaying or modifying the schedule or performance of any medical procedure; or
(G) Providing services or products in response to government appeal or repurposing operations to address an urgent need for personal protective equipment, sanitation products, or other products necessary to protect the public;
(5) “COVID-19” means the novel coronavirus, SARS-CoV-2, and coronavirus disease 2019, commonly referred to as COVID-19, including any variant of SARS-CoV-2 or COVID-19;
(6) “COVID-19 vaccine” means a substance used to stimulate the production of antibodies and provide protection against COVID-19, prepared from the causative agent of COVID-19, its products, or a synthetic substitute, and treated to act as an antigen without inducing a COVID-19 infection;
(7) “Employer” means a person, private business, or governmental entity employing one (1) or more persons within this state;
(8) “Face covering” means a protective covering designed to be worn over the nose and mouth to reduce the spread of COVID-19, but “face covering” does not include an industry required mask;
(9) “Governmental entity”:
(A) Means a state department, agency, or political subdivision, including a city, town, municipality, metropolitan government, county, utility district, public building authority, housing authority, emergency communications district, county board of health, a development district created and existing pursuant to the laws of this state, or an instrumentality of government created by one (1) or more local governmental entities;
(B) Does not include a school or LEA, as defined in § 49-1-103;
(C) Does not include an airport authority;
(D) Does not include a Medicare or Medicaid certified provider, but only to the extent such provider is subject to a valid and enforceable Medicare or Medicaid condition of participation that imposes a requirement contrary to this title, except a person in a position covered by the definition of emergency medical services personnel in § 68-140-302;
(E) Does not include an entity operating on property owned, managed, or secured by the federal government, but only to the extent such entity is subject to a valid and enforceable federal requirement contrary to this title;
(F) Does not include a healthcare provider enrolled in Medicare or Medicaid that is subject to fines or penalties for nonadherence to federal rules and regulations, but only to the extent such provider is subject to a valid and enforceable Medicare or Medicaid requirement contrary to this title; and
(G) Does not include an assisted-care living facility, a home for the aged, a nursing home, or a residential hospice, as those terms are defined in § 68-11-201;
(10) “Healthcare provider” means a healthcare practitioner, person, or facility licensed, authorized, certified, registered, or regulated under title 33, title 63, title 68, federal law or order, or an executive order of the governor, including but not limited to any employees, agents, or contractors of such a practitioner, person, or facility, and residents, interns, students, fellows, or volunteers of an accredited school or of such school’s affiliated teaching or training hospitals or programs in this state;
(11) “Industry required mask” means a face covering, protective cover, or prophylactic device designed to be worn over the nose and mouth for a particular industry that may prevent the spread of COVID-19, but that would be used in the particular industry regardless of the risk of exposure to COVID-19;
(12) “Legal guardian” means a person or entity that has the legal authority to provide for the care, supervision, or control of a minor as established by law or court order;
(13) “Minor”:
(A) Means a person who has not attained eighteen (18) years of age;
(B) Does not include a person who has been emancipated pursuant to title 29, chapter 31; and
(C) Does not include a person who is seventeen (17) years of age and is enlisted in the military;
(14) “Monoclonal antibodies” means bamlanivimab plus etesevimab, casirivimab plus imdevimab, sotrovimab, or any other anti-COVID-19 monoclonal antibody products that target the spike protein of COVID-19 and are approved or authorized by the federal food and drug administration for use as a treatment or prophylaxis for a COVID-19 infection;
(15) “Person” means an individual;
(16) “Private business” means a person, sole proprietorship, corporation, limited liability company, partnership, trust, association, nonprofit organization described in § 501(c) of the Internal Revenue Code that is exempt from federal income taxation under § 501(a) of the Internal Revenue Code (26 U.S.C. § 501(a)), or any other legal or non-governmental entity whether formed as a for-profit or not-for-profit entity engaged in business or commerce in this state, but does not include:
(A) A school;
(B) A Medicare or Medicaid certified provider, but only to the extent such provider is subject to a valid and enforceable Medicare or Medicaid condition of participation that imposes a requirement contrary to this title, except a person in a position covered by the definition of emergency medical services personnel in § 68-140-302;
(C) A healthcare provider enrolled in Medicare or Medicaid that is subject to fines or penalties for nonadherence to federal rules and regulations, but only to the extent such provider is subject to a valid and enforceable Medicare or Medicaid requirement contrary to this title; or
(D) An assisted-care living facility, a home for the aged, a nursing home, or a residential hospice, as those terms are defined in § 68-11-201, or an entity other than a school, as that term is defined in subdivision (19), that operates a residential congregate living facility, including, but not limited to, a home that provides care for adults with disabilities or traumatic brain injury, a home that provides residential mental health treatment for children or adults, or an alcohol and drug treatment facility;
(17) “Proof of vaccination” means physical documentation or digital storage of a person’s receipt of a COVID-19 vaccine;
(18) “Quarantine” means:
(A) The limitation or restriction of a person’s freedom of movement or isolation of a person, or preventing or restricting access to premises upon which the person or the cause or source of COVID-19 may be found, for a period of time to prevent the spread of COVID-19; and
(B) Limiting or restricting the operation of a private business to prevent the spread of COVID-19;
(19) “School” means:
(A) A public elementary or secondary school operated by a local education agency or by the state with public funds, including a charter school;
(B) A publicly-operated child care agency, as defined in § 71-3-501; child care program, as defined in § 49-1-1102; preschool; or nursery school; and
(C) A public postsecondary educational institution;
(20) “School property” means all real property, improvements to real property, and facilities used for school purposes; and
(21) “Severe conditions” means:
(A) The governor has declared a state of emergency for COVID-19 pursuant to § 58-2-107; and
(B) A county has an average rolling fourteen-day COVID-19 infection rate of at least one thousand (1,000) new known infections for every one hundred thousand (100,000) residents of the county based on the most recent data published by the department of health. For purposes of this subdivision (21)(B), the number of new cases per one hundred thousand (100,000) persons within the last fourteen (14) days is calculated by adding the number of new cases in the county in the last fourteen (14) days divided by the population in the county by one hundred thousand (100,000).

14-1-102. Findings.
The general assembly finds that:
(1) Setting forth the rights of people in the context of COVID-19 restrictions in a statute assists the citizens of this state in the enforcement and protection of their rights and creates a safe harbor for those desiring to avoid litigation;
(2) Tennessee, as a great southern state within our federal system of government, is free to enact laws to protect the health and safety of its citizens under the police powers inherent to all states of a federal system of government;
(3) The United States Constitution does not prohibit the states from regulating health and medical practices, nor does it require any person to consent to any form of medical treatment, directly or indirectly, in relation to COVID-19;
(4) The right at common law to personal security and the liberty to be free from an unwanted touching of one’s limbs and body was retained by the people of this state, and that right includes rights and duties with respect to medical treatment administered by other persons, such as through COVID-19 vaccinations;
(5) Informed consent between patients and healthcare practitioners protects the rights at common law of persons and all such consent must be voluntary and not given under duress, coercion, misrepresentation, or fraud; and
(6) Consistent with our constitutionally recognized and inalienable right of liberty, every person within this state is and must remain free to choose or to decline to be vaccinated against COVID-19 without penalty or threat of penalty.

14-1-103. Broad construction to safeguard liberty.
The purpose of this title is to safeguard the constitutional rights and liberty interests of persons during the COVID-19 pandemic. This title must be construed broadly to effectuate the purpose described in this section.

14-1-104. Construction with other laws.
(a) Notwithstanding any other law to the contrary, a governmental entity or public official shall not suspend any provision of this title, regardless of whether there is a state of emergency. This subsection (a) does not prohibit the governor from suspending a provision of this title pursuant to title 58, chapter 2, if the governor has declared a state of emergency.
(b) This title is in addition and supplemental to all other provisions of state law; wherever the application of this title conflicts with the application of other provisions of state law, this title prevails.

14-2-101. COVID-19 vaccine mandates by governmental entities.
A governmental entity, school, or local education agency shall not mandate that a:
(1) Person receive a COVID-19 vaccine; or
(2) Private business or school require proof of vaccination as a condition to access the private business’s or school’s premises or facilities or to receive the benefits of the private business’s or school’s products or services.

14-2-102. COVID-19 vaccine status.
(a) A private business, governmental entity, school, or local education agency shall not compel or otherwise take an adverse action against a person to compel the person to provide proof of vaccination if the person objects to receiving a COVID-19 vaccine for any reason.
(b) Allowing a person to voluntarily provide proof of vaccination or proof of COVID-19 antibodies instead of a negative COVID-19 test in order to gain admission to a place of entertainment, as defined in § 47-25-512, is not a violation of subsection (a).
(c) Notwithstanding subsection (a), a person is not prohibited from requiring another person to provide proof of vaccination as a condition to entering that person’s personal residence for purposes of providing products or services.

14-2-103. Face coverings generally.
(a) Notwithstanding any law to the contrary and except as otherwise provided in subsections (c) and (e):
(1) A governmental entity shall not require a person to wear a face covering as a condition to access the governmental entity’s premises or facilities, or to receive the benefits of the governmental entity’s products or services, unless severe conditions exist and the requirement is in effect for no more than fourteen (14) days; and
(2) An employer that is a governmental entity shall not require an employee to wear a face covering as a term or condition of employment, or take an adverse action against an employee for failing to wear a face covering, unless severe conditions exist at the time the requirement is adopted and the requirement is in effect for not more than fourteen (14) days.
(b) A governmental entity may renew its face covering requirement for additional fourteen-day periods if severe conditions continue to exist each time the face covering requirement is renewed. If, at the end of a fourteen-day period, severe conditions no longer exist, then the governmental entity shall not renew its face covering requirement or otherwise require a person to wear a face covering as a condition to access its premises or facilities; to receive the benefits of its products or services; or as a term or condition of employment.
(c) Notwithstanding subsection (a), a governmental entity shall not require a person to wear a face covering if the person provides documentation from the person’s healthcare provider that wearing a face covering is contraindicated for the person, or if the person objects to wearing a face covering because of the person’s sincerely held religious belief.
(d) This section does not authorize a person to access the premises or facilities of a governmental entity, or to receive the benefits of a governmental entity’s products or services, if the person is otherwise prohibited from accessing its premises or facilities, or from receiving the benefits of its products or services.
(e) This section does not apply to state or local correctional facilities housing inmates in a congregate living arrangement.

14-2-104. Face coverings for schools.
(a) Notwithstanding title 49 or any other law to the contrary and except as otherwise provided in subsection (c), a school or a governing body of a school shall not require a person to wear a face covering while on school property unless:
(1) The principal or president of the school submits a written request to the school’s governing body for the adoption of a policy requiring all persons on school property to wear a face covering;
(2) Severe conditions exist;
(3) The school’s governing body adopts such a policy on a school-by-school or campus-by-campus basis and only:
(A) For the school for which a request is submitted by the principal or president pursuant to subdivision (a)(1);
(B) If all other conditions or requirements of this subsection (a) exist at the time the policy is adopted; and
(C) If the policy is in effect for no more than fourteen (14) days;
(4) The school provides face coverings for persons twelve (12) years of age and older that meet the U.S. National Institute for Occupational Safety and Health N95 classification of air filtration, meaning that the face covering filters at least ninety-five percent (95%) of airborne particles, including droplets containing COVID-19; and
(5) The school provides age-appropriate face coverings for persons under twelve (12) years of age, but over five (5) years of age, that provide air filtration similar to the face coverings described in subdivision (a)(4).
(b) A principal or president of a school may submit a written request to the school’s governing body to renew the face covering requirement for the school for an additional fourteen-day period if the requirements of subsection (a) exist at the time the face covering requirement is renewed. If, at the end of a fourteen-day period, one (1) or more of the requirements or conditions of subsection (a) no longer exist, then a school shall not renew the school’s face covering requirement or otherwise require a person to wear a face covering on school property.
(c) Notwithstanding subsection (a), a school shall not require a person to wear a face covering if the person provides documentation from the person’s healthcare provider that wearing a face covering is contraindicated for the person, or if the person objects to wearing a face covering because of the person’s sincerely held religious belief.
(d) Notwithstanding subsection (a):
(1) A school shall, to the extent practicable, provide a reasonable accommodation pursuant to the Americans with Disabilities Act (42 U.S.C. § 12101 et seq.) to a person who provides a written request for a reasonable accommodation to the principal or president of the school. If the person requesting a reasonable accommodation under this subsection (d) is a minor, then the person’s parent or legal guardian must provide the written request on the minor’s behalf.
(2) The principal or president of the school shall evaluate the request on behalf of the school and, to the extent practicable, provide a reasonable accommodation. The principal or president shall issue a decision approving or denying the request in writing. If the principal or president denies the request, then the grounds for denial must be provided in the principal’s or president’s written decision. If the principal or president approves the request, then the school shall place the person in an in-person educational setting in which other persons who may place or otherwise locate themselves within six feet (6′) of the person receiving the reasonable accommodation for longer than fifteen (15) minutes are wearing a face covering provided by the school that:
(A) For persons twelve (12) years of age or older, meets the U.S. National Institute for Occupational Safety and Health N95 classification of air filtration, meaning that the face covering filters at least ninety-five percent (95%) of airborne particles, including droplets containing COVID-19; and
(B) For persons under twelve (12) years of age, but over five (5) years of age, is age-appropriate and provides air filtration similar to the face coverings described in subdivision (d)(2)(A).
(e) The governing body of a school shall not use state funds to mandate or require students to wear face coverings in violation of this section. If a school’s governing body violates this subsection (e), then the commissioner of education may withhold future distributions of school funds from a local education agency in the amount of the state funds used in violation of this section, or the attorney general and reporter may initiate legal proceedings to recover all state funds used in violation of this subsection (e).
(f) This section does not authorize a person to access a school’s property or to receive the benefits of a school’s services if the person is otherwise prohibited from accessing the school’s property, or from receiving the benefits of the school’s services.

14-2-105. Prohibited adoption or enforcement of statute, ordinance, rule, policy, procedure or practice relating to acquired immunity.
(a) A governmental entity, local education agency, or school shall not adopt or enforce a statute, ordinance, rule, policy, or practice arising from COVID-19 that:
(1) Fails to recognize acquired immunity as providing a level of immune protection that is at least as protective as a COVID-19 vaccine; or
(2) Treats individuals with acquired immunity differently than individuals who have received the COVID-19 vaccine.
(b) A private business shall not adopt or enforce a rule, policy, procedure, or practice arising from COVID-19 that:
(1) Fails to recognize acquired immunity as providing a level of immune protection that is at least as protective as a COVID-19 vaccine; or
(2) Treats individuals with acquired immunity differently than individuals who have received the COVID-19 vaccine.