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Pepperdine University

Vaccination Exemptions

Pepperdine's COVID-19 vaccination policy includes medical, religious, and philosophical exemptions.

Instructions for Students

Students claiming an exemption (medical, religious, or philosophical) from the COVID-19 Vaccination Policy should do the following:

  1. Log into the Student Health Center Patient Portal.
  2. Select  the "Forms" icon at the center of the page or the "Forms" tab at the top of the page.
  3. In the "COVID-19" section, select "COVID-19 Vaccination Exemption."
  4. Complete and submit the form. Once submitted, the Student Health Center will verify receipt in 3-5 business days. If additional details are needed, you will receive a secure message from the Student Health Center's medical staff through the Patient Portal.

This claim will be documented in the patient's chart and allow for secure messaging between the medical provider and the student. Following receipt of the formal exemption claim the RN will provide further instructions.

Instructions for Employees

Employees who wish to claim an exemption (medical, religious, or philosophical) from the COVID-19 Vaccination Policy may do so by completing the Vaccination Exemption Form for faculty and staff.

Exemption Form


Additional Information for Employees

How can employees claim a medical exemption from the COVID-19 vaccine?

In addition to completing the COVID-19 Vaccine Exemption Form, employees should submit to Human Resources a doctor's note from a licensed, treating medical provider [a physician (MD or DO), nurse practitioner (NP), or physician's assistant (PA)] that includes each of the following:

  • The practice location's address and telephone number, the signing provider's license number and title, and the state where the licensed medical provider practices
  • The specified COVID-19 vaccine(s) from which the employee is exempt (Pfizer, Moderna, and/or Johnson & Johnson) with a statement that the employee's physical condition or medical circumstances is such that immunization is not considered safe
  • A determination whether the COVID-19 Vaccine exemption is permanent or temporary, and, if temporary, the expiration date of each vaccine's exemption

How can employees claim a religious or philosophical exemption from the COVID-19 vaccine?

Employees should complete the COVID-19 Vaccine Exemption Form in which they briefly describe the basis for their claim.