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Submitted: Covid-19 Vaccine Religious Exemption Request Form

Attached is a ‘Religious Exemption from Vaccine Request’ as a public service. Many corporations in the United States are imposing a Vaccine Mandate as a new condition of employment. Many people have legitimate concerns and reservations about getting the vaccine.

Some employers do allow for a Religious or Medical exemption. Unfortunately, many people are simply unaware or do not have time to do the proper research to draft an effective argument for a Religious Exemption.

The mainstream media apparently is suppressing a lot of very important and legitimate information about the vaccines that are only found in “alternative” sources. If you have concerns and do not want to get the vaccine, and are in danger of losing your job unless you provide a Religious Exemption, please feel free to use this form.

Of course you can run by your Rabbinical authority and can modify it as needed.

You can download copies of the form here.

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There are 57 Comments to "Submitted: Covid-19 Vaccine Religious Exemption Request Form"

  • Joe says:

    Why would you post this?
    Orthodox Judaism not only doesn’t prohibit taking the vaccine it actually mandates taking it!
    Is there anyone that can argue with Maran Sar Hotorah who gave a clear psak that everyone must take it?!

    • nyj says:

      Where is that psak? Did he actually say everyone must take it? Even kids? Even people who recovered from Covid? Even expectant women? Even people who have medical reasons not to take it? Please show me the exact psak. thank you.

      • david says:

        the video is available if you simply search it on google, give us a break please

        • nyj says:

          I saw one video where he gave a psak to ONE lady to get the vaccine and she should be mispallel. I did not see any video of R Chaim saying everyone must vaccinate, no matter whether they had recovered from covid, etc, as I mentioned above. . Please let me know where I can find the psak? Is it written anywhere?

    • yottle says:

      Maybe because Poskim in Lakewood hold otherwise

    • Its not for everyone says:

      You OBVIOUSLY didn’t read Attachment ‘A’.

    • Its not for everyone says:

      Many of the Poskim that said to get the vaccine said so 15 month ago when we didn’t have case history that we do now…. To quote Attachment ‘A’ in the Exemption attached to this article: “As reported on the US Government’s Center for Disease Control (CDC) VAERS (Vaccine Adverse Event Reporting System) website, 16,310 people have died as a result of the COVId-19 vaccines worldwide. That is almost double the 9,155 people who have died as a result of ALL OTHER VACCINES IN THE PAST 221 YEARS from the year 1990 until present. If you take the average number of deaths annually from all other vaccines, that is an average of 435 per year. One year alone of the COVID-19 vaccines (16,310 deaths) is 3,749% higher than the average year of ALL OTHER VACCINE DEATHS. These deaths from the vaccines are in additions to 778,Adverse Reactions, 17,618 Life-Threatening Events, 75,605 Hospitalizations, 23,712 Permanent Disabilities after Vaccination, 121,304 Office Visits, 87,758 Emergency Room Visits and 528 Birth Defects reported since COVID-19 vaccine reporting began. HOW IN THE WORLD could Orthodox Judaism “Mandate” taking such a risk???

    • old lakewooder says:

      Seems that you do not know that contemporaries of R Chaim have paskened that it is osur to take the vaccine, at all costs, since from their medical research they have concluded that it is a sakana from the many deaths and life altering damages that have occurred soon after the Pfizer shot. There is definitely a large group of klal yisrael who can claim a religious exemption.

    • Argue? says:

      Who can argue? TRUTH, EVIDENCE and FACTS.

    • me says:

      Because all you need to do is look at the scoop the last few weeks & see all the deaths from heart attacks & “sudden petiras” r”l in young(ish) people. In our religion, one may not put himself in a matzav sakana.

  • Anonymous says:

    We need people to get vaccinated.

  • Chaya says:

    Why do we need to get vaacinated? If you are vaacinated then you are protected right. Why would I want to take this vaacine if I already have antibodies, and if this vaacine is not a typical vaacine, and has no long term studies. Are you ok with taking 2 shots and now a booster shot and unending shots? I’m not. My body, my choice. Have you seen the side effects that people are getting. Blood clots, paralysis, miscarriages, still births, heart attacks and much more. And again, we don’t know what’s in store for all these people in the long run.

    • Get Over It says:

      Chaya, have you actually seen all those side effects you mentioned or have you only heard about them? I certainly haven’t seen them. I just had the booster shot. Although the side effects for a couple of days weren’t fun, they weren’t serious. However, I do know people who have had serious side effects from Corona. And I do know people who have died from Corona. True that we don’t know enough about the vaccine so we don’t kow the long term effects. But we do know for sure that Corona itself has long term effects. The ignorant, baseless shittos that many in our community have been picking up are shameful!

      • Its not for everyone says:

        You are unfortunately not aware of early treatments such as Monoclonal Antibodies to be taken right away at first sign of infection and other extremely effective early treatments (within 1-5 days of infection) such as Dr. Zelenko’s protocol of Hydroxychloroquine (or Ivermectin for humans), Erythromycin and Zink where he saw a near 100% success in over 6000 patients not dying, and now even an Israeli study suggest Low Dose Aspirin significantly reduces the effect of a Covid infection. So when you have these early treatments AND afterward superior Natural Immunity that has been proven in studies to be at least 27 times more effective than these vaccines, why in the world would you take an experimental gene therapy “vaccine” with NO long term trials???

  • Just sayin says:

    These bogus religious exemptions are at the expense of skepticism when such exemplary are really warranted

  • SpellCheck says:

    This is not a service to the public.

    • Its not for everyone says:

      FOR PEOPLE who do not want to take this experimental gene therapy… IT MOST DEFINITELY IS!

  • Thank you says:

    Thank you for posting this. For those who would like to follow R’ Kanievsky, I firstly advise you to go see him and ask him for his psak for you personally. But I live here in Lakewood and have not heard any Rav here give a psak for ALL to take this vaccine across the board

  • proud anti cvid shmax says:

    You are doing a tremendous service to the klal! I want to thank you for this incredible resource! May you always spread awareness about the dangers of the vaccine not found on mainstream media and help keep us all safe.

  • Simcha says:

    This is a response to all of the above:

    Most of you are missing the point. It is irrelevant whether this gadol or that gadol issued a psak to get vaccinated or whether you decide not to get vaccinated because you believe you have sufficient antibodies. The question is whether you can legitimately claim a religious exemption under the umbrella of halachic Judaism. The answer is NO!

    As far as I know, there is nothing in halacha that prohibits a person from getting a vaccine that the majority of the medical community deems to be safe.

    In fact, the opposite is true. Actual COVID poses risks. When the Ribono shel Olam provides an antidote to a machla through His shlichim (the medical community), there is a chiyuv to avail oneself of it.

    Vaccinations do NOT pose a halachic problem for Torah observant Jews. Period.

    But let’s suppose you can get away with it. You tell your employer that your religion forbids vaccines and he buys your story and lets you off hook. You have just committed a huge Hillul HaShem because you have told a non-Jew that Judaism forbids vaccinations when that it patently false. That non-Jew now goes around believing that the Am HaNivchar is against public health safety measures. Do we really want to perpetuate the slogan of “Dirty Jew”? Do we really want them to think that we love to wallow in disease and filth?

    • You Are Soo Wrong says:

      You have no opinion unless you read the Exemption in Attachment ‘A’. You OBVIOUSLY didn’t, this is the Chilul Hashem here. Specifically THIS “vaccine” is what the exemption is for…. READ THE REASONS. People spewing falsehoods such are yours are misguided.

  • Hi says:

    Chaya, alot of the side effects you’re mentioning from the vaccine happend to pple that had covid also and didn’t have the vaccine.

  • Its not for everyone says:

    Thank you for providing this resource for all those WHO DON’T WANT TO BE FORCED TO TAKE THIS EXPERIMENTAL VACCINE WITH NO LONG TERM TRIALS.

  • lakewood resident says:

    This religious exemption thing is complicated. Judaism requires us to protect our health and the health of others. Most of us are by now thoroughly confused about whether the vaccine helps or harms. If you are a rabbi who has been convinced that it helps, then you can fairly say that Jewish law requires taking it. If you are a rabbi who has been convinced that it harms, then you can fairly say that Judaism forbids taking it. It depends on the “metzius” (fact of the matter) not really religious law.

    • Simcha says:

      Concerning rabbis (and others) who are “convinced” that COVID vaccines harms…

      There is a ton of misinformation out there. Even if you can identify 5,000 people who have died from complication due to the vaccine, there are currently over 5 billion people who have taken the vaccine. That amounts to one ten thousandth of 1%. Compare that to the millions who have died from the virus itself. There is not even a shayla here.

      Many rabbonim can also fall into believing all this antivax bunk.

      People should be getting competent medical advice from a competent medical professional and stop looking at this as if they are asking a shayla about the kashrus of a chicken.

      The overwhelming consensus of the medical community is to get vaccinated. That is the advice we should be following period.

  • This is sad says:

    This is sad. Judaism does not take exception to taking vaccines and using such a claim weakens legitimate claims that we make. This becomes like the boy who cried wolf. It’s also a lie and a Chilul Hashem.

    This is made even more clear by this story as the reason for using a religious exemption is clearly explained to be a means to not take the vaccine and not because of a legitimate religious exemption.

  • Moshe Rose says:

    This is dishonest. If your rabbi feels vaccines are bad for your health, it’s not a religious belief, it’s a medical opinion.

    Claiming such religious exemptions makes other religious exptions, such as taking off on shabbos, less valid.

    Additionally, everyone knows the Torah doesn’t forbid vaccines. Lying is a chilul hashem. But using our religion to lie, with the support of a rabbi, is much worse.

  • Not impulsive says:

    Which Religion..

    Says not to get the shot?

  • MD says:

    Being religiously observant, while also being against vaccination isn’t a case of legitimate religious exemption.
    Such an exemption means that one’s religious beliefs are in opposition to taking the vaccine.
    Otherwise, it’s not too different from being frum and against paying income tax. That would be a nice try.

  • disagree says:

    this is most definetly not a service to the public……. why would you promote and perpetuate these scare tactics and misinformation on such a public forum????????? Absolutely no real halachik authority is not encouraging vaccination at this point.

  • Everyone is Missing the Point! says:

    First of all, it seems most people didn’t even read the Attachment ‘A’ that shows the unfortunate truths cited for the Religious Exemption.

    Secondly, There is no ‘Psak’ in the exemption, but rather facts that go against the religious ‘conscience’ and is some cases are counter to a Jews obligation to protect themselves IF they have concerns about the vaccines. If someone has these concerns, this alone should be enough to absolve him/her from taking an experiment without long term trials to prove safety. Many experts are very concerned about this winter because the vaccines seem to causing ADE (Antibody Dependent Enhancement) that causes the body to overreact to even regular viruses like the Cold and Flu. H’ Yishmor.

    Thirdly, I see the sheep are speaking up here who haven’t done research for themselves and likely just listen to Mainstream Media cheerleading for the vaccines, when the government’s OWN website, the CDC VAERS website, lists so many deaths in only one year of the vaccine that is more than 3,749% higher than ALL Other vaccines combined for a single year.

    Wake up folks, the Chilul Hashem is the blind leading the blind into perilous danger. The Chilul Hashem is not doing the proper research in the name of protecting your health and relying on your ‘Government’ to promise everything will be OK.

  • Aborted Fetus Cells Made Your Vaccine says:

    I guess all you pro-vaxxers don’t mind murdered baby tissue and cells were used to develop your Pfizer vaccine…. that’s nice.

  • SALOMON FRID says:

    Religious Exemption:
    Once you are providing religious arguments in the document, why don’t you back them up with the multiple links which are available, showing the opinion of one of the most respected authorities in Halacha , R’ Chaim Kanievsky , where he clearly says it’s a religious obligation to vaccinate for covid (including expecting women) OOPS!;
    Maybe also make reference to the Shulchan Aruch o.c. 618, M.B. 8, quoting E.R.and the Rambam, who holds that we go after the amjority of medical opinions (rov deyos) ; OOPS!
    You can also include a couple of links of the extensive lectures of R’ Asher Weiss (in youtube) which he quotes and explains sources and documentation why it’s an obligation to vaccinate OOPS!

    • Fine But Don't Force Me says:

      That’s all well and good FOR YOU. But what if I don’t want to get the vaccine because I am afraid of the potential adverse affects of an experimental gene therapy with NO long term trials?? I should be able to get a Religious Exemption for myself! You do you, I’ll do me!

      • write a comment says:

        You may have a reason to be afraid of the vaccine, but that is not a religious reason and using a religious exemption is disingenuous.

        Find a ‘too scared’ exemption, and use it. But don’t hijack my religion.

      • SALOMON FRID says:

        i can understand someone being reluctant to vaccinate himself, but don’t tell me it’s based on Halacha!

  • Rychmona shain says:

    All those reports on VAERS are completely meaningless. Probably all of them were written by six people. I put a few hundred on there just for laughs and giggles. You can write the vaccines gave you superpowers. Why anyone would put any stock in any of that is completely beyond me. It’s a completely voluntary submission site that has no verification behind and a practical joker can submit any nareshkeit they feel like and there is absolutely zero proof that anything anyone has ever written there is true.

    • Misguided says:

      YOU’VE obviously never gone on the VAERS website. Each account is detailed with narrative. And, it’s well known that MAYBE 1% of occurrences are reported, the actual numbers are frighteningly higher.

    • nyj says:

      You don’t have to believe it but the US govt believes it because they gave out millions of dollars in compensation to those injured by vaccines. They wouldn’t give out millions of dollars to people for no reason.

  • IMPORTANT: IF YOU VAXX INJURED says:

    Dr. Zandre Botha (drzandrebotha.com/copy-of-treatments) has treated many vaccine injured people. She advocates that following to help offset the adverse effect of the vaccine:
    NAC
    Ivermectin
    Food grade hydrogen peroxide
    Molecular hydrogen therapy
    Glutathione
    Ozone Therapy
    Zeolite
    Important to support the heart with potassium
    Selenium is also good at detoxification of cells
    Chelation therapy

    Of course seek out medical advice from your medical practitioner prior to engaging in any medical treatment.

  • Educated says:

    1– you do realize monoclonal antibodies are just as “experimental” as the “experimental” vaccine you are trying to avoid?

    2– I’m sure in your extensive “research” (aka watching YouTube videos put out mainly by people who lack actual medical/scientific backgrounds) you learned that the vaers system relies on self report and most of the reports made there have not been verified, and many have been proven to be fake. Do you know any of these thousands of people who’ve been hospitalized from the vaccine? I don’t. But I know dozens who’ve been hospitalized from Covid.

    3– no, I don’t get my data from “mainstream media”, and I couldn’t be farther from a “sheep”. I read the latest medical journal articles published data, and frankly they don’t support your claims. Do you really think you know better Than the doctors you chase after for every serious medical issue your relatives have ever experienced? Or they know their stuff when it comes to everything else but with COVID they are simply “brainwashed”?? Come on. You can’t seriously believe you are better educated than the overwhelming majority of doctors and scientists out there. Next time your relative has cancer, or a heart attack, will you base their treatment on suggestions from wackos on YouTube?

  • Educated says:

    And for all you claiming our religion doesn’t allow use of the vaccine because it’s development included the use of fetal tissue lines, I’m sure you are aware that ibuprofen,
    Tylenol, pesto bismol, the chicken pox vaccine, Claritin, and many other meds you probably have in your medicine cabinet were developed the same way? Does your rav tell you all those meds are against your religion??

    • nyj says:

      Nobody is forcing me to take tylenol, pepto bisomo, claritin, chicken pox vaccine. We want freedom of choice. As a matter of fact, I don’t take any of the above. There is also a difference in taking a medication when you are perfectly healthy (this vaccine), and taking medication when you are sick.

  • Rychmuna Shain says:

    To the poster above who wrote about chelation. I spent a lot of time looking into chelation when it was suggested as a treatment for my child. I strongly suggest to anyone considering chelation to research it a lot as it is very, very dangerous.

  • MD says:

    @11:14
    “Dr” Zandre Botha? Are you for real? She is a true nutjob, whose degree (which has nothing to do with medicine or any sort of science) isn’t accepted in her own country of South Africa.
    The woman sells dubious supplements, along with Christian mythology, as her “treatments”.
    By the way, would you ever seek medical help in that country?
    How desperate must someone be to hold on to his warped beliefs, if Zandre Botha is also a source of information?

  • Simcha says:

    To all, especially @You are so wrong…

    You are correct. I did not read the attachment. So now that I have read it I give a big Ho Hum. All baloney.

    First of all if all this were true, why are so many frum doctors and rabbonim advocating for the vaccine? Do they not know the halacha?

    The attachment a foregone conclusion and laughable. Here’s why.

    To cite the concept of ViNishmartem L’Nafshoseichem is the ultimate in chutzpah. I would bet good money that those who would use this concept are the same people that were ignoring calls to social distance and mask all the months prior to the vaccine – gathering in shuls and yeshivas without masking. Where was your precious V’Nishmartem then?

    Now, let’s suppose Pfizer used aborted fetal tissue in their research. Does that make the vaccine assur behana’a? We did not ask them to use fetal tissue in their research. What’s done is done. There is no fetal tissue in the shots you are getting. So you are not getting any benefit from aborted tissue. The proof that this is a trumped up excuse is the fact that no kashrus organization goes around and researches what methods were used in procuring any other drug on the market. And as someone else pointed out, is anyone seeking religious exemption on these grounds careful with any other drug out they take? Forgive me if I doubt that.

    The deaths count as someone pointed out is unreliable.

    And as for the claims for infertility, this has been debunked a long time ago.

    And the fact that the mRNA leaves the site of the injection is also a nothingburger. It is totally irrelevant. mRNA does not linger in the body. It signals a cell to make a spike protein and then it has done its shlichus.

    The attachment is such a chillul HaShem because it is clear just from the way it is written that the authors used Judaism as a cudgel – selectively quoting from Torah concepts precisely to achieve the goal they wanted.

    It is a total misrepresentation of Yiddishkeit.

    Shame on The Lakewood Scoop for even giving the hint of promoting it.

    • Avraham says:

      I read your comment and I must say that you have very valid points.

    • Fine But Don't Force Me says:

      It’s not “hijacking my religion”… read the reasons in Attachment ‘A’ of the document. These are all legitimate reasons that have basis in Jewish faith.

    • old lakewooder says:

      I dont know whats going on in lakewood, but here it is not good. I know personally of four people that died after the shot-a neighbor, a big rosh yeshiva, world renown Rav, and another from the neighborhood that all died within a couple of weeks of taking the vaccine, while they lived through the whole pandemic fine. what a coincidence. a few pregnancies in the neighborhood were recently ended with miscarriages soon after taking the third shot . Did you see the facebook page of the misrad habriut before two weeks ago? they invited people to report if they had any adverse effects after the third pfizer shot- thousands and thousands of comments were posted, deaths, terrible effects, and they were constantly deleting them so it wouldn’t look so bad. you could see the number of comments go up and then down each day… They recently just deleted that whole post so now you cant see it. this is only in one tiny county with a population the size of one city in the US. what is happening in the rest of the world?!
      Doctors, where are you? how can you quote med info that says it is safe, dont you know that the med info has been censured? There are gemachim here for oxygen if a covid patient needs it , for they are afraid to go to the hospitals, as they are not treated properly.
      Yisratzeh Vyispayes Ldor Ani ki ein oizer!

  • Don't Force Me says:

    I don’t want to get the vaccine, I should NOT be mandated to get this vaccine or lose my job, PERIOD. If I have a Religious Exemption, I should be allowed to use it. PERIOD.

    • Simcha says:

      The only problem is that YOUR religion, assuming you are Jewish, has no issue with getting vaccines.

      So is it OK for you to misrepresent Judaism to the world just so you can get what you want?

      You remind me of a friend of mine who got a job working for a non-Jewish company that knew zero about Judaism. He got his job during the winter and told his boss that he had to leave around 1PM because of Sabbath observance. His boss was a nice guy and didn’t ask any questions. He then told me that he also leaves work on Fridays in the summer months at 1PM. Why? Because his boss didn’t know that the start of Shabbos is connected with the time of sunset. So he just figured he would play the game and keep his boss in the dark and continue to leave at 1PM the whole year because he could get away with it – taking advantage of his boss’s ignorance and good will.

      This would work nicely (aside from being dishonest) until he would be caught misrepresenting his religion.

      Lying about Yiddishkeit has two problems:

      1) You portray us as being against public health measures (a chillul Hashem)
      2) You have a double chillul HaShem when you get caught in your lie. And you will get caught because tens of thousands of frum Jews have gotten vaccinated. Obviously THEY have no issue with vaccinations.

  • Sarah cogen says:

    I see the medical facilities that accepted bribe money to promote the vaccine did a great job.