A requirement isn't a requirement if it isn't required and it isn't required if you can refuse.
You can't "just refuse" you're mincing words because what you believed was proven incorrect.
Enough, child.
According to your own link, All 50 states allow medical exemptions, 44 states allow religious exemptions, and 15 states allow philosophical (or personal belief) exemptions. DC allows medical and religious exemptions.
So 35 States have a requirement, with exceptions.
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