The regulation contradicts itself about the HPV vaccine.  It is listed as the twelfth requirement.  Then, under Exemptions it states:  "C. HPV vaccine. Because the human papillomavirus is not communicable in a school setting, a parent or guardian, at the parent's or guardian's sole discretion, may elect for the parent's or guardian's child not to receive the HPV vaccine, after having reviewed materials describing the link between the human papillomavirus and cervical cancer approved for such use by the board."   So, it's not really required and doesn't require a written medical or religious exemption to be exempted.  VA has created a situation that fools parents into thinking it is required.  Remove it, so this medical decision can remain between the parent/child and their doctor, as all medical decisions should be.  Because medical decisions involve risk.