Is “in sickness and in health” in every wedding vow?

In nearly all of them. All four Catholic forms contain it, as do the Anglican, Episcopal, Methodist and Presbyterian texts. The notable exception is the short Lutheran Book of Worship vow, which promises faithfulness without listing conditions at all.

In a civil or non-liturgical ceremony, yes — nothing legally requires it anywhere. In a liturgical service you cannot: it is part of the authorised text and the officiant will read from the book.

“In sickness and in health”

The care obligation, and the only clause in the traditional vow that names a specific hardship you can reasonably expect to face.

Where it comes from

The phrase reached English through the medieval Sarum marriage rite and Thomas Cranmer’s Book of Common Prayer of 1549, and it has survived every subsequent revision almost untouched. Where the neighbouring clauses are pairs of opposites standing in for everything between them — better and worse, richer and poorer — this one is literal. Sickness is not a figure of speech.

That is why it outlasts the rest. Modernising committees have removed “obey,” dropped “plight thee my troth” and reworded “till death us do part” — and left this line alone.

The exact wording, rite by rite

“in sickness and in health”

1662 prayer book · Common Worship · 1979 Episcopal · Methodist

… for richer for poorer, in sickness and in health, to love and to cherish …

Identical across the whole prayer-book family, and always in the same position — after the money clause, before “to love and to cherish.”

“in good times and in bad, in sickness and in health”

Roman Catholic · Order of Celebrating Matrimony, Form A

I promise to be faithful to you, in good times and in bad, in sickness and in health, to love you and to honor you all the days of my life.

The Catholic rite keeps the sickness clause but replaces better/worse and richer/poorer with a single pair. The United States alternative form uses the older sequence instead, with all three pairs intact.

“in plenty and in want; in joy and in sorrow; in sickness and in health”

Presbyterian · Book of Common Worship

… to be loving and faithful to you in plenty and in want; in joy and in sorrow; in sickness and in health; as long as we both shall live.

Three pairs rather than three clauses, and the only mainline text that names sorrow directly.

Absent

Lutheran Book of Worship, 1978 · the short form

… to join with you and share all that is to come, and I promise to be faithful to you until death parts us.

Worth knowing if the list of conditions feels heavy to you: the shortest mainline vow does not enumerate them at all. It promises faithfulness and leaves the circumstances unnamed.

Modern rewrites that keep its weight

The clause works because it is concrete. Rewrites fail when they become abstract again — “I will support you through anything” promises less than the line it replaced, not more.

Three that hold

Secular · usable as written

I will look after you when you are ill, and I will let you look after me, which I will find harder.

When you cannot carry it, I will carry it. Not gladly, necessarily, but without being asked and without making you thank me.

In good health and in poor, and for however long the poor stretches last — I am not going anywhere.

Can you drop it?

In a civil or non-liturgical ceremony, yes. No jurisdiction requires it: the words that are legally prescribed, where any are, concern consent and impediment rather than sickness — see non-religious wedding vows for what is actually required.

In a liturgical service you cannot. It is part of the authorised text in the Catholic, Anglican, Episcopal, Methodist and Presbyterian rites, and the officiant reads from the book. Couples who want a shorter vow inside a church service should ask about the Lutheran-style form rather than about editing this one out.

The other clauses: for better or for worse · to have and to hold · till death do us part

Common questions

What does “in sickness and in health” actually mean?: It is the care obligation: a promise that illness will not end the marriage or shift it onto someone else. It is the only clause in the traditional vow that names a specific, foreseeable hardship, which is why couples so often say it is the line they understood properly only years later.
Is “in sickness and in health” in every wedding vow?: In nearly all of them. All four Catholic forms contain it, as do the Anglican, Episcopal, Methodist and Presbyterian texts. The notable exception is the short Lutheran Book of Worship vow, which promises faithfulness without listing conditions at all.
Can we leave it out?: In a civil or non-liturgical ceremony, yes — nothing legally requires it anywhere. In a liturgical service you cannot: it is part of the authorised text and the officiant will read from the book.