Some states are getting rid of vaccine mandates

The United States has had a long history of vaccine mandates, with the U.S. Supreme Court ruling in 1909 that compulsory vaccination to protect public health was constitutional.

According to a CDC analysis published last year, routine childhood vaccinations prevented over 1.1 million deaths and 32 million hospitalizations in the United States over the last three decades. This helped save $540 billion in direct costs and $2.7 trillion in indirect costs. Notably, the analysis did not include the lives or money saved by flu or RSV vaccines, meaning that the true impact of childhood vaccines is likely much higher.

"Somehow [vaccination] became a social norm," said Heidi Larson, an anthropologist and researcher at the London School of Hygiene and Tropical Medicine. Historically, American attitudes toward vaccination have been, "'This is what we're doing to protect the health of our kids as a group,' not 'It's being imposed on me as an individual.'"

However, antivaccine sentiments have grown significantly over the last few years, and some U.S. states are now actively banning vaccine mandates.

In April, Idaho Gov. Brad Little (R) signed the Idaho Medical Freedom Act into law. The law prohibits state and local governments, private businesses, employers, schools, and daycares from requiring anyone take a vaccine or receive any other kind of "medical intervention."

The law expands upon Idaho's already permissive rules for vaccine mandates. Since the 1990s, parents in Idaho have been able to send their unvaccinated children to school by signing a form saying vaccination was against their religious or personal beliefs. The state also banned almost all COVID-19 vaccine requirements in 2023.

In an interview with ProPublica, Leslie Manookian, who wrote the Idaho Medical Freedom Act, said that her goal is to get people to "understand and appreciate that the most basic and fundamental of human rights is the right to direct our own medical treatment — and to codify that in law in every state."

"Breaking that barrier in Idaho proves that it can be done, that Americans understand the importance of this, and the humanity of it, and that it should be done in other states," Manookian added.

Starting in early December, there will no longer be school vaccine mandates for hepatitis B, chickenpox, haemophilus type b, and pneumococcal conjugate virus. Vaccine mandates for poliomyelitis, diphtheria, tetanus, pertussis, measles, mumps, and rubella will remain in place since they require action from the Florida legislature to be changed.

Currently, healthcare providers in the state are pushing back on these changes and urging their local legislators to oppose any proposals to remove the remaining vaccine mandates if they're introduced. 

"Vaccine requirements are not about government overreach, they are about public responsibility," said Lisa Rush, a pediatrician with Health Care Alliance. "They're protecting the vulnerable and ensuring that our schools, businesses, and healthcare systems remain strong and resilient in the face of infectious disease."

Florida's decision to end childhood vaccine mandates has also reinvigorated anti-vaccine lobbyists, who are planning to push for a medical freedom bill that failed last year.

"We feel like the climate is ready for it," said Jill Hines, codirector of the anti-vaccine group Health Freedom Louisiana. "That conversation has already started with Florida's foot in the door."

Separately, Jackie Schlegel, president of the anti-vaccine group Texans for Medical Freedom, said that "sweeping reforms [would be occurring] in Texas in the coming years."

"Putting parents as the sole decision maker and not the CDC or local school districts is what our legislators are talking about," Schlegel said.

As anti-vaccine sentiment continues to grow, state health officials and medical leadership are working to emphasize the importance of vaccines and oppose efforts to remove mandates.

"We have a really strong, educated legislature that values evidence-based medicine, and they've seen the importance of vaccines in preventing unnecessary deaths," said Katherine Pannel, president of the Mississippi State Medical Association. "They have been really valuable. So when any legislation to weaken the vaccine legislation has come up, they have been on target and have killed any kind of legislation."

"I sincerely hope that other states don't do this. We're seeing at the national level an immense threat to the nation's vaccine policy," said Northe Saunders, president of American Families for Vaccines. "Any erosion at any level of government is going to put kids at risk and they're going to get sick and unfortunately, people are going to die."