Vaccination Laws

Mandatory vaccination laws help halt the spread of communicable diseases by ensuring that a critical mass of persons enjoys immunity from vaccine-preventable diseases. Before the invention of vaccines, infectious diseases claimed countless lives.

Mandatory vaccine laws aim to ensure everyone has a similar level of immunity from vaccine-preventable diseases. The COVID-19 pandemic, along with subsequent vaccines, offer proof of their effectiveness. Enforced by public health officials, mandatory vaccinations helped this vaccine to achieve a critical mass.

The following article explores U.S. vaccination laws, including exemptions to such mandates and key court cases.

Understanding Vaccines

Your immune system consists of white blood cells and organs that protect you from external germs and diseases. If you fall and scrape your knee, the resulting open wound leaves you vulnerable to a host of germs. Your white blood cells will rush to the wound to protect you from a possible infection.

Although your immune system is quite powerful, it often needs help to protect you. Vaccines help your immune system fight dangerous diseases like measles and smallpox. Dr. Edward Jenner, a British physician, created the first successful smallpox vaccine in 1796. Scientists have built on Jenner’s success and developed vaccines to combat communicable diseases like measles and polio.

Communicable Diseases

The following are examples of communicable diseases:

• Measles
• Mumps
• Varicella
• Rubella
• Pertussis
• Pneumococcal disease
• Meningococcal disease
• Mandatory Vaccination Law

This is not an exhaustive list.

Mandatory Vaccination Requirements

Mandatory vaccine laws date back to 1855, when Massachusetts required all schoolchildren to get a smallpox vaccine to attend school. The purpose of this law was to protect children from catching smallpox. As scientists discovered and developed different vaccines, school immunization requirements grew.

Due to school vaccination requirements, parents start developing their children’s immunization records soon after birth. By age five, most children have received the vaccines needed for school, child care, or daycare.

Failure to comply with vaccination requirements by the given deadline can result in being prohibited from attending school or daycare. There are some legal exemptions available.

State Power To Set Immunization Laws

The U.S. Supreme Court has long recognized that vaccine laws and mandates are a legitimate exercise of a state’s power to protect the health of its citizens. Jacobsen v. Massachusetts is the first Supreme Court case that addressed mandatory vaccines. 

In Jacobson v. Massachusetts, the City of Cambridge adopted a vaccine mandate against smallpox. Under this mandate, they offered free vaccines to Massachusetts residents. Henning Jacobson, a Massachusetts citizen, refused to follow this law. The Supreme Court ruled the law as a proper exercise of Massachusetts’s power to protect public health.

Every state establishes its own vaccination requirements and vaccination exemptions. School vaccination requirements may differ from those for healthcare workers. Check with your healthcare provider or local Department of Health and Human Services if you have any specific questions.

State Immunization Laws

State laws can vary on which vaccinations are mandated.  The following are common inclusions:

• Poliovirus vaccine (IPV)
• Two doses of the Measles, Mumps, and Rubella vaccine (MMR)
• Hepatitis B vaccine
• Two doses of Varicella (chicken pox) vaccine
• DTaP (Diphtheria, Tetanus, Acellular, and Pertussis vaccine)
• Meningitis vaccine (by age 11)
• Tetanus Diphtheria Acellular Pertussis vaccine, or Tdap (by age 11)

In the U.S., the Centers for Disease Control and Prevention(CDC) helps states set vaccination policies and create public health laws. The CDC is a federal public health agency that uses science to protect public health. Many state public health officials rely on advice from the CDC’s advisory committee in developing vaccination requirements and public health laws.

Federal Vaccination Laws

The federal government can only set national mandates for populations under its jurisdiction. During the COVID-19 pandemic, the federal government established COVID-19 vaccine requirements for the following populations:

• Government workers (including contractors)
• Health care facilities that receive Medicaid or Medicare reimbursements
• Employers with more than 100 employees

Federal COVID-19 mandates also applied to international travelers, who had to carry proof of vaccination to enter the U.S.

Mandatory Vaccine Laws Exemptions

Most state vaccination laws provide limited exemptions from vaccination requirements. States can restrict children under these exemptions from attending school during an outbreak. Common exemptions to these requirements include the following:

• Medical
• Religious
• Philosophical

Some states, such as California, New York, and Maine, only allow medical exemptions for school vaccines. Medical exemptions apply when a physician determines a child’s health issues would be worsened by vaccination. 

Religious exemptions apply where vaccination requirements go against religious beliefs. Certain states also allow exemptions for philosophical reasons.

Get Help With Vaccination Issues From an Attorney

It’s challenging to balance public health concerns with personal liberties. A healthcare attorney can help you understand your rights under mandatory vaccine laws. Speak to an experienced healthcare attorney for assistance.