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Many Republican governors have reacted with fury after President Joe Biden said he would require employees at large companies to either get vaccinated against COVID-19 or undergo weekly tests. But Republican and Democratic-led states are already demanding that hundreds of thousands of their citizens – infants, toddlers and schoolchildren, for the most part – be vaccinated against a host of diseases. In fact, mandatory immunizations for children have been a feature of American society since the 19th century.
Currently, the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices recommends routine immunization against 16 diseases from birth to age 18. young people for their age cannot attend school (public, private or parish) or enroll in childcare programs, although there are exemptions for religious, medical or other reasons.
President Biden’s new tenure on the COVID-19 vaccine has sparked political controversy. At the time, several news articles pointed out that vaccination warrants were common at the state level, including in states ruled by Republicans. We wanted to know how common these mandates are and how they differ from state to state.
To find out, we researched the state laws and rules governing the vaccinations required for entry into schools and daycares, by far the most common vaccination mandates in the state. We also checked the websites of each state’s health department and, where details were not yet clear, news articles and other unofficial sources.
Our information on recommended vaccines for infants, children, and adolescents comes direct from the Centers for Disease Control and Prevention. For the history of vaccine development, approval, and recommendations, we consulted the CDC and the Food and Drug Administration, as well as histories held by the College of Physicians of Philadelphia and the Children’s Hospital of Philadelphia.
As part of Biden’s plan, all companies with more than 100 workers will either need to require their employees to be immunized or undergo weekly testing. Biden also acted to fire federal contractors and most federal workers, and extended a previously announced vaccine mandate for nursing home workers to cover virtually all healthcare workers.
Some states already require certain vaccinations for specific categories of adults. New York, for example, requires all workers in hospitals, nursing homes and other health care facilities to be immunized against measles and rubella. Rhode Island requires that child care workers not only be immunized against several common childhood illnesses, but that they also get the flu shot every year. Several states have specific vaccination mandates for students.
But overall, most immunization mandates apply to children and adolescents. We studied state laws, regulations, and state health department information to assess how broadly mandated the CDC’s vaccine recommendations are.
Of the 16 vaccinations recommended by the CDC for children and adolescents, all 50 states (plus the District of Columbia) impose diphtheria, tetanus, pertussis (pertussis), polio, measles, rubella and chickenpox. Additionally, all states except Iowa make mumps vaccination mandatory. (Diphtheria, tetanus, and pertussis vaccines are usually given as a single combined injection, as are measles, mumps, and rubella vaccines.) With the exception of the chickenpox vaccine, which has become available. in the United States in 1995, all of these vaccines have been around for 50 years or more.
Among the newer childhood vaccines, however, state mandates are somewhat mixed. Only two states (Alabama and South Dakota) do not require hepatitis B vaccination at some point in a child’s life, but about half (24) do not require it for hepatitis A. Only six states – including five in the Northeast – require annual flu shots for daycares or preschool enrollments, and none do so for K-12 students.
Three vaccines – against rotavirus, pneumococcal disease and Haemophilus influenzae type b, or Hib – are generally recommended for children under 5 years old. (Hib, despite what its name might imply, does not cause the flu, but it can cause a range of other conditions, from mild ear infections to life-threatening meningitis and infections of the blood.) However, while all states except four require Hib vaccine for daycare or preschool, 10 do not require pneumococcal vaccine, and only eight require rotavirus vaccination.
The two remaining vaccines, against human papillomavirus (HPV) and meningococcal disease, are recommended for adolescents and older children around 11 or 12 years old. its requirement and Vermont only requires it for students living on campus. But only DC, Hawaii, Rhode Island, and Virginia require the HPV vaccine, which protects against cervical and other cancers, but has been controversial because HPV is sexually transmitted.
Vaccination mandates in the United States date back to the 19th century, when many cities and states began requiring that children be vaccinated against smallpox; the Supreme Court upheld these warrants in a landmark decision of 1905. A combined vaccine against diphtheria, tetanus, and pertussis became available in 1948, and it was quickly added as a consistently recommended vaccine.
In 1977, the World Health Organization’s Expanded Program on Immunization set the goal of giving every child in the world access to immunization against six diseases by 1990: diphtheria, pertussis, tetanus, polio, measles, and tuberculosis or tuberculosis. (Infants and young children are usually vaccinated against tuberculosis in countries where the disease is prevalent. In the United States, however, only children who are specifically at risk of contracting tuberculosis – or adults in settings with high tuberculosis. exposure, such as health workers – are offered the shot.)
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