HARTFORD, Conn. — An increase in vaccination-related legislation is currently observed in over 15 states, where lawmakers are seeking to either reinstate or establish new religious exemptions from immunization requirements. These proposals may also include the formation of state-level databases for vaccine-related injuries and stipulations on the information healthcare providers must share with patients regarding vaccines.
As political dynamics shift with the potential return of former President Donald Trump and the candidacy of anti-vaccine figure Robert F. Kennedy Jr. for the role of secretary of the Department of Health and Human Services, many see this as an opportunity to reconsider vaccination policies at the state level. The Department of Health and Human Services plays a crucial role in managing all aspects of national vaccination efforts, from funding vaccine development to setting medical guidelines and overseeing vaccine distribution through federal programs.
Concerns rise as the rates of childhood vaccination for serious illnesses, such as measles and polio, show a downward trend across the country. This decline has been accompanied by an increased number of parents opting for non-medical exemptions for their children’s mandatory immunizations. Notably, 2024 witnessed alarming rates of whooping cough and 16 outbreaks of measles, primarily affecting Chicago and Minnesota, prompting alarm from health officials. Most states currently fall below the 95% vaccination rate threshold necessary to effectively safeguard communities against outbreaks of measles.
A recent poll indicates that approximately half of Americans are “very” or “extremely” concerned about the possibility of rising outbreaks due to decreased vaccination rates. However, only around 40% of respondents oppose reconsidering government recommendations on widely used vaccines, while approximately 30% approve of such a discussion, and the remaining 30% expressed neutrality.
Scott Burris, who heads Temple University’s Center for Public Health Law Research, has observed an increasing backlash against vaccines, particularly following the COVID-19 pandemic. He notes that anti-vaccine sentiments have gained traction in political spaces as a result. “COVID and political dynamics have certainly given those vaccine skeptics increased momentum,” Burris stated.
While it remains uncertain which proposed bills will ultimately become law, Burris highlights that these initiatives provide insight into lawmakers’ concerns and potential future directions.
Among the most frequently proposed measures are those advocating for religious exemptions from school vaccination mandates. States like New York, Virginia, Connecticut, and Mississippi have seen lawmakers introduce bills aimed at expanding these exemptions. Additionally, Indiana is considering allowing the same for medical students. Recently, West Virginia’s newly elected Republican Governor Patrick Morrisey signed an executive order granting religious exemptions, marking a significant move for a state that previously had no such allowances.
Brian Festa, co-founder of the legal firm We The Patriots USA, praised this development. “It’s a major advancement,” he noted, emphasizing the political influences underscoring such changes, including Trump’s nomination of Kennedy and a federal court ruling requiring Mississippi to permit religious exemptions for childhood vaccinations.
In Connecticut, GOP legislators have submitted several bills seeking to restore a previously eliminated religious exemption that applied to schools and daycare facilities. Public health experts highlighted that there has been a gradual increase in the need for religious exemptions along with a decline in vaccination rates in certain schools. Connecticut, traditionally known for its robust vaccination rates, maintains over 97% coverage for essential vaccines among kindergartners in the current school year.
Despite the odds, some state lawmakers express belief that cultural shifts might create a climate favorable for revisiting such discussions, though much depends on legislative leadership. Senator Eric Berthel mentioned, “I feel that we are not adequately supporting families with genuine faith-based reasons for declining vaccinations.”
However, Hawaii is an outlier among these state trends, as lawmakers are looking to eliminate all non-medical exemptions due to persistent high exemption rates.
Other proposed legislation addresses rising concerns rooted in the pandemic’s aftermath. Oklahoma and Alabama are considering bills that would mandate parental consent for vaccinations administered to minors. In contrast, Wyoming, Oregon, and Oklahoma are advocating against discrimination against unvaccinated individuals. Legislators in New York and Oklahoma propose a requirement for vaccination providers to disclose complete ingredient lists, while Florida aims to outlaw edible vaccines, even though none are currently approved in the U.S.
The notion of vaccine injuries has also gained attention, with states like Indiana and North Dakota introducing bills to create state-level databases to mirror the federal Vaccine Adverse Event Reporting System, which drew scrutiny during the pandemic. While North Dakota lawmaker Dick Anderson acknowledges the importance of vaccines, he proposed the bill due to widespread distrust in the CDC. “We need to restore faith in the system,” Anderson remarked.
Despite these proposals, experts argue that state-level databases may create unnecessary duplication, disrupting the ultimate goal of controlling communicable diseases. “These initiatives may ultimately undermine efforts to promote vaccination,” warns Andy Baker-White from the Association of State and Territorial Health Officials, advocating for policy aimed at removing barriers to vaccination instead of compounding them. Dr. Susan Kressly, president of the American Academy of Pediatrics, echoes this sentiment, noting that many families miss vaccinations due to practical issues rather than ideological opposition. “Vaccines represent a significant success story for public health in the U.S.,” she concluded.
