Vaccination-related bills are cropping up in 15 states, as lawmakers consider measures that could bring back or expand religious exemptions from immunization mandates, create state-level vaccine injury databases, or impose new requirements on healthcare providers regarding vaccine information.
With the return of President Donald Trump to the White House and the nomination of anti-vaccine activist Robert F. Kennedy Jr. as the next Secretary of the Department of Health and Human Services, some see a political opening to revisit or revise vaccine policies at the state level. The Department of Health and Human Services plays a central role in U.S. vaccination efforts, overseeing everything from vaccine development and funding to distribution and recommendations for medical providers.
At the same time, vaccination rates for diseases like measles and polio are on the decline across the U.S., and the number of parents seeking non-medical exemptions to avoid required vaccinations is increasing. In 2024, cases of whooping cough reached a 10-year high, and 16 measles outbreaks, including major ones in Chicago and Minnesota, prompted concern among health officials. Many states now fall below the 95% vaccination threshold needed to prevent measles outbreaks.
A new poll from The Associated Press-NORC Center for Public Affairs Research reveals that nearly half of Americans are highly concerned that the decline in childhood vaccination rates will lead to more outbreaks. However, only about 40% oppose revisiting government vaccination recommendations, while roughly 30% are in favor of reconsidering them. The remaining 30% remain neutral.
Scott Burris, director of Temple University’s Center for Public Health Law Research, has been tracking public health legislation for years and notes how the backlash against COVID-19 vaccines has expanded to include routine vaccines, with anti-vaccine activists gaining influence in political circles. “I think COVID and the politics gave standard vaccine denialists a lot of wind in their sails,” Burris said.
While it’s hard to predict which bills will ultimately become law, Burris points out that proposed legislation often provides insight into lawmakers’ intentions and the kinds of changes that could emerge.
Religious Exemptions Take Center Stage
One of the most prominent proposals involves expanding religious exemptions for school vaccination requirements. Lawmakers in states like New York, Virginia, Connecticut, and Mississippi have introduced bills allowing more individuals to opt out of vaccines for religious reasons. In Indiana, lawmakers are even considering extending religious exemptions to medical students.
West Virginia’s Republican Governor Patrick Morrisey made headlines earlier this month by issuing an executive order on his first day in office, granting families the ability to claim religious exemptions for school vaccinations. “That’s a huge step,” said Brian Festa, co-founder of the law firm We The Patriots USA, which works on vaccination-related cases nationwide. “That’s a state that never had a religious exemption.”
Currently, only four states—Connecticut, California, New York, and Maine—permit only medical exemptions for immunization requirements in childcare and K-12 schools.
Festa attributes West Virginia’s new religious exemption to both Trump’s nomination of Kennedy and a 2023 federal court ruling that required Mississippi to allow residents to cite religious beliefs when seeking exemptions. “I think the writing’s on the wall and they did feel the pressure,” Festa said.
In Connecticut, at least four Republican bills are attempting to restore the state’s religious exemption for schools, colleges, and daycare centers, a measure that was eliminated in 2021. The state has long maintained some of the highest childhood vaccination rates in the country, with over 97% of kindergarteners in the 2023-2024 school year vaccinated against a range of diseases, including measles and chickenpox.
Though the state’s Democratic-controlled legislature rejected challenges to the law, GOP state Sen. Eric Berthel remains hopeful that shifting cultural attitudes could spark renewed debate on the issue. “I think that we’re not being fair to families who have a true faith-based reason to not vaccinate their child,” Berthel said.
In contrast, Hawaii is considering a bill that would eliminate all non-medical vaccination waivers in an effort to curb high exemption rates.
Vaccine Injury and Consent Legislation
Other vaccine-related bills are focused on growing concerns that have emerged since the pandemic. Proposals in Oklahoma and Alabama would require parental consent for any vaccine given to minors. In Wyoming, Oregon, and Oklahoma, lawmakers are proposing bills that would prevent discrimination against individuals who decline vaccinations.
In New York and Oklahoma, bills are being introduced that would mandate healthcare providers give patients a full list of vaccine ingredients. Florida is also considering a bill that would ban edible vaccines, even though none are currently approved or in widespread use.
Vaccine injury is another area receiving attention. Legislation in Indiana and North Dakota seeks to establish state-level databases similar to the federal Vaccine Adverse Event Reporting System (VAERS), which gained attention during the pandemic. While anyone can submit a report to VAERS about a potential adverse event after vaccination, the CDC clarifies that a report doesn’t prove the vaccine caused the issue.
North Dakota state Sen. Dick Anderson, a Republican, explained that his bill aims to address growing distrust in the CDC. “We have to do something to restore trust in the system,” he said. But experts caution that state databases would likely be redundant and counterproductive. “A lot of these proposals are trying to fix something that’s not broken and could work against the goal of preventing the spread of communicable disease,” said Andy Baker-White, senior director of state health policy for the Association of State and Territorial Health Officials.
Experts argue that the focus should be on eliminating barriers to vaccination, not adding new ones. Dr. Susan Kressly, a pediatrician and president of the American Academy of Pediatrics, emphasizes that many families miss vaccines not due to ideological opposition, but because of practical obstacles, like lack of transportation or nearby healthcare providers. “Vaccines are really an American success story,” Kressly said, reflecting on her experiences with concerned parents early in her career when dangerous infections like bacterial meningitis were more common.
