School vaccine mandates aren't new: A history of requirements

Last week, California Gov. Gavin Newsom issued future COVID-19 vaccine requirements for kids in grades K-12 who attend school in-person. The mandate will only go into effect after the vaccine has been fully approved for kids by the US Food and Drug Administration, which means it'll be rolled out first for kids in grades 7-12, and eventually for children in kindergarten through 6th grade. (Pfizer's vaccine has full approval for people ages 16 and up, but it is available and authorized for kids ages 12 and older. The company says that its vaccine is safe for children ages 5 to 11, but it's not available to those age groups yet.)

California was the first state to add COVID-19 vaccination to the list of vaccine requirements for kids, but other states and districts may do the same in the coming weeks or months.

Vaccine requirements in schools are far from being a new concept. As the question continues to be debated whether your local school will mandate a COVID-19 vaccine for students, it's important to take a look back at the history of vaccine requirements -- because vaccinations have been required in schools for a long, long time.

"I agree with what Gov. Newsom did in California," Dr. Anthony Fauci told CBS. "People need to realize that having a vaccine requirement for schools is not a new, novel thing that is very peculiar or specific to COVID-19. We've been doing this for decades."

In fact, according to the National Conference of State Legislatures, every state in the United States has a vaccine mandate in place for students, and has for many years. All US states require vaccines of some kind, whether for MMR, chickenpox, HPV or other diseases. (Religious and medical exemptions are in place for these as well.) 

Because of the vast history of vaccine mandates in US schools, it only makes sense for parents to wonder if that means the COVID-19 vaccine will eventually become a school requirement as well. Below, we take a look back at how vaccine mandates originally came to be and how they've evolved over the course of time. 

How vaccines became required in schools

The earliest record of vaccines being mandated in schools can be traced back to the 1850s, according to the Centers for Disease Control and Prevention. The rule was enacted in Massachusetts to slow the spread of smallpox. By 1900, the CDC reports, nearly half the states had a mandate in effect, and that continued to evolve as time wore on. 

In the 1960s the US was battling measles, which meant that states started to require students to be vaccinated against the disease. The major outbreaks were in Alaska and Los Angeles. According to the CDC: "In Alaska, on the announced day of [vaccine] enforcement, 7,418 of 89,109 students (8.3%) failed to provide proof of vaccination and were excluded from school. One month later, fewer than 51 students were still excluded. No further cases of measles occurred." A similar result was seen in Los Angeles, showing the schools, the government and Americans in general that vaccine mandates could have a significant impact on eradicating disease.

Soon after this happened, the US government created the Childhood Immunization Initiative to create a vaccine plan for children. These vaccines covered diphtheria, measles, mumps, pertussis, poliomyelitis, rubella and tetanus. As the states started to vaccinate more and more children, schools quickly saw the rate of illness decrease. Again, proving that vaccine mandates had a powerful effect in the classroom. And by the 1980 school year, every single state had a vaccine mandate in place that pertained to students of all ages.

Vaccines currently required for kids

While each state has the power to create their own vaccine mandates, there are plenty of similarities around the country for which vaccinations are required for school. The CDC has a recommended vaccine schedule that many states adhere to, though they are not required to. 

Some of the most common vaccines for students are: 

• MMR (measles, mumps and rubella)
• Hepatitis B
• Hepatitis A
• Diphtheria
• Meningococcal
• Rotavirus
• Varicella (chickenpox)
• Hib
• Polio
• Tetanus
• Pertussis (whooping cough)

Most of these immunizations are done when children are infants and toddlers, with a few coming in the early years of life. Other than a yearly recommended flu shot, the other later vaccinations are meningitis and Tdap.

While all 50 states do have some sort of vaccine requirement in place for public and private schools, each state also has its own list of exemptions. (You can find out more about your own state here.) Some states offer medical or religious exemptions to vaccines, and if that's a concern for you and your family, you can discuss it with your school and doctors. 

The current COVID-19 vaccine landscape for kids

Right now, California's COVID-19 vaccine mandate for school-age kids (which isn't in effect yet) is the only statewide coronavirus vaccine mandate, though there are a few districts in California that had previously issued vaccine mandates. In September, the Los Angeles Unified School District -- the second largest in the country -- enacted a vaccine mandate for all vaccine-eligible students. It was the first major school district to do so. Meanwhile, New York City Schools -- the largest school district in the country -- has discussed a vaccine mandate but not yet put one in place. 

Although vaccination requirements are often established at the state level, the ever-changing requirements necessitated by COVID-19, whether it's masks, school closures or vaccines, have been coming down to school districts and even individual schools as each place decides what's best for them and their students. It's possible that more school districts will require vaccines for students eligible for a COVID-19 shot before they're mandated at the state level, such as California's.

In general, taking a look at how this country has handled vaccinations in schools in the past, it's a fair assessment to assume that the COVID-19 vaccination could eventually be a requirement in most schools.