On September 3, 2025, Florida announced a plan to attempt to phase out childhood vaccine requirements. Vaccine requirements have existed for over 200 years in the United States to support the health of communities. Use these up-to-date messages to communicate about vaccine requirements with your community.
Updated on September 18, 2025
Topline Messages
- What are vaccine requirements?
Vaccine requirements, also referred to by some as vaccine mandates, require people to get certain vaccines before participating in public activities. Most vaccine requirements are for children to attend daycare and school, from elementary school to college. State health officials and agencies typically establish vaccine requirements for children. Vaccines that prevent polio, measles, mumps, and rubella (MMR), chickenpox, and hepatitis B are some of the vaccines often required for children in each state.
While most vaccine requirements are created at the state level, they may sometimes be determined at the federal level. For example, in 2021, COVID-19 vaccines were required for federal employees and contractors, healthcare workers, large private employers, and international travelers.
- Which states have vaccine requirements?
As of September 2025, all 50 states and Washington, D.C. have vaccine requirements for students to attend school. While all states allow exemptions from vaccine requirements for medical reasons, some states also allow exemptions for religious or personal reasons. Only California, New York, Maine, Connecticut, and West Virginia do not allow exemptions for non-medical reasons.
- Why are vaccine requirements in place?
Vaccine requirements help lead to higher vaccination rates, which lead to fewer infections, less disease transmission, and fewer deaths. In America, their use dates back to George Washington and his focus on protecting soldiers from smallpox. While vaccine requirements are rarely the preferred public health tool, their focused use has supported public health in the United States for nearly two-hundred years. Since the early 1900s, states have required children to get vaccines before attending school to help prevent the spread of infectious diseases like smallpox and make these shared public spaces safer for students and educators. Vaccine requirements have helped eliminate or reduce the spread of polio and measles, allowing new generations to thrive at school, home, and beyond.
- Is there support for vaccine requirements?
Most Americans support vaccine requirements for children to help prevent the spread of infectious diseases and decrease the risk of hospitalization or death. Across party lines, 79% of US adults support vaccine requirements for children to attend school.
- Are vaccine requirements helpful?
Vaccine requirements helped eliminate serious infectious diseases, such as smallpox. Before the smallpox vaccine, about 3 out of 10 infected people died from the disease. Vaccine requirements in the United States reduced the spread of infection in communities until no cases of smallpox were reported. Smallpox vaccines are no longer necessary for children and adults because the disease has not circulated for decades.
For diseases that still spread, like measles, vaccine requirements are essential to prevent the serious effects of the disease. The measles vaccine has helped eliminate the spread of measles for nearly two decades. As childhood vaccination decreases due to religious or personal exemptions, previously eliminated diseases are more likely to spread. The 2025 measles outbreak spread primarily in under-vaccinated populations.
- Why are vaccine requirements controversial?
People want to make informed decisions about their health. Requirements, of any kind, can seem to prioritize other concerns, like community benefit, over individual choice. However, vaccine requirements are informed by decades of research and debate on the overall benefits to individual and community health. Vaccine requirements consider the safety of all, including young children, older adults, and people with compromised immune systems, and in doing so have decreased the spread of serious disease and reduced hospitalizations and deaths.
