Vaccine Requirements vs. Federal Vaccine Recommendations

There is a difference between federal vaccine policies and state vaccine laws. Federal public health officials at the Centers for Disease Control (CDC) make national vaccine policy recommendations for children and adults. With the approval of state legislatures, public health officials in state health departments make and enforce vaccine mandates. That is why vaccine laws and legal exemptions to vaccination vary from state to state.

The first vaccine mandated in the U.S. was smallpox vaccine. By 1922, some states had passed laws requiring that children show proof they were vaccinated for smallpox in order to attend school. By the early 1980’s, the CDC recommended and most states mandated that children get 23 doses of seven vaccines (polio, diphtheria, tetanus, pertussis, measles, mumps, rubella) to attend kindergarten.

By the summer of 2022, the CDC recommended that children get 72 doses of 17 vaccines between day of birth and age 18. Most states mandate that children get 29 doses of nine vaccines to attend kindergarten and children enrolled in daycare in many states are required to get multiple doses of 13 vaccines.

While vaccine policymakers in the American Academy of Pediatrics (AAP) and the Centers for Disease Control (CDC) make vaccine recommendations for children and adults, the bottom line is that your state may not require all federally recommended vaccines as a condition of employment, and school or daycare attendance.

Below are links to additional law and policy resources:

• State Vaccine Law and Exemption Resources
• Vaccine Safety Research Gaps
• Police Powers, Tracking System and Privacy
• Federal Vaccine Law and Injury Resources