The History of Vaccine Mandates in the U.S.

While the COVID-19 pandemic has brought its share of unprecedented questions and experiences, the topic of vaccine mandates, though hotly debated, is actually not a new concept. From the question of legality to the history of past mandates, here are some interesting facts about vaccine mandates.

What are vaccine mandates?

A vaccine mandate is a public health requirement that one must be vaccinated against a particular disease in order to take a specific action covered by the mandate, such as attend school, work, travel, etc. If a mandate is adopted, it means the government or other authority that enacted the mandate may legally prevent you from entering their building or accessing their services. However, certain exemptions may be required when it comes to vaccine mandates, such as for religious beliefs or medical reasons.

How did vaccine mandates first arise?

The discourse around vaccine mandates is front and center amid the COVID-19 pandemic, but immunization efforts in the form of vaccination requirements have been a part of American history since the 19th century, when vaccination against smallpox was a necessity. All 50 states have vaccination requirements in place for children attending school. As it stands today, states require vaccination for children from birth to age 18 against 16 diseases, including polio, measles and meningitis, among others, to attend school. Some states also have vaccine mandates in place for adults that work in certain settings The widespread adoption of vaccines has contributed to greatly minimizing and even eradicating certain diseases from the world.

Who can enact vaccine mandates?

While nationwide vaccine mandates have yet to be enacted by the federal government, state governments have historically mandated vaccines. Although it’s important to remember with a legally adopted mandate, the government or authorities can’t force an individual to get vaccinated.  However, once a mandate is adopted, they can withhold services and access, such as attending school or going to concert venues and other public spaces. Additionally, private companies have also utilized their authority to decide whether they want to enact mandates for their employees and those accessing their services or entering their premises.

What about the COVID-19 vaccine?

(As of February 23, 2022)

Given the number of vaccine mandates already in existence, it was no surprise that a wide variety of vaccine mandates related to COVID-19 would be proposed and put in place. While President Biden’s sweeping vaccine mandate for larger companies comprising of 100+ employees was recently blocked by the Supreme Court, several COVID-19 vaccine mandates remain in place. There is a federal COVID-19 mandate for healthcare workers who are employed at facilities that participate in Medicare or Medicaid. At the state level, COVID-19 vaccine mandates are in place in many states, while other states have prohibited vaccine mandates altogether. Likewise, many private companies have also mandated COVID-19 vaccines among their workforces, though again there are some states that have passed legislation prohibiting them from doing so. The Equal Employment Opportunity Commission (EEOC) anti-discrimination laws don’t interfere with the ability of employers to follow CDC and other state and local public health guidelines; employers can encourage and even require their employees to be vaccinated. That being said, all employers must consider any applicable exemptions and accommodations, such as increased testing or social distancing.

For information about COVID-19, vaccinations and more, visit Harvard Pilgrim Health Care’s COVID-19 resource center.