Legislative activity in early 2023 related to vaccination requirements in schools was largely unsuccessful

Between January 1, 2023, and May 22, 2023, legislators in 43 states and the District of Columbia introduced 196 bills addressing school entry vaccination requirements, non-medical exemptions, and scope of practice for providers to administer vaccines.

Of those 196 bills, only about 5% (11 bills) were enacted, according to new data published by the Center for Public Health Law Research at Temple University Beasley School of Law.

The new legal data capture school entry vaccination requirements, non-medical exemptions to school vaccination requirements, the reallocation of authority to determine vaccination requirements for schools, and expansions to provider scope of practice to administer vaccines in all 50 states and the District of Columbia.

"Vaccination around COVID-19 opened the door for discussions and legislation on vaccination more generally, but it was mostly just a lot of debate and introduced bills, with very few laws enacted so far," said Lizzy Platt, JD/MA, director of research and operations at CPHLR and a lead researcher on this project.

Of the domains tracked, only two types of vaccination legislation were successfully enacted:

• In 27 states, legislators introduced 63 bills to expand scope of practice for providers to allow them to administer vaccines. Eight of those bills were ultimately enacted in Georgia, Kansas, Maryland, Montana (two bills), North Carolina, and West Virginia (two bills).
• Nearly one-third of the bills included in the dataset—72 bills across 25 states and the District of Columbia—sought to prohibit school entry vaccination requirements. Three of those 72 bills were enacted: Florida Senate Bill 252 and Tennessee companion bills House Bill 252 and Senate Bill 644, which became Public Law 296.

This research is part of a broader effort by researchers and public health law experts to understand how legislatures are considering the role of public health departments, health providers, and government in response to public health issues and emergencies after the COVID-19 pandemic.

Among the legislation tracked, the researchers identified 18 bills in 10 states that sought to reallocate determinations of vaccine requirements from health agencies. None were enacted.

The data also reveal other unsuccessful efforts to:

• Expand non-medical exemptions in 19 states, 0/47 bills passed;
• Limit non-medical exemptions in two states, 0/3 bills passed;
• Add school entry requirements for vaccination in five states, 0/10 bills passed.

This dataset was created using a scientific legal mapping process developed by the Center, in collaboration with the Association of State and Territorial Health Officials as a part of the Act for Public Health initiative. These data join a growing suite of legal data produced by CPHLR for the Act for Public Health initiative. All the data on this topic, and more, may be explored for free on LawAtlas.org.