Research finds most Americans strongly support vaccination requirements for K-12 students

A new study, published in Vaccine suggests that most Americans overwhelmingly support requirements for a number of common vaccinations for kindergarten through 12th grade students—even the one for COVID-19.

An association between vaccination and public school attendance in the United States dates back to 1827, when Boston schools required students to be vaccinated against smallpox. In recent years, however, two groups—some parents of K-12 students and some policymakers—have been particularly vocal in their opposition to the mandatory COVID-19 vaccines. More recently, opposition has spread to mandates that have been in place for decades.

Now, however, the first comprehensive assessment of U.S. public opinion about student vaccination has found that these views are not widely shared.

Support for vaccine requirements for K-12 students by those surveyed ranged from a high of 90% for diphtheria, tetanus and pertussis (DTaP); measles, mumps and rubella (MMR); polio; and chickenpox to a low of 68% for COVID-19. The other commonly mandated vaccines for students in public K-12 schools are for hepatitis and human papillomavirus (HPV), which 84% and 75% of survey respondents supported, respectively.

"Vaccinations are one of public health's biggest achievements, but this does not mean that those who need them the most always get them," said Dr. Simon Haeder, an associate professor of health policy and management in the Texas A&M University School of Public Health who conducted this study. "This was especially true during the COVID-19 pandemic."

According to the Centers for Disease Control and Prevention, for example, orders for pediatric vaccines and the number of pediatric vaccines administered in the United States declined markedly during the pandemic, and at least one study suggests that worldwide, these numbers have not yet risen to pre-pandemic levels.

Haeder said vaccine mandates for school-age individuals are especially effective, because this age group has fewer preventive visits and thus would be less likely to have access to preventive services like vaccines without such a requirement. The goal of high vaccination rates across an entire population remains important given the potentially devastating consequences of a disease outbreak.

"Vaccinations have been a political hot topic in recent years, however, and those who were the most vocal against them tended to get a lot of media coverage," Haeder said. "This led policymakers to introduce bills at the state level to limit or eliminate vaccine mandates for students. We wanted to find out the true level of opposition across the country."

Study methods

For the study, funded by the Interdisciplinary Research Leaders Program, Haeder developed an online survey that was completed by 16,461 respondents in the United States from January to April 2022. He used standard t-tests to assess and compare overall support for the vaccine requirements, then ordinary least squares regression to assess correlates of support and opposition to the various vaccination mandates.

The study found that student vaccination support was strongest among those who believed that vaccines are safe and important, who trusted the National Institutes of Health and the Food and Drug Administration, who identified as ethnic and racial minorities, those with liberal political views, and those living in urban areas. This group also had stronger support for the vaccine mandate and higher trust in medical doctors. Women were generally more supportive of mandates, except for HPV and COVID-19.

On the other hand, the strongest opposition came from those who believed that vaccines cause autism and those with better health and more trust in religious leaders. Income and education levels had no effects on vaccine support.

Haeder said the study's findings have broad implications given that similar—although more limited —mandates also have been implemented in daycares, colleges and universities, and some workplace settings.

"The bottom line is that our study suggests K-12 vaccination mandates have broad support among the American public, even in more controversial cases such as HPV and COVID-19," Haeder said.