Antivaccine Bills Surge in States, Led by GOP Push

Author: Boston University School of Public Health
Published: 18 Jul 2026
Publication Details: Peer-Reviewed | Research, Study, Analysis

Table of Contents:
Synopsis - Definition - Introduction - Main - FAQ's - Insights, Updates - Related Content

Synopsis: This research finds that antivaccine sentiment in the United States has moved beyond individual belief and public debate into formal state legislation, with proposed bills to reduce vaccine access, weaken requirements, and broaden exemptions rising sharply between 2021 and 2023. Led by Boston University School of Public Health researchers and published in the peer-reviewed American Journal of Public Health, the study categorized 1,513 vaccine-related bills introduced across state legislatures from 2019 to 2023 and found clear partisan drivers: Republican lawmakers sponsored 86 percent of antivaccine bills, while Democratic lawmakers introduced 54 percent of provaccine bills. This matters because roughly 24 percent of antivaccine bills gained enough support to become law, expanding religious and personal belief exemptions for school immunizations and limiting workplace vaccine mandates - shifts that affect families, children, workers, and medically vulnerable groups such as seniors and people with disabilities who depend on high community vaccination rates for protection. The findings carry weight because they draw on the State Vaccine Policy Project, a first-of-its-kind dataset, and represent the first analysis to examine these partisan differences before and after the pandemic.*

At a Glance

• 1 - About 24 percent of antivaccine bills gained enough support to become law.
• 2 - In 2021, states introduced 1,154 vaccine-related bills, up from just 386 in 2019.
• 3 - Nearly 82 percent of Democratic bills were provaccine, while more than 65 percent of Republican bills were antivaccine.
• 4 - Researchers link the surge partly to GOP lawmakers appealing to constituents who frame their views around medical freedom, autonomy, and parental rights rather than opposition to vaccines.

Topic Definition: Antivaccine Legislation

Antivaccine legislation refers to bills and enacted laws introduced in government bodies, particularly US state legislatures, that seek to limit vaccine access, weaken vaccination requirements, or broaden the grounds on which people can claim exemptions from immunization. Such measures commonly expand religious or personal belief exemptions for school and childcare vaccinations or restrict the ability of employers to require certain vaccines. Distinct from personal vaccine hesitancy, this type of legislation translates skepticism into binding public policy, and researchers track it to understand how political polarization influences public health outcomes and the protection of communities that rely on high vaccination rates.

Introduction

Antivaccine Legislation Is Rising Rapidly in US States, Driven Primarily by GOP Push

A new study revealed that Republican lawmakers were responsible for 86 percent of antivaccine bills introduced across state legislatures after the onset of the COVID-19 pandemic, raising concerns about public health.

Despite overwhelming evidence on the safety and efficacy of COVID-19 vaccines, vaccine hesitancy intensified during the COVID-19 pandemic and has fueled skepticism towards other life-saving vaccines for children, adults, and pets.

Main Content

A new study led by Boston University School of Public Health (BUSPH) researchers has revealed another worrying trend: the antivaccine sentiment once reserved for individual beliefs and public discourse has transformed into actual legislation across the US that could undermine vaccine uptake and pose a threat to the public's health.

Published in the American Journal of Public Health, the study shows that proposed bills aiming to reduce vaccine access, weaken vaccination requirements, and increase vaccine exemptions increased dramatically in state legislatures from 2021-2023, at times exceeding the number of bills seeking to strengthen vaccine access and mandates. At least 40 percent of bills introduced in each full legislative cycle after the start of the pandemic have been antivaccine-related.

Partisan polarization is clearly driving this legislation: Republican lawmakers sponsored 86 percent of the antivaccine bills introduced during this period. Democratic lawmakers, meanwhile, introduced 54 percent of provaccine bills, which are bills that supported an increase in access to, or funding and promotion of, vaccines across state legislatures.

"Our work shows that state lawmakers affiliated with the Republican party are responsible for the overwhelming majority of antivaccine bills introduced in recent years," says study corresponding author Dr. Matt Motta, who authored the study with Dr. Timothy Callaghan, both of whom are associate professors of health law, policy and management at BUSPH. "While the majority of these bills do not actually pass, it's important to remember that we live in an increasingly connected and globalized world - one in which low vaccine coverage in one part of the country can get people sick thousands of miles away. Weakening vaccine regulations in one state puts everyone's health at risk, as the current measles outbreak demonstrates."

Furthermore, a sizable amount of antivaccine legislation - 24 percent - during this period did receive enough state legislative support to become law. Several states enacted laws that expand religious or personal belief exemptions for childcare and school immunizations, and measures that prohibit employers from mandating certain vaccinations in the workplace.

"These antivaccine bills not only signal the discontent that some have with vaccines, but also the more hostile policy environments towards vaccination," Dr. Callaghan says. As the US approaches the November midterm elections, "who society chooses to elect in 2026 could shape vaccine policymaking for years to come," he says.

This analysis is the first to explore these partisan differences among vaccine-related bills proposed before and after the pandemic. For the study, Dr. Motta and Dr. Callaghan, along with a team of student and alumni researchers at BUSPH, systematically categorized partisan changes in 1,513 vaccine-related bills introduced in state legislatures between 2019-2023. The team utilized preliminary data of all vaccine-related proposed bills in state legislatures from 2019-2023 via the State Vaccine Policy Project (SVPP), a first-of-its-kind initiative created to understand and inform policies that address the politicization of public health. The SVPP is housed under The Politics and Health Lab that Dr. Motta and Dr. Callaghan direct at BUSPH.

In 2021, a total of 1,154 vaccine-related bills were introduced in state legislatures, compared to just 386 proposed bills in the 2019 legislative session. Over the four-year period, nearly 82 percent of bills proposed by Democrats were provaccine, compared to less than 10 percent that were antivaccine. Comparatively, more than 65 percent of bills proposed by Republicans were antivaccine, compared to 28 percent that were provaccine.

The spike in antivaccine legislation may be attributed in part to election-seeking GOP lawmakers who are eager to appease antivaccine Republican constituents who frame themselves as champions of medical freedom, individual autonomy, and parental rights, rather than opponents of vaccines. But health experts also emphasize that vaccine hesitancy is the result of the widespread misinformation, evolving public health guidelines, and broad distrust in science that has persisted in the US during and after the pandemic.

"Nobody likes being told what to do. But our government has the ability and obligation to take actions that protect public health," says Dr. Motta. "To the many people who ground their opposition to vaccination in deeply held values, political views, religious beliefs, and more, I would say: infectious disease has no sense of morality or religious creed. Taking action to protect yourself and others is one of the safest and most effective actions you can take to live your life the way you want it. Vaccination is a way to take your freedom back from the pathogens that have caused sickness and death for all of human history."

The team says their findings also underscore the importance of voter engagement in local elections and the need for continued efforts to improve communication about vaccines to the general public.

"We need to recognize that the reasons people lack trust in science are multifaceted, and that there isn't a one-size-fits-all solution that will work in restoring trust," Dr. Callaghan says. "We must also recognize that messengers matter as much, if not more, than the message. For public health, that also means recognizing that public health officials are not always going to be the right messengers to encourage vaccine uptake. Identifying the correct messages and messengers will take considerable investment in vaccine communication research, which is currently severely underfunded."

In future research, the researchers intend to expand the SVPP dataset to analyze vaccine legislation over a larger period of time, as well as explore how public experiences with vaccination have shaped legislation and vice-versa. They will also examine health policies related to other subjects, including gender-affirming care, reproductive health, and water fluoridation.

"Our hope is to provide researchers with a large, up-to-date database cataloging health policy legislative activity across the states, so that we can study how changes in our social and political worlds impact health policy, and how changes in health policy impacts public health," Dr. Motta says.

Frequently Asked Questions

NOTE: Researched FAQ's by Disabled World (DW)

What is the difference between a vaccine exemption and a vaccine mandate?

A vaccine exemption is a legal allowance that lets an individual opt out of an otherwise required immunization, typically on religious, personal belief, or medical grounds. A mandate is a rule requiring vaccination for a specific setting, such as school enrollment or employment. Antivaccine legislation often works by broadening exemptions or restricting mandates rather than banning vaccines outright.

Do the antivaccine bills in this study ban vaccines?

No. The legislation described does not outlaw vaccines. Instead, it reduces vaccine access, weakens vaccination requirements, or expands the grounds on which people can claim exemptions. This means vaccines remain legally available, but the policy environment makes requirements easier to avoid.

How can low vaccine rates in one state affect people in other states?

Infectious diseases do not respect state borders, and people travel widely in a connected society. When vaccination coverage drops in one area, outbreaks such as measles can spread and reach communities thousands of miles away. This is why weakened rules in a single state can raise health risks nationwide.

Why are people with disabilities and seniors especially affected by lower vaccination rates?

Many seniors and people with disabilities are medically vulnerable and may be unable to be vaccinated themselves or may respond less strongly to vaccines. They rely on high vaccination rates in the wider population, known as community protection, to shield them from disease. When coverage falls, these groups face greater exposure and risk.

What does the term medical freedom mean in vaccine debates?

Medical freedom is a framing used by some to describe the idea that individuals should have autonomy over their own health decisions, including whether to be vaccinated. In the legislative context, it is often paired with arguments about individual autonomy and parental rights. Supporters present these values as central rather than framing themselves as opposed to vaccines.

How can someone find out what vaccine laws apply in their own state?

Vaccine requirements and exemptions are set at the state level, so rules vary widely across the country. Residents can check their state health department or legislature websites, and researchers can consult databases such as the State Vaccine Policy Project that track legislative activity. Because laws change frequently, it is wise to confirm current rules before relying on older information.

What can individuals do if they are concerned about rising antivaccine legislation?

Researchers emphasize the importance of engaging in local and state elections, since lawmakers shape vaccine policy directly. Individuals can also support clearer vaccine communication and seek trusted messengers within their own communities. Staying informed about proposed bills and voting in midterm and local elections are practical steps highlighted by the study.

Insights, Analysis, and Developments

Attribution/Source(s): This peer reviewed publication was selected for publishing by the editors of Disabled World (DW) due to its relevance to the disability community. Originally authored by Boston University School of Public Health and published on 18 Jul 2026, this content may have been edited for style, clarity, or brevity.

* Editorial additions by Ian C. Langtree.