States Determine School Immunization Requirements, Not CDC

States Determine School Immunization Requirements, Not CDC

Students in a classroom. Photo by Kenny Eliason we Unsplash.

A Virginia Department of Health spokesperson, Maria Reppas, similarly told the Associated Press that there “is no direct, immediate impact” on school-required vaccines — and that it would take legislative or regulatory action to make such a change.

Tennessee, New Jersey and Massachusetts, as well, don’t always follow the CDC immunization schedule. Those states don’t require vaccination for rotavirus, influenza or HPV, for instance.

Tennessee actually has a law on the books prohibiting schools from requiring COVID-19 vaccination.

Wiley told us that ACIP’s recommendations on vaccines “have a lot of influence on state decisions about which vaccinations they choose to require for school attendance” — and that it’s possible some states could be swayed by the recommendation and require COVID-19 vaccines next school year . “But the decision is still up to the individual states,” she said. “I’m not aware of any state where statutes or regulations automatically trigger such a requirement.”

She noted that in some states, a vaccine must be on the CDC schedule to be considered for a school-entry requirement. But again, the decision would still be up to state and local officials.

Benefits Outweigh Risks for Vaccines on List

During the ACIP meeting, several committee members emphasized that a vaccine being listed on the immunization schedule does not constitute a mandate—and in fact simply reflects the current recommendations.

“This doesn’t represent new recommendations, this represents sort of a summary of existing recommendations,” committee member Dr. Matthew F. Daley said in response to many public comments about the issue. He added that he nevertheless recognized the symbolism of adding the COVID-19 vaccines to the schedule, and said that when shots are added, it’s because the benefits continue to greatly outweigh the risks.

AC DC presentation from Oct. 19 noted that myocarditis and pericarditis—the primary serious safety concerns identified with the mRNA COVID-19 shots—are already rare, but are even more rare in children.

The conditions, which involve inflammation of the heart or its surrounding tissue, are most common in adolescent males after the second dose. But even for that group, experts say the benefits of vaccination outweigh the risks.

As of Oct. 13, the CDC recorded 22 verified reports of myocarditis in 5- to 11-year-olds, after 21.6 million doses administered; 355 reports in 12- to 15-year-olds, after 24.4 million doses; and 308 reports in 16- and 17-year-olds, after 13.4 million doses.

Post-vaccination myocarditis is milder than typical viral myocarditis, and follow-up studies have shown that most people recover within three months.

The advisory group voted unanimously to add the COVID-19 vaccines to the Vaccines For Children program and to accept the proposed changes to the pediatric immunization schedule, which included adding the COVID-19 vaccines. Committee approval is required before the schedules will be published in the Morbidity and Mortality Weekly Report in February 2023.

“It’s important to note that there are no changes in COVID-19 vaccine policy, and today’s action simply helps streamline clinical guidance for healthcare providers by including all currently licensed, authorized and routinely recommended vaccines in one document,” the CDC said in a statement sent to after the ACIP vote.

Along with conveying which vaccines are recommended for children — which is the basic function of the immunization schedule — there are other practical implications of adding vaccines, including triggering an Affordable Care Act requirement that health insurance plans cover the listed vaccines without charging a deductible or copay , Wiley said.

According to the National Academy for State Health Policy, no states are enforcing a COVID-19 vaccine mandate for school attendance, and only two jurisdictions have announced or implemented one.

California’s mandate, which would only apply to vaccines that have full FDA approval — and therefore only to primary vaccination for kids 12 and older — would not take effect until at least July 2023. Washington, DC, has implemented a mandate, also only for vaccines that have full approval, but is not enforcing it until January. The city council is scheduled to vote on Nov. 1 on whether to further delay the mandate to the 2023-2024 school year.

Numerous states have banned requiring COVID-19 vaccines in schools. Tea National Academy for State Health Policy shows in a map last updated on Oct. 3 that 21 states have such bans, although the details of these vary, with some only applying to vaccines that don’t have full FDA approval.

Lori Robertson and Robert Farley contributed to this article.

Editor’s note: SciCheck’s COVID-19/Vaccination Project is made possible by a grant from the Robert Wood Johnson Foundation. The foundation has no control over’s editorial decisions, and the views expressed in our articles do not necessarily reflect the views of the foundation. The goal of the project is to increase exposure to accurate information about COVID-19 and vaccines, while decreasing the impact of misinformation.


ACIP Presentation Slides: October 19-20, 2022 Meeting.” CDC. Accessed 21 Oct 2022.

Wiley, Lindsay. Professor of law and faculty director of the Health Law and Policy Program at UCLA Law. Emails to 20 and 21 Oct 2022.

About VFC.” CDC. Accessed 21 Oct 2022.

Role of the Advisory Committee on Immunization Practices in CDC’s Vaccine Recommendations.” CDC. Accessed 21 Oct 2022.

School and Day Care Minimum Immunization Requirements.” Virginia Department of Health. Accessed 21 Oct 2022.

CDC (@CDCgov). “Thursday, CDC’s independent advisory committee (ACIP) will vote on an updated childhood immunization schedule. States establish vaccine requirements for school children, not ACIP or CDC. More:” Oct 19, 2022.

Filera, Angelo. “FACT FOCUS: States, not CDC, set school vaccine requirements.” PA. Oct 20, 2022.

Selected Adverse Events Reported after COVID-19 Vaccination.” CDC. Accessed 21 Oct 2022.

Heymans, Stephane and Leslie T. Cooper “Myocarditis after COVID-19 mRNA vaccination: clinical observations and potential mechanisms.” Nature Reviews Cardiology. 9 Dec 2021.

Kracalik, Ian et al. “Outcomes at least 90 days since onset of myocarditis after mRNA COVID-19 vaccination in adolescents and young adults in the USA: a follow-up surveillance study.” Lancet Child & Adolescent Health. Sep 22, 2022.

Pauley, Scott. CDC spokesperson. Email to Oct 20, 2022.

States Address School Vaccine Mandates and Mask Mandates.” National Academy for State Health Policy. Updated 3 Oct 2022.

Laudano, Jennifer. Senior Director of Communications and Community Engagement, National Academy for State Health Policy. Email to Oct 20, 2022.

Lumpkin, Lauren. “DC Council could delay coronavirus vaccine mandate for kids.” Washington Post. Oct 13, 2022.

Warchut, Katie, public health communication officer, Vermont Department of Health. Email to 21 Oct 2022.

Virginia Department of Health. SchoolRequirements. accessed 21 Oct 2022.

Tennessee Department of Health. Diseases Covered by Tennessee Child Care and School Immunization Requirements. last updated Jan 2020.

Vermont Department of Health. Vermont Required and Recommended Child & Teen Vaccination Schedule. Apr 2022.

New Jersey Department of Health. Immunization Requirements. last updated 18 May 2022.

New Jersey Department of Health. “Summary of NJ School Immunization Requirements.” Dec 2021

Massachusetts Department of Public Health. “Massachusetts School Immunization Requirements.” 4 Mar 2022.

Ohio Legislative Service Commission. Ohio Laws & Administrative Rules. Section 3313.671: Proof of required immunizations – exceptions. Accessed 21 Oct 2022.

Ohio Department of Health. Ohio Immunization Summary for School Attendance. Accessed 21 Oct 2022.

Ohio Department of Health. News Release: CDC committee vote won’t change Ohio school vaccine requirement. 21 Oct 2022.

Leave a Comment

Your email address will not be published. Required fields are marked *