Vaccination & Immunization State Policy Activity/Trends

During the current legislative session, many states introduced proposals and initiatives addressing vaccination policies in various forms. Lawmakers have advanced a range of proposals addressing divergent general population health priorities, including diverging state policy from federal policies and recommendations on one hand, while on the other, taking steps to roll back K-12 student immunization requirements to make it easier to get exemptions.

For colleges and universities, these proposals carry direct implications for campus health protocols, enrollment compliance, and student life. As a result, higher education leaders may need to navigate an increasingly complex patchwork of state policies while balancing legal obligations, student autonomy, and the imperative to protect campus communities.

Here are some examples of state legislation under consideration this year as of early April 2026. A more expansive, updated, and detailed list can be found on the ACHA website through the updated ACHA State Policy Tracker.

Weakening or Eliminating Education Immunization Requirements

Several state bills would weaken or eliminate current vaccination requirements for attendance in school and college. Examples of these proposals include:

• Getting rid of all vaccine mandates: Arizona HB 2086 and Rhode Island SB 2565
• Updates to current K-12 immunization requirements: Iowa HF 2171 and Idaho HB 808 (along with daycare)
• Prohibiting college and school requirements: Oklahoma HB 1475/SB 1977
• Prohibiting daycare, school, and college measles, mumps, and rubella (MMR) vaccine requirements: South Carolina SB 897
• Targeted removal of certain requirements: Kentucky HB 466 (hepatitis B for 6^th grade attendance, along with requiring any new requirements to be approved by the General Assembly) and Oklahoma SB 1568 (hepatitis B birth dose)
• Requiring state legislature approval for all new requirements: Kentucky HB 466
• Requiring full FDA approval before requiring: Alaska HB 279
• Prohibiting gene-based vaccines: Michigan HB 4778
• Delaying approval of COVID-19 mRNA vaccines until the state’s Department of Health analyzes data and concludes that vaccine benefits outweigh associated risks: New York AB 4798/SB 7342
• Prohibiting all COVID-19 vaccines: New Jersey AB 368, AB 845, and SB 878; Missouri SB 1428; New York AB 3807; and Oklahoma SB 422

Exemptions

Some states have introduced legislation granting vaccination exemptions based on religious or other beliefs. Examples of these proposals include:

• Exemptions for religious tenets or practices of parents: Hawaii HB 2166/SB 2472; Illinois HB 2597 (COVID-19); New Hampshire HB 1022; West Virginia HB 4073; and West Virginia SB 608 and SB 609
• Exemptions for personal or conscientiously held beliefs: Minnesota HF 3775/SF 4017
• Parentally approved exemptions through a written statement: Alabama HB 24
• Exemptions based on medical issues: California SB 1377; Michigan HB 5351 (authorizing an exemption if a vaccine is certified to be harmful to the child’s health); Michigan HB 5349; and West Virginia HB 5378 (if a medical professional says a vaccine could be harmful for a child, could skip that vaccine temporarily) and SB 610
• Requiring notification of ability to get exemptions: Iowa SF 2345; New Hampshire HB 1584; and South Carolina HB 4803
• Not allowing the state to make exemptions more difficult: Michigan HB 5634/SB 797
• There is at least one example of making it harder to get an exemption by removing the personal or conscientiously held beliefs exemption: Minnesota SF 4458

Diverging from Federal Standards/Recommendations

As the Trump Administration’s Department of Health and Human Services (HHS) upends recommendations around vaccinations, states have started to decouple their requirements and recommendations from those of the federal government. Examples of these bill proposals include:

• Setting standards based on national professional organizations, such as the American Academy of Pediatrics recommendations: Alaska HB 238 and New York AB 9060/NY SB 8496, AB 9648/SB 8853, AB 10710/SB 9599
• Having a state body set the recommendations/policies, often taking into account recommendations from a variety of sources: California SB 144; Colorado SB 32 (now law); Connecticut HB 5044; Maryland HB 637/SB 385; Michigan HB 5351, HB 5352, and HB 5353; Minnesota HF 3743/SF 3859 and HF 4439/SF 4416; New Jersey AB 6166/SB 4894 (now law); New York AB 9060/SB 8496 and AB 10711/SB 9598; and Vermont HB 545/SB 166 (now law)

ACHA has reaffirmed its longstanding Position Statement on Vaccine Use to Promote Health and Prevent Disease, asserting that immunizations are safe and offer effective protection from vaccine-preventable diseases. ACHA recognizes the vital role vaccinations play in health and discourages non-medical exemptions to required vaccines. As state legislatures continue to debate immunization requirements, higher education leaders should remain attentive to these policy changes and their potential long-term implications. Safeguarding student health requires a coordinated effort across all education levels, and ACHA will remain informed on ongoing examples of other forms of vaccination-related legislation impacting students and higher education communities.

ACHA continues to foster healthier and more supportive college communities through our Advocacy work.  Should you have any questions, feedback, or impacts (both positive and negative of vaccination policies on your campus), along with things you think should be considered for either of the documents, you can email advocacy@acha.org or supply anonymously through the ACHA website here.