Massachusetts becomes 1st US State to mandate 
'Proof of Vaccination' for school children

1855: Massachusetts Enforces Statewide School Vaccination Law

• May 19, 1855: Massachusetts passed “An Act to secure General Vaccination” requiring:

  1. Vaccination before age two for all children

  2. Proof of vaccination as a prerequisite for public school enrollment

  3. Penalties: Parents/guardians neglecting to vaccinate could be fined $5 per year per child

In 1855, Massachusetts became the first U.S. state to enact a law requiring smallpox vaccination for children as a prerequisite for attending public school. This marked a significant moment in both public health policy and the history of vaccination in the United States.

• The 1855 Massachusetts Law:

  • The law required all children attending public schools to present proof of smallpox vaccination

  • Schools were not allowed to admit unvaccinated students unless they had a valid medical exemption

  • The intent was to prevent the spread of smallpox in crowded school environments and among children

• Public Response and Legal Precedent:

  • While some parents objected on personal or religious grounds, the law was generally upheld by public health authorities

  • It set a legal and public health precedent for mandatory vaccination laws in other states and for other diseases

  • The law eventually contributed to Jacobson v. Massachusetts (1905) — a landmark U.S. Supreme Court case that upheld the authority of states to enforce compulsory vaccination laws in the interest of public health

• Impact:

  • Massachusetts's vaccination law was one of the first examples of using state power to enforce immunization, helping to reduce smallpox incidence

  • It also influenced broader trends in school-entry immunization requirements, which are now standard for multiple diseases in all 50 states