Survey reveals shift in U.S. views on childhood vaccine requirements

With President Donald Trump having threatened school vaccine mandates for children during his campaign, a new survey finds that nearly three-quarters of U.S. adults support requiring that children be vaccinated against preventable diseases such as measles, mumps, and rubella. To protect children who cannot be vaccinated for medical reasons, over half of Americans also support states prohibiting other unvaccinated children from attending school, either private or public. However, support for this prohibition has dropped significantly since the spring of 2019, prior to the Covid-19 pandemic.

Comparing responses from a new January 2025 Annenberg Public Policy Center (APPC) nationally representative survey with an APPC national survey conducted in April and May 2019, less than a year before the World Health Organization declared Covid-19 a global pandemic, we find a significant drop in support for states prohibiting unvaccinated children (for non-medical reasons) from attending public or private schools. Further, the new survey finds increased support for state policies allowing parents to opt out of vaccinating their children for medical, religious, and personal or philosophical reasons. The public, however, continues to support state policies that set aside funding to provide free or discounted access to the measles, mumps, and rubella (MMR) vaccine.

The survey finds that these changes are driven in part by changing views from 2019 to 2025 among self-described Republicans – notably, a decline in support for the mandatory vaccination of children for preventable diseases such as measles, mumps, and rubella, and large increases in support for parents to opt out of having their children vaccinated for medical, religious, and personal or philosophical reasons. The growing support for parental opt-outs is universal across political party for medical exemptions, while religious and personal exemptions are seen to lesser degrees among self-described Democrats or political independents (identifying as independent or with a party other than the Republican or Democratic ones). 

APPC’s latest survey asked about state policies because school-related vaccine requirements are set at the state level, not the federal level. Nonetheless, federal actions can influence state-level policy. At a June 22, 2024, campaign event, then-presidential candidate Donald Trump said he would not provide federal funding to any school that has a vaccine requirement:

And on Day One, I will sign a new executive order to cut federal funding for any school pushing Critical Race Theory, and I will not give one penny to any school that has a vaccine mandate or a mask mandate.

To date, Trump has not signed such an order on vaccine mandates.

His nominee for Secretary of Health and Human Services, Robert F. Kennedy, Jr., who lately has been seeking to distance himself from his long-promoted anti-vaccine views, led the vaccination-focused organization Children’s Health Defense before he stepped aside in April 2023 to run for president. As stated currently on its website, that organization takes the position “it should be the parent’s choice, and not the government’s, to decide what goes into the bodies of their children. Statewide policy is becoming more and more oppressive while, at the same time, more inadequately-tested vaccines are added to the childhood schedule. Parents in many states are now fighting to keep their personal beliefs and religious exemptions in place and prevent mandates.”

In July 2023, Kennedy told podcaster Lex Fridman that “There’s no vaccine that is, you know, safe and effective.” However, in a Nov. 6, 2024, statement to NBC News, Kennedy said, “If vaccines are working for somebody, I’m not going to take them away. People ought to have choice, and that choice ought to be informed by the best information … So, I’m going to make sure scientific safety studies and efficacy are out there, and people can make individual assessments about whether that product is going to be good for them.”

Infectious disease expert Paul A. Offit, of Children’s Hospital of Philadelphia, says parents have every right to be skeptical, but that Kennedy has misrepresented the findings of vaccine safety studies and “is a vaccine cynic, failing to accept studies that refute his beliefs.” The Centers for Disease Control and Prevention (CDC) says that the “Food and Drug Administration regulates vaccines to make sure they are safe and effective,” and the CDC publishes an immunization schedule for childhood vaccinations.

While policies around school-related vaccine requirements are set at the state level, most states follow the guidelines and recommendations of the CDC’s Advisory Committee on Immunization Practices (ACIP), part of the U.S. Department of Health and Human Services, which, if confirmed by the U.S. Senate, Kennedy would oversee. Because the HHS secretary has the authority to approve those appointed to ACIP, Kennedy would have the power to refashion that committee’s membership.

The APPC survey findings are based on a nationally representative panel survey of 538 U.S. adults fielded from Jan. 3-5, 2025, with a margin of sampling error of ± 5.2 percentage points. It is compared here with a nationally representative panel survey of 2,344 U.S. adults conducted from April 18-May 13, 2019, with a margin of error of ± 2.8 percentage points, and, where noted, APPC’s nationally representative Annenberg Science and Public Health (ASAPH) knowledge panel waves conducted in January 2023 (n=1,641, MOE ±3.2 pp), June 2023 (n=1,586, MOE ±3.3 pp) and August 2023 (n=1,482, MOE ±3.5 pp). For more on the surveys, see the end of this news release or the topline.

Support for vaccine requirements for MMR for children remains high

Over 7 in 10 U.S. adults (73%) support a policy making it mandatory for parents to vaccinate their children against preventable diseases such as measles, mumps, and rubella. This is not significantly different than the 2019 findings which indicated that 77% supported this type of vaccine requirement.

An analysis of the current findings by party reveals a sharp partisan split, with 86% of Democrats saying it should be mandatory for parents to vaccinate their children against preventable diseases such as measles, while just 62% of Republicans and 72% of independents feel this way.

Most favor states requiring vaccination to attend school, though support has fallen

Certain vaccinations are required for students to attend school in all 50 states and Washington D.C. A majority of U.S. adults (52%) support their state requiring vaccination as a condition of school attendance, whether public or private, in an effort to protect children who cannot be vaccinated for medical reasons. However, this represents a nearly 20-point drop from our survey in spring 2019, when 71% supported requiring vaccination as a condition of public or private school attendance. Support for this requirement declined across all political groups.

In addition, the percentage of those who “strongly support” school-related vaccination requirements has fallen sharply, from nearly half (47%) of U.S. adults in 2019 to barely a quarter (24%) in January 2025.

Nevertheless, when asked to indicate which view is closer to their own when it comes to childhood vaccines for MMR and public-school attendance, 66% say they are closer to the view that healthy children should be required to be vaccinated because of the potential risk when children are not vaccinated. Only a fifth of adults (21%) say they are closer to the view that parents should be able to decide whether to vaccinate their children who attend public schools, even if their decision not to vaccinate creates health risks for other children and adults. These views are little changed from 2023, when we asked ASAPH survey panelists their views in January, June, and August 2023.

Post-pandemic support grows for opt-out choice on vaccinating children

According to the National Council of State Legislatures (NCSL), all states have exemptions from school vaccination requirements for medical reasons. Thirty states and Washington, D.C., allow exemptions from school vaccination requirements for religious reasons, and 13 states allow exemptions for personal or philosophical reasons.

Our survey shows a large and significant increase in support among U.S. adults for states giving parents the choice to opt out of school-associated vaccination of their children for medical, religious, or personal/philosophical reasons. Nearly two-thirds of U.S. adults (63%) somewhat or strongly support a law allowing parents in their state to choose not to vaccinate their children for medical reasons, while a little more than a fifth (22%) oppose such a policy. In 2019, 36% said they would support such a policy and 46% would oppose it.

Nearly 4 in 10 (39%) say they would support a state policy that would allow parents to choose not to vaccinate their children for religious reasons, almost double from 2019, when 20% said they would support this policy. In 2019, 63% said they would oppose states allowing parents to choose not to vaccinate their children on religious grounds, while 41% said they would do so in our 2025 survey.

Support has doubled for state-sanctioned parental choice around vaccines for philosophical reasons. In our January survey, 35% said they would support a policy in their state that would allow parents to choose not to vaccinate their children for personal or philosophical reasons, double the proportion expressing such support in the spring of 2019 (17%). Opposition to this policy dropped from 69% in spring 2019 to 49% in January 2025.

Growing support for parental opt-outs by party

When our 2019 and 2025 respondents were questioned about support for different reasons parents might choose not to vaccinate their children, or to opt out, there was a disproportionate growth over time in Republican and independents’ support, compared with Democrats’, for religious opt-outs, and among Republicans compared with independents and Democrats for personal/philosophical opt-outs. Over time, all three groups saw similar growth in support for medical opt-outs.

Medical opt-outs for childhood vaccines: From 2019 to 2025, support for states offering medical opt-outs for childhood vaccinations increased to 63% from 36%. Over this period, support for medical opt-outs grew by a stunning 31 percentage points among Republicans (to 69% from 38%), 28 percentage points among independents (to 66% from 38%), and 22 points among Democrats (to 53% from 31%). Over this period, the number of those who opposed these opt-outs shrank dramatically, to 20% from 47% among Republicans, 32% from 51% among Democrats, and 17% from 41% among independents. (See the topline for details.)

Religious opt-outs for childhood vaccines: From 2019 to 2025, support for states offering religious opt-outs for childhood vaccinations nearly doubled, to 39% from 20%. Among Republicans support for religious opt-outs grew to 52% from 24% and among independents to 42% from 22% (the change for Democrats was not significant). Again, opposition to these opt-outs sharply dropped, to 29% from 62% among Republicans and 34% from 58% among independents (the change for Democrats was not significant).

Personal or philosophical opt-outs for childhood vaccines: From 2019 to 2025, support for states offering personal or philosophical opt-outs for childhood vaccines more than doubled, to 35% from 17%. Again, Republicans led in supporting these opt-outs, with support growing to 44% from 16% in 2019. Support among Democrats grew to 22% from 12%, and among independents to 38% from 22%. The numbers opposing these opt-outs collapsed most sharply among Republicans, to 41% from 71%, and independents, to 42% from 61% (the change among Democrats was not significant).

Most support state funding of free or discounted MMR vaccines

More than 8 in ten U.S. adults (84%) say they would support their state setting aside public funds to provide free or discounted access to MMR vaccines. This has not significantly changed from 2019, when 81% expressed support for such a policy.

Survey methodology

The data come from survey questions the Annenberg Public Policy Center (APPC) placed on SSRS’s nationally representative opinion panel of 1,077 U.S. adults conducted from Jan. 3-5, 2025. SSRS is an independent market research company. A randomly assigned half-sample of 538 respondents were asked these questions in the same manner as the 2019 survey. The margin of sampling error (MOE) is ± 5.2 percentage points at the 95% confidence level for the n=538 half-sample. The results are compared with a nationally representative panel survey of 2,344 U.S. adults conducted from April 18-May 13, 2019, with a margin of error of ± 2.8 percentage points, and where noted, APPC’s nationally representative ASAPH panel waves conducted in January 2023 (n=1,641 MOE ±3.2 pp), May 2023 (n=1,586, MOE ±3.3 pp) and August 2023 (n=1,482, MOE ±3.5 pp). The margin of sampling error for demographic subgroups is higher. All figures are rounded to the nearest whole number and may not add to 100%. Combined subcategories may not add to totals in the topline and text due to rounding.