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NPR National News

COMIC: If history is a guide, schools will start requiring COVID vaccines

A look at the history of vaccines in schools.

The first time kids had to get a vaccine to go to school was more than 200 years ago. The disease? Smallpox.

For the past four decades, all 50 U.S. states have required that parents, if they want to enroll their children in any school, public or private, must vaccinate them against contagious diseases like polio and measles. The reason is simple: High rates of vaccination dramatically cut deaths and have all but eliminated some diseases.

But as long as there have been vaccines, there have been people who oppose them, formerly known as "anti-vaccinationists." They have brought many legal challenges over the years, but the U.S. Supreme Court ruled on the constitutionality of school vaccine mandates nearly a century ago, and that has pretty much been upheld to this day.

That said, there's also a strong tradition of granting exemptions to vaccine requirements based on religious and philosophical beliefs. There has also, at times, been lax enforcement and an unwillingness to punish students by keeping them out of school.

But when diseases break out or come back, so do vaccine campaigns and the really strong stuff: mandates.

Scroll on to take a look at a historical timeline of vaccines in schools:

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The war between humans and microbes goes back centuries. One of our biggest victories was over smallpox. The earliest evidence of smallpox is on the mummified corpse of Egyptian Pharaoh Ramses V. Smallpox was far deadlier than COVID. Fatality rates were as high as 30%. Smallpox traveled the globe through trade expeditions.
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1796: English doctor Edward Jenner successfully vaccinates a child named James Phipps with pus taken from a cowpox pustule. The principle goes back centuries to the traditional practice of variolation in Central Asia, India, China and Africa.1818: The first known school vaccine mandate comes from the king of Wittenberg, in Germany.
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1827: Boston is the first U.S. city to require all children entering public schools to provide evidence of vaccination. Throughout the 19th century, more U.S. states require smallpox vaccines because ... they work! Mortality from smallpox fell 88% in Europe after vaccine adoption. 1980: World Health Organization declares smallpox officially eradicated.
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<strong>1938: </strong>President Franklin D. Roosevelt, a polio survivor, founds the March of Dimes to fund polio research.<strong>Early 1950s: </strong>There are 25,000 to 50,000 new cases of polio each year in the United States. Polio is feared "second only to the atomic bomb" and mainly affects children under 5.It leaves many permanently disabled and some dead.
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<strong>1955: </strong>Jonas Salk introduces his polio vaccine after a field trial involving 2 million children, conducted in public schools. <strong>But the first mass vaccination program in the U.S. had to be halted when a lab error caused live virus to be injected into 200,000 children.</strong> The "Cutter Incident" led to the effective federal regulation of vaccines, but mistrust lingered.
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As long as there have been vaccines, there have been people opposed to them (formerly known as "anti-vaccinationists").1885: Up to 100,000 people demonstrate against vaccination in Leicester, England. They hang Edward Jenner in effigy.
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"No shots, no school" 1980: All 50 states have laws requiring vaccination for school entrance.
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1998: Andrew Wakefield publishes a notorious flawed article raising questions about a link between autism and the MMR vaccine. 2010: The article is retracted for bad data, and Wakefield, who also has undisclosed financial interests, is barred from practicing medicine. Yet vaccine refusal grows, thanks in part to misinformation and conspiracy theories.
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2020 Coronavirus and Vaccines in SchoolsThe COVID-19 pandemic leads to lots of kids missing basic vaccines. And it whips up anti-vaccination sentiment.
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Misinformation and political polarization have undermined efforts to fight this pandemic, but there are signs that employer-based vaccine mandates are working. Could school COVID-19 vaccine mandates get us to herd immunity, as they have for diseases throughout history? Or could they simply bring more resistance than ever?
LA Johnson / NPR