For decades, Tennessee has been a national leader in childhood vaccination requirements, safeguarding students, teachers, and communities since 1967. However, a new legislative proposal could overturn this longstanding protection. House Joint Resolution 28, introduced by Representative Gino Bulso, a Republican from Brentwood, seeks to make school vaccination mandates unconstitutional.
Vaccination requirements have been vital in controlling diseases. The eradication of measles highlights their effectiveness. However, recent outbreaks in states like Texas emphasize the ongoing need for immunization laws.
The measles vaccine was first approved in 1963, followed by a nationwide campaign in 1966. Within two years, the number of measles cases had dropped by over 90%. Tennessee responded swiftly by enacting its first school vaccine requirements in 1967. This law required kindergarteners to be vaccinated unless a physician provided a medical exemption or parents cited religious beliefs that relied solely on prayer for healing.
This early initiative played a key role in reducing measles cases across the state. Research from Kevin Malone and Alan Hinman’s book Law in Public Health Practice confirms that states with strict vaccination laws reported significantly lower measles rates than those without.
By 1977, vaccination rates had begun to decline, prompting President Jimmy Carter to introduce the Childhood Immunization Program. This nationwide effort aimed to achieve 90% vaccination coverage by 1979.
Tennessee lawmakers, recognizing gaps in the existing law, passed stricter immunization requirements in 1978. The updated law expanded the vaccination mandate to all K-12 students and introduced penalties for non-compliance. Schools would no longer receive state funding for unvaccinated students who lacked valid exemptions. The law required students to be immunized against diphtheria, tetanus, pertussis, polio, measles, and rubella before attending school.
Ensuring vaccinations for Tennessee’s 840,000 K-12 students was a major undertaking. Health departments collaborated with schools, media outlets, the Red Cross, and the State PTA to inform parents. Parents formed long lines to meet the vaccination deadline.
State Health Commissioner E.W. Fowinkle praised the public’s support for the campaign. Although some tension arose between the health and education departments regarding enforcement, their combined efforts proved successful. By the end of the 1978–1979 school year, 95.3% of Tennessee’s public school students were immunized. Only 0.2% of parents claimed medical or religious exemptions.
Public health experts have long recognized Tennessee’s vaccination success. Malone and Hinman’s analysis found that states with comprehensive immunization laws and strict enforcement had the lowest measles incidence rates.
In 1981, Commissioner Fowinkle emphasized that outbreaks were far less devastating than before, yet still tragic because they were preventable. His message remains relevant today.
Tennessee’s strong vaccination framework has endured since 1978, with only minor changes. The state broadened its religious exemption policy to include any conflicts with a parent’s or guardian’s religious beliefs. Despite a gradual decline in immunization rates, Tennessee maintained a measles vaccination rate of 94.9% — exceeding the national average.
According to a 2024 Centers for Disease Control (CDC) survey, 76.6% of parents agree that school vaccination mandates are crucial for public safety. In Tennessee, over 90% of students are vaccinated despite the state’s broad exemption policy.
Tennessee’s leadership in childhood immunization has contributed to low rates of preventable diseases. If Representative Bulso’s bill is approved, Tennessee could face rising cases of illness, hospitalizations, and even deaths. Lawmakers now face a critical decision — whether to protect public health or risk the consequences of weakened vaccination laws.
As Tennessee’s legislators deliberate, public health advocates hope they will prioritize the safety of children and communities by rejecting Bulso’s bill.
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