Ending school vaccine requirements is a cruel experiment on Iowa’s children

In 1855, Massachusetts became the first state in the U.S. to require a vaccine before starting school — specifically, the smallpox vaccine (1). It was a bold experiment, but a necessary one: smallpox was a uniquely terrible disease, and nearly everyone in the state would have known a loved one killed or mutilated by the virus. While initially controversial, school vaccination requirements proved highly effective in Massachusetts, leading other states to follow suit in the following decades. The U.S. would officially become smallpox-free in 1949, less than a century after Massachusetts’ school vaccination mandate. And in 1977, a Somali hospital cook cleared the last-ever naturally occurring case of smallpox from his system (2). Smallpox, a disease that claimed roughly 300 million lives in the 20th century alone, was gone for good thanks to widespread vaccination.

Since then, vaccines have seen other staggering successes around the world, including in the U.S. Not long ago, American children risked having their brains crushed against their skulls by measles or having their throats rotted out by diphtheria. Routine vaccines have made tragedies like these exceedingly rare. School vaccination mandates are no longer an experiment, as they were in Massachusetts in 1855. Rather, they are a basic, responsible policy to keep children safe.

Today, all 50 states require certain vaccinations before starting school (1). Soon, however, Iowa may become an exception: the House is considering HF2171, a bill that would eliminate all vaccine mandates from public schools (3). This bill recently cleared committee review, and it will likely face a full House vote in the next month. State legislators will soon decide whether or not to conduct an experiment on Iowa’s schoolchildren, presumably to test the hypothesis that we can safely ignore a century of miraculous success.

To end school vaccine mandates would be a moral disgrace. Measles has been surging across North America at its fastest rate in decades, with recent outbreaks in South Carolina and Texas. It has already caused three deaths in the U.S. (4), and even many of the children who recovered well are likely to die of measles-inflicted brain damage before reaching adulthood. Any child who has not received routine vaccinations is in very real danger right now.

And even from a pessimistically political angle, HF2171 makes no sense. According to a poll conducted by Harvard in March 2025, 79% of Americans, including 68% of Republicans, support mandatory vaccinations for schoolchildren (5). How is it, then, that of the sixteen Republicans on the House Education Committee, just two voted against the passage of HF2171? For only 12.5% of the committee’s Republican legislators to defend a policy that 68% of Republican voters support is a stunning betrayal.

In the coming weeks, Iowa state representatives will have a simple but important job: vote “no” on HF2171. The rest of us have a job that is less simple but no less important: make calls, write letters, and join protests to keep Iowa’s schoolchildren safe from this cruel experiment.

Stein Acker an M.D.-Ph.D. student at the University of Iowa.