Childhood Immunizations: Mississippi’s Mandatory School Immunization Law

Tuesday, November 11th, 2014

Mississippi law mandates that all children attending school must be vaccinated against certain diseases.  All states have similar laws but vary in the number and type of exemptions allowed.  Mississippi allows only medical exemptions.

The Center for Mississippi Health Policy has prepared an Issue Brief that summarizes the scientific literature on the safety and efficacy of childhood immunizations, outlines the legal environment for Mississippi’s policies, and examines policy issues related to exemptions. A key focus of the policy analysis is the 1979 Mississippi Supreme Court decision Brown v. Stone that ruled a religious exemption was unconstitutional.

Summary of Key Findings

  • All states have mandatory child immunizations laws requiring vaccination against selected diseases before school entry.
  • Mandatory school immunization laws are based on the concept that a sufficient proportion of children must be immunized in order to protect persons who either failed to develop immunity from a vaccination or were unable to be vaccinated due to age or medical condition.
  • All states allow medical exemptions from this mandate, all but two allow religious exemptions, and nineteen allow philosophical exemptions.
  • Because the Mississippi Supreme Court ruled in 1979 that a religious exemption was unconstitutional (see quotes from the ruling below), Mississippi only allows medical exemptions.
  • Approximately one hundred medical exemptions are granted annually by the Mississippi State Department of Health.
  • There is a direct relationship between the ease of obtaining an exemption and the risk of resurgence in vaccine-preventable diseases.
  • The nationwide trend in state legislative actions since 2009 has been to restrict exemptions.
  • Vaccinations are generally delivered according to a schedule recommended by the national Advisory Committee on Immunization Practices.  The actual schedule followed, however, is at the discretion of the parents and their child’s health care provider, as long as the child is immunized prior to school entry.

Mississippi Supreme Court Decision: Brown v Stone (1979)

The precedent for Mississippi’s current school immunization law, which allows for only medical exemptions, can be found in Brown v. Stone, a 1979 state Supreme Court case in which the Court ruled that a religious exemption in Mississippi statute was unconstitutional.  The Court reasoned that a religious exemption would violate the Fourteenth Amendment since it would “require the great body of school children to be vaccinated and at the same time expose them to the hazard of associating in school with children exempted under the religious exemption who had not been immunized.”

The Court’s strong stance upholding the law is summarized by their recognition of the evidence in support of the efficacy of immunization:

“The fundamental and paramount purpose of the Mississippi Legislature in the enactment of…Mississippi Code Annotated section 41-23-37 was to afford protection for school children against crippling and deadly diseases by immunization.  That this can be done effectively and safely has been incontrovertibly demonstrated over a period of a good many years and is a matter of common knowledge of which this court takes judicial notice.”

The Court concluded that this purpose served an “overriding and compelling public interest” and further stated:

“The protection of the great body of school children attending the public schools in Mississippi against the horrors of crippling and death resulting from poliomyelitis or smallpox or from one of the other diseases against which means of immunizations are known and have long been practiced successfully, demand that children who have not been immunized should be excluded from the school community until immunization has been accomplished….To the extent that it may conflict with the religious beliefs of a parent, however sincerely entertained, the interests of the school children must prevail.  [The law] is a reasonable and constitutional exercise of the police power of the state insofar as it provides for the immunization of children before they are to be permitted to enter school.”

Continuing this logic, the Court concluded:

“Therefore, we hold that the provision providing an exemption from the operation of the statute because of religious belief is in violation of the Fourteenth Amendment to the United States Constitution and therefore is void.”

For More Information

Copies of the issue brief can be downloaded HERE.  Printed copies of the issue brief are available by contacting the Center for Mississippi Health Policy at 601-709-2133 or by e-mail at