When Maine Gov. Janet Mills signed a law in 2019 tightening the state’s rules for vaccinating students, Northe Saunders captured the historic moment in a photo: his then 3-year-old daughter standing on the granite steps of the State House in Augusta, raising her arms in celebration.
“It’s wonderful now to think about her being involved that day when the law passed in Maine, and now sending her off to school every day,” said Saunders, now the president of American Families for Vaccines.
Just six years after Maine decided families cannot cite their religious beliefs to avoid required vaccines, the policy is already showing a dramatic effect: The state recently touted a record high immunization rate of more than 97% of schoolchildren.
Connecticut, which took a similar step in 2021, recorded the country’s highest measles vaccination rate for kindergarteners this year. And New York, which ended religious exemptions shortly after Maine, is also near the top of the list on kindergarten vaccination rates, according to Centers for Disease Control and Prevention data.
In Massachusetts, however, religious exemptions for school vaccines have steadily climbed. More than 1.3% of the 2024-25 kindergarten class had religious exemptions — the highest level recorded by the state’s Department of Public Health since it started tracking exemption data in the 1980s. While the percentage of unvaccinated public school kindergarteners remains low, health experts see the trend as unsettling.
This comes as measles and whooping cough cases have been climbing nationally, according to the CDC. A September poll from KFF and The Washington Post revealed that one in six parents have either skipped or delayed at least one routine childhood vaccine, excluding COVID-19 and flu shots.
In Massachusetts, kindergarten vaccination rates were above 96% for both MMR, the measles vaccine, and DTaP, which protects against whooping cough, in the 2024-2025 school year.
Yet advocates like Saunders want the commonwealth to join its three neighbors by ending the religious exemption option. Supporters say that would help fend off future outbreaks by lifting up immunization rates in pockets of the state where the numbers are too low for herd immunity.
Battling bills
In Massachusetts, medical exemptions require a doctor’s note but religious exemptions are much easier to obtain: a parent or guardian can simply submit a letter stating that a vaccine conflicts with their sincerely held religious beliefs.
Haverhill Rep. Andy Vargas, a Democrat, sponsored legislation this session that would strike the section of state law allowing religious exemptions to vaccines. His bill would also require all K-12 schools — public, private and charter — to report student vaccination numbers to the state.
Other lawmakers, like Rep. Nicholas Boldyga, a Republican from Southwick, are fighting for the opposite; his bill would let parents avoid vaccines for reasons of religion or ”conscientious objection“ — without sacrificing their child’s public education.
For either of these bills to pass, they first need to grab the attention of the two Democrats who lead the House and Senate, whose job it is to wade through the thousands of bills submitted each session and determine what to bring to the floor.
Senate President Karen Spilka and House Speaker Ron Mariano don’t appear to have childhood vaccine exemptions on their to-do lists almost halfway into the two-year legislative session.
Asked about the bills at a press conference recently, Spilka said it’s important “that vaccines are available and are given to people, including children.” She wants to hear from senators and other interested parties on the issue.
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“There’s been so much misinformation about vaccines that we have to do a better job of educating the members” of the House, said Mariano.
Gov. Maura Healey was similarly indirect when asked if Massachusetts should follow Maine, New York and Connecticut on religious exemptions.
“I’m going to be guided by medical experts and pediatricians, you know?” she said. “I think that childhood immunizations have been part of what we do in this country, and I think they’ve proven to be to great success.”
Passionate testimony
While top policymakers are muted on the issue, the State House has no shortage of voices.
A marathon hearing in June featured almost eight hours of testimony on vaccine policy.
Lawmakers heard passionate pleas from dozens of parents who want to keep religious exemptions. Some cited specific faith tenets or beliefs. Others shared concerns about government overreach and the influence of the pharmaceutical industry.
They also heard from doctors urging them to end the exemption. Rick Moriarty, a retired pediatric infectious disease specialist who lives in Plymouth, was one of them.
Moriarty remembers his parents being scared to let him outside during polio epidemics when he was a kid. Years later, he worked in Liberia and encountered, as he puts it, an immunization system that “had fallen apart” after years of civil war.
“Many women didn’t get the vaccines that they needed, particularly around pregnancy,” Moriarty said. “The two times I was there, we saw a few babies die from neonatal tetanus, and that was very sad.”
In New England, Moriarty recalls parents coming into his practice unsure about vaccinating their kids. When one mother questioned shots for her 4-month-old, he sent her a link to a video of an infant with whooping cough.
“It’s one of the most upsetting things that you can see,” Moriarty said. ”She saw the film and then called me back and said, ‘I’m bringing my baby in for the shots.’”
He said his message to lawmakers is simple: Listen to the medical experts who are telling you how bad these diseases can be.
A poll conducted by Massachusetts Families for Vaccines this year found that 70% of voters support passing legislation to end the religious exemptions. Support is even higher among parents of school-age children, with three out of four on board.
State Sen. Becca Rausch has been filing a bill she calls the Community Immunity Act since she first took office in 2019.
Rausch’s bill would maintain both religious and medical exemptions, but would require the state to develop standardized paperwork for each. Critically, it would also require state health officials to collect immunization and exemption data from schools, daycares and camps. Programs that land below the herd immunity threshold would then be labeled “elevated risk.”
Rausch, a Needham Democrat, said her legislation would not mandate vaccines for anyone but would “plug up the Swiss cheese holes in our statutes on immunization infrastructure.”
She doesn’t see one particular obstacle that’s kept the Legislature from acting.
“I think sometimes it’s not necessarily a roadblock so much as we need a lot of motivation,” Rausch said. “And I think — I hope — that the national decimation of our public health strategies and policies and protocols by Trump and RFK Jr. are the motivation we need to put this infrastructure into place.”
