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2021 Vaccine Policy State Legislative Scorecard 

Prepared July 7, 2021

2021 Vaccine Policy State Legislative Scorecard 
Executive Summary

The number of anti-vaccine bills introduced and passed in the states far exceed the number of pro-vaccine bills introduced and passed.


Health Policy Advocates (“HPA”) reviewed all vaccine-related bills introduced during the 2021 state legislative sessions. Over 800 bills were introduced across the 50 states. As of this writing, some state legislatures have ended with some legislation still pending upon the Governor’s action while some state legislative sessions are still active. HPA believes it is important to provide an interim scorecard based on the number of pro-vaccine bills passed and signed into law. A vaccine legislation scorecard will be issued once at the end of the calendar year to accommodate the variable timings of sessions.

HPA defines pro-vaccine bills as legislation that can have a positive impact improving vaccination coverage rates, access to vaccination, and/or improve immunization awareness and education. Anti-vaccine bills are defined as legislation that can have a negative impact on immunization coverage rates, decrease access to vaccination, and/or impede immunization awareness and education. In reading the bills, just over the half of bills introduced were obviously pro vaccination or anti vaccination.

Slightly less than half of vaccine related bills filed, did not clearly fit into either of those buckets, therefore were labeled as “other”. For example, Wisconsin’s bill AB 132 is related to “immunization-related mail.” This legislation does not impact vaccination rates or improve immunization education, nor does it have a negative impact on immunization rates; hence, we categorized it as “other.”

Summary of Methodology

The following describes the methodology used by HPA to generate the Vaccine Bill Scorecard.

Source of Data

HPA searched the FiscalNote repository to find all vaccine bills. HPA manually reviewed all vaccine bills introduced in every state and coded those bills as “Pro,” “Anti,” or “Other.”  The bill was assigned a weighting depending upon whether a bill was simply introduced or a bill was introduced and passed. We consider a bill passed when the legislature passes the bill and the bill is signed into law by the Governor. Failure of anti-vaccination bills also received weighting given the complexities and effort required to stop bills from moving through the legislative process. The sum of the weightings generated a score. That score is then converted to an A, B, C, D or F grade.


Scores were calculated by multiplying the number of bills in each category by the weighting in the chart below. The grading criteria was based on a score range to determine the letter grade.

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