The prevalence and nature of anti-vaccination legislation in ten midwestern states: Implications for public health and policy.

Legislative proposals that could lower vaccination rates pose a threat to public health in the United States. We tracked and analyzed anti-vaccination bills proposed in the legislatures of ten Midwestern states from 2013 to 2024. We used the LegiScan database to search for bills, and three researchers independently classified each identified bill. We classified 374 bills as anti-vaccination bills. The legislative sessions during 2021-2022 saw 222 anti-vaccination bills proposed, mostly concerning COVID-19 vaccination. During 2023-2024, 101 bills were proposed; however, these bills were broader in scope, covering vaccines beyond COVID-19. Most anti-vaccination bills were introduced by Republican lawmakers and only 9 had Democratic sponsorship or co-sponsorship, and only 22 were signed into law. Scholars should continue systematically tracking and analyzing anti-vaccination proposals and other bills impacting public health.