History19th centuryUnited Stateslow confidence

In 1855, Massachusetts became the first U.S. state to require children to receive a smallpox vaccine before attending school.

Notes on verification

Confirmed by multiple independent sources including historical/legal references and the original 1855 statute text ('An Act to secure General Vaccination'). Nuance: Boston had a city-level mandate earlier (1827), but Massachusetts was first at the state level, consistent with the claim.

Sources