In 1916, Arkansas became the first state to implement a policy of mandatory vaccinations for children attending public or private school. The only vaccination requirement at the time was for smallpox, which sickened between 7,000 and 10,000 people in Arkansas every year. The new rule met with heated opposition, resulting in a legal challenge that landed in front of the Arkansas Supreme Court. The court upheld the regulation in June 1918 as public opinion began to change to favor the vaccinations. The impact of the rule was swift and widespread; by 1930, the state was only seeing 250–300 cases of smallpox each year. The Arkansas Supreme Court again supported the rule in 1931, saying that the Carroll County School District was correct in refusing to admit students who had been vaccinated using an oral vaccine instead of the route prescribed by the State Board of Health. Today, the Arkansas Department of Health requires vaccinations against more than a dozen illnesses as a requirement for attending school in the state.

Photographs and information for this article were provided by the Arkansas Department of Health.