For the nearly two years that COVID has hung over our heads, my children have been at risk of contracting and spreading the disease. I recently got them vaccinated, and I will never forget the relief I felt as we walked away from the mass vaccination site.

I am a college professor and am routinely in small rooms with students who have tested positive for COVID, even with mask and vaccine mandates in place at my university. While getting my girls vaccinated doesn’t completely eliminate their chances of getting sick, it significantly reduces their risks. To me, vaccination is crucial for protecting children and families.

But even as the availability of vaccines broadens to include nearly all school-aged children, I believe that many parents will choose not to vaccinate them. This is because vaccine refusal is about the power and the legitimacy people build among like-minded friends, congregants or clients when they take a stand against what they think is government overreach. To protect the most vulnerable among us, and to end this pandemic before a new coronavirus mutation takes over, we need to have a federal vaccine mandate for children in public schools.

Mandates already exist; children are required to have multiple vaccinations to enter school, and these requirements have reduced the incidence of several childhood diseases. In adults, COVID workplace mandates have increased the number of people who have been inoculated. Some people who have struggled with this decision have expressed relief at no longer having to do so; “secret” vaccination sites throughout the United States, including particularly conservative communities, have shown that many people want to get shots but not be seen.

If COVID-19 vaccines are also required to attend public schools, overall community transmission will lessen; and despite resistance, I believe even vaccine-hesitant people will eventually see the value in vaccines. I hope entire communities will come together to see a mandate as part of the social contract on which our collective union stands.

Vaccine mandates are particularly important for communities where social and cultural beliefs of individualism compete with collective goals of public health. I am a medical anthropologist who studies the social experience of epidemics, and during the first pandemic summer, I traveled to Okoboji, Iowa, to study mask hesitancy. Okoboji is one of eight towns around the Iowa Great Lakes. It is a majority white, conservative and religious community. People told me repeatedly that masking and vaccination should be personal choices.

Okoboji is also my hometown.

During that year I spoke with hundreds of people in the Iowa Great Lakes over Facebook, coffee, Zoom and text about their pandemic experiences. It was fascinating to learn why people, many whom I had known for decades, rejected masks, while navigating their own complicated feelings about loved ones who were at high risk for COVID complications.

Some of those people told me God would protect them from harm. Others simply said they chose to reject fear and live their lives. Even school board members said they wouldn’t make children wear masks.

The time I spent in Iowa turned into a book: Unmasked: COVID, Community, and the Case of Okoboji. In it, I describe the culture, politics, religion and social networks that are at the center of mask and vaccine refusals, and that refusing masks and vaccines builds social status among certain groups of people.

In many ways, fights about masking in Iowa and elsewhere have become preludes to fights over vaccinations. Among white families in particular, vaccine refusal is a weapon wielded to control social networks and build solidarity, respect or a following. 

The social power of vaccine refusal is well-documented. Anthropologist E.J. Sobo found many parents at a California Waldorf school used vaccine refusal to help build relationships and community. American sociologist Jennifer Reich has written that “mothers who refuse some or all vaccines access social capital as they gain informational, emotional, and appraisal support from networks for their position and in opposition to those who disapprove.” She describes how many mothers asserted their individual power over their children’s bodies to navigate feelings of powerlessness in other aspects of their lives.

Vaccine hesitancy in Okoboji is no different; one family physician became an outspoken opponent of masking, quarantine and vaccinations. He eventually left medical practice, but I heard people around town dismiss public health recommendations while citing his critiques.

Broadly, the movement is driven by an alternative wellness community that is also deeply religious. Most of the people in this community are conservative and Christian, entwining their fervor for President Trump with their Christian faith and beliefs about coronavirus.

In Okoboji, mothers like Maureen used vaccine refusal to elevate their social status. This was exemplified by Maureen’s teacher who used these beliefs to build a stronger social and religious network. Based on my research in my hometown, I do not believe many children in Okoboji and similar communities all over the U.S. will ever be vaccinated against COVID-19 if we leave it up to personal choice. To protect the most vulnerable children—and particularly those who cannot get vaccinated—we need to close this gap of vaccine refusals with a mandate.

As many people believed in Okoboji during the first several months of the pandemic, we are all in this together. Mandates will make it easier to share in this social responsibility.