Among the hallmarks of the beginning of school are school immunizations.

While decidedly less fun than shopping for back-to-school clothes, these immunizations have saved untold lives since they became common requirements.

Massachusetts was the first state to require immunization before children could go to school, according to a history of vaccine requirements posted on the Mayo Clinic website. Established in 1855, Massachusetts’ rule affected only one disease: smallpox.

Through the 1900s, other states came on board, some to fight smallpox and others targeting other diseases as well. By 1963, 20 states required children to have several vaccines before going to school for the first time. By 1980, all states had some kind of vaccine-related law; some states required certain vaccines while others allowed county public health boards to decide which vaccines would be required.

It’s hard to describe the full effect of these vaccines because they’re all about what might have happened but didn’t.

Just to cite the easiest example: Smallpox plagued the world at least as far back as the 4th century and possibly even before the time of Christ. The disease killed three out of every 10 people who contracted it, according to the CDC, and left its survivors with scars, some of which were horrific. For a long time, people knew about inoculation — exposing a healthy person to smallpox under controlled conditions so that they got a lesser form of the disease and developed an immunity. In 1796, Dr. David Jenner invented vaccination, which used a related virus that causes less serious illness to create immunity to smallpox. In 1855, Massachusetts ordered vaccination of children to prevent smallpox’s spread in schools and other states followed suit. Less than 100 years later — in 1949 — the United States saw its last case of smallpox. A worldwide effort at eradication began in 1959 and was declared successful in 1980.

One of the most fearsome diseases in history was ended, in large part by the vaccination of both children and adults. School vaccinations were not the whole story, but they were a huge part of it.

Children don’t have to be vaccinated against smallpox any more, but they are required to receive multiple other vaccines to keep them safe from a variety of other diseases: measles, mumps, rubella, hepatitis A and B, polio and several others. Some are required before starting school, while others are required before entering certain grades.

More details about Georgia’s requirements are available at https://dph.georgia.gov/schoolvaccines.

Each county health department offers back-to-school immunizations whenever they’re open, or you can contact your child’s pediatrician.

Vaccines save lives. Make sure your child is ready for school, not just with new clothes and bookbags and pencils but with immunizations too.