During the 2022-2023 school year, the percentage of kindergartners exempted from state-required childhood vaccinations reached an all-time high, as revealed by recent federal data.
The Centers for Disease Control and Prevention’s report highlights the enduring impact of the COVID-19 pandemic on routine immunization rates and its consequences for school-age children. The United States has witnessed several measles outbreaks in areas with low vaccination rates, underscoring the importance of maintaining robust immunization coverage.
State regulations mandate vaccinations against diseases like measles, whooping cough, and polio for all schoolchildren, with annual reporting to the CDC on compliance or exemptions. While medical reasons are universally accepted for exemptions, an increasing number of states also permit religious or philosophical exemptions.
The overall percentage of children with vaccination exemptions rose from 2.6 percent in the 2021-2022 school year to an unprecedented 3 percent in 2022-2023, encompassing approximately 3.8 million public and private school kindergartners. The report does not definitively explain the reasons behind this surge, leaving open the possibility that it could be due to a genuine increase in vaccine opposition or other factors like convenience or barriers to vaccination.
Even before the pandemic, vaccine hesitancy and anti-vaccine sentiments led to a rising number of parents opting out of mandatory immunizations in various states. The contentious debates surrounding COVID-19 vaccines and school mandates during the pandemic likely exacerbated these concerns, as indicated by a 2022 survey revealing shifting attitudes, especially among Republicans.
Multiple factors contribute to the declining vaccination coverage, including difficulties in scheduling well-child visits early in the pandemic, politicization of vaccines, and, in some cases, the convenience of opting for exemptions over vaccination. National coverage for childhood immunizations among kindergartners dropped from 95 percent pre-pandemic to 93 percent in recent school years.
The report’s data suggests that approximately 250,000 kindergartners are “at risk” for measles infection, with the national coverage for the measles, mumps, and rubella (MMR) vaccine reaching 93 percent. The CDC recommends two doses of the MMR vaccine, with the first administered at 12 to 15 months and the second between 4 and 6 years old.
Vaccination exemptions surged across 41 states, with 10 states reporting exemption rates exceeding 5 percent for kindergartners. States like Alaska, Arizona, Hawaii, Idaho, Michigan, Nevada, North Dakota, Oregon, Utah, and Wisconsin faced exemption rates above this threshold, posing a significant challenge to achieving the 95 percent vaccination protection threshold against measles.
The national data also reveals disparities in vaccination rates across states, with Mississippi maintaining high vaccination rates, while Idaho struggles with consistently low immunization coverage. In Idaho, where only 81.3 percent of kindergartners received the required MMR vaccine doses, and approximately 20 percent remain unvaccinated against measles, concerns arise about the potential for a widespread outbreak.