The number of students attending schools without state-required vaccinations is rising along with the number of kindergartners seeking exemptions, and experts say it could lead to a spike in cases of preventable diseases.
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During the 2023-2024 school year, vaccination coverage among kindergartners in the U.S. decreased for all reported vaccines from the year before, ranging from 92.3% for diphtheria, tetanus and acellular pertussis vaccine (DTaP) to 92.7% for measles, mumps and rubella vaccine (MMR), according to the Centers for Disease Control and Prevention. That's below coverage levels of the past decade and beneath the "target" rate of 95%, the level needed to prevent community transmission.
As recently as the 2019–20 school year, coverage with each measured vaccine was 95%, the CDC noted.
Coverage with MMR, DTaP, poliovirus vaccine (polio), and varicella vaccine (VAR) decreased in the 2023-2024 school year in more than 30 states, compared with coverage the year before. Idaho had the lowest rates of coverage for all vaccines while West Virginia had the highest rates.
The number of kindergartners attending school without documentation of completing the MMR vaccine series was about 280,000 during the 2023-2024 school year -- roughly 7.3% of the nation's kindergartners.
At the same time, the number of kindergarteners with an exemption from one or more required vaccinations is also rising. According to the CDC, exemptions from one or more vaccines among kindergartners increased nationwide to 3.3% -- the highest percentage ever reported -- up from 3% the year before. Of all exemptions, 0.2% are medical and 3.1% are non-medical.
Exemptions increased in 40 states and DC, with 14 states reporting exemptions exceeding 5%, the CDC said. The number of kindergartners exempt from one or more vaccines was about 127,000 during the 2023-2024 school year.
Additionally, 4.0% of kindergarten students nationwide were neither fully vaccinated with MMR nor exempt.
Decreasing vaccination coverage and increasing exemptions set the stage for accumulation of clusters of under vaccinated children, which can lead to preventable disease outbreaks, the CDC said.
As for what's driving these trends, it began with the COVID-19 pandemic and appears to be related to increasing vaccine hesitancy, fueled in part by vaccine misinformation, according to KFF, a nonprofit group that researches health policy issues. It's also likely to continue with the upcoming change in presidential administration.
"President Trump has supported anti-vaccination attitudes and shared vaccine misinformation. On the campaign trail, he vowed to 'stop all COVID mandates' and said he would cut federal funding to schools with a 'vaccine mandate or a mask mandate,'" Elizabeth Williams and Jennifer Kates wrote in an analysis of the data for KFF.
"If the Trump administration chooses to question or reject vaccine evidence, seeks to change the current system for recommending vaccines, or otherwise pressures states to make different decisions, it could further drive down vaccination rates among children," they added.
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