Vaccination rates for kindergartners in the U.S. dropped last year, with an increasing number of children receiving exemptions, according to newly released federal data. The proportion of children exempted from required vaccinations reached a record 3.3%, a slight increase from the previous year’s 3%. Meanwhile, 92.7% of kindergartners received their mandated vaccines, a decrease from the previous two years, and well below the pre-pandemic rate of 95%. Public health officials warn that this drop in vaccination rates may contribute to a rise in vaccine-preventable diseases such as measles and whooping cough.
While these changes may seem small, they have a significant impact, as they translate to around 80,000 children not receiving their necessary vaccinations. Dr. Raynard Washington, chair of the Big Cities Health Coalition and director of the health department in Charlotte, North Carolina, pointed to this decline as a factor in the increasing incidence of outbreaks across the country. “We are seeing emerging outbreaks of vaccine-preventable diseases like whooping cough and measles,” he said. “These diseases are on the rise, and we must be vigilant in addressing the decrease in vaccination coverage.”
According to the Centers for Disease Control and Prevention (CDC), coverage rates for vaccines such as MMR (measles, mumps, rubella), DTaP (diphtheria, tetanus, and whooping cough), polio, and chickenpox fell in more than 30 states for the 2023-2024 school year. Vaccination rates for kindergartners are particularly important, as schools are high-risk environments for the spread of contagious diseases.
Historically, high vaccination rates have been achieved through school attendance mandates that require children to be vaccinated against a range of diseases. All U.S. states and territories require vaccinations for diseases such as measles, mumps, and polio, though exemptions are allowed for medical, religious, or nonmedical reasons. Over the past decade, medical exemptions have remained steady, while nonmedical exemptions have more than doubled, reaching the highest levels in recent years.
This rise in exemptions has been fueled in part by the spread of misinformation, especially during the COVID-19 pandemic, which saw a sharp political divide over vaccinations. Public health experts warn that this trend may be contributing to the resurgence of diseases like measles, with some regions, such as Idaho, reporting exemption rates as high as 14.3%, while states like Connecticut and Mississippi have rates under 1%.
Noel Brewer, a health behavior professor at the University of North Carolina, noted that communities with higher levels of vaccine skepticism are often clustered together, creating a fertile ground for outbreaks. “When unvaccinated children are concentrated in certain schools or neighborhoods, it increases the risk of disease transmission,” he explained.
The decline in vaccination rates is not limited to kindergartners. A recent CDC report also highlighted a decrease in vaccinations for 2-year-olds, further raising concerns about public health. Increases in international travel and migration also add to the risk of introducing vaccine-preventable diseases, making it more critical than ever to maintain high vaccination coverage.
Measles and whooping cough cases have surged to their highest levels since 2019, with 200 pediatric flu-related deaths reported this season, the highest since 2009. Public health officials, including those in Mecklenburg County, North Carolina, are closely monitoring these trends, which have included an increase in cases of measles, whooping cough, and mumps this year.
With concerns mounting over the return of these dangerous diseases, experts are calling for a renewed focus on improving vaccination coverage to protect children and the broader community.
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