Kindergarten vaccination exemptions at highest level ever

According to new federal data released Thursday, the percentage of kindergartners whose parents opted them out of school-required vaccinations reached an all-time high during the 2022-2023 school year.

The drop in coverage for routine vaccinations against diseases such as measles, mumps, and rubella (MMR) increases the likelihood of an outbreak and highlights the ongoing fallout from vaccination barriers during the COVID-19 pandemic.

An outbreak of measles in central Ohio last winter heightened awareness of the dangers of failing to complete MMR vaccinations. The CDC discovered that 94 percent of the cases occurred in unvaccinated children under the age of five.

During the COVID-19 pandemic, this kindergarten class became old enough to receive the majority of state-mandated vaccinations. Every state and the District of Columbia require children to be vaccinated against certain diseases, including measles, mumps, polio, tetanus, whooping cough, and chickenpox, before they begin school.

“Because clusters of undervaccinated children can lead to outbreaks, it is important for immunization programs, schools, and providers to make sure children are fully vaccinated before school entry, or before provisional enrollment periods expire,” said the Centers for Disease Control and Prevention report.

National coverage for all vaccines remained near 93 percent, similar to the 2021-22 school year, lower than the 94 percent coverage in the 2020-21 school year, and even lower than the 95 percent coverage in the 2019-20 school year, when children were vaccinated prior to the COVID-19 public health emergency.

According to the CDC, all states and D.C. grant medical exemptions, and all but three states grant nonmedical exemptions for religious or philosophical reasons.

Exemptions were low overall, according to the CDC, but at 3 percent, they were the highest ever recorded, compared to 2.6 percent during the 2021-22 school year.

Exemptions increased in 40 states and the District of Columbia, with 10 states reporting that more than 5% of kindergartners were exempted from at least one required vaccine.

Overall, Idaho had the highest percentage of exemptions, with 13% of kindergartners receiving at least one exemption. In New York, only 0.1 percent of kindergarten students were exempted.

The CDC recommends two doses of the MMR vaccine before starting school, with the first administered between the ages of 12 and 15 months and the second administered between the ages of 4 and 6 years.

For the third year in a row, national MMR coverage among kindergarten students fell short of the Healthy People 2030 target of 95 percent.

The report did not investigate the reasons for the decline in vaccination coverage.

“It is not clear whether this reflects a true increase in opposition to vaccination, or if parents are opting for nonmedical exemptions because of barriers to vaccination or out of convenience,” the CDC said in a statement. “Whether because of an increase in hesitancy or barriers to vaccination, the COVID-19 pandemic affected childhood routine vaccination.”

Nonetheless, the politicization of COVID-19 vaccines exacerbated anti-vaccine sentiment.

According to the authors of the report, a “better understanding of the reasons behind nonmedical exemptions increasing in 40 states and DC, and their impact, could help develop policies … to bring higher vaccination coverage and protection against vaccine-preventable diseases within reach of more states.”

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