Kindergarten vaccination rates have not rebounded from the COVID-19 pandemic, and exemptions from school requirements reached an all-time high during the 2022-’23 school year.
“Because clusters of unvaccinated 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,” authors from the Centers for Disease Control and Prevention (CDC) wrote in a new Morbidity and Mortality Weekly Report.
The team analyzed vaccination data from 49 states and Washington, D.C. Montana did not report kindergarten vaccination data. Coverage for each of four vaccines — measles, mumps and rubella (MMR); diphtheria, tetanus toxoids and acellular pertussis (DTaP); polio and varicella — was about 93% last school year. This rate is similar to the previous year but down from 95% in the 2019-’20 school year.
About 93.1% of kindergartners were fully vaccinated with MMR, with coverage ranging from 81.3% in Idaho to at least 98.4% in Mississippi. For the third consecutive year, MMR coverage was below the Healthy People 2030 target of 95%. About 250,000 kindergartners remain at risk for measles, according to the report.
Coverage rates for other vaccines were 93.1% for polio, 92.9% for varicella and 92.7% for DTaP. As with MMR, rates for each of these were lowest in Idaho and highest in Mississippi.
About 3% of kindergarten students had a vaccine exemption, up from 2.6% the previous school year and the highest rate ever reported. Forty states and Washington, D.C., saw exemption rates increase. Nearly all exemptions were nonmedical, and authors said it was unclear whether parents sought these because they were opposed to vaccines or because they faced barriers to getting their child vaccinated. They encouraged school and health care providers to take action.
“Enforcement of school vaccination requirements, school-based vaccination clinics, reminder and recall systems, and follow-up with undervaccinated students have already been shown to be effective in increasing vaccination coverage,” authors wrote.
Last week, another CDC report showed vaccine coverage for children by 2 years has been relatively stable, although disparities continue.
The CDC recently announced the 2024 immunization schedules will be published online later this month, several months ahead of the usual timeline. They also will be updated more frequently as the timing impacts insurance payment and the ability of certain health care providers to administer immunizations in some states. In addition, health care providers referring to the schedule otherwise may not be aware of recommendations made after its publication. The AAP and numerous other medical organizations have expressed support for updating the schedules more frequently.