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Kindergarten vaccination rates decline as exemptions rise

October 17, 2024

Kindergarten vaccination rates decreased last school year, as exemptions from school vaccine requirements reached another record high, according to a new report.

“Decreasing vaccination coverage and increasing exemptions increase the risk for vaccine-preventable disease outbreaks,” authors from the Centers for Disease Control and Prevention (CDC) wrote in a new Morbidity and Mortality Weekly Report. “Efforts by health departments, schools, and providers are needed to ensure that students begin school fully vaccinated.”

Authors analyzed 2023-’24 school year data from 49 states (all except Montana) and the District of Columbia. Coverage for four vaccines — measles, mumps and rubella (MMR); diphtheria, tetanus and acellular pertussis (DTaP); polio and varicella — dropped to an average of about 92.5%, falling below the 93% mark from the previous school year. In the 2019-’20 school year, coverage was about 95%.

About 93% of kindergartners were fully covered with MMR in 2023-’24, marking the fourth consecutive year of missing the Healthy People 2030 goal of 95% and leaving about 280,000 children at risk, according to the study.

Coverage rates were 93% for polio and 92% for DTaP and varicella. Idaho had the lowest rates for each vaccine (79%-80%), while West Virginia had the highest (98%-nearly 100%). West Virginia does not allow nonmedical exemptions, according to the National Conference of State Legislatures.

Rates for each vaccine decreased in more than 30 jurisdictions compared to the previous school year, according to the report.

A record high 3.3% of kindergartners had a vaccine exemption, up from 3% the year before. Exemption rates were above 5% in 14 jurisdictions. Most exemptions were nonmedical.

The report comes on the heels of another CDC study showing vaccine coverage for children by 2 years of age was lower for those born during the COVID-19 pandemic than in previous years.

Authors said the declining rates leave more children at risk for preventable illnesses. There have been 267 cases of measles reported this year, the highest since 2019, according to CDC data. About half of the cases this year have been in children under 5 years, and 88% of all patients were unvaccinated or had an unknown vaccination status.

Pertussis rates also have been high this year with 18,506 cases compared to just under 4,000 in 2023, according to CDC data. The count is the highest since the COVID-19 pandemic began.

Experts urged health departments, schools and clinicians to help improve vaccination rates by enforcing school vaccination requirements, offering school-based clinics, using reminder systems and giving strong provider recommendations.

 

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