Childhood Vaccination Rates Decline across the U.S., Raising Concerns About Disease Outbreaks
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A concerning trend is emerging across the United States: more than three-quarters of U.S. counties and jurisdictions are experiencing declines in childhood vaccination rates, a pattern that began in 2019. A September 2025 investigation by NBC News and Stanford University revealed that a significant portion of the country no longer maintains the “basic, ground-level immunity” necessary to prevent the spread of highly contagious diseases like measles.
The decline in vaccinations poses a serious threat to public health, experts warn. Dr. David Higgins, an assistant professor of pediatrics at the University of Colorado CU Anschutz Medical Center and a pediatrician specializing in vaccines, discussed the dangers of reduced immunization rates. This article highlights key insights from that discussion,edited for clarity and brevity.
What Vaccinations Are Required for Schoolchildren?
Vaccination requirements for school attendance are determined at the state level, not by the federal government. Generally, most states mandate kindergartners receive vaccinations against pertussis (whooping cough), tetanus, measles, mumps, rubella, and chickenpox.
Older children typically need booster shots for some of these vaccines, and additional vaccinations may be required for middle and high school students, such as the HPV vaccine and the meningococcal vaccine. The percentage of the population that needs to be vaccinated to achieve herd immunity – the protection of a community when a high percentage of individuals are immune to a disease.
“When that happens,it’s not a matter of if,but when,we see an outbreak of these infectious diseases,” Dr. Higgins explained. He further noted that outbreaks often occur at the local level, citing an earlier outbreak of measles in West Texas that spread rapidly through communities with below-average vaccination rates. Therefore, vaccination rates within a school or community are more indicative of risk than national averages.
Understanding Non-Medical Vaccine Exemptions
While medical exemptions – granted when a vaccine is unsafe for a child due to a severe allergic reaction – are rare,non-medical exemptions are on the rise. These exemptions are typically based on religious, personal, or philosophical beliefs. they have increased from a range of 1 to 2% to 3.6% in the 2024-25 school year, a trend that continues to raise concerns among public health officials.
Addressing Vaccine Hesitancy
Several factors contribute to parental vaccine hesitancy. Misinformation spread through social media “echo chambers” plays a significant role, as does a growing lack of trust in institutions and experts. Additionally, the very success of vaccines has led some to underestimate the risk of diseases that are no longer commonly seen.
“Vaccines are victims of their own success,” Dr.Higgins stated. “They have worked so well that many diseases like polio aren’t routinely seen anymore. That might lead a parent to think the risk for their child is so low that the vaccine is not necessary. But the fact is, vaccines are simply holding these diseases at bay.”
Advice for Parents
The most significant step parents can take is to ensure their children are up-to-date on all recommended vaccines, including the annual flu shot.Parents should follow state requirements and consult trusted sources like the American Academy of Pediatrics and their personal pediatrician to determine which vaccines are appropriate for their child.
Beyond vaccination, Dr. Higgins recommends reinforcing basic hygiene practices, such as proper handwashing, staying home when sick, and covering coughs and sneezes. He encourages open communication with pediatricians, emphasizing the importance of addressing parental concerns to facilitate informed decision-making. “As a pediatrician, I love when my families come and talk to me about their concerns,” he said. “I help them walk through their worries so they can feel more confident that they’re making a truly informed decision that’s in the best interest of their child’s health.”
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