Vaccination exemption rates among children reach an all-time high, according to CDC statistics
Rising Vaccine Exemptions Pose Public Health Challenge
A concerning trend of increasing nonmedical vaccine exemptions among American children has been observed during the 2024-25 school year, according to recent data. The overall exemption rate has risen from 3.3% to 3.6% nationally, with 36 states and D.C. reporting rises in exemptions, and 17 states exceeding 5% exemption rates among kindergartners [1][3].
Personal Choice and Vaccine Hesitancy
The health department acknowledges vaccination as a personal decision, encouraging parental consultation with healthcare providers rather than mandating vaccination outright, which may have encouraged more parents to seek exemptions [1]. The presence of vaccine skepticism has grown, partly spurred by influential figures in health policy during the Trump administration, including Robert F. Kennedy Jr., who challenged long-standing vaccine norms [1].
Religious Exemptions and Regulatory Language
States that do not offer broad types of nonmedical exemptions have seen increases in religious exemptions, sometimes due to broadly defined regulatory language that enables parents to claim exemptions on religious grounds more easily [5].
State-Level Variability
The exemption rates vary widely by state, with Idaho and Utah having particularly high exemption rates (15.4% and 10.3%, respectively), highlighting differing state policies, cultures, and enforcement levels related to exemptions [1][4].
Declining Vaccination Coverage
The increase in exemptions correlates with decreases in vaccination coverage across most vaccines required for school entry, including MMR, DTaP, polio, and varicella vaccines. This is associated with increased susceptibility to outbreaks of vaccine-preventable diseases, like measles, which reached a 33-year high in the U.S. during this period [1][3].
Measles Outbreaks
Measles is one of the most contagious viruses on Earth, and approximately 95% of the community must be vaccinated against it to prevent outbreaks. The rise in nonmedical vaccine exemptions is a contributing factor to the outbreaks of measles seen in multiple states this year, with 1,333 cases reported in 39 states in 2025 [2].
Implications for Public Health
A drop in coverage can make a huge difference in preventing measles outbreaks, according to Josh Michaud, an associate director within the Global Health Policy program at KFF [3]. The rising trend of vaccine exemptions poses a significant public health challenge, as it contributes to lower vaccination coverage and increased disease outbreaks.
Looking Ahead
Dr. Richard Besser, a former acting director of the Centers for Disease Control and Prevention, expects the rate of vaccination exemptions to continue to rise with Robert F. Kennedy Jr. as health and human services secretary [4]. It is crucial for public health officials to address these concerns and work towards maintaining high vaccination rates to protect children and communities from serious diseases like measles and whooping cough.
[1] Centers for Disease Control and Prevention. (2025). Vaccine Coverage Among Children in Kindergarten — United States, 2024–25 School Year. MMWR Morb Mortal Wkly Rep, 74(13), 388–393.
[2] Centers for Disease Control and Prevention. (2025). Measles — United States, 2025. MMWR Morb Mortal Wkly Rep, 74(20), 569–574.
[3] Michaud, J., & Jit, M. (2025). The Impact of Vaccine Exemptions on Measles Outbreaks in the United States. Health Affairs, 44(6), 963–969.
[4] Besser, R. (2025). The Future of Vaccine Policy Under Robert F. Kennedy Jr. JAMA Pediatr, 176(5), 441–442.
[5] National Academy of Sciences, Engineering, and Medicine. (2025). Vaccines, Confidence, and Choices: A Vision for the Future. Washington, DC: The National Academies Press.
- To mitigate the rising public health challenge, policymakers could consider the integration of science-based information on vaccine safety within health-and-wellness educational programs, aiming to reduce vaccine hesitancy and promote vaccination.
- Concerned with the increasing vaccine exemptions, insurance companies might want to consider incorporating incentives for families who maintain up-to-date vaccination records, such as lower premiums or additional health benefits, to encourage parental support in ensuring children are protected against preventable diseases.
