Vaccination Exemption Rates Increased Among U.S. Kindergarteners in 40 States
- by Rishma Parpia
- Published November 21, 2023
- Vaccines
A new report published in the U.S. Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report (MMWR) states that during the 2022–2023 school year, vaccination coverage remained at 93 percent for all reported vaccines. However, the vaccine exemption rate increased 0.4 percentage points to three percent. Exemptions increased in 41 states, and in 10 states was more than five percent.1
National Kindergarten Vaccine Coverage Rate at Average 93 Percent, Down from 95 Percent in 2019-2020.
Data in the MMWR report showed that national vaccination coverage among kindergarten children remained at 93 percent for Measles Mumps and Rubella (MMR); Diphtheria, Tetanus and acellular Pertussis (DTaP); polio and varicella (chickenpox)—similar to that in the 2021–2022 school year, but lower than the 94 percent coverage in the 2020–2021 school year, and even lower than the 95 percent coverage during the 2019–2020 school year.2
The 2022-2023 school year was the third consecutive year that the national MMR coverage among kindergarten children remained below the U.S. Department of Health and Human Services’ (HHS) Healthy People 2030 target of 95 percent. Coverage of all four vaccines declined in most of the states.3
In addition, the data showed that the overall percentage of children with a vaccine exemption increased from 2.6 percent during the 2021–2022 school year to three percent during the 2022–2023 school year, which is the highest exemption rate ever reported in the United States. The percentage of children with an exemption increased in 40 states and the District of Columbia.
The 40 states with rising vaccine exemption rates include Mississippi, Nebraska, New Mexico, Washington, Alabama, Rhode Island, Vermont, Indiana, Kentucky, Maryland, Massachusetts, Illinois, Virginia, North Carolina, Pennsylvania, South Dakota, Arkansas, Florida, Iowa, Kansas, New Jersey, Texas, Arizona, South Carolina, Minnesota, Missouri, Nevada, Ohio, Tennessee, Wyoming, Delaware, Michigan, Wisconsin, Colorado, Alaska, Oregon, Louisiana, Oklahoma, Idaho and Hawaii. According to the CDC, to achieve the Healthy People 2030 target of 95 percent MMR coverage, exemptions cannot exceed five percent.4
Ten states had an exemption rate that exceeded five percent. These states included Alaska, Arizona, Hawaii, Michigan, Nevada, North Dakota, Oregon, Utah, Wisconsin, and Idaho having the highest exemption rate at 12.1 percent.5
Commenting on the increase in vaccine exemptions, Ranee Seither, MPH, author of the MMWR report and an epidemiologist at the CDC said:
This is quite a jump. Just three years ago, only two states had an exemption rate of more than five percent.6
Increasing Distrust in Medicine and the U.S. Health Care System
Although the MMWR report did not specify the reasons why the vaccine exemptions rates are increasing among kindergarteners, medical professionals stated that the findings of the report indicate a growing mistrust in medicine and the U.S. health care system. Amna Husain, MD, a pediatrician in North Carolina and spokesperson for the American Academy of Pediatrics (AAP) said:
There is a rising distrust in the health care system. Vaccine exemptions have unfortunately trended upward with it.7
Other medical professionals speculate that the increase in vaccine exemptions for children has stemmed from the politicization of medicine during the COVID-19 pandemic, when many Americans were concerned about the safety of COVID shots and that concern led to more parents questioning the safety of all vaccines. Mysheika Roberts, MD, MPH, health commissioner for Columbus Public Health in Ohio said, “So many people were reluctant to get that new vaccine.” She said she feared “it would have a trickle-down effect and impact vaccination coverage for our children.8
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