Childhood Vaccination Rates Decline: A Growing Public Health Concern

Childhood vaccination rates in the U.S. have declined in recent years, raising concerns among public health officials. This trend,coupled with increasing exemptions,poses a important threat to community immunity and could lead to outbreaks of preventable diseases.

Why Vaccination Rates Are Falling

Before the COVID-19 pandemic, childhood vaccination rates remained relatively stable, with about 95% of kindergarten children up to date on all state-required vaccines, according to William Moss, professor at the Johns Hopkins Bloomberg School of Public Health. These included shots for polio, varicella, measles, mumps, rubella (MMR), diphtheria, tetanus, and pertussis.

Though, data collected by the CDC show a dip in vaccination rates as the pandemic. Less than 93% of kindergarteners had received all state-required vaccines in the 2023-2024 school year.

• Increased Exemptions: The share of U.S. children claiming an exemption from one or more shots rose from 2.5% in the 2019-2020 school year to 3.3% in the 2023-2024 school year.
• Non-Medical Exemptions: Nearly all of this increase was driven by non-medical exemptions, such as religious or personal belief reasons.

The Impact of Vaccine Skepticism

A Gallup survey released in August revealed that only 40% of Americans consider childhood vaccines “extremely significant,” down from 58% in 2019 and 64% in 2001.

According to KFF’s Michaud, vaccine skepticism “certainly existed far before the pandemic” but was amplified by the politicization of COVID-19.

• Partisan Divide: in 2024, 63% of Democrats and Democratic-leaning voters said childhood vaccinations where “extremely critically important,” compared to just 26% of Republicans and GOP leaners, according to the August Gallup survey.

Sean O’Leary, chair of the american Academy of Pediatrics committee on infectious diseases, noted that the pandemic “created a partisan divide on the public’s acceptance of the Covid vaccine,” and that “falsehoods about Covid shots spilled over to an extent to other types of vaccinations.”

“There was a vrey precipitous drop [in vaccination rates] right when the pandemic hit, in those first few months afterwards,” O’Leary said. “And we never really wholly caught up.”

Measles Outbreaks and Community Risk

Over three-quarters of U.S. states,or 39,had vaccination rates for the MMR shot below the “Healthy Peopel 2030” target rate of 95% during the 2023-2024 school year,according to the CDC.

This means that “roughly 280,000 school children” were unvaccinated and unprotected against measles during that school year.

Moss noted that “clusters of unvaccinated people within a specific community increase the risk of disease outbreak.”

Recent outbreaks highlight the dangers:

• Texas: A child who wasn’t vaccinated died in an outbreak in rural West Texas in late February, the first U.S. death from the disease since 2015.
• New Mexico: A second patient, an unvaccinated adult, “tested positive for measles after death,” state officials said.

Potential Policy Changes and Concerns

There are concerns that key parts of U.S. vaccine policy are being targeted.

Georgetown’s Gostin warns that a “clear step” to undermine vaccinations is removing members of advisory panels that shape the government’s shot recommendations.

Kennedy’s potential actions include:

• Advisory Panel Shake-Up: Replacing members perceived to have “conflicts of interest.”
• “Bogus Recommendations”: Producing recommendations that highlight the harms rather than the benefits of shots, according to Gostin.
• Reviewing the Childhood Immunization Schedule: Potentially removing recommendations for certain vaccines or changing their suggested use from “routine” to more of an individual choice.

Gostin also cautioned that there are concerns that Kennedy could also “cherry-pick data, studies and any other information about vaccines that create the misleading impression that shots aren’t safe and cause severe side effects.”

kennedy reportedly wants the CDC’s advertisements to promote the idea of “informed consent” in vaccine decision-making instead, according to STAT news. Experts worry that shifting the framing of advertisements “to focus more on the potential risks could undermine people’s willingness to get vaccinated.”

“When a parent exercises informed consent not to have their child immunized with measles, it certainly puts that child at risk, but it puts every child in that school with them at risk,” Gostin said.

The Path Forward

The decline in childhood vaccination rates is a serious public health issue that requires immediate attention. State and local governments may need to “expand the work they do” in some cases to “make up lost ground” and advocate for vaccinations, according to Northeastern’s Maniar.

It is crucial for healthcare providers, policymakers, and community leaders to work together to address vaccine hesitancy, promote accurate information, and ensure that all children have access to life-saving vaccines. By prioritizing public health and evidence-based decision-making, we can protect our communities from preventable diseases and secure a healthier future for all.