The declines can partly be explained by the 3.3 percent exemption rate, which is up 0.3 percent from 2022–2023. Since then, 41 states and DC saw increases in the number of kindergartners with one or more vaccine exemptions. Now, 14 states have exemption rates above 5 percent, meaning that even if they vaccinated all non-exempt children, the state would still not be able to reach the 95 percent target. By contrast, during the 2020–2021 school year, there were only two states that couldn’t make the 95 percent target due to exemptions.
Of course, these are just big-picture numbers for the country; vaccination rates vary by state, town, zip code, and community. Any areas with pockets of low vaccination rates are susceptible to outbreaks of vaccine-preventable infections. The more susceptible people cluster together, the easier it is for a contagious disease to gain a foothold and spread widely. In recent years, the country has seen upticks in measles outbreaks and whooping cough cases, for instance.
But, even on larger scales, some of the current US numbers are worrying. In Idaho, for example, vaccination rates for the four key vaccines hover around just 80 percent, and the exemption rate in the state is a staggering 14.3 percent.
As the CDC researchers concluded in their analysis: “Among kindergarten students, vaccination coverage continues to decline as exemptions increase, setting the stage for accumulation of clusters of undervaccinated children, which can lead to outbreaks.”
The analysis didn’t explore the reasons for the declining vaccination rates, but the researchers briefly speculated that the slide toward preventable outbreaks could be due to COVID-19 vaccine hesitancy bleeding over to routine vaccinations, or simply backlash to vaccine mandates during the pandemic. Regardless, the researchers pointed to evidence-based strategies to boost vaccination, including school-based vaccination clinics, enforcement of school vaccination requirements, and strong recommendations from health care providers for routine vaccinations.
