Are Non-Medical Exemptions Causing Children Vaccination Decreases

According to the U.S. Centers for Disease Control and Prevention (CDC), during the 2022–23 school year, nationwide vaccination coverage among kindergarten children was about 93% for common vaccines, similar to that in the 2021–22 school year.

However, last year's data was lower than the 94% coverage in the 2020–21 school year and lower still than the 95% coverage during the 2019–20 school year.

On November 10, 2023, the CDC announced two concerning trends.

The overall percentage of children with an exemption increased from 2.6% during the 2021–22 school year to 3.0% during the 2022–23 school year, the highest exemption rate ever reported in the United States.

Overall, the percentage of children with a vaccine exemption increased in 40 states and D.C. 

Nonmedical exemptions account for about 90% of reported exemptions and approximately 100% of the increase in the national exemption rate. 

Furthermore, from the 2019–20 to the 2021–22 school year, national coverage with state-required vaccines among kindergartners declined from 95% to approximately 93%, ranging from 92.7% for DTaP to 93.1% for polio.

And the National measles, mumps, and rubella (MMR) coverage among kindergarten students remained below the Healthy People 2030 target of 95% for the third consecutive year.

Nationally, 2-dose MMR coverage was 93.1% (range = 81.3% [Idaho] to ≥98.4% [Mississippi]).

While there have been a few measles outbreaks in the U.S. this year, several countries, such as India, continue reporting significant measles outbreaks in late 2023.

Various MMR vaccines remain available at most clinics and pharmacies in the U.S. A January 2023 IQVIA study showed that 60-70% of all flu vaccines are administered at pharmacies during late 2022.

To address the declines in routine immunization coverage across the lifespan, the CDC launched the Let's Routine Immunizations on Schedule for Everyone (RISE) initiative earlier in 2023 and provides a broad range of communication and enhanced technical assistance, including back-to-school campaigns.