Childhood Vaccination Rates Fall Again, Exemptions Rise on Cusp of New School Year: CDC Annual Update

Vaccination rates for measles, polio, and other preventable childhood diseases declined again among US kindergartners during the 2024–2025 school year, according to new data released by the Centers for Disease Control and Prevention (CDC).1

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Nationwide coverage for the measles, mumps, and rubella (MMR) vaccine dropped to 92.5%, down from 95.2% in the 2019–2020 pre-pandemic school year and from 92.7% last year. Similar declines were observed for other routine childhood immunizations, with diphtheria, tetanus, and acellular pertussis (DTaP) vaccine coverage at 92.1% and polio vaccine coverage also at 92.5%.1

Particularly concerning among public health officials is the drop in protection against measles; the 92.5% level falls significantly below the 95% threshold that the CDC identifies as necessary for community (herd) protection against the infection.1 Worry is compounded as the undervaccination of one of the populations most vulnerable to measles and its complications is proceeding during the worst US measles outbreak in more than 3 decades. As of the CDC's last update on July 30, there have been more than 29 measles outbreaks across 40 states, accounting for 1,333 cases in 2025.2 The largest proportion of infections was among youths aged 5-19 years, according to the CDC. Among those cases, 92% were recorded as unvaccinated or vaccination unknown.2 measles page

Although the actual percentage changes appear small, they stand for large numbers of school children. During the school year 2024-2025, the number of kindergartners attending school without documentation of having completed the 2-shot MMR vaccine series was approximately 286,000, according to the CDC.1

Exemptions Rising

As vaccination levels fall, there has been a simultaneous rise in the percentage of children with documented exemptions from 1 or more vaccines, with the proportion reaching a record 3.6% in the 2024-2025 school year, up from 3.3% the previous year. This makes a 3-year trend, according to the CDC. The federal agency's data show that exemptions increased in 36 states and the District of Columbia, with 17 states reporting exemption rates exceeding 5%.1 The range among states in the proportion of kindergarteners with a vaccine exemption is wide. In Idaho, 15.4% of kindergartners had an exemption to at least 1 vaccine in 2024-2025, compared to fewer than 0.5% in Connecticut.1

Exemptions from receiving vaccines are allowed in all US states for children with medical conditions that preclude specific shots. Most states also allow exemptions for religious or other nonmedical reasons. While medical exemptions have remained low over the past 10 years at approximately 0.2%, the percentage of nonmedical exemptions has risen, according to the CDC.1

Experts attribute declining vaccination coverage to multiple factors, including misinformation, politicization of vaccines during the COVID-19 pandemic, and policy changes in some states that have made it easier for parents to opt out. Speaking this week with the AP, Philip Huang, MD, MPH, health director for Dallas County Health and Human Services, said that in Texas, where more than half of the national measles cases this year were reported, state lawmakers passed legislation that facilitates school vaccine exemptions. “It’s crazy,” he said.3

Shift in Tone, Tradition

The CDC typically reports the vaccination rate data for the previous school year in the agency's widely read publication, Morbidity and Mortality Weekly Report. The analysis includes CDC commentary on trends and possible reasons for them as well as significant focus on the importance of vaccination. This year, the data were posted online with no announcement or other indication that they were available.

According to the AP, an email statement was sent in response to media inquiries, which read in part: “The decision to vaccinate is a personal one. Parents should consult their health care providers on options for their families,” while reiterating that “vaccination remains the most effective way to protect children from serious diseases like measles and whooping cough, which can lead to hospitalization and long-term health complications.”3

Sean O’Leary, MD, MPH, chair of the infectious disease committee for the American Academy of Pediatrics, was critical of the apparent shift in the CDC's tone, noting that the messaging now places personal choice before community protection. “To sort of weaken the language or weaken the messaging that they’re sending is very concerning, because what they say does matter,” he said during an AP interview.3

It’s good news that the vast majority of parents continue to get their kids vaccinated, O’Leary said. But it is concerning that rates have dropped, he added, “because that really matters in terms of spread of disease.”3

References

1. Vaccination coverage and exemptions among kindergartners. SchoolVaxView. Centers for Disease Control and Prevention. July 31, 2025. Accessed August 1, 2025. https://www.cdc.gov/schoolvaxview/data/index.html

2. Measles cases and outbreaks. Meases (Rubeola). Centers for Disease Control and Prevention. July 31, 2025. Accessed August 1, 2025. https://www.cdc.gov/measles/data-research/index.html#cdc_data_surveillance_section_4-measles-cases-in-2024

3. Stobbe M. US childhood vaccination rates fall again as exemptions set another record. Health. AP. July 31, 2025. Accessed August 1, 2025. https://apnews.com/article/vaccination-rates-cdc-kindergarten-0d261546a130dc256735d7b1ff8c6a5f