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November 09, 2023
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Kindergarten vaccination rates remain below pre-pandemic levels

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Key takeaways:

  • Routine vaccine coverage among kindergartners in the United States has fallen from 95% to 93%.
  • Vaccine exemptions reached an all-time high last year, driven by nonmedical exemptions.

Routine vaccination rates among kindergartners in the United States remained lower than pre-pandemic levels last school year as vaccine exemptions increased to an all-time high, according to data published Thursday by the CDC.

Last year, researchers reported that national vaccination coverage among kindergarten students dropped from 95% to lower than 94% during the 2020-2021 school year.

IDC1123Seither_Graphic_01
Data derived from Seither R, et al. MMWR Morb Mortal Wkly Rep. 2023;doi:10.15585/mmwr.rr7205a1.

According to the new report, the downward trend continued last year, as coverage with state-required vaccines among kindergartners in 2022-2023 declined to about 93%.

“Whether because of an increase in hesitancy or barriers to vaccination, the COVID-19 pandemic affected childhood routine vaccination,” the authors wrote.

According to the report, national coverage among kindergarteners for two doses of a vaccine for measles, mumps and rubella fell to 93.1%, and was the same for polio — below the target of 95% that is widely recommended for measles elimination. Rates of coverage for the state-required number of doses of DTaP dropped to 92.7%.

Vaccination exemptions increased to 3%, the highest vaccination exemption rate ever reported in the U.S. In 10 states, it exceeded 5% of kindergarten students. Among the exemptions, 0.2% were reported as medical exemptions and the other 2.8% as nonmedical exemptions.

“Exemptions [greater than] 5% limit the level of achievable vaccination coverage, which increases the risk for outbreaks of vaccine-preventable diseases,” the authors wrote. “Because clusters of undervaccinated children can lead to outbreaks, it is important for immunization programs, schools, and providers to make sure children are fully vaccinated before school entry, or before provisional enrollment periods expire.”

Vaccine exemption rates ranged from a low of less than 0.1% in West Virginia to 12.1% in Idaho.

“Schools and providers should work to ensure that students are vaccinated before school entry, such as during the enrollment process, which is often several months before school starts,” the authors wrote. “State and local provisional enrollment periods that allow students to attend school while on a catch-up schedule also provide the opportunity to fully vaccinate students and to prevent nonmedical exemptions resulting from lingering undervaccination due to COVID-19 pandemic-related barriers to vaccination, such as reduced access to vaccination appointments.”