Routine vaccination coverage among U.S. kindergartners declined for a second consecutive year during the 2021-2022 school year, according to health officials on Thursday who cited disruptions in immunization programs related to the COVID-19 pandemic and an overall rise in vaccine hesitancy.
Coverage among kindergarten students fell to approximately 93% during the 2021-2022 school year across common vaccines children typically get before entering school, estimates published in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report show. Along with shots to protect against measles, mumps and rubella, the study examined vaccine coverage for poliovirus and chickenpox, as well as diphtheria, tetanus and acellular pertussis.
The latest rates mark a decline from approximately 94% coverage for the 2020-2021 school year and from the 95% coverage reported for the 2019-2020 school year.
Of particular concern is the decline in measles, mumps and rubella vaccination coverage, which fell to 93.5% nationally from 93.9% for the prior school year. Two-dose MMR vaccination rates among states ranged from a low of 78% in Alaska to a high of 98% in New York, according to the report, which notes that while all states require two doses of a measles-containing vaccine, dosage requirements for rubella and mumps can vary.
In all, 13 states saw two-dose MMR coverage at or above the national target of 95%, while nine states and the District of Columbia had coverage rates below 90%.
“This affects everyone in these communities,” Dr. Sean O’Leary, chair of the American Academy of Pediatrics’ Committee on Infectious Diseases, said on a call with reporters Thursday.
Dr. Georgina Peacock, director of the Immunization Services Division in the CDC’s National Center for Immunization and Respiratory Diseases, said MMR coverage for the 2021-2022 school year translated to nearly 250,000 children being potentially unprotected against measles, a highly transmissible disease. A measles outbreak in Ohio that began in November led to more than 80 cases by late December, and as of Jan. 5, 118 measles cases had been tallied in the U.S. for 2022 – more than double the number reported for 2021.
The CDC analysis said 2.6% of children had an exemption during the 2021-2022 school year for one or more required vaccines, compared with 2.2% during 2020-2021, and that 3.9% of kindergarten students nationally were neither fully vaccinated nor exempt.
Peacock said disruptions in immunization programs due mostly to the closures of schools and pediatric clinics early in the pandemic are still tied to delays in many kindergartners receiving their routine vaccinations.
“Despite challenges caused by the COVID-19 pandemic, we must stay vigilant to ensure children get the vaccines they need to protect themselves against serious diseases,” Peacock said.
Recent evidence indicates a rise in vaccine hesitancy among parents, with a Kaiser Family Foundation survey in late 2022 showing 71% of adults more closely aligned with the sentiment that healthy children should be required to be vaccinated against measles, mumps and rubella in order to attend public schools, due to the potential risk for others. That was down from 82% in 2019.
The same survey found 28% of adults more closely aligned with the stance that parents should be able to decide not to vaccinate their children, “even if that may create health risks for other children and adults. That contrasts with just 16% alignment in 2019.
“Certainly misinformation is a problem and has always been a problem, and we’re still trying to understand the extent to which misinformation around COVID-19 vaccines has spread to misinformation about other childhood vaccines,” O’Leary said.