Routine childhood vaccination rates for kindergartners in U.S. public and private schools declined from 95% in 2019-20 and 93% in 2022-23 to less than 93% in 2023-24. At the same time, the exemption rate rose to 3.3% from 3.0% and 2.6%, respectively, hitting a record high.
The findings, published today in the Morbidity and Mortality Weekly Report (MMWR), are based on data from 49 states and Washington, D.C., reported to the Centers for Disease Control and Prevention (CDC).
Vaccination was considered complete protection against measles, mumps, and rubella (MMR). Diphtheria, tetanus and acellular pertussis (DTaP). Poliovirus; Varicella (VAR) vaccine.
“These results indicate that changes in attitudes toward routine immunization from hesitancy toward COVID-19 vaccinations, or changes in attitudes toward vaccine requirements resulting from opposition to COVID-19 vaccination mandates, or even significant changes in coverage. “This may indicate a possible decline or increase in exemptions,” the CDC researchers wrote.
Coverage for each vaccine applies to most states
Compared to national vaccination coverage estimates for all vaccines reported in the 2019-20 and 2022-23 school years (95% and 93%, respectively), coverage in 2023-24 was below 93%; DTaP ranged from 92.3% to 92.7%. For MMR.
Uptake of MMR, DTaP, polio, and VAR vaccines decreased in 35, 32, 33, and 36 states, respectively, compared to 2022-23. The national two-dose MMR vaccination rate was 92.7% (range, 79.6% in Idaho to 98.3% in West Virginia), with 11 states having rates above 95% and 14 states having rates below 90%.
Five-dose DTaP vaccination coverage was 92.3% (Idaho 79.5% to West Virginia 98.4%), with coverage rates above 95% in 12 states and below 90% in 15 states. Four-dose polio vaccination rates are 92.6% (ranging from 80.1% in Idaho to 98.4% in West Virginia), with coverage at least 95% in 12 states and less than 90% in 13 states.
Two-dose VAR vaccine coverage was 92.4% (range, 79.1% in Idaho to 99.7% in West Virginia), with 10 jurisdictions reporting coverage of at least 95% and 15 reporting coverage of 90%. reported that it was less than Uptake rates for each vaccine decreased in most states in 2023-24 compared to 2022-23.
Exemptions expanded in 41 states
The exemption rate for at least one essential vaccine (not limited to MMR, DTaP, polio, VAR) was 3.3% (medical (0.2% for medical use, 3.1% for non-medical use). 2023-24 (range, less than 0.1% in West Virginia to 14.3% in Idaho). Exemptions increased in 41 states, with 14 states reporting that 5% or more of kindergarteners are exempt from at least one vaccine.
Reduced coverage and increased exemptions jeopardize achieving the Healthy People 2030 goal of covering 95% of kindergarteners with MMR.
Non-medical exemptions accounted for more than 93% of exemptions and nearly all of the increase in national exemptions. Exemption rates for one or more vaccines exceeded the national estimate of 3.3% in 30 states.
States with increased exemption amounts were distributed across all U.S. Department of Health and Human Services regions. Nationally, 4.0% of kindergartners were not fully vaccinated or exempted from MMR vaccination, and the attainable coverage rate was 96.9%.
“Decreased coverage and increased exemptions jeopardize achieving the Healthy People 2030 goal of 95% coverage for kindergarteners with MMR,” the authors write. “The number of jurisdictions with exemption rates above 5% will not be able to achieve MMR coverage above 95% even if all non-exempt kindergarteners are vaccinated, but in 2020-21, two This number increased to 14 in 2023-24. Approximately 280,000 (7.3%) kindergarten children did not have a record of receiving two doses of MMR, potentially putting them at risk of measles infection. ”
The provisional, or grace period, attendance rate for kindergartners who need more time to get vaccinated was 2.6% in the 31 states reporting these data (ranging from 0.3% in Delaware to 0.3% in Arkansas). 8.0%).
Approaches to increase vaccination
Proven methods to increase vaccine uptake include enforcement of school vaccination requirements, school-based vaccination clinics, reminders and recalls, strong health care provider recommendations, and follow-up of undervaccinated students. The authors said that this includes.
Health care providers can specifically educate parents about the safety and effectiveness of vaccinations required for school entry and the risks of late, incomplete, or non-vaccination. Dew.
The researchers said, “Schools should work with parents to avoid exemptions due to difficulties in meeting deadlines for vaccination requirements, or to avoid vaccination requirements as part of school vaccination assessments by state and local health departments. They can also share data on vaccinations and exemptions.”
“While following evidence-based practices to improve vaccination rates, health care providers must ensure that vaccinations are safe and effective, especially for school admissions, and for children, families, classmates, and communities.” “Parents can be educated about the risks of delayed, incomplete, or non-vaccinated vaccinations,” they concluded.
