Childhood Vaccine Exemptions Hit Record High as Measles Cases Surge Across U.S.

• A CDC report shows that MMR vaccination coverage among U.S. kindergartners fell from 92.5% in 2024–25 to 92.4% from 2025–26, well below the 95% associated with herd immunity against infectious diseases like measles.
• Medical or religious exemptions from one or more school-required vaccines rose from 3.6% to a record 4.2%, with 24 states reporting exemption rates above 5%.
• The vaccine exemption report arrives on the heels of an executive order issued by President Trump that suggests splitting the MMR vaccine into separate shots.
• The CDC reported 2,566 confirmed measles cases in the United States as of August 13, marking a 35-year high.

Vaccines are widely regarded as safe and effective in preventing the spread of infectious diseases. 

Despite this, vaccine safety is under scrutiny by top U.S. health officials just as vaccine exemptions in the United States hit an all-time high.

A record 4.2% of U.S. kindergartners had an exemption from at least one required vaccine during the 2025–26 school year.

The Centers for Disease Control and Prevention (CDC) released a report on August 17 showing that coverage for the measles, mumps, and rubella (MMR) vaccine declined to 92.4% during the 2025–26 school year, down from 92.5% the previous year.

Coverage for the DTP, DTaP, or DT vaccine also fell, reaching 92.0%. The CDC estimates that about 280,000 kindergartners attended school without documentation of completing the MMR series in 2025–26.

The report arrives just one week after President Donald Trump issued an executive order that aims to split the MMR vaccine into three separate shots and limit other vaccines for children, raising alarm among experts. 

The Trump administration aims to change federal vaccine policies and promote greater parental choice, including religious and medical exemptions. 

Although states still have control of school vaccination requirements, the administration plans to encourage states to adopt its new guidelines, with reports of ties to federal funding in exchange for compliance.

Experts have already linked low vaccination rates to a resurgence of measles cases in the United States, which recently hit a 35-year high. Because of this, the Pan American Health Organization will review the United States’ measles elimination status in November.

“[My] primary concern are the unfortunate individuals who contract these preventable diseases,” said Graham Tse, MD, pediatrician and chief medical officer of MemorialCare Miller Children’s & Women’s Hospital in Long Beach, CA.

“Many of the highest at risk are our children and infants. These are diseases that can cause serious illness, permanent disability, and death. Vaccinations have decades of research and are proven to prevent or reduce the severity of these illnesses and have been proven to be very safe,” he told Healthline.

U.S. kindergarten vaccination rates fall below critical threshold

The CDC’s SchoolVaxView vaccination data highlight local differences in vaccination rates that may contribute to the spread of infectious diseases.

A community may have a high overall vaccination rate, but may still contain smaller clusters where children are unvaccinated. These local pockets, the CDC notes, may allow measles to spread. 

The nationwide measles outbreak, for instance, began in a small Mennonite community in Western Texas.

The 95% herd immunity threshold matters for highly contagious infectious diseases like measles. 

Tse explained that herd immunity is the protection that occurs when enough of the population has immunity to an infectious disease, typically through vaccination, making it difficult for the disease to spread.

According to the CDC, 9 out of 10 unvaccinated people who have close contact with an infected person can contract measles. 

“Measles is so highly contagious, and there are now enough individuals who are not immunized that it has the ability to quickly spread. Without herd immunity, we will continue to see a rise in outbreaks and the number of cases of these vaccine-preventable diseases,” Tse said.

Maintaining high vaccination coverage not only helps curb spread, but also offers protection for those who can’t be vaccinated, such as immunocompromised individuals.

Nonmedical vaccine exemptions reach historic highs

As vaccination coverage is declining, religious and medical exemptions are increasing.

The CDC reports that exemptions from one or more vaccines among kindergartners rose from 3.6% in 2024–25 to 4.2% in 2025–26, affecting roughly 155,000 children.

Exemptions increased in 41 states, and the District of Columbia, and 24 states reported rates above 5%.

Medical exemptions are granted when a vaccine is medically inappropriate for a child. Nonmedical exemptions generally reflect religious or philosophical objections, depending on state law.

When exemptions become concentrated geographically, larger outbreaks may ignite.

School vaccination policies help prevent such outbreaks, but requirements vary from state to state, including whether nonmedical exemptions are permitted.

Vaccine gaps fueled the spread of measles

As of August 13, the CDC confirmed 2,566 measles cases in 2026. More than 94% of these cases were associated with measles outbreaks, and more than half of all cases have occurred in children ages 19 and younger. 

Experts note that declining national MMR coverage and pandemic-era disruptions to routine doctors’ visits contributed to missed or delayed vaccinations.

Currently, the CDC recommends two doses of MMR vaccine for children, generally with the first dose at 12–15 months and the second at 4–6 years. 

Two doses are about 97% effective at preventing measles, while one dose is about 93% effective.

President Trump’s executive order targeting vaccines is not yet federal law, which means there are no immediate changes to the childhood vaccine schedule. Medical organizations like the American Academy of Pediatrics (AAP) have criticized the move to break up the MMR shot and limit other vaccinations for children.  

“The bottom line is vaccinations are safe and help protect our children and population from preventable infectious diseases,” Tse said.

“When there is contradictory, conflicting, and inflammatory messaging, it creates confusion and vaccine hesitancy. The end result is fewer individuals vaccinated. The reduced vaccination rate is not only demonstrated in studies showing fewer children vaccinated, but it is also shown in real life by the number of infectious disease outbreaks; measles being a prime example.”

If your child is behind on their vaccinations, talk with their pediatrician. 

Measles remains highly preventable, but the challenge is maintaining sufficient protection across communities to prevent its spread.

“Even if an unvaccinated individual does not catch the disease, exposure to infected individuals can lead to long periods of required isolation for those not vaccinated — up to 21 days in the case of a measles exposure,” Tse said. 

“For children, this means isolation out of school, which has negative effects on their education and social skills. With school starting and children coming together in large, close groups, it is so important to ensure that they have the protection vaccines provide so they don’t catch these preventable and serious infections,” Tse said.