On the heels of President Trump’s executive order directing changes to the childhood vaccine schedule, the Centers for Disease Control and Prevention (CDC) released updated data for the 2025-2026 school year showing a decrease in coverage on all vaccines for incoming kindergartners.
Specifically, vaccination rates to protect against diseases such as measles, mumps, rubella, tetanus, diphtheria, polio, and varicella (also known as chickenpox) decreased in more than half of the states. Additionally, the CDC data show that exemptions increased in nearly all states, with 4.2% of kindergartners nationally receiving exemptions, compared with 3.6% in the previous school year. This figure represents about 155,000 children without one or more vaccines due to an exemption. Importantly, the data show that medical exemptions have not increased since the 2019-2020 school year. The marked increase in exemption status is attributable solely to non-medical exemptions – including those for either religious or personal reasons.
Vaccination rates have been declining since the COVID-19 pandemic. During the 2019-2020 school year, 95.2% of kindergarten students had received the appropriate doses of MMR, which protects against measles, German mumps, and rubella. This metric had decreased to 92.4% of kindergartners in the 2025-2026 school year.
Generally, a community needs to be above 95% vaccination rate to create a robust herd immunity against measles, a bar all but 11 states have slipped underneath during the 2025-2026 school year. This trend is also seen with the DTaP/DTP and polio vaccines, with coverage rates decreasing 2.9 percentage points and 2.6 points respectively between the 2019-2020 and 2025-2026 school years.
At the same time, the share of students receiving non-medical exemptions has more than doubled. Nationally, exemptions for religious and personal reasons hit a low point during the 2020-2021 school year, with only 1.9% of kindergartners receiving such waivers. In 2025-2026, non-medical exemptions among kindergarten students had risen to 4.0% – a 2.1 percentage point increase.
In Idaho alone, 17% of incoming kindergartners had received a non-medical exemption for the 2025-2026 school year, more than double their 2019-2020 exemption rate (7%). States have nearly unilateral authority to set their own vaccine policy for school and daycare entry requirements, including exemption allowances.
Only four states – California, Connecticut, Maine, and New York – do not allow non-medical exemptions to vaccine requirements. If the trend continues, exemption rates will continue to climb, causing vaccine coverage to dip below critical levels needed to protect against disease. This has already begun, with 2,777 confirmed measles cases among 36 new outbreaks in this year alone. For comparison, there were 2,289 confirmed measles cases in the entirety of 2025 and only 285 cases in 2024.
As new policies and misinformation continue to threaten children’s health and put vulnerable populations at risk of contracting a once-eradicated disease, states now have the option to forgo reporting critical quality measures to the Centers for Medicare & Medicaid Services (CMS).
A CMS letter sent late last year to state health officials announced the elimination of mandatory reporting for two child and adolescent quality measures that relate to vaccines. States will now have the option to no longer report on: 1) the number of two-year olds who are up-to-date with the recommended doses of several crucial vaccines (CIS-CH); and 2) the number of 13-year-olds who are up-to-date with the recommended doses of Tdap, meningococcal, and HPV vaccines (IMA-CH). These metrics reflect the quality of care children enrolled in Medicaid and CHIP receive; lower levels of coverage often correlate with worse care and health outcomes. Allowing states the option to no longer report on these two vaccine metrics will make it harder for advocates to ensure children in their state are receiving adequate care and access to vaccines.