### Decline in Kindergarten Vaccination Rates Raises Public Health Concerns

A growing number of kindergarteners in the United States are starting school without the required vaccinations, according to new data from the US Centers for Disease Control and Prevention (CDC) released on Wednesday. Last school year, more than 125,000 new schoolchildren lacked coverage for at least one state-mandated vaccine, an issue exacerbated by a notable increase in vaccine exemptions.

The CDC report sheds light on the concerning drop in measles vaccination rates, marking the fourth consecutive year where coverage has fallen below the federal target. The US Department of Health and Human Services aims for 95% of children to receive two doses of the measles-mumps-rubella (MMR) vaccine. However, the coverage for the 2023-24 school year was just 92.7%.

Dr. Marcus Plescia, chief medical officer for the Association of State and Territorial Health Officials, highlighted the importance of vaccines in combating infectious diseases, noting the alarming decline in vaccination rates for other critical inoculations, such as diphtheria, tetanus, and acellular pertussis (DTaP), and polio.

The data also reveals that the rate of vaccine exemptions among kindergartners reached an all-time high last school year, with 3.3% exempted from one or more required vaccines, the majority being nonmedical exemptions. Local health officials, such as Lori Tremmel Freeman, CEO of the National Association of County and City Health Officials, expressed concerns about these trends and public health risks, noting a decrease in vaccination coverage in 35 states, with 14 of those states seeing at least a one percentage point drop.

Outbreaks of vaccine-preventable diseases have already been observed in communities with low vaccination rates. Examples include a measles outbreak in Chicago linked to a migrant shelter and another significant outbreak at an elementary school in Broward County, Florida. By March 2024, more states had reported measles cases than in all of 2023, signaling a grim warning from the CDC about the potential threat to the nation's disease elimination status.

Coverage varies widely by state, with only about a dozen achieving the 95% measles vaccination target among kindergartners. Amy Pisani, CEO of Vaccinate Your Family, emphasized the broader implications of even minor drops in vaccination rates, stressing that every percentage point decrease places children at heightened risk for serious infectious diseases like measles.

Measles remains a highly contagious and potentially serious disease, especially for young and unvaccinated children. General symptoms include fever, cough, runny nose, watery eyes, and a rash, with severe complications such as pneumonia and encephalitis posing significant risks. The CDC notes that up to 3 out of every 1,000 children infected with measles may die from related complications, underscoring the critical need for high vaccination coverage to protect public health.