New CDC Data Show Decrease in Vaccine Coverage Among Kindergarteners For 2023-2024 School Year

The CDC has released new data on vaccination coverage and exemptions among kindergartners for the 2023-2024 school year. Notably, vaccination coverage among kindergartners in the United States decreased for all reported vaccines from the prior year, a downswing in vaccination coverage.¹

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For the diphtheria, tetanus, and acellular pertussis vaccine (DTaP), coverage was 92.3% among kindergartners. This is a slight drop from 92.7% in the 2022-2023 season, though any drop in vaccination coverage can mean hundreds of children not receiving a vaccine, therefore increasing the threat of disease.¹

Regarding the measles, mumps, and rubella vaccine (MMR), coverage among kindergartners was 92.7%. Another slight drop can be seen, from 93.1% in the 2022-2023 season. These national surveys were conducted across a population of over 3.8 million kindergartners throughout the country.¹

Concerningly, the number of children attending kindergarten without documentation of completing the 2-dose MMR vaccine series was around 280,000 during the 2023-2024 school year. This coincides with an increase in kindergarteners being granted exemptions from 1 or more vaccines, from 3.0% the year prior to 3.3% in 2023-2024. In total, 126,747 kindergarteners received an exemption, with an increase by 11,172.¹

This increase in exemptions were seen across the country. Exemptions increased in 40 states and Washington DC, with 14 states reporting exemptions exceeding 5%. The state with the highest percentage difference in exemptions from 2022-2023 to 2023-2024 was Idaho, with a 2.2% increase in exemptions.¹

Rising exemptions from vaccine series are attributable to medical and non-medical reasons, but interestingly, more kindergartners were exempted due to non-medical reasons versus medical reasons. The rate of non-medical exemptions has been on the rise since the 2020-2021 school year—the first full year of the COVID-19 pandemic.¹

These CDC data align with recently released information from the World Health Organization and UNICEF that indicated major setbacks in children’s immunization coverage globally. Again, the stalling of vaccination for children has not returned to 2019 levels, with significant decreases in vaccine coverage for DTP and MMR present among children.²

According to the data, 2.7 million children were un- and under-vaccinated compared to pre-pandemic levels in 2019. In 2023, there was a reported increase in infants not receiving an initial dose of DTP, from 13.9 million to 14.5 million. Furthermore, measles vaccination rates have stalled—only 83% of children worldwide received their first dose in 2023. These data are troubling and could lead to increased risk of disease spread in the general population.²

Many factors have contributed to the sagging vaccination coverage globally, and it is difficult to pinpoint a single reason. However, in the US, there is an observable jump in the CDC’s data showing exemptions and vaccine under-coverage since the pandemic began, with a corresponding increase in non-medical exemptions.¹

Based on these observations, it is reasonable to suggest that the significant polarization surrounding the proliferation of COVID-19 vaccines in late 2020 and early 2021 had some impact in leading to vaccine hesitancy. Whatever the reason may be leading parents to not vaccinate their children, it is essential for pharmacists to reach out to parents and caregivers and discuss the importance and robust health benefits of vaccination.

Evelyn Twentyman, MD, MPH, senior advisor for vaccine strategy at the CDC’s National Center for Immunization and Respiratory Diseases, spoke to the ways immunizers can answer questions about childhood vaccination and provide clarity to those seeking it. Above all, being attentive and answering their questions thoroughly and honestly while providing a strong recommendation in support of vaccination is critical.³

“Since health care providers have this really unique, special position as parents and caregivers most trusted source of information, their strong recommendation is very critical for vaccine acceptance,” Twentyman said.³

REFERENCES

1. CDC. New findings on vaccination coverage and exemptions among kindergartners. SchoolVaxView. Updated October 2, 2024. Accessed October 4, 2024. https://www.cdc.gov/schoolvaxview/data/index.html

2. Halpern L. Global immunization coverage lacking since COVID-19 pandemic, especially in children. Pharmacy Times. Published July 30, 2024. Accessed October 4, 2024. https://www.pharmacytimes.com/view/global-immunization-coverage-lacking-since-covid-19-pandemic-especially-in-children

3. Halpern L. CDC expert urges equitable vaccination of children to prevent spread of serious disease. Pharmacy Times. Published September 24, 2024. Accessed October 4, 2024. https://www.pharmacytimes.com/view/cdc-expert-urges-equitable-vaccination-of-children-to-prevent-spread-of-serious-disease