Dive Brief:

• The rate of kindergartners entering school exempt from one or more vaccines continued its upward trend during the 2025-26 school year, with 4.2% of kindergartners being exempted — up from 3.6% in the previous year, according to data released by the U.S. Centers for Disease Control and Prevention. 
• About 155,000 kindergartners had exemptions from one or more vaccines during the 2025-26 school year. Vaccine exemption rates for these young students increased in 41 states and the District of Columbia, and 24 states reported exemptions exceeding 5%.
• The vaccination rate among K-12 students has declined in recent years due to what some health organizations say is misinformation about the safety and effectiveness of vaccines. Conflicting vaccine recommendations can "create confusion for families, complicate school health practice, and undermine confidence in vaccines that have protected generations of children," said the National Association of School Nurses said in an Aug. 11 statement. 

Dive Insight:

The CDC data released this week shows vaccination coverage among kindergartners in the U.S. in 2025-26 fell for all reported vaccines from the year before, ranging from 92% for the diphtheria, tetanus and acellular pertussis vaccine to 92.4% for measles, mumps, and rubella vaccine and polio vaccine.

About 280,000 kindergartners attended school without documentation of completing the MMR vaccine last school year, CDC said. The number of reported measles cases for people of all ages reached a 35-year high nationally by July 30 this year. 

The newly released vaccine data from CDC comes as the Trump administration attempts to reform childhood vaccine standards by making recommendations for the number and sequencing of the vaccines. President Donald Trump signed an executive order Aug. 10 calling for changes "ensuring that Americans are receiving the best scientifically supported medical advice in the world, as well as to protecting religious liberty and parental authority."

Here are a few of the executive order recommendations, according to a fact sheet released by the White House Aug. 10:

• Reducing the number of immunizations to provide protection against 11 diseases, rather than the 18 diseases recommended by CDC in 2024.  
• Separating the combined measles, mumps, and rubella vaccine into three single-disease shots and administering all vaccines during separate medical visits. 
• Updating state laws for school vaccine policies to align with the new standards for childhood vaccinations.
• Ensuring states comply with constitutional and federal laws related to parental authority, religious freedom, disability accommodations and equal protection under the law. This includes what the order calls "state obligations to provide religious and medical exemptions" from childhood and adolescent immunization requirements.

Even though the CDC makes recommendations for childhood vaccination schedules, school immunization requirements are typically set at the state level. All 50 states and Washington, D.C., require certain vaccinations for school attendance, according to the National Conference of State Legislatures. And all allow exemptions for medical reasons. 

Most states also gave exemptions for religious or personal reasons in 2025. Just five states — California, Connecticut, Maine, New York and West Virginia — allow only medical exemptions, according to KFF, a nonprofit health policy research, polling and news organization.

NASN said it was "deeply concerned" by the Aug. 10 executive order, saying that "decisions that affect the health of children and school communities must be guided by transparent, rigorous scientific review and the best available evidence."

In an October 2025 statement, NASN urged state leaders to identify professional organizations, including the American Academy of Pediatrics and the American Public Health Association, as reputable and trustworthy sources for scientifically backed information. 

"School nurses see the consequences of vaccine-preventable illness in real time — students missing school, families missing work, medically vulnerable students placed at greater risk, and learning disrupted," said NASN President Lynn Nelson, in the Aug. 11 statement. "School nurses need clear, credible guidance so they can help families make informed decisions and keep students healthy, safe, and ready to learn.”

CDC and other health organizations encourage parents to discuss childhood vaccination options with their doctors.