by David Higgins,The Conversation

Credit: Unsplash/CC0 Public Domain

More than three-quarters of U.S. counties and jurisdictions are experiencing declines in childhood vaccination rates, a trend that began in 2019, according to a September 2025NBC News–Stanford University investigation. The report also found a "large swath" of the U.S. no longer has the "basic, ground-level immunity" needed to stop the spread of measles.

Dr. David Higgins, an assistant professor of pediatrics at theUniversity of Colorado CU Anschutz Medical Centerand a pediatrician who researches vaccines, discusses the dangers of not vaccinating your children.

The vaccine requirements for kids to attend school are set by states, not the federal government. Most states require kindergartners getvaccines for pertussis—that's whooping cough—andtetanus,measles,mumps,rubellaandchickenpox.

For older kids, a booster of the tetanus andpertussis vaccineis typically required, as well as avaccine for meningococcaldisease.

Vaccinesreduce the risk of outbreaksin places where transmission of these diseases is easy. Not only do vaccinations help keep both students and teachers safe, it alsoencourages overall higher community coveragefor these vaccines.

Before vaccines are approved,they undergo rigorous trials. During this process, scientists look at the safety and effectiveness of the vaccine, testing it first in small groups to assess safety, then in larger groups to confirm protection and detect uncommon side effects. That process continuesafter the vaccine is approved. Those systems continually monitor the safety of vaccines, both here in the U.S. as well as around the world.

What we have seen is asmall downward trend since 2019, the year prior to the COVID-19 pandemic. It slipped from 95% of new kindergartners being up to date on many of their routine vaccines to about 92%.

That's a small percentage decrease, so a great majority of parents are still vaccinating their kids. But at the same time, anything below our target of 95% for diseases like measles becomes a problem, because that's below the level that's needed for what we callherd immunity, or community immunity. When that happens, it's not a matter of if, but when, we see an outbreak of these infectious diseases.

And while nationwide rates are important to look at, outbreaks happenat local community levels. For example, earlier this year, an outbreak of measles in West Texas spread rapidly through communities where vaccination rates had slippedwell below the state average.

So, the vaccination rate at your own school or community is much more meaningful than what the national vaccination rate is.

First, actual medical exemptions are rare, and these occur when the vaccine isunsafe for the child to receive, like when he or she has a known severe allergic reaction to vaccine ingredients.

Non-medical exemptions for vaccines are often forreligious, personal or philosophical reasons. They have been increasing for the past several years, rising from the range of 1 to 2%up to 3.6% in the 2024–25 school year. That's a small increase, but again, it's still concerning.

There are multiple reasons. These include misinformation which algorithm-driven echo chambers onsocial mediacanspread at an alarming rate right now. Also, Americans reportless trust in institutions and experts, and studies have foundgrowing partisanship around vaccines.

Additionally, vaccines arevictims of their own success. They have worked so well that many diseases like polioaren't routinely seen anymore. That might lead a parent to think the risk for their child is so low that the vaccine is not necessary. But the fact is, vaccines are simply holding these diseases at bay. And as vaccination rates drop,these diseases will come backand more kids will be at risk.

The most important thing you can do as a parent is to keep your kids up to date on required vaccines. That includes theannual flu shot. Follow your state's requirements and current recommendations from trusted sources like theAmerican Academy of Pediatricsand your own personal pediatrician to know which vaccines your child should have.

You also want to reinforce other common sense approaches to keeping your children healthy. Make sure they knowhow to wash their hands properlyand that they stay home when they're sick. Teach them to sneeze and cough into their elbow instead of into their hands—even though doing soisn't a perfect solution.

As a pediatrician, I love when my families come and talk to me about their concerns. I help them walk through their worries so they can feel more confident that they're making a truly informed decision that's in the best interest of their child's health.

This article is republished fromThe Conversationunder a Creative Commons license. Read theoriginal article.

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