Falling Child Vaccinations

After years of holding steady, American vaccination rates against once-common childhood diseases fell during the coronavirus pandemic and continued to drop for much of the past four years.

States, not the federal government, set vaccine mandates. But the incoming Trump administration could encourage anti-vaccine sentiment and undermine state programs. The president-elect’s pick for health secretary, Robert F. Kennedy Jr., has spread the false theory that vaccines cause autism, among other misinformation.

Already, falling vaccination rates have followed a partisan pattern.

There are two ways vaccination rates can drop: More families can get an exemption, which gives them legal permission to skip vaccines; or more families can fail to vaccinate their children without permission.

In states that supported Donald Trump for president, the number of children receiving exemptions rose. The story with noncompliance is more complex. It rose in both blue and red states, although more in red states. (An unknown amount of noncompliance reflects families that did vaccinate their children but didn’t file the paperwork verifying they’d done so.)

Lawmakers in red states have tried to roll back school vaccine mandates, but most changes have been minor: Louisiana required schools to pair any mandate notifications with information about exemption laws; Idaho allowed 18-year-old students to exempt themselves; and Montana stopped collecting data from schools on immunizations.

The decline in vaccination seems likely to have consequences. “Herd immunity,” in which unvaccinated children can’t easily spread measles because others are protected, requires about 92 percent inoculation. The further rates fall, the more likely an outbreak becomes. For children, measles and other once-common childhood diseases can lead to hospitalization and occasionally death.

“It’s trouble waiting to happen,” said Dr. William Schaffner, an infectious disease specialist at Vanderbilt.

There are thousands more schools with vaccination rates below 90 percent than there were just five years ago, according to a New York Times analysis of data from 22 states. Schools with falling rates can be found in red and blue states, in large urban districts and in small rural ones.

You can see the change in states in the article we published today.

For more

• Polio once paralyzed and killed thousands of people a year in the U.S. Lagging vaccination could lead to a resurgence.

• If immunizations continue to fall, experts say that adults — even those who are vaccinated — could be vulnerable to childhood diseases like measles, mumps and rubella.

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