Areas of low vaccination rates are popping up all over the country, raising concerns that some of America's most vulnerable populations are at risk. Here is a look at what a new report released this week is telling health care experts about declining vaccination rates.

New Research Reveals Pockets of Declining Vaccination Rates

A new analysis published on Wednesday in the medical journal JAMA demonstrates that exemption rates for vaccines have increased in over half of the counties throughout the country since the beginning of the COVID-19 pandemic. These exemptions are required for children to attend school, often granted for religious or personal beliefs.

What is most interesting about the data analysis is that while nonmedical exemptions have increased, exemptions for medical reasons have remained stable. Typical medical exemptions are granted to individuals who may be immunocompromised or have a severe allergy to an ingredient in the vaccine.

The medical community is growing increasingly concerned about the increase in nonmedical exemption rates. A policy statement released by the American Academy of Pediatrics (AAP) noted that the science behind immunizations has not changed over the last five years. The AAP is reminding Americans that vaccines are safe, effective, and that they reduce morbidity and mortality.

Researchers compared the average rate of immunization exemptions at the county level for kindergartners entering school for a period before the pandemic to more recent years. Almost 90% of the counties did not have the data needed to be included in the analysis. However, the data that did come in demonstrated that the median rate of nonmedical exemptions jumped from an average of 0.6% in 2010 - 2011 to over 3% in 2023 - 2024. The rate of medical exemptions did not change significantly during this period.

Approximately 53.5% of U.S. counties noted an increase of at least 1% over this period for nonmedical vaccine exemptions. More alarmingly, more than 5% of the counties studied saw an increase of at least 5% for these types of exemptions.

The U.S. Centers for Disease Control and Prevention (CDC) is blaming the increase in exemptions on a corresponding increase in vaccine hesitancy. A survey conducted by the CDC in 2024 found that most parents supported immunization requirements to attend school. However, the most commonly reported objections focused on personal beliefs of philosophical reasons. Medical reasons were cited by approximately a quarter of the parents who objected to vaccines.

Areas of High Exemption Rates Fueling Ongoing Disease Outbreaks

Scientists are also cautioning that while overall vaccination rates across the country remain robust, there are large pockets where vaccine coverage is dangerously low. It is these areas that tend to drive the outbreaks of preventable diseases.

For example, data from Spartanburg County, South Carolina, shows that almost 8% of students had nonmedical vaccine exemptions in 2024. This is an increase of nearly 6% from 2014. It is likely no surprise that Spartanburg County is the epicenter of a large measles outbreak that has doubled over the past week. State health officials in South Carolina have confirmed over 400 cases. In addition, at least 400 more people are in quarantine after being exposed to the measles without immunization protection. As such, the numbers are expected to keep growing.

The South Carolina health department is also warning that cases are likely to skyrocket on the heels of the holidays. Family gatherings, travel, and more are all contributing to the size of the outbreak. The outbreak is particularly pronounced in areas with lower vaccination rates.

About 92% of measles cases in the ongoing outbreak have been among unvaccinated children. While the unvaccinated are the most at risk, doctors warn that the entire community is under the threat.

All it takes is one contagious person to spread the disease to neighboring counties and states. For instance, several cases of the measles in North Carolina have been connected to travel to Spartanburg County, South Carolina. In addition, the New Mexico health department recently warned residents of potential measles exposure in Albuquerque after an infected person visited from South Carolina.

More states are beginning to pass legislation that removes the ability of residents to rely on nonmedical vaccine exemptions. These states include Maine, New York, Connecticut, and California. The latest research indicates that these four states have seen more vaccine coverage after the laws were passed.

On the other side of the spectrum, Florida recently ended all vaccine mandates in the state. This includes the requirement for children to be vaccinated before attending school. This puts the decision of vaccination solely on the parents.

Although the news about declining vaccination rates may seem dire, medical professionals point out that it is important to remember that more than 96% of all American kindergartners were fully vaccinated.

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