Vaccine exemption rates are rising among U.S. kindergartners. Here’s why some parents request them for medical reasons.
Making sure vaccines are up to date is par for the course for many kids entering kindergarten. However, according to the Centers for Disease Control and Prevention (CDC), during the 2022-23 school year, the number of exemptions for kindergartners in the U.S. went up to 3%, with exemptions rising in 41 states.
In 10 states, Alaska, Arizona, Hawaii, Idaho, Michigan, Nevada, North Dakota, Oregon, Utah and Wisconsin, the exemption rate exceeded 5%. Among the states that reported exemptions, Idaho had the highest rate of exemptions, with more than 12%.
According to the Journal of Pediatric Pharmacology and Therapeutics, most parents who seek exemptions do so because of religious reasons, personal beliefs or philosophical reasons, safety concerns and a desire for more information from health care providers. Some parents, however, seek exemptions for their children due to medical reasons, which include allergic reactions and other medical conditions that make it unsafe for the children to receive vaccines. According to the CDC, all 50 states and the District of Columbia permit medical exemptions.
Vaccine exemption rates rising due to 'growing misinformation'
Dr. Hector De Leon, a pediatrician with Kaiser Permanente in Colorado, tells Yahoo Life that vaccine exemption rates are rising due to “growing misinformation” and that “the trust barometer between parent and medical institutions seems to have waned.” He notes that while more information is readily available, such information is not always accurate or well-researched. Moreover, De Leon says that some parents don’t believe certain vaccines are necessary because “we haven’t seen a lot of these illnesses for decades.” Nevertheless, he notes that a recent case of polio in the U.S. that resulted in a man becoming paralyzed is “an important reminder of the long-term benefits of vaccinating.”
De Leon says that — given all of the misinformation about vaccines — vaccine hesitancy is understandable. He adds that most pediatricians want parents to understand both the risks of getting a vaccine and the risks of not getting vaccinated. “As medical providers, we’re here to support, provide education and help in shared decision making,” he says. “It’s clear these vaccines save lives, keep children and the community healthy, influence better immune responses and so much more,” De Leon says.
He emphasizes that he is always willing to talk through concerns about vaccines with parents. “We want to hear those questions, continue to build trusting relationships, and ultimately work together to help provide the best care possible for your kids,” he says.
Which vaccines do parents seek exemptions from most often?
There is a spectrum of vaccine refusal among parents who seek vaccine exemptions. Some parents refuse all vaccines for their children while others have concerns about specific vaccines. The measles, mumps and rubella (MMR) vaccine is the most commonly refused routine vaccine for nonmedical reasons, followed by the human papillomavirus virus or HPV vaccine, Dr. Elizabeth Hammershaimb, an infectious disease pediatrician with the University of Maryland Children’s Hospital, tells Yahoo Life. However, she says that seasonal influenza and COVID-19 vaccines have the highest total rates of refusal.
Some children can’t get vaccinated due to medical concerns
Although the majority of parents seeking exemptions do so for religious or philosophical reasons, some children can’t get vaccinated due to medical concerns. “In my practice, parents ask for medical exemptions when children have previously had a reaction to a specific vaccine or are immunocompromised. So it’s a safety question,” De Leon says.
Hammershaimb adds that children with cancer cannot get vaccines while they are undergoing chemotherapy. Similarly, children who have medical conditions that require suppressing their immune systems can’t get vaccinated either, she says. “For medical reasons, the most common vaccines kids can't get are what we call ‘live’ vaccines; these include MMR and chicken pox,” Hammershaimb explains.
Austin Carrigg’s 11-year-old daughter Melanie is one of the kids who can’t get vaccines due to health concerns. Melanie, who has Down syndrome, a primary immunodeficiency and other medical conditions, takes a biologic medication that makes getting live vaccines dangerous. She cannot get the MMR and some other vaccines. Even the vaccines Melanie can get don’t work very well because “her body can't use them to create protection for herself,” Carrigg tells Yahoo Life.
Dr. Jennifer Silver’s child cannot get some vaccines because the child had a severe allergic reaction to the first MMR vaccine. This makes “the standard vaccination schedule a dangerous option,” Silver tells Yahoo Life.
'We’re looking for the rest of the community to vaccinate themselves' to protect patients
Life is difficult for families whose children can’t receive vaccines for medical reasons. “For these kids, we recommend isolating as much as possible. That can be quite difficult and challenging, especially for young children who want to be outside, explore, go to the library, movies, mall and so on,” De Leon says.
Carrigg and Silver have both altered their lives to try to keep their children healthy and safe, but they haven’t been able to protect them entirely. Silver says that “stringent hygiene” and “minimizing public exposure have become daily routines to shield our children from potential health risks,” especially from activities “that might pose a risk of exposure to vaccine-preventable diseases.”
Melanie lives in “lockdown,” Silver says. Despite being so careful, she has had COVID-19 and RSV twice. Carrigg says that spending “countless sleepless nights watching your child gasp for air from conditions that could be prevented is heartbreaking.” Melanie has been out of school for over a year while she receives immunoglobulin therapy that may provide her with enough immune system protection to enable her to return to school safely.
“We’re looking for the rest of the community to vaccinate themselves to not only protect themselves,” but also children who cannot get vaccinated as well, De Leon says. Hammershaimb points out that “some of these diseases have real, long-term complications that a lot of parents don't realize.” The more people who are vaccinated, the more “rings of protection” there will be around these children, she explains.
Carrigg says that she believes people have the right to refuse vaccinations. However, she says, “I'd urge anyone considering declining vaccination to think about my little girl and the life she could have if true herd immunity were achieved.”
