There is only so much Jen Fisher can do to protect her son from the kinds of diseases that kids can get at school. She said that other pupils and parents in their hometown of Franklin, Tennessee, are responsible for the rest.
Raleigh, Fisher’s 12-year-old son, has a congenital cardiac issue that has compromised his immune system. Raleigh has gotten every vaccination advised for a youngster his age in order to safeguard him. However, Fisher noted that despite his vaccines, he may become ill and end up in the emergency room due to a sickness that would simply prevent another youngster from playing.
In order to prevent diseases like measles and other diseases that have essentially been eradicated from resurfacing, we urge everyone to get vaccinated, Fisher stated. Those may undoubtedly have a negative impact on Raleigh.
Fisher could find solace in Tennessee’s high childhood immunization rate during a large portion of Raleigh’s life. Tennessee is a public health shining star in a conservative state with terrible health outcomes and one of the lowest life expectancies in the country.
According to James Colgrove, a professor at Columbia University who focuses on public health factors, Mississippi and West Virginia, two similarly conservative states with low life expectancies and poor health outcomes, also have some of the highest kindergarten vaccination rates in the country. This apparent contradiction arises because childhood vaccination requirements don’t always match state characteristics.
According to Colgrove, state policies don’t easily fit into one region or another or into red against blue.
Researchers, physicians, advocates, and public health officials are concerned that these public health hotspots are disappearing in some states: As Americans’ opinions change, many states have recently recorded a rise in the number of parents choosing not to vaccinate their children.
According to data from the Centers for Disease Control and Prevention, the number of kindergarteners who were exempt from one or more immunizations increased to 3.3% during the 2023–24 school year, the highest rate ever recorded. This increase occurred in 40 states and Washington, D.C. Among those with increases were Mississippi and Tennessee. Nationally, almost all exemptions were granted for non-medical grounds.
Vaccine advocates are concernedA burgeoning health freedom movement spearheaded by leaders in states like Florida may gain momentum if anti-vaccine rhetoric is used. With Donald Trump’s victory as president and his suggested appointment of anti-vaccine activist Robert F. Kennedy Jr. as secretary of the Department of Health and Human Services, the movement against vaccines is likely to continue to gain momentum.
Pediatricians in areas with high exemption rates, like Florida and Georgia, express alarm about the drop in kindergarten vaccination rates, which they believe could result in a rise of vaccine-preventable illnesses like measles. In certain places, nonmedical exemption rates for children might reach 50%, according to the Florida Department of Health.
Dr. Brandon Chatani, a pediatric infectious disease specialist in Orlando, Florida, stated that the religious exemption is significant. This has made it simple for these children to attend school without receiving vaccinations.
A religious exemption is more easily obtained in many states than a medical one, which frequently needs a doctor’s approval.
Religious and philosophical exemptions from school vaccination laws have been eliminated in California, Connecticut, Maine, and New York during the last ten years. They haven’t existed in West Virginia.
According to the CDC, the states with the greatest exemption rates for the 2023–24 school year were Idaho, Alaska, and Utah. In those states, parents or legal guardians can submit a signed statement or a notarized document to exempt their children for religious reasons.
With some of the lowest documented required immunization rates for kindergarteners, Florida and Georgia permit parents to exempt their children by submitting a form to the child’s daycare or school.
One of the most popular pediatric vaccinations, the measles, mumps, and rubella vaccine, has shown a drop in adoption in both states. According to the CDC, Georgia’s kindergarten MMR coverage fell from 93.1% in 2019–20 to 88.4% in 2023–24. Florida fell from 93.5% to 88.1% in the same time frame.
Pediatric infectious disease specialist Dr. Andi Shane of Atlanta attributes Georgia’s falling rates to families without access to pediatricians. According to her, state exemption policies are also crucial.
Vaccination rates are greater when personal belief exemptions are prohibited, according to a wealth of data, she noted.
Public health officials in Georgia issued a caution in December, stating that the number of whooping cough cases in the state had increased dramatically compared to the previous year. Georgia reported 280 cases in 2024, up from 96 the previous year, according to CDC data.
Mississippi was one of the few states that let parents to choose not to vaccinate their children unless they had a doctor’s prescription and for medical reasons exclusively, until 2023. As of the 2023–24 school year, it had one of the highest immunization rates in the country.
Dr. Anita Henderson, a pediatrician who has worked in the southern region of the state for almost 30 years, said it’s one of the few things Mississippi has done well. She said that the state’s top health indicator was its children immunization rates.
However, in April 2023, a federal judge ordered state officials to begin granting religious exemptions, which changed things. According to Henderson, the decision has given many families more confidence.
Because of this decision, we are witnessing an increasing amount of mistrust, vaccine hesitancy, and a lack of confidence, she said.
The state health department reports that since the court order permitting religious exemptions, state officials have issued over 5,000 of them.The majority of the requests, according to state health officer Dr. Daniel Edney, have come from wealthier citizens in certain areas of the state.
Since it’s the greatest way to safeguard their kids, most people follow the advice of their pediatricians and family medicine specialists to stick to the vaccination schedule, he said.
Dr. Matthew Christiansen, the state’s health officer until his resignation in December, stated that the vaccine law in West Virginia, which does not permit nonmedical exemptions, may soon change as well.
Last year, a bill that would have expanded exemptions passed the legislature but was vetoed by Republican Governor Jim Justice, who is leaving office. Republican Pat Morrisey, the incoming governor, has been an outspoken opponent of vaccination requirements.
According to Christiansen, people who exercise their personal choice to refuse to vaccinate their children may ultimately limit the lives of others. According to him, children who contract measles, mumps, and polio and end up paralyzed for the rest of their lives are unable to exercise their personal freedom and autonomy.
In Tennessee, anti-vaccine sentiment has been on the rise since the Covid epidemic. The medical director of Tennessee’s Vaccine-Preventable Diseases and Immunization Program should retire, according to a letter written by Stand for Health Freedom for citizens to deliver to their state legislators. According to the group, she showed a lack of regard for people’s rights to informed consent.
According to Emily Delikat, director of Tennessee Families for Vaccines, a pro-vaccine organization, they are encouraged by the notion that current presidential administration appears to strongly believe that many of these matters should be returned to the states.
According to Henderson, the pediatrician from Mississippi, immunizations are ultimately a victim of their own success, just like many other successful public health initiatives. “Most people forget how dangerous measles and polio are because they haven’t seen outbreaks,” she said.
Unfortunately, she said, it might take a comeback of those illnesses to bring attention to the fact that they are preventable and dangerous. I hope that doesn’t happen.
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