Jen Fisher does her best to protect her son Raleigh from infections common in schools, but she relies on the cooperation of other students and parents in Franklin, Tennessee to keep him safe. Raleigh, 12, has a weakened immune system due to a congenital heart condition, making him more susceptible to illnesses. Despite receiving all recommended vaccines for his age, Raleigh remains at risk of severe illness if exposed to certain viruses that could land him in the emergency room. Fisher emphasizes the importance of community-wide vaccination to prevent diseases like measles from resurfacing and posing a serious threat to Raleigh’s health.
Throughout Raleigh’s life, Fisher has found reassurance in Tennessee’s high childhood vaccination rates, a bright spot in a state known for poor health outcomes and low life expectancies. Despite being conservative states with similar health challenges, Mississippi and West Virginia also boast high vaccination rates among kindergartners. This discrepancy highlights that vaccination policies do not always align with other state characteristics, according to public health expert James Colgrove of Columbia University.
Concerns arise as some states report increasing numbers of parents opting out of vaccinating their children, driven by shifting attitudes and misinformation. The rise in vaccine exemptions, predominantly for nonmedical reasons, raises alarms among advocates, health officials, and researchers. They fear that anti-vaccine sentiments, fueled by a “health freedom” movement, could jeopardize public health efforts. The potential appointment of anti-vaccine activist Robert F. Kennedy Jr. as Secretary of Health and Human Services under the Trump administration further fuels concerns about the future of vaccination policies.
In states with high exemption rates like Florida and Georgia, pediatricians witness declining immunization levels among kindergartners, raising the risk of a resurgence in preventable diseases such as measles. In Florida, some areas have reported nonmedical exemption rates as high as 50%, with religious exemptions often cited as the primary reason for unvaccinated children entering schools. Pediatric infectious disease specialist Dr. Brandon Chatani in Orlando expresses apprehension over the ease of obtaining religious exemptions compared to medical ones, potentially compromising herd immunity and putting vulnerable individuals like Raleigh at greater risk.
In the last ten years, California, Connecticut, Maine, and New York have eliminated religious and philosophical exemptions from school vaccination requirements. Meanwhile, West Virginia has not implemented such exemptions. According to the CDC, Idaho, Alaska, and Utah had the highest rates of exemptions for the 2023-24 school year, allowing parents to opt out for religious reasons by submitting a notarized form or a signed statement. On the other hand, Florida and Georgia, states with some of the lowest reported vaccination rates for kindergartners, permit parents to exempt their children by submitting a form through the child’s school or daycare. Both states have seen a decrease in measles, mumps, and rubella vaccine uptake. In Georgia, MMR coverage for kindergartners dropped to 88.4% in the 2023-24 school year compared to 93.1% in 2019-20, while Florida dropped to 88.1% from 93.5% during the same period. Dr. Andi Shane, a pediatric infectious disease specialist in Atlanta, attributes Georgia’s declining rates to factors such as limited access to pediatricians and state exemption policies. She noted that higher vaccination rates tend to be associated with restrictions on personal belief exemptions. Georgia public health officials recently reported a significant increase in whooping cough cases compared to the previous year. Mississippi, previously known for allowing exemptions only for medical reasons with a doctor’s approval, had one of the highest vaccination rates until a federal judge ordered the allowance of religious exemptions in April 2023. This change has led to an increase in vaccine hesitancy and skepticism among families in the state. Notably, more affluent residents in specific areas have been seeking religious exemptions. West Virginia, which currently does not allow nonmedical exemptions, may see changes to its vaccine law in the future. A bill that aimed to broaden exemptions was vetoed last year but could resurface under the new governor, Pat Morrisey, who has expressed opposition to vaccine mandates. Dr. Daniel Edney, the state health officer, emphasized the importance of following expert medical advice to protect children through vaccination.
“Poliomyelitis and the lifelong paralysis it inflicts serve as a hindrance to personal freedom and autonomy for affected children,” stated a concerned individual. In the wake of the Covid-19 pandemic, a surge in anti-vaccine sentiment has been observed in Tennessee. Stand for Health Freedom, an organization, has crafted a letter urging constituents to petition for the removal of Tennessee’s Vaccine-Preventable Diseases and Immunization Program medical director. The group has accused her of disregarding the informed consent rights of the public.
Encouraged by the current administration’s stance on devolving certain matters to individual states, anti-vaccine proponents are becoming increasingly vocal. Emily Delikat, who heads Tennessee Families for Vaccines, a pro-vaccine entity, expressed concern over this shift in policy. She emphasized the importance of maintaining informed consent rights when it comes to vaccination decisions.
Dr. Henderson, a pediatrician from Mississippi, noted that vaccines have become victims of their own success. Due to the absence of widespread measles or polio outbreaks, many individuals underestimate the severity of these diseases. Dr. Henderson warned that a potential resurgence of these once eradicated illnesses may be necessary to remind the public of their deadly nature and the importance of prevention measures.
Reflecting on the critical role of vaccines in public health, the hope is to avoid the resurgence of vaccine-preventable diseases. KFF Health News, a renowned national newsroom dedicated to comprehensive health journalism, stands as a pillar at KFF — a reputable source for health policy research, polling, and journalism.
