According to the World Health Organization, “Measles is a highly contagious viral disease that affects individuals of all ages and remains one of the leading causes of death among young children globally.” Almost one in three children under the age of five who contract the disease will need to be hospitalized, highlighting the seriousness of this public health threat. But in the United States, since the COVID-19 pandemic, vaccination rates among kindergartners for all state-required vaccines, including the measles vaccine, have declined from 95% to 93%. As of the end of April, there have been 12 measles outbreaks in 2025 among children under the age of 5, with 23% of those affected requiring hospitalization. In comparison, 16 outbreaks were reported in all of 2024.

Vaccination rates and the rates of exemptions granted vary across the 50 states, with the reasons for these discrepancies depending on many factors, including religion, misinformation, vaccine confidence, and poverty. PARequirements examined the data for each state to highlight where the most kindergartners are not up to date on their measles vaccines.

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From Waning Threat to Rising Health Risk

Many of the diseases that once claimed the lives of children have become far less common, largely due to the success of vaccinations. In fact, in 2000, the United States declared that it was free of measles, and in 2016, the WHO issued a similar declaration for all of the Americas. However, as long as measles hasn’t been fully eradicated worldwide, it can always be imported through international travel, making vaccination still necessary to prevent infection. As vaccination rates have fallen, the number of infections with this highly contagious disease has climbed, turning an illness that once caused little worry for most Americans into a looming threat. With current vaccination rates, researchers predict that measles could become endemic in the U.S. again within two decades.

Why Aren’t All Children Being Vaccinated?

Children can be exempted from routine vaccinations for both medical and non-medical reasons, with the allowable exemptions varying from state to state. Medical exemptions are allowed in every state and are applied when an individual has an underlying health condition that makes it unsafe to receive a particular vaccine. But in many states, children can also be exempted due to religious, personal, or philosophical beliefs. As non-medical exemptions have become increasingly popular, the United States has seen a corresponding surge in vaccine-preventable diseases. Research shows that in areas with higher rates of vaccine exemptions, people face a greater risk of both infection and death from these diseases. Thirty states and Washington, D.C., permit exemptions from vaccination requirements for those with religious objections. Thirteen states allow exemptions for both personal and religious reasons. In Louisiana and Minnesota, there is no requirement to specify the reason for the exemption. Five states (California, Connecticut, Maine, New York, and West Virginia) do not permit any form of non-medical exemption.

The States With the Highest Rates of Children Who Are Not Up to Date on the Measles Vaccine

Here are the ten states with the highest percentages of children who are not current with the measles vaccine:

• Idaho: 20.4%
• Alaska: 15.7%
• Wisconsin: 15.2%
• Minnesota: 13.0%
• Florida: 11.9%
• Oklahoma: 11.7%
• Colorado: 11.7%
• Utah: 11.2%
• Iowa: 10.9%
• Ohio: 10.8%

Overall, the data suggests that states with more lenient exemption policies tend to have higher rates of unvaccinated children, which directly correlates to a greater susceptibility to infection.

Closing Public Health Gaps Through Education

Clear, science-based public health education is one of the best tools we have to protect children. As debates over vaccine policies grow louder, fueled in part by misinformation and political tension, public trust has taken a hit. Rebuilding that trust means equipping families and professionals with accurate information, strengthening community-level outreach, and supporting policies that follow established medical guidance. When families are informed and confident, vaccination rates go up and the chances of dangerous disease outbreaks go down. Education and awareness can also be powerful tools in preventing a wide variety of dangers to children’s health and safety, from potentially fatal illnesses to child abuse. Just as declining vaccination rates have led to the outbreak of preventable diseases, failing to report suspected abuse leaves vulnerable children at risk of continued harm. Pennsylvania’s mandated reporter training helps prepare health professionals to identify warning signs of child abuse and understand their legal responsibilities, which can be overlooked due to a misunderstanding of the law. When adults are well-informed, they’re better equipped to make the best decisions to protect children’s health and welfare, decisions that can potentially save lives.

Percentages of Children Not Up to Date on Measles Vaccine and State Exemption Rates

Sources:

• https://www.cdc.gov/schoolvaxview/data/index.html
• https://www.cdc.gov/measles/data-research/index.html
• https://www.kff.org/policy-watch/childhood-vaccination-rates-continue-to-decline-as-trump-heads-for-a-second-term
• https://www.ncsl.org/health/state-non-medical-exemptions-from-school-immunization-requirements