Recent analysis reveals a significant rise in nonmedical exemptions for childhood vaccinations across the United States, potentially threatening public health. The report, which analyzed 2016–2019 data from 3,053 counties across 45 states and Washington, DC, found some of the most alarming trends focusing on vaccine hesitancy.
From 2021 to 2024, over half of these counties experienced an increase in nonmedical exemptions. In reality, 53.5% of the 2,842 counties with publicly available data reported increases greater than 1%. In addition to this troubling news, 5.3% of these counties saw their increase top 5%. To make matters worse, this continuing upward trend could further drive down already declining vaccination rates among children.
Trends in Nonmedical Exemptions
Our analysis found that the median nonmedical exemption rate increased dramatically over the last few years. Between 2010 and 2020, the median rate grew by an average of 0.11 percentage points per year. This figure shot up to 0.52 average annual increase percentage points after the advent of SARS-CoV-2. The median county-level nonmedical exemption rate jumped from only 0.6% in the 2010-11 school year to 3.1% in 2023-24.
Medical exemptions remained consistent over this period. Despite its relatively recent and restricted rise, the explosion of nonmedical exemptions to vaccination mandates represents a wholly distinct countercurrent in vaccination policy. This unexpected change encourages deeper exploration into what’s driving parents’ decisions to vaccinate—or not.
State-Level Variations
The study pointed out how nonmedical exemption rates were found to differ tremendously even from state to state. States such as Arizona, Idaho, Oregon, Utah, and Wisconsin exhibited the highest rates of nonmedical exemptions from 2021 to 2024. States such as California, Connecticut, Maine, and New York showed real courage to protect their populations by fully eliminating nonmedical exemptions. Consequently, these states have experienced a drop in their exemption rates.
A total of ninety-one point one percent of all counties contain a minimum of five years’ worth of data. Ninety-eight percent encompass at least one year from the last five, underscoring the need for policymakers to address increasing exemption rates with urgency.
“These findings support the need to reconsider policy on use of nonmedical exemptions, which are actively being debated, to address declining childhood vaccination in the US.” – The authors
Implications for Public Health
The implications of these findings are profound. As U.S. childhood vaccination rates plummet, experts caution that vaccine-preventable diseases will come roaring back. The authors of the study stated, “US childhood vaccination rates are declining, posing the risk that vaccine-preventable infectious diseases will resurge.”
Public health officials need to immediately address these disturbing patterns. They need to reevaluate nonmedical exemption policies already in place and do more to compel a nationwide public health narrative that emphasizes the importance of vaccination. Reaching the communities affected and communicating their concerns could be key to turning the tide on this trend.
