Back-to-School Is Here: It’s Time to Get Kids Caught Up on Their Vaccines

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Back-to-school season is a critical opportunity to focus on one of the most effective strategies to keep children safe and healthy: routine immunizations. Childhood vaccination is one of the lowest-cost and most effective strategies to control and prevent disease over a person’s lifespan. In economic terms, researchers estimate that every dollar spent on childhood vaccination saves more than $10 in societal costs and $3 in direct medical savings. It’s no coincidence that August was National Immunization Awareness Month. This back-to-school season, state policymakers and school leaders should enforce school vaccine requirements and engage communities in immunization campaigns to catch kids up on these important vaccines. 

Unfortunately, since the onset of the COVID-19 pandemic, rates of routine childhood immunization have declined due to difficulties in accessing health care, vaccine hesitancy and the loosening of vaccine requirements. These put children and communities at greater risk of outbreaks of preventable disease.  

Measles provides a helpful case study. According to the Centers for Disease Control and Prevention, “measles is so contagious that if one person has it, 9 out of 10 people of all ages … will also become infected if they are not protected.” Despite this risk, almost 250,000 kindergartners in the 2021-22 school year may not have been protected against measles. Measles cases have resulted in community outbreaks, productivity loss and direct medical costs; the CDC estimates it can cost more than $140,000 to contain one case of measles. 

State requirements that children be vaccinated to attend public school have a proven track record in producing high immunization rates. These generally are higher in states with more restrictive policies around grace and provisional enrollment periods, which temporarily allow children who are getting but have not completed their vaccinations to attend school. Yet, during the 2021-22 school year, due to pandemic-related health care disruptions, many states allowed students who did not meet school requirements and lacked valid exemptions to continue to attend class. In part because of these lenient policies, 4.4% of kindergartners nationally were not up to date on their measles, mumps and rubella vaccine. 

This is particularly concerning because a population vaccination rate of 95% is recommended for measles herd immunity. This means that measles is less likely to spread, protecting the 5% percent who are not vaccinated. Of the 33 states and the District of Columbia that have vaccination rates of less than 95% for measles, 31 could potentially reach the 95% goal and prevent outbreaks if they were able to vaccinate kindergartners who do not have valid exemptions. For instance, 93% of Vermont kindergarteners were vaccinated against measles, mumps and rubella, and 6.8% were covered under grace periods or provisional enrollment exceptions. If those children were vaccinated, Vermont’s overall rate potentially would exceed 95% and all youngsters — and their surrounding communities — would be protected.

Unfortunately, state immunization programs are facing reductions in federal funding that supports data systems, as the result of unspent COVID funding being pulled back during congressional debt limit negotiations. The country can’t afford to waste the investments it made on immunization systems and programs, including data modernization, during the height of the pandemic. Now is the time to build on those improvements, making sure states have efficient and effective systems to track vaccine orders, enroll health care providers as vaccinators, provide patients and families with timely information about their immunization status and their need for updates, and address gaps so all children are protected from preventable disease.  

The back-to-school season is a key moment to catch kids up on their vaccines. To do this, schools should reinstate and reinforce vaccine requirements, sending a message to families about the importance of routine childhood immunizations. Schools should also engage community leaders to bolster vaccine confidence, counter disinformation and provide families with timely, accurate, culturally sensitive and evidence-based information about vaccines. Lastly, schools should help families access vaccines through back-to-school immunization drives, which provide an opportunity to identify children who need to catch up, engage their families and connect them to clinical personnel. The CDC provides evidence-based strategies and tools for schools and health care providers to catch kids up on routine immunizations.

Public health systems are often unnoticed, working behind the scenes to prevent diseases and avoid their health and economic consequences. Americans must keep investing in wellness and prevention to promote good health, reduce absenteeism from preventable diseases and promote positive school environments for learning. Catching kids up on routine vaccinations must be a critical priority for advancing community well-being.

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