Newly-minted kindergarteners are getting ready for school, which means backpacks, crayons, and, for some, vaccine exemption forms. For the 2024–25 school year, 3.6% of kindergarteners had a vaccine exemption, up from 2.2% in 2014–15.
The share of kindergarteners with medical exemptions has remained at 0.2% year over year, with little variation. The nonmedical exemption rate has steadily increased, from 2.0% in 2014 to 3.4% in 2024.
Nonmedical exemptions have increased, medical exemptions have stayed stable.
National percentage of kindergarteners with an exemption from one or more vaccines by school year, school year starting 2014 - 2024
Nonmedical exemption rates hovered around 2.0% from 2014 to 2020 and then rose each year through 2024. The Centers for Disease Control and Prevention attributes the 2020 decline in all exemption rates to expanded grace periods and provisional enrollment policies during the COVID-19 pandemic; lots of kids went to school without being fully vaccinated not because they were exempt but because routine health care and vaccinations were delayed. (Overall vaccination coverage also dropped during the pandemic.)
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What are reasons for vaccine exemptions?
Vaccine exemptions fall into two categories, medical and nonmedical. States set their own exemption laws.
- Medical exemptions are granted when a child has a health condition that makes vaccination unsafe, like a severe allergy to a vaccine ingredient or a weakened immune system from cancer treatment.
- Nonmedical exemptions are based on a family’s beliefs and can be either religious (when vaccination conflicts with a family’s faith) or philosophical (when parents object for personal or moral reasons).
All states allow medical exemptions. Rules for nonmedical exemptions vary: most states permit religious exemptions, fewer allow philosophical exemptions, and some allow both.
How do nonmedical exemption rates vary by state?
Nonmedical exemptions were highest in Idaho, where 15.1% of kindergarteners had one. Idaho allows exemptions on both religious and philosophical grounds.
Utah had the second-highest rate of kindergarteners with nonmedical exemptions, 10.0%. It also allows religious and philosophical exemptions.
Three other states had exemption rates above 9.0%: Oregon (9.7%), Alaska (9.0%), and Arizona (also 9.0%).
The state with the lowest rate was Connecticut, where 0.1% of children had nonmedical exemptions. Connecticut repealed nonmedical exemptions in 2021, although those approved before the law repeal came into effect remain valid. It’s the only state with an exemption rate below 1.0%.
Over 15% of kindergarteners in Idaho had nonmedical vaccine exemptions.
Percentage of kindergarteners with a nonmedical vaccine exemption for the 2024–25 school year
Five other states had nonmedical exemption rates below 2.0%: Mississippi (1.1%), Massachusetts (1.3%), Rhode Island (1.7%), Maryland (1.7%), and New Mexico (1.9%). All of these states allow religious exemptions but not philosophical.
Since the 2014–15 school year, nonmedical exemptions increased the most in Idaho (+8.9 percentage points), Utah (+5.9 percentage points), Nevada (+5.6), and South Dakota (+5.2).
Nonmedical exemptions increased in all but three states in the last decade.
Change in percentage of kindergarteners with a nonmedical vaccine exemption from the 2014–15 school year compared to the 2024–25 school year.
Nonmedical exemptions decreased in three states over the last decade: Colorado (-1.3 percentage points), Connecticut (-1.5), and Vermont (-2.2).
All three put limitations on nonmedical exemptions. Vermont repealed philosophical exemptions even earlier than Connecticut, in 2015. And Colorado adjusted the process of seeking nonmedical exemptions to require either completion of an online immunization education module or a nonmedical exemption form signed by an immunization provider.
How do medical vaccine exemptions vary by state?
National medical exemption rates remained around 0.2% with little variation from the 2014–15 to 2024–25 school years. Of all reporting states in 2024–25 school year, medical exemption rates were below 1.0%.
Maine had the highest medical exemption rate in kindergarteners at 0.8%, followed by Maryland, Nebraska, Nevada, and Wisconsin (all 0.5%).
Fewer than 1% of kindergarteners had a medical exemption in all reporting states.
Percentage of kindergarteners with a medical vaccine exemption for the 2024–25 school year
Eighteen states reported medical exemptions of 0.1%, the lowest reported rate.
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