School reopenings bring more vaccine confusion
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Illustration: Maura Losch/Axios
The new school year is bringing more ambivalence and confusion over children's vaccines, as shifting policies under HHS Secretary Robert F. Kennedy Jr. and lingering skepticism lead more parents to opt out.
Why it matters: The U.S. this year experienced the worst measles outbreak in 30 years, a large uptick in whooping cough and the highest number of pediatric flu deaths in more than a decade.
State of play: Clinicians say moves like Kennedy's decision to stop recommending COVID-19 vaccines for healthy kids have emboldened segments of the public to question the effectiveness and safety of a range of shots for measles, mumps and rubella (MMR), pertussis, chicken pox and more.
- "They feel like if the government has chosen RFK Jr. to be the head of Health and Human Services, there must be something to that. There must be a reason to question vaccines," said Paul Offit, director of the Vaccine Education Center at the Children's Hospital of Philadelphia.
- Some pediatricians offices and even children's health systems have begun weighing whether to keep unvaccinated patients on their rosters.
- "It's gotten so bad that you're concerned about the waiting room with a lot of children who are unvaccinated. That's a risk, not only to them, but the children they come in contact with," Offit said.
Zoom out: Vaccine hesitancy is not a new phenomenon: Kindergarten exemptions from one or more vaccines grew in 36 states and the District of Columbia during the 2024-2025 school year.
- But pediatricians report they've been facing far more questions and concerns prompted by shifting federal policies, like the removal from all flu shots of the mercury-containing preservative thimerosal that anti-vaccine activists have suggested is linked to autism.
- Kennedy also qualified his support of the measles shot during the Texas outbreak, saying "the decision to vaccinate is a personal one" and suggesting the use of ineffective treatments.
- Professional societies like the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics have been increasingly out front publicly disagreeing with Kennedy's stances.
The confusion may extend to adult vaccines — and whether pregnant women should get COVID boosters or the relatively new maternal RSV vaccine, said David Hackney, a fetal medicine physician in Cleveland.
- Higher-risk patients like seniors and people with chronic conditions may face confusion when it comes to getting COVID shots, the Washington Post reported.
- "It's a little bit tricky since the COVID [shot] was taken off of the immunization schedule for the CDC, " Hackney told Axios. "You always just have a lot of baseline vaccination hesitancy and we've always relied on alignment with our federal institutions."
Reality check: The vast majority of parents aren't seeking vaccine exemptions and most school-aged children have already received a baseline of vaccination compared with younger kids.
- "Most parents believe in vaccination and get their kids fully vaccinated on time," said Richard Besser, CEO of the Robert Wood Johnson Foundation.
Yes, but: While the overall vaccination rates still appear high, they can mask regional drop-offs, such those seen in, West Texas where some classrooms had upward of 50% of kids not vaccinated, Besser said.
- "Measles doesn't care so much about what's going on nationwide, it cares what's going on in the community that it's entered," he said.
