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2w ago

Nonmedical Vaccine Exemptions Surge Across U.S. Counties as Measles Outbreak Expands

A new JAMA county-level analysis finds growing clusters of nonmedical opt-outs that raise the risk of outbreaks.

A child is vaccinated during an immunization event at the L.A. Care and Blue Shield of California Promise Health Plan Community Resource Center in the Panorama City neighborhood of Los Angeles, California, on October 24, 2025.
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Overview

  • In 2010–2011 the median nonmedical exemption rate for kindergartners was 0.6%, rising to 3.1% in 2023–2024, with 53.5% of counties recording increases of at least one percentage point.
  • Medical exemptions remained stable while researchers attribute most growth to religious or personal-belief opt-outs, and the CDC links the trend to increased vaccine hesitancy.
  • South Carolina’s Spartanburg County now reports more than 400 measles cases since September, mostly in unvaccinated children, with exposures tied to schools, churches and travel to other states.
  • States that eliminated nonmedical exemptions, including California, Connecticut, Maine and New York, saw declines in overall exemptions, while rates remain highest in Utah, Idaho, Oregon, Wisconsin and Arizona with some areas exceeding 20%.
  • Public health experts note measles control requires about 95% coverage, yet 92.5% of kindergartners received MMR in 2024–25, and they say laws and consistent clinician–family discussions are key to reversing the slide.