Vaccine Rates for Measles Decline as Exemptions Grow

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Recommended Measles Vaccination Schedule 

The first vaccination for measles—which is packaged along with mumps and rubella, leading to the shorthand name of MMR—is recommended for children between 12- and 18-months-old. A second dose of the MMR vaccine is given to children before they enter school, between ages 4 and 6. 

State Vaccination Rates
The CDC each year releases statistics on MMR vaccination coverage among children in kindergarten2. Among the most recent findings: 

  • The national median rate of 94.7 percent for the 2013-14 school year is approaching the Healthy People 2020 goal of 95 percent MMR vaccination coverage, but rates among states vary significantly.
  • Only 24 states have kindergarten immunization rates of 95 percent or more.
  • In seven states—Arkansas, Colorado, Idaho, Kansas, Maine, North Dakota and Pennsylvania—and the District of Columbia, the immunization rate is below 90 percent.
  • Immunization rates are between 90 and 95 percent in 19 states.
  • In the four territories where rates are calculated, Guam is below 90 percent; Puerto Rico and the U.S. Virgin Islands are between 90 and 95 percent; and the Northern Mariana Islands rate is 96 percent.
  • In contrast to the current MMR immunization rate, the national rate reported by CDC for the 1999-2000 school year—97.4 percent—was higher.

Exemptions from MMR Vaccination
State laws provide ways for parents to exempt their children from vaccination requirements.

  • CDC data show 90,613 children entering school in the 2013-14 school year were exempted from the MMR vaccination3.
  • California led the nation with 18,270 MMR vaccine exemptions in the 2013-14 school year.
  • Nationally, just 12 percent of MMR exemptions were for medical reasons.
  • All states allow exemptions from vaccine requirements for medical reasons. For children with cancer and other serious medical conditions, physicians may recommend against vaccination at the scheduled age.
  • Nearly half of all exemptions from the MMR vaccine in the 2013-14 school year nationally—48 percent—were for philosophical reasons or personal belief. Another 40 percent of exemptions were for religious reasons. Nonmedical exemptions are allowed for religious reasons in 46 states.
  • Exemptions also are allowed for philosophic reasons and personal beliefs in 18 states.
  • Mississippi and West Virginia are the only states that do not allow exemptions for any reason other than medical conditions.

States Revisit Exemption Laws
Some states with lower rates of vaccine coverage have begun to re-examine their laws on parental exemptions and tighten the requirements.

  • Despite the total discrediting and eventual retraction of a 1998 article published in The Lancet that linked the MMR vaccine to autism, some parents still believe the link exists. Some national politicians appeared to give credence to that belief in public statements after the newest measles outbreak in early 2015.

  • California legislators are currently considering SB 277 to eliminate the personal belief exemption in its school vaccination requirements. In 2012, the state made the personal belief exemption more restrictive. Effective Jan. 1, 2014, parents, guardians or emancipated minors must obtain the signature of their health care practitioner to obtain the exemption.

  • In Colorado, a bill (SB 77) is advancing in the 2015 legislative session guaranteeing parents’ rights to make medical decisions concerning their children. The proposal would reinforce the state’s existing personal belief exemption for vaccinations. 

  • Pennsylvania legislators have announced plans to introduce bipartisan legislation to eliminate the state’s existing philosophical exemption. House co-sponsor Rep. Becky Corbin, a pharmaceutical
    chemist, notes that Pennsylvania has one of the lowest immunization rates in the nation, and that the philosophical exemption was the most commonly used.





1 Centers for Disease Control and Prevention, “Measles Cases and Outbreaks.” Accessed February 12, 2015.

2 Ranee Seither, et al. “Vaccination Coverage Among Children in Kindergarten –United States, 2013-14 School Year,” Centers for Disease Control and Prevention, MMWR, October 17, 2014/63(41);913-920. 

3 Ibid.


Vaccine Rates for Measles Decline as Exemptions Grow