All summer long, Dr. Marvia Jones kept coming back to the same unsettling numbers. As director of the Kansas City Health Department, she watched data showing that far too many public school students were not up to date on the vaccinations they needed before the new school year. If things didn’t change, children could be sent home when classes resumed in late August — a disruption that would not only interrupt their learning but also create a logistical nightmare for working families. So Jones tried to meet families where they were. She added more vaccine clinics, brought shots to church picnics and community events, and extended hours so parents who didn’t work traditional schedules could still get their children immunized. But by mid-August, traffic for back-to-school vaccinations was still down between 20 and 30 percent. That’s when Jones scheduled a last-minute news conference with nursing staff from Kansas City Public Schools to plead with parents directly. They also clarified an important point: President Donald Trump’s executive order aimed at reducing the number of recommended childhood vaccines had not actually changed school vaccine requirements in Missouri. Jones understood why parents might feel confused. “I understand having a deluge of information from many sources and just being confused and having concerns,” she said. “There’s no judgment in that.” Within days, the department saw a spike in vaccinations. Jones felt relieved — and a little hopeful. “I was happy and just really elated to know that some aspects of our public health work — despite all the stuff about lack of trust and disintegration of faith in government — that we can do some things that still speak to people,” she told The 19th.
That scene in Kansas City is part of a much larger national story. As parents scramble to make sure their children are protected before heading back to school, public health officials are trying to spread accurate information about vaccines while also pushing back against misinformation from the Trump administration about the safety and effectiveness of immunizations. Medical groups are increasingly worried that this misinformation is contributing to falling vaccination rates among school-aged children. Dr. Michelle Taylor, commissioner of health for the Baltimore City Health Department and chair of the Big Cities Health Coalition, described the situation bluntly: local health departments are now standing in the gap, taking on responsibilities that used to belong to the federal government, especially the Centers for Disease Control and Prevention. The latest CDC data shows why that matters. Vaccination rates for routine childhood vaccines continue to decline among kindergartners. Coverage for the measles, mumps, and rubella (MMR) vaccine remains below the level needed for herd immunity. At the same time, requests for vaccine exemptions are rising — 4.2 percent of kindergartners received exemptions this year, up from 3.6 percent the previous year. “Overall, we’re not seeing what we want to see,” Jones said. “We are not going in the right direction.” The numbers are not abstract; they have real consequences for classrooms, families, and communities.
The stakes are especially high heading into respiratory virus season, which typically runs from fall through spring and is expected to include flu, COVID-19, and RSV. Last season, nearly 200 children died from flu-related complications, and most of those children were not vaccinated. Already, some school districts are on high alert. One district in South Texas canceled classes for two days because of rising COVID cases. In Louisiana, a middle school shut its doors for a day after dozens of teachers and students reported infections. Measles is another major concern. The United States has confirmed more than 3,100 measles cases this year, a figure that has already surpassed the total from the previous year, and some public health experts believe the real number may be even higher because of underreporting. Dr. Andrew D. Racine, president of the American Academy of Pediatrics, warned that even a small drop in vaccination rates can lead to outbreaks of diseases like measles because community immunity requires more than 95 percent of susceptible individuals to be immunized. “This risk is real,” he said. “The United States is experiencing a 35-year high for measles cases as federal officials continue to elevate misleading and disproven information about vaccines, inserting unnecessary fear and confusion into families’ decision making.”
Much of that confusion can be traced to Health and Human Services Secretary Robert F. Kennedy Jr., who co-founded an anti-vaccine organization before being appointed by Trump. In January, Kennedy announced plans to recategorize some childhood vaccines. Shots used to protect against flu, COVID, and RSV — which had previously been recommended for all children — would now be recommended only for high-risk children or after extra consultation with doctors. The American Academy of Pediatrics and other medical groups filed a lawsuit challenging the changes, and the changes did not go into effect. The AAP still recommends all of those vaccines for children. Kennedy has also said he recommends the MMR vaccine, but he has shared misleading information about its safety at the same time. He became involved in a public dispute with Pennsylvania officials, including Governor Josh Shapiro, after the state health department reported two measles-associated deaths involving infants. Those were the first measles deaths reported in the country this year. Kennedy challenged the circumstances surrounding the cases, adding another layer of conflicting headlines for parents trying to figure out what to do.
In Cleveland, Dr. David Margolius, director of the city’s Department of Public Health, described the situation as “swimming against a strong current” of misinformation coming from the White House and the back-and-forth headlines about vaccines and measles. During an executive order signing last month, Trump inaccurately described the MMR vaccine as “quite lethal” and expressed interest in splitting the typically two-shot series into separate shots — a proposal that is not logistically possible anytime soon. Margolius was direct about the challenge: “The current against us is strong, and we’re paddling as hard as we can. It would just be a heck of a lot easier to make progress if the White House started speaking the truth and helping to be part of the solution instead of being part of the problem.” Despite the headwinds, Cleveland has seen some progress. Vaccination rates in Ohio have fallen overall, but Cleveland has improved rates for children entering kindergarten, jumping from 68 percent a few years ago to 76 percent this past school year. The MMR rate for children entering kindergarten is now in the low 80s, which is still below what’s needed for herd immunity, but it’s moving in the right direction. Margolius credits building community trust, bolstering federally qualified health centers, and expanding access to care, including more embedded clinics in Cleveland schools. “We’ve improved, but obviously have a long way to go to where we want to be,” he said.
Public health officials and major medical groups continue to recommend that parents consult their pediatrician or family physician about vaccines, including flu and COVID shots, as the respiratory virus season begins in earnest in the coming weeks. New polling data released in August shows that public confidence in people’s own health care providers remains high, which could be a powerful counterweight to national misinformation. The need is urgent because illness and the threat of disease exposure can be deeply disruptive to both schooling and family life. Quarantine rules can send a child home for days or even weeks, creating a ripple effect on childcare responsibilities in a country that has no federally mandated paid sick time. Jones worries about how fragile the system is when it depends on children never getting sick. “What happens when your child is sick for four days? Does another older kid have to stay home and care for them? Does someone have to miss work? Does someone lose pay? Does someone else get sick? Does an older relative that’s living with them now have to be the childcare provider? And how does that put them at risk, particularly for families that are already unstable in some way — whether it’s due to health or socioeconomic status. So all of these things are interplaying together.” In the end, the path forward is not just about data or policy. It’s about meeting families where they are, rebuilding trust through local clinics and schools, and reminding people that vaccines are one of the safest, most effective ways to keep children healthy and in the classroom.