The number of children who presented excuses for not complying with the vaccination requirements demanded by public schools in all states of the country reached another all-time high in the 2025-2026 academic year, according to federal data published this week: it went from 3.6% of kindergarten students to 4.2%, which means that about 155,000 students were not vaccinated because their parents or caregivers cited personal and religious reasons, the vast majority (medical ones were only 0.2%).
The increase is “disappointing, but not surprising”Dr. David Margolius, director of the Cleveland Department of Public Health, told NBC News. “It is a reflection of the lack of clear messages at the national level about vaccines.”
The fact that the president of the United States, Donald Trump, and health authorities such as the Secretary of Health, Robert F. Kennedy Jr., have questioned the safety of the vaccines is having a tangible effect on the number of skeptics and the drop in vaccination in the country. Trump last week signed an executive order to reduce the number of vaccines recommended for children, a decision that has been criticized by pediatricians and public health advocates.
“There is no new evidence to justify significant changes in the childhood vaccination guideline,” the president of the American Academy of Pediatrics (AAP), Dr. Andrew Racine, reacted in a statement: “Dozens of studies involving millions of people show that there is no relationship between vaccines and autism, and even so, federal leaders continue to promote this outdated and discredited idea to generate fear among families (…) The only thing I see that will happen as a result of the announcement is that higher levels of uncertainty, fear and confusion where they do not need to exist.”
To better understand why this concerns specialists and parents of children who – despite being vaccinated – have weak immune systems or diseases that make them highly vulnerable in the event of an outbreak, we spoke with Dr. Ilan Shapiro, pediatrician and director of medical affairs at AltaMed.
According to him, “the vaccines have worked so well that we have forgotten those waves of polio that we had and all the infections that really filled the pediatric intensive care with brain infections and meningitis. Also the complications of measles, which we have stopped seeing when we give these vaccines.”
- What does a vaccination exemption mean? And why is this figure worrying?
–In the United States there are three different types: medical, religious or personal and philosophical. The medical ones may be related to allergies or to the fact that a person has a very weak immune system and cannot tolerate vaccines that are attenuated viruses. But they are very extreme cases. It is important to remember that the vast majority of monotheistic religions – both Jews, Muslims and Christians – believe in vaccines and are approved by their religious leaders. And finally, the philosophical part: for some reason they are saying ‘this is not for my son’.
- What are the risks of not receiving recommended vaccines for both unvaccinated children and their peers?
–The problem we are having at the moment is that we have fewer people vaccinated: the best example is a ship. Let’s imagine that each unvaccinated person is a hole in that boat: as there are many, water will begin to enter. If there are not so many vaccinated people, that little boat is going to fill with water and sink. We are going to have more illnesses and that is why it is important at this time to consider what the best options are for your son or daughter.
- Most pediatricians and organizations such as the American Academy of Pediatrics advocate for the importance and safety of vaccines. Why is it key for parents to trust science and not get carried away by anecdotal testimonies?
–I perfectly understand all parents with what we see on social media, our neighbors, what we have heard around us, but it is extremely important to fight fear with a dose of truth: the reality is that we already have millions of people who have been studied and really the conclusion is that if we vaccinate and protect people, our children are going to be much healthier, they are going to live longer, they are going to have fewer complications. We must remember that one in five children previously died from these types of infections, something that vaccines and these public health changes have made a big difference: we are no longer seeing that rate.
- Why do you think parents in the United States are increasingly requesting these permits?
–The only thing we want is for our children to be protected, for them to be well, for them to be healthy. When we hear the anti-vaccine theories, it can give us a certain fear: suddenly they say well, one day it was fine, the other day it was no longer fine and absolutely everything is over. So, the truth is that it sounds horrendous. And what do I do as a parent? Well, I better wait, I better wait to see what is going to happen. Either I better jump or I better do this. And that’s where the problem comes, that. We have not seen many of the diseases that existed before: waves of polio, measles, whooping cough. We are no longer seeing them. Because? Because vaccines work.
