The number of kids whose caregivers are opting them out of routine childhood vaccines has reached an all-time high, the Centers for Disease Control and Prevention reported Thursday, potentially leaving hundreds of thousands of children unprotected against preventable diseases like measles and whooping cough.

The report did not dive into the reasons for the increase, but experts said the findings clearly reflect Americans’ growing unease about medicine in general.

“There is a rising distrust in the health care system,” said Dr. Amna Husain, a pediatrician in private practice in North Carolina, as well as a spokesperson for the American Academy of Pediatrics. Vaccine exemptions “have unfortunately trended upward with it.”

The CDC report found that 3% of children entering kindergarten during the 2022-2023 school year were granted a vaccine exemption from their state. This is the highest exemption rate ever reported in the U.S.

Forty states saw rises in exemptions. In 10 states — Alaska, Arizona, Hawaii, Idaho, Michigan, Nevada, North Dakota, Oregon, Utah and Wisconsin — the exemption rate soared over 5%.

“This is quite a jump,” said Ranee Seither, a CDC epidemiologist and author of the new report. Just three years ago, Seither said, only two states had an exemption rate of more than 5%.

Idaho was a standout in the new report. More than 12% of children entering kindergarten in that state had a vaccine exemption in 2022.

The trend appears to coincide with doubts about Covid vaccines.

“So many people were reluctant to get that new vaccine,” said Dr. Mysheika Roberts, health commissioner for Columbus Public Health. She feared that it would “have a trickle-down effect and impact vaccination coverage for our children.”

The report also found that vaccination rates among young kids have remained stagnant following a pandemic-related dip in coverage.

As of the 2022-2023 school year, vaccination coverage among kindergartners remained at 93%. Before the pandemic, the rate had consistently hovered around 95%.

Generally, populations need 95% immunity to protect against viral outbreaks.

“The fact that we haven’t been able to recover is concerning,” said Shannon Stokley, deputy director for science implementation in CDC’s Immunization Services Division. “It means there are children who may be unprotected from very serious diseases.”

While states differ in their vaccination requirements for attending public and most private schools, they generally include vaccines to protect against measles, mumps and rubella (MMR), diphtheria, tetanus and acellular pertussis (DTaP), poliovirus and chickenpox.

Some states require medical evidence that a child cannot receive a vaccine. In others, parents cite religious or other personal concerns about vaccines.

“It’s very easy to get an exemption in the state of Ohio,” Roberts said. “Very easy.”

It was Roberts who dealt with a measles outbreak in central Ohio this time last year. The first cases were associated with a person who had traveled overseas to an area with an ongoing measles outbreak.

But the virus quickly spread among children left unprotected. Kids who had not been vaccinated against measles, Roberts said, were infected just by being in the same doctor’s office as kids sickened with measles.

Overall, 85 people became ill, all under the age of 16. No deaths were reported, but 36 of those patients had to be hospitalized, mostly for dehydration from intense diarrhea. All of this occurred during a time when hospitals were already dealing with surges in Covid, RSV and flu.

“We really have to have our guard up,” said Dr. Julie Morita, executive vice president of the Robert Wood Johnson Foundation and former head of the Chicago Department of Public Health. “We’ve forgotten how bad these diseases actually are.”

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