Despite mountains of research on the efficacy and necessity of vaccines for kids, the number of unvaccinated children is on the rise, according to new CDC reports on unvaccinated children. In addition to kids forgoing vaccines entirely, one report found that more kids are entering kindergarten without full immunizations—for the third year in a row.

The U.S. Centers for Disease Control just released two new reports detailing vaccination trends. While the first study showed that vaccination rates overall  remained steady, the number of unvaccinated kids under age two increased. In 2011 the percentage of unvaccinated kids under two was just 0.9, which rose to 1.3 percent in 2015. In 2001 only 0.3 percent of toddlers 19 to 35 months received no vaccinations.

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While the report doesn’t give an exact reason for the drop in vaccinations, it does state that it could be linked to cost and where families live. “Coverage was lower for most vaccines among uninsured children and those insured by Medicaid, compared with those having private health insurance, and for children living outside of metropolitan statistical areas,” the reported states.

The CDC suggests that this decrease in vaccinations could be corrected by raising awareness of the Vaccines for Children program that provides free vaccinations to American kids who are unable to afford the cost.

The second CDC report looked at vaccine exemption rates among kindergarteners. During the 2017-20118 school year, 2.2 percent of kindergarten students had an exemption from at least one vaccine, while the average rate of coverage for the MMR, DTaP, and varicella vaccines was 95 percent. “Although the overall percentage of children with an exemption was low, this was the third consecutive school year that a slight increase was observed,” the report stated.

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According to the report possible explanations for this increase include greater ease for obtaining exemptions and vaccine hesitancy among parents. However, it’s important to note that the percentage listed as exempt didn’t distinguish between the number of exemptions. In other words, many students with exemptions have still received at least some vaccines.

Some of the reported under-vaccinations might also be due to just plain fear of the doctor. A recent study out of the University of Michigan found that one in 25 parents had delayed vaccinating their kids because their kids were afraid of going to the doctor.

—Shahrzad Warkentin

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