Here is a six-paragraph news summary of The 19th report:
All summer, Dr. Marvia Jones, director of the Kansas City Health Department in Missouri, watched the data with growing alarm. Reports showed that too many public school students were not up-to-date on their vaccinations ahead of the new school year, meaning children risked being sent home when classes resumed in late August. That prospect threatened not just missed learning but immense logistical strain for working families who would have to arrange sudden childcare. To lower barriers, Jones scheduled additional vaccine clinics at church picnics and community events, and extended clinic hours to accommodate parents with nontraditional work schedules. Yet by mid-August, back-to-school vaccination traffic was still down 20 to 30 percent. In response, Jones held a last-minute news conference with Kansas City Public Schools nursing staff, pleading with parents to immunize their children and clarifying that President Donald Trump’s recent executive order aimed at reducing recommended childhood vaccines had not changed Missouri’s school immunization mandates. “I understand having a deluge of information from many sources and just being confused and having concerns,” Jones said at the news conference. “There’s no judgment in that.” Within days, vaccinations spiked, and Jones felt relieved, saying it proved that public health work can still reach people despite widespread distrust in government.
As children across the country return to classrooms during a back-to-school period that typically runs from late July to early September, public health officials like Jones are working to help families navigate the traditional surge of back-to-school illnesses. But they are doing so while also countering misinformation from the Trump administration about vaccine safety and effectiveness, which medical groups worry is driving down 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, said local health departments are “literally standing in the gap” as state health departments take on roles usually led by federal agencies like the Centers for Disease Control and Prevention. Newly released CDC data shows that routine vaccination rates for kindergartners continue to decline, including the measles-mumps-rubella (MMR) vaccine, which remains below the threshold needed for herd immunity. Requests for vaccine exemptions are also rising, with 4.2 percent of kindergartners receiving exemptions compared with 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 upcoming respiratory virus season, which typically begins in fall and extends into early spring, is expected to include flu, COVID-19, and RSV. Nearly 200 children died last season from flu-related complications, and most cases involved unvaccinated children. Already, some school districts are on high alert: a district in South Texas canceled classes for two days last month because of growing COVID cases, and a middle school in Louisiana closed for a day after dozens of teachers and students reported having COVID. Lynn Nelson, president of the National Association of School Nurses, which serves nearly 20,000 school nurses nationwide, said it is not unusual for students to get sick in the first few weeks after summer or spring break, especially after travel. But now, she said, because vaccination rates are significantly reduced for nearly every disease—in many cases below herd immunity levels—faith communities and neighborhoods are likely to see more vaccine-preventable illnesses appear as children return to school. “The difference now is with the reduced vaccination rates—and they’re significantly reduced for almost everything now, to below what we call herd immunity level—we’re going to be seeing more vaccine-preventable illnesses come back to school as kids come back,” Nelson said.
The country is already experiencing the consequences of declining vaccine coverage. The number of confirmed measles cases in the United States has surpassed 3,100 this year, toppling the total number reported in all of 2025 and reaching a 35-year high; some public health experts believe the figure may be an undercount. Dr. Andrew D. Racine, president of the American Academy of Pediatrics, warned in a statement after the CDC data release that even small drops in vaccination rates can lead to more outbreaks because community immunity requires over 95 percent of susceptible individuals to be immunized. “This risk is real: 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,” Racine said. Health and Human Services Secretary Robert F. Kennedy Jr., who co-founded an anti-vaccine organization before his appointment, announced plans in January to recategorize certain childhood vaccines, including flu, COVID, and RSV shots, so they would be recommended only for high-risk children or after extra consultation with doctors. Those changes did not go into effect because of an ongoing lawsuit by medical groups, including the American Academy of Pediatrics, which still recommends all of those vaccines. Kennedy has recommended the MMR vaccine but has also shared misleading information about its safety, and he is currently in a public dispute with Pennsylvania officials over two measles-associated infant deaths reported in the state.
Dr. David Margolius, director of the Cleveland Department of Public Health, described the situation as public health officials “swimming against a strong current” of misinformation from the White House and the back-and-forth headlines surrounding vaccines and measles. Last month, during an executive order signing, Trump inaccurately described the MMR vaccine as “quite lethal” and expressed interest in splitting its typically two-shot series—a proposal that is not logistically possible in the near term. “The current against us is strong, and we’re paddling as hard as we can,” Margolius said. “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 challenges, Cleveland is making some progress. While vaccination rates in Ohio have fallen overall, Cleveland’s kindergarten entry vaccination rate has risen from 68 percent a few years ago to 76 percent this past school year, and the MMR rate for children entering kindergarten is now in the low 80s—still below herd immunity. Margolius credited building community trust and strengthening federally qualified health centers to improve vaccine access, along with embedding more health 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 advise parents to consult their pediatrician or family physician about vaccines, including flu and COVID shots as respiratory virus season approaches. New polling data released in August found that public confidence in one’s own healthcare provider remains high. Lynn Nelson, who is also a nurse administrator in Washington state, said most parents eventually vaccinate their children once they receive accurate information from a trusted healthcare provider or school nurse. But the delay caused by misinformation is having a real impact, particularly in rural communities with fewer urgent care services. “There’s just so much misinformation about [vaccines] out there, that it slows everything down and people wait longer,” Nelson said. “And when influenza or COVID hits your community, or RSV or pertussis, it might be too late.” Illness or exposure to disease can be very disruptive to both schooling and working families. Quarantine rules can send a child home for days or weeks, creating childcare ripple effects for parents in a country without federally mandated paid sick leave. Jones, in Kansas City, said she worries about how fragile the system becomes when families depend on children staying healthy. “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,” she said. The story was originally published by The 19th.