Kindergarten vaccination rates declined nationally, but are higher in WV 

By: - August 15, 2023 6:00 am
An elementary school classroom with multicolor reading charts on the blue wall on the left side, with activity books laying on a long table below it.

According to information from the West Virginia Department of Health and Human Resources, 68 students requested a medical exemption from a vaccine requirement in 2022, up from 27 in 2021 and 29 in 2020. (Lexi Browning | West Virginia Watch)

The number of kindergarteners to get their school-required vaccinations has declined after the COVID pandemic, but West Virginia’s rate has been higher, a success health leaders say is due to the state’s strong public health policy. 

During the 2021-2022 school year, the latest for which data is available, coverage for all required school vaccinations nationally was around 93 percent, lower than the 94 percent reported in the 2020-2021 school year and the 95 percent reported in the 2019 to 2020 school year.  

Among West Virginia kindergarteners, vaccination rates decreased for each required vaccine between the 2019-2020 school year and the 2021-2022 school years, but was still 96% to 98% for each immunization, according to the latest data. 

Dr. Lisa Costello, president of West Virginia State Medical Association and a member of the American Academy of Pediatrics, said West Virginia state law, which does not allow religious or philosophical exemptions for school-required vaccinations, is the reason for the state’s success at vaccinating children.

“[Strong public health policy] has allowed us to be a leader in the nation in regards to school-age vaccination rates,” Costello said. “This really is important for the public, because by having those high immunization rates, we’re able to have better protection in our communities.”

All states require a series of vaccinations against infectious diseases for students entering schools. West Virginia students entering school for the first time must show proof of five immunizations that protect against diphtheria, pertussis, tetanus, polio, measles, mumps, rubella, varicella and hepatitis B.

According to, formerly Immunization Action Network, West Virginia is one of only five states that do not allow exemptions for vaccine requirements because of religious or personal beliefs. The state requires students to have an approved medical exemption in order forgo the vaccines. 

Costello said any decline in vaccination rates is worrisome because when fewer people in a community are immunized, it opens the door for diseases to resurface. 

“I think sometimes people think the measles doesn’t exist anymore,” Costello said. “The only disease we’ve ever eradicated in the world is smallpox… because of immunization rates declining in some areas, we’ve seen some of these diseases resurface. The diseases still exist. It’s just a matter through immunizations we’ve gotten better at protecting [against] them.”

The pandemic presented challenges for vaccination including closed doctor’s offices and the need to social distance, she said.

“Hopefully we can get back to having stronger immunization rates, and certainly it’s on all of us to continue to try to build vaccine confidence in our communities to ensure that people are able to make informed decisions and choices in knowing the importance that immunizations play,” she said. 

Costello said the state’s strong policies are the reason West Virginia hasn’t seen measles cases, while Ohio and Kentucky, both states that allow religious exemptions for school vaccines, have.

State health officials say West Virginia has not reported a measles case since 2009. 

“We did not see that in West Virginia, because we have really good school aged immunization rates,” Costello said. “A lot of that is because of our strong public health policy as well as our providers in the state are really working to ensure that kids get vaccinated. But I think undoubtedly that strong public health policy is what keeps West Virginia at the top when it comes to school-aged vaccination.”

In Tennessee, a state with similar politics to West Virginia, but looser requirements for school vaccines, state health officials reported that last school year, only 26 of its 95 counties met a threshold of having 95 percent of kindergarteners fully immunized. Tennessee law allows religious exemptions for vaccination. 

According to information from the West Virginia Department of Health and Human Resources, 68 students requested a medical exemption from a vaccine requirement in 2022, up from 27 in 2021 and 29 in 2020.  Of those, 14 were granted a permanent medical exemption and 34 got a temporary exemption. Seventeen requests for an exemption were denied. 

Costello said there could be multiple reasons for an increase in exemption requests last year. As the public continues to have a discussion around vaccinations, Costello said she encourages people to get information about them from trusted sources like the Centers for Disease Control and the American Academy of Pediatrics. 

“Immunizations are one of the most effective and cost saving public health interventions ever introduced,” she said. “I graduated medical school in 2011 and I have never personally seen some of these diseases. And if I did, they had them when they were a child. It’s because of the success of immunization. That’s why it’s really important we do this education and continue to encourage people to stay up to date. Because if we don’t, these diseases can come back.”


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Lori Kersey
Lori Kersey

Lori Kersey is a reporter with a decade of experience reporting in West Virginia. She covers state government for West Virginia Watch.