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A coalition of public health and community organizations is sounding an alarm over Utah’s falling rate of children entering kindergarten fully vaccinated.

This week, the Community Vaccine Forum released a study, “ The Impact of Declining Vaccination Rates for Children Entering School in Utah.” The groups making up the forum have gathered data on what’s happening as what they call misinformation and mistrust build around vaccines that were created to protect people from some of the most miserable illnesses. They say children will suffer the most if the downward trend in vaccine uptake continues.

The study was created with three goals in mind, according to Michael Stapley, forum chairperson. First, the groups wanted to assess whether the existing drop in vaccine uptake creates a “genuine public health concern.” They also wanted to spark “responsible and informed discussion” about vaccines for children, he said, and provide accurate information to counter misrepresentations that have been gaining a foothold.

“The gravity of infectious disease and the importance of vaccines in managing them are well-documented,” per the report, which said that when well-intentioned individuals challenge the value of vaccines for children, it can “heighten the potential for a disease epidemic and represent a legitimate public health concern.”

The study was designed, per the report, to answer whether having a highly vaccinated population improves well-being.

Members of the Community Vaccine Forum include the Utah Citizens’ Counsel, Promise Partnership Utah, Voices for Utah Children, Utah Medical Association, Utah Chapter of the American Academy of Pediatrics and the Utah Department of Health and Human Services.

Close look at measles

Because measles — long considered eliminated in the U.S. — has the highest number of cases in decades, much of the report’s emphasis is on that highly-contagious illness. Oxford Academic, cited in the report, has reported that one person with measles in an unvaccinated population could infect 12 to 18 others, who could then each go on to infect 12 to 18 others in similar circumstances. Controlling an outbreak requires that 93%-94% of those nearby have immunity by way of vaccination or previous infection, which is called “herd immunity.”

Measles spread in the U.S. this year is worse than in more than three decades. There are at least 1,288 cases nationally so far in 2025. Utah now has nine cases, but there are large outbreaks in some states, including Texas and New Mexico. America’s measles-free status is at risk. The Associated Press reported it could happen ”if the virus has nonstop spread for 12 months."

As for the measles, mumps and rubella combined vaccination, in the 2005-2006 school year, 98.3% of children entering kindergarten had gotten it. That number had fallen to 88.8% for the 2023-24 school year, according to CDC data.

Vaccination doesn’t stop the measles virus from entering one’s body, but it does reduce the risk of becoming ill from it, the report said. Folks who are partially or fully vaccinated could even spread the virus, but “many studies conclude that this happens at a much lower rate compared to those who are unvaccinated.” CDC has said vaccinated people are less likely to transmit the disease, including to those who are too young to be vaccinated or who have weakened immune systems.

Vaccination falling in Utah

The report cites historical data to quantify how easily different diseases spread, using data from before vaccine was introduced for each one. Out of 1,000 children, 900 exposed to measles would contract it. That’s second only to smallpox, where the number is 950. Given 1,000 children exposed to pertussis (whooping cough), 700 could become ill.

“The first measles outbreak in the Americas was so infectious that it spared almost no one,” the report notes. “It caused a vivid red rash and fevers that spiked so high and lasted so long that the sick searched desperately for relief from the fire of measles. In populations that had never encountered the virus before, measles could kill up to a quarter of people.”

Although measles is less apt to kill than in the past, there are a range of complications, including pneumonia, rare cases of severe brain inflammation and a weaker immune system that can persist after measles leaves.

Measles vaccine was introduced in 1963 and the number of cases by 2017 had fallen by 99.9%, per the Centers for Disease Control and Prevention.

Preventing transmission of measles and other highly contagious illnesses has depended on herd immunity, but in Utah, just 26.5% of schools met that benchmark for measles vaccination in 2023-24.

“When measles vaccination levels for a school fall to 90%,” per the report, “the chance of a community outbreak following the arrival of a child with measles rises to 51%.” As vaccination rates drop lower, the risk rises, but not in a linear fashion.

According to data from the Utah Department of Health and Human Services, in the 2023-2024 school year, Murray School District had the highest vaccination rate at 93%, just ahead of Tooele and Ogden School District. North Sanpete and Kane both had 75% of kindergartners adequately vaccinated, based not just on measles but on overall vaccination requirements.

State law allows for exemptions for medical, personal or religious reasons. And parents can request an exemption from some vaccines and not others, though Stapley said parents asking for exemptions tend to go for the whole slate of vaccines. He said the biggest increase has been in those seeking an exemption on religious grounds, but added he knew of just one faith in Utah that opposes vaccines — and it’s got a small footprint in Utah.

Vaccine safety is the main concern cited on the exemption request form, Stapley said.

The study showed there are various reasons vaccination rates among children have fallen in Utah, including public awareness of the severity of illness slipping because the diseases are not seen as often, as well as the politicization of vaccines. The report also cited misinformation.

According to the state’s immunization program, the total number of exemptions has doubled from the 2015-16 rate of 4.6% to the 2023-24 rate of 9.3%.

Countering the claims

The report disputes claims that vaccines for childhood infectious diseases have not been well studied in clinical trials. In a rare use of bold type, the report notes that “perhaps the most compelling truth is that vaccines for childhood infectious diseases have been around for generations and have been safely administered to millions of children. Contrary to what some may claim, the fact remains that childhood vaccinations have undergone extensive clinical trials before public use.”

Stapley acknowledged that the vaccines are not entirely without risks; they are medications. There can be allergies or side effects. But the report quantifies them, he said.

For instance, for the measles vaccine, 1 in 10 recipients get a fever and 1 in 20 develop a rash, similar to the share who get swollen lymph nodes. Joint pain is a side effect for 1 in 200. Serious side effects are rarer: 1 in 30,000 develop immune thrombocytopenic purpura, 1 in 1,500 have a febrile seizure and 1 in 700,000 have anaphylaxis.

The study showed that risk from measles without vaccine is greater: 1 in 1,000 die and a like number have encephalitis, 1 in 20 develop pneumonia. Between 20% and half are hospitalized, 1 in 20,000 develop the immune thrombocytopenic purpura, and between seven years and a decade after measles infection, 1 in 1,300 develop subacute sclerosing panencephalitis, which is sometimes fatal.

According to the report, since 1986 when Congress set up a reporting system, there have been 25,000 claims of injury made to the Vaccine Injury Compensation Program, with half of them receiving some compensation. “This amounts to one compensated injury for every 1 million doses of vaccine distributed,” the forum reported.

Among the most enduring claims is that there’s a link between the measles-mumps-rubella vaccine and autism. That claim gained traction with a study years ago involving 12 children that was published in the journal The Lancet. The journal retracted it in 2010 after other studies directly refuted findings and the study was deemed “critically flawed.” In Britain, the General Medical Council revoked the lead author’s medical license after finding that, among other things, he failed to disclose that the research received funding from lawyers suing vaccine manufacturers.