Record measles cases and rising childhood exemptions are raising alarms about why vaccination rates are falling in the U.S. Public health experts say a growing share of Americans occupy an uncertain middle, neither firmly pro-vaccine nor opposed, and are vulnerable to mixed messages about safety and effectiveness.
Survey findings released in July by health policy research organization KFF indicate that only a small fraction of adults fully accept common myths about vaccines. KFF presented four widely circulated false claims and found fewer than 1 in 10 respondents said each was definitely true. At least half of respondents fell into a gray area, labeling the claims as probably true or probably false. KFF CEO Drew Altman said many people are confused about whom and what to trust, leaving them undecided and open to persuasion. He cautioned that uncertainty can lead people to delay or avoid vaccination decisions.
Experts note that most Americans still receive recommended shots. Yet even modest declines in coverage can allow highly contagious viruses such as measles to circulate, according to Jess Steier, a public health scientist and founder and CEO of Unbiased Science. She added that people with questions can be reached with clear, evidence-based guidance and conversations with trusted clinicians. “Uncertainty can resolve once people have time, information and access,” she said.
Why vaccination rates are falling
Vaccine hesitancy is more nuanced than outright opposition, Steier said. Social media platforms, which often amplify emotionally charged content, and the current political climate contribute to confusion by exposing people to conflicting claims. Some of those messages come from political figures, including President Donald Trump and Health and Human Services Secretary Robert F. Kennedy Jr. Kennedy has said he is not anti-vaccine, while critics and medical experts have documented repeated inaccuracies in his statements about vaccine safety and efficacy.
Drawing on years of questions and feedback on Unbiased Science’s social channels, Steier said the group developed a framework to understand vaccine hesitancy. A narrower version, called “LANDS,” was created with the National Alliance of State Pharmacy Associations to support pharmacists, who now administer many adult vaccines. The framework outlines five broad groups: Lost, people confused by conflicting information; Anxious, people worried about side effects; Naturalists, who favor natural immunity and are skeptical of medical interventions; Distrusters, who harbor broader suspicions of institutions; and Shruggers, who do not prioritize vaccinations for themselves. Steier and other experts, including Dr. Lori Handy of Children’s Hospital of Philadelphia, emphasized that individuals may not fit neatly into one category and that beliefs can vary by vaccine.
Personal dynamics can also shape decisions. A 19-year-old from Pennsylvania, who asked to use only his first name, Andrew, said his family’s views, influenced by misinformation, distrust of healthcare and government, and religious background, led him to avoid vaccines. After researching on his own, he plans to start catching up on recommended shots, though he still worries about side effects and potential family conflict.
Measles cases rise, childhood vaccinations fall
Uncertainty is emerging as the U.S. confronts a surge in measles. The Centers for Disease Control and Prevention reported 2,777 confirmed cases and 36 new outbreaks across 47 jurisdictions so far this year, a 35-year high that exceeds the record set in 2025. More than 93% of those infected are unvaccinated or have unknown vaccination status, according to the CDC.
At the same time, childhood vaccination coverage for kindergartners has slipped to about 92 percent, and nonmedical exemptions climbed to a record 4.2 percent during the 2025–2026 school year, the CDC said. That level represents an estimated 155,000 children and leaves some communities more vulnerable to preventable disease.
Steier said measles spreads easily where vaccination rates dip. Handy said concerns about the measles, mumps and rubella vaccine trace back at least to 2000 and a now-retracted paper that tried to link the shot to autism, despite extensive research finding no association. She said recent political rhetoric has compounded doubts, citing calls this month by Trump to split the MMR vaccine into separate shots and his unsupported claims tying vaccines to autism. Handy said such statements from high-profile leaders can erode parental confidence even as pediatric and infectious disease experts continue to recommend the MMR vaccine based on a strong safety record.
Conflicting messages from government, clinicians and other authorities have made vaccine science feel partisan to some parents, Handy said, complicating their decisions about whom to trust.
Approaching hesitant individuals about why vaccination rates are falling
Health experts recommend starting with listening. Steier said providers should first understand what drives a person’s concerns instead of simply instructing them. Handy advised acknowledging that many people seek health information on platforms such as TikTok, then helping them compare what they see online with evidence from reputable medical sources.
Open, tailored conversations can help people weigh risks and benefits. Handy added that vaccines are, in a sense, victims of their own success, because many parents have not seen illnesses like measles firsthand and may underestimate the disease risk relative to the vaccine. She urged families to reassess today’s risk environment to keep children safe.
Parents also face financial pressures as they juggle health, work and savings priorities. For some, decisions about preventive care compete with choices about where to keep cash, from checking accounts to products like a 16-month CD, even as public health officials stress the long-term value of staying up to date on recommended vaccines.