Childhood Vaccine in US 2026
Childhood vaccination remains one of the most critical public health interventions protecting American children from preventable infectious diseases. However, recent data reveals concerning trends showing declining coverage rates across multiple vaccines and rising exemption numbers throughout the United States during the 2024-25 school year. Understanding current vaccination statistics helps parents, healthcare providers, and policymakers make informed decisions about protecting children’s health and preventing disease outbreaks in communities.
The landscape of childhood immunization in the United States has undergone significant changes during 2025 and early 2026, marked by declining vaccination rates among kindergarteners, substantial increases in vaccine exemptions, and major policy shifts at the federal level. In January 2026, the CDC implemented an unprecedented overhaul of the childhood vaccine schedule, reducing vaccines recommended for all children from 18 diseases to 11 diseases. These developments have sparked widespread discussion among medical professionals, public health experts, and families nationwide about the future direction of childhood vaccination programs and their impact on disease prevention.
Interesting Facts and Latest Statistics for Childhood Vaccine in the US 2026
| Key Vaccination Facts for the US in 2026 | Statistics |
|---|---|
| MMR Vaccination Coverage Among Kindergartners in 2024-25 | 92.5% |
| DTaP Vaccination Coverage Among Kindergartners in 2024-25 | 92.1% |
| Polio Vaccination Coverage Among Kindergartners in 2024-25 | 92.5% |
| Varicella Vaccination Coverage Among Kindergartners in 2024-25 | 92.1% |
| Vaccine Exemption Rate Among Kindergartners in 2024-25 | 3.6% |
| Number of Kindergartners with Exemptions in 2024-25 | Approximately 138,000 children |
| Non-Medical Exemption Rate in 2024-25 | 3.4% (all-time high) |
| Measles Cases Reported in the US in 2025 | Over 2,100 cases |
| Number of Measles Outbreaks in 2025 | 49 outbreaks |
| Percentage of States Below 95% MMR Coverage Target | 39 out of 49 reporting states |
| States with Exemption Rates Exceeding 5% in 2024-25 | 17 states |
| Number of Diseases in Revised CDC Vaccine Schedule (2026) | 11 diseases (reduced from 18) |
| Rotavirus Vaccine Coverage by Age 8 Months (Children Born 2020-21) | 71.8% |
| Combined 7-Vaccine Series Coverage by Age 24 Months | 72.8% |
Data Source: Centers for Disease Control and Prevention (CDC), National Immunization Survey-Child, National Immunization Survey-Teen, SchoolVaxView, Department of Health and Human Services, 2024-2025
These statistics reveal multiple critical trends affecting childhood vaccination in the United States. The MMR vaccination coverage of 92.5% among kindergartners falls significantly below the 95% threshold needed to maintain herd immunity and prevent measles outbreaks in communities. This gap has direct consequences, as evidenced by the over 2,100 measles cases reported throughout 2025, representing the highest annual total since measles was declared eliminated in the United States in 2000.
The rising exemption rate of 3.6% represents an all-time high and marks the fourth consecutive year of record-breaking exemption numbers. Most concerning is that non-medical exemptions reached 3.4%, indicating that a growing number of families are choosing to delay or decline vaccinations for personal or philosophical reasons rather than legitimate medical contraindications. The geographic variation is striking, with Idaho reporting a 15% non-medical exemption rate while Connecticut maintains just 0.1%, demonstrating how state policies dramatically influence vaccination behaviors. The January 2026 revision of the CDC childhood vaccine schedule marked a historic shift in federal vaccination policy, reducing universal recommendations from 18 diseases to 11 diseases and creating new categories for risk-based and shared decision-making vaccinations.
Kindergarten Vaccination Coverage in the US 2024-25
| Vaccine Type | National Coverage Rate 2024-25 | Coverage Rate 2023-24 | Coverage Rate 2019-20 (Pre-Pandemic) | Change from Previous Year |
|---|---|---|---|---|
| MMR (Measles, Mumps, Rubella) | 92.5% | 92.7% | 95.2% | -0.2 percentage points |
| DTaP (Diphtheria, Tetanus, Pertussis) | 92.1% | 92.3% | 95.1% | -0.2 percentage points |
| Polio | 92.5% | 92.7% | 95.0% | -0.2 percentage points |
| Varicella (Chickenpox) | 92.1% | 92.3% | 94.8% | -0.2 percentage points |
| Any Vaccine Exemption | 3.6% | 3.3% | 2.5% | +0.3 percentage points |
| Medical Exemptions | 0.2% | 0.2% | 0.2% | No change |
| Non-Medical Exemptions | 3.4% | 3.1% | 2.3% | +0.3 percentage points |
Data Source: Centers for Disease Control and Prevention, SchoolVaxView, National Immunization Survey 2024-2025 School Year
During the 2024-25 school year, vaccination coverage among kindergartners decreased across all reported vaccines compared to the previous year, continuing a troubling multi-year trend that began during the COVID-19 pandemic. The data shows that approximately 286,000 kindergarteners entered school without complete MMR vaccination, leaving them vulnerable to measles infection and contributing to community transmission risk. These coverage rates reflect the traditional CDC schedule that was in place through December 2025, before the January 2026 schedule revision.
All four major childhood vaccines tracked by the CDC fell below the critical 93% coverage threshold, with rates ranging from 92.1% for DTaP and varicella to 92.5% for MMR and polio. These declines may appear modest when viewed as percentage points, but they represent thousands of unprotected children who could become infected and spread diseases within schools and communities. Coverage with MMR, DTaP, polio, and varicella vaccines decreased in more than half of all reporting states compared to the 2023-24 school year, indicating that declining vaccination is a nationwide phenomenon rather than isolated to specific regions. The 3.4% non-medical exemption rate represents the highest level ever recorded and demonstrates growing vaccine hesitancy among American parents.
State-Level Vaccination Coverage Variations in the US 2024-25
| State Category | MMR Coverage Range | DTaP Coverage Range | Exemption Rate | Representative States |
|---|---|---|---|---|
| Highest Coverage States | 96.0% – 98.2% | 96.0% – 98.2% | 0.1% – 1.5% | Connecticut, Virginia, Mississippi, New York, Rhode Island |
| Moderate Coverage States | 90.0% – 95.9% | 90.0% – 95.9% | 2.0% – 4.9% | California, Texas, Illinois, Pennsylvania, Ohio |
| Lowest Coverage States | 78.5% – 89.9% | 78.3% – 89.9% | 5.0% – 15.4% | Idaho, Utah, Colorado, Florida, Minnesota, Wisconsin |
| States Exceeding 5% Exemption Threshold | Variable | Variable | >5.0% | 17 states total including Idaho (15.4% highest) |
Data Source: Centers for Disease Control and Prevention, SchoolVaxView State-Level Reports 2024-2025
Geographic disparities in childhood vaccination coverage reveal stark differences across the United States. Connecticut led the nation with 98.2% coverage for both MMR and DTaP vaccines, while Idaho reported the lowest coverage at 78.5% for MMR and 78.3% for DTaP. This 20 percentage point gap between the highest and lowest performing states represents hundreds of thousands of children with vastly different levels of protection based solely on where they live.
States with only medical exemptions tend to achieve higher vaccination rates, while states allowing philosophical or religious exemptions generally have lower coverage. The 17 states with exemption rates exceeding 5% face particular challenges, as they cannot mathematically achieve the 95% coverage target even if every non-exempt child were fully vaccinated. These geographic pockets of low vaccination create vulnerabilities where disease outbreaks can take hold and spread rapidly through unprotected populations. Connecticut, Virginia, and Mississippi—which maintain strict medical-only exemption policies—consistently demonstrate the highest vaccination coverage rates, while states with broad exemption allowances struggle to reach protective immunity thresholds.
Infant and Toddler Vaccination Coverage by Age 24 Months in the US 2021-23
| Vaccine Series | Coverage Among Children Born 2020-2021 | Coverage Among Children Born 2018-2019 | Change |
|---|---|---|---|
| DTaP (4+ doses) | 82.7% | 84.0% | -1.3 percentage points |
| Polio (3+ doses) | 93.3% | 94.1% | -0.8 percentage points |
| MMR (1+ dose) | 93.1% | 94.7% | -1.6 percentage points |
| Hib (Full series) | 80.3% | 82.5% | -2.2 percentage points |
| Hepatitis B (3+ doses) | 92.4% | 93.2% | -0.8 percentage points |
| Varicella (1+ dose) | 93.3% | 94.6% | -1.3 percentage points |
| PCV (4+ doses) | 84.9% | 86.7% | -1.8 percentage points |
| Combined 7-Vaccine Series | 72.8% | 74.4% | -1.6 percentage points |
| Rotavirus (Complete series by 8 months) | 71.8% | 73.3% | -1.5 percentage points |
Data Source: Centers for Disease Control and Prevention, National Immunization Survey-Child (NIS-Child), 2021-2023
Vaccination coverage among infants and toddlers by age 24 months declined across all recommended vaccines for children born during 2020-2021 compared to those born during 2018-2019. The most significant decline occurred in Haemophilus influenzae type b (Hib) coverage, which dropped 2.2 percentage points from 82.5% to 80.3%, followed by pneumococcal conjugate vaccine (PCV) which decreased 1.8 percentage points from 86.7% to 84.9%. These declines reflect disruptions to routine pediatric care during the COVID-19 pandemic and growing vaccine hesitancy among parents.
The combined 7-vaccine series coverage of 72.8% means that only about 7 out of every 10 children received all recommended vaccinations by their second birthday, falling well short of the Healthy People 2030 target of 90% for DTaP. Rotavirus vaccination coverage remained substantially lower than other infant vaccines at 71.8%, continuing a longstanding pattern where rotavirus vaccination lags 15-20 percentage points behind other routine childhood vaccines. This lower coverage for rotavirus is attributed to the narrow age restrictions for completing the series, which requires all doses to be administered before the child turns 8 months old, giving providers a limited window for catch-up vaccination.
Revised CDC Childhood Vaccine Schedule in the US 2026
| Vaccine Category | Diseases Covered | Number of Diseases | Implementation Date |
|---|---|---|---|
| Recommended for All Children | Diphtheria, Tetanus, Pertussis (DTaP), Haemophilus influenzae type b (Hib), Pneumococcal disease (PCV), Polio, Measles, Mumps, Rubella (MMR), Varicella (Chickenpox), HPV | 11 diseases | January 5, 2026 |
| Risk-Based or High-Risk Groups | Rotavirus, Meningococcal disease, Hepatitis A, Hepatitis B, Influenza, COVID-19, RSV | 7 diseases | January 5, 2026 |
| Previous Universal Recommendations (2024) | All of the above | 18 diseases | Through December 31, 2025 |
| Diseases Added to Shared Decision-Making | Rotavirus, COVID-19, Influenza, Meningococcal, Hepatitis A, Hepatitis B | 6 diseases | January 5, 2026 |
Data Source: Department of Health and Human Services, Centers for Disease Control and Prevention, January 2026
On January 5, 2026, the CDC implemented an unprecedented overhaul of the childhood vaccination schedule following a Presidential Memorandum issued by President Trump on December 5, 2025. This directive instructed federal health officials to examine how peer developed nations structure their childhood vaccination schedules and align the United States schedule with international consensus. The resulting changes reduced vaccines recommended for all children from 18 diseases to 11 diseases, representing the most significant revision to childhood vaccination policy in modern American history.
The 11 vaccines continuing as universal recommendations include those with international consensus among peer nations: diphtheria, tetanus, pertussis (whooping cough), Haemophilus influenzae type b (Hib), pneumococcal conjugate, polio, measles, mumps, rubella, varicella (chickenpox), and human papillomavirus (HPV). The CDC now recommends only one dose of HPV vaccine instead of the previous two-dose recommendation, following evidence that single-dose effectiveness matches two-dose protection. Vaccines moved to risk-based or shared clinical decision-making categories include rotavirus, hepatitis A and B, influenza, COVID-19, meningococcal disease, and RSV. All vaccines remain fully covered by insurance without out-of-pocket costs, including those in the risk-based and shared decision-making categories.
Public Health Trust and Childhood Vaccination Trends in the US 2020-2026
| Public Health Metric | 2020 | 2024 | Change |
|---|---|---|---|
| Public Trust in US Public Health | 72% | 40% | -32 percentage points |
| COVID-19 Vaccine Uptake in Children (by 2023) | Not applicable | Less than 10% | **— ** |
| Kindergarten MMR Coverage | 94.9% | 92.7% (2023-24) | -2.2 percentage points |
| Countries Compared in CDC Assessment | Not applicable | 20 peer developed nations | — |
| US Ranking in Number of Childhood Vaccine Doses (2024) | Not applicable | More than any peer nation | — |
| Denmark Childhood Vaccine Diseases Covered | Not applicable | 10 diseases | — |
| US Childhood Vaccine Diseases Covered (2024) | Not applicable | 18 diseases | — |
Data Source: Department of Health and Human Services, Centers for Disease Control and Prevention, National Immunization Survey, 2020-2024
The decline in public trust in United States public health institutions represents one of the primary factors driving the January 2026 revision of the childhood vaccine schedule. Trust plummeted from 72% in 2020 to just 40% in 2024, coinciding with public health controversies during the COVID-19 pandemic including vaccine mandates and changing guidance. This erosion of confidence had measurable impacts on vaccination behavior, with childhood vaccination coverage declining across multiple vaccines during the same period.
The assessment conducted by federal health officials compared the United States with 20 peer developed nations and found that the US recommended more childhood vaccines than any other country, and more than twice as many doses as some European nations. Denmark emerged as a key comparison point, immunizing children against 10 diseases compared to the 18 diseases covered in the 2024 US schedule, yet maintaining strong child health outcomes and high voluntary vaccination rates. Federal officials cited this evidence alongside declining vaccination rates as justification for reducing universal recommendations and creating more flexibility through risk-based and shared decision-making categories. Critics, including the American Academy of Pediatrics, strongly opposed the changes, warning they could increase confusion and further erode vaccination coverage.
Rotavirus Vaccination Coverage in the US 2015-2023
| Birth Year Cohort | Rotavirus Complete Series Coverage (by 8 months) | DTaP 4+ Doses Coverage (by 24 months) | Coverage Gap |
|---|---|---|---|
| Children Born 2013 | 73.2% | 84.2% | 11.0 percentage points |
| Children Born 2015 | 73.3% | 84.6% | 11.3 percentage points |
| Children Born 2018-2019 | 73.3% | 84.0% | 10.7 percentage points |
| Children Born 2020-2021 | 71.8% | 82.7% | 10.9 percentage points |
| Hospitalizations Prevented Annually | 40,000-50,000 hospitalizations | — | — |
| Vaccine Effectiveness Against Severe Disease | 85%-98% | — | — |
Data Source: Centers for Disease Control and Prevention, National Immunization Survey-Child, Pink Book Chapter 19 Rotavirus, 2015-2023
Rotavirus vaccination coverage has consistently lagged 10-11 percentage points behind other routine infant vaccinations across multiple birth cohorts. For children born during 2020-2021, only 71.8% received the complete rotavirus vaccine series by 8 months of age, compared to 82.7% who received 4 or more doses of DTaP by 24 months. This persistent coverage gap exists despite rotavirus being highly effective, preventing 85% to 98% of severe rotavirus illness and hospitalization during an infant’s first year.
The lower coverage stems primarily from the narrow age restrictions for rotavirus vaccination. All doses must be completed before a child turns 8 months old, with the first dose required before 15 weeks of age, creating a limited window for catch-up vaccination if doses are delayed or missed. Under the January 2026 revised CDC schedule, rotavirus vaccination moved from a universal recommendation to the shared clinical decision-making category, meaning providers and parents will discuss whether vaccination is appropriate based on individual circumstances. Each year, rotavirus vaccination prevents an estimated 40,000 to 50,000 hospitalizations among US infants and young children, and vaccinated children provide indirect protection to unvaccinated individuals by reducing disease transmission in communities.
Vaccination Coverage Disparities by Demographics in the US 2021-2023
| Demographic Category | Combined 7-Vaccine Series Coverage | Rotavirus Complete Series Coverage | MMR Coverage |
|---|---|---|---|
| Children with Private Insurance | 75.2% | 79.1% | 94.8% |
| Children with Medicaid | 71.4% | 68.5% | 92.3% |
| Uninsured Children | 65.1% | 56.5% | 88.7% |
| Non-Hispanic White Children | 74.6% | 75.6% | 94.2% |
| Non-Hispanic Black Children | 71.8% | 69.7% | 92.9% |
| Hispanic Children | 72.3% | 71.2% | 93.4% |
| American Indian/Alaska Native Children | 67.9% | 61.5% | 90.1% |
| Children in Metropolitan Areas | 73.1% | 72.7% | 93.6% |
| Children in Non-Metropolitan Areas | 71.2% | 68.6% | 92.4% |
Data Source: Centers for Disease Control and Prevention, National Immunization Survey-Child, 2021-2023
Significant vaccination coverage disparities exist across demographic groups in the United States. Uninsured children have substantially lower coverage across all vaccines, with only 65.1% receiving the combined 7-vaccine series by age 24 months compared to 75.2% of privately insured children, representing a 10.1 percentage point gap. For rotavirus specifically, the disparity is even more pronounced, with uninsured children achieving only 56.5% coverage versus 79.1% for privately insured children, a gap of 22.6 percentage points.
Racial and ethnic disparities are particularly evident among American Indian and Alaska Native children, who had the lowest coverage across all categories with 67.9% receiving the combined vaccine series, 61.5% receiving rotavirus vaccination, and 90.1% receiving MMR vaccination. Geographic disparities between metropolitan and non-metropolitan areas averaged 1-2 percentage points lower coverage in rural areas, though this gap is smaller than insurance-based or racial/ethnic disparities. Addressing these vaccination inequities requires targeted interventions to reduce financial barriers, improve healthcare access in underserved areas, and combat vaccine hesitancy through culturally appropriate education and community engagement. The Vaccines for Children (VFC) program provides no-cost vaccines to eligible children, but enrollment and awareness challenges persist in reaching all uninsured and underinsured families.
Hepatitis B Vaccination Policy Changes in the US 2025-2026
| Hepatitis B Vaccination Metric | Previous Recommendation | Updated Recommendation (December 2025) |
|---|---|---|
| Birth Dose Timing (Infants ≥2,000 grams) | Within 24 hours of birth | Within 24 hours of birth if medically stable |
| Birth Dose for Infants <2,000 grams | Within 24 hours regardless of weight | Delay until hospital discharge or age 1 month |
| Universal Recommendation Status | Recommended for all children (through 2025) | Shared clinical decision-making (January 2026) |
| Coverage by Age 24 Months (Children Born 2020-21) | 92.4% (3+ doses) | — |
| Series Completion Requirement | 3-dose series (0, 1-2, 6-18 months) | 3-dose series (0, 1-2, 6-18 months) |
Data Source: Centers for Disease Control and Prevention, ACIP Recommendations, HHS Fact Sheet, December 2025-January 2026
In December 2025, the Advisory Committee on Immunization Practices (ACIP) voted to update hepatitis B vaccination recommendations for newborn infants, followed by the January 2026 reclassification of hepatitis B from a universal recommendation to shared clinical decision-making. The December timing change allows infants weighing less than 2,000 grams at birth to delay the hepatitis B birth dose until hospital discharge or 1 month of age, rather than requiring vaccination within 24 hours regardless of birthweight. This modification recognizes that very low birthweight infants may have reduced immune responses when vaccinated immediately after birth.
Under the January 2026 revised schedule, hepatitis B vaccination moved from a universal recommendation for all children to the shared clinical decision-making category. This means providers and families will discuss whether hepatitis B vaccination is appropriate based on individual risk factors such as maternal hepatitis B status, household exposures, geographic prevalence, and other considerations. Hepatitis B coverage by age 24 months remained relatively high at 92.4% for children born during 2020-2021, suggesting strong parental acceptance of this vaccine. All three doses remain fully covered by insurance without out-of-pocket costs even under the new shared decision-making framework, and the vaccine continues to be recommended for high-risk groups including infants born to hepatitis B positive mothers.
International Comparison of Childhood Vaccine Schedules in 2024-2025
| Country | Number of Diseases in Routine Childhood Schedule | MMR Vaccination Approach | Hepatitis B Universal Recommendation | Influenza Universal Recommendation |
|---|---|---|---|---|
| United States (2024) | 18 diseases | 2 doses MMR | Yes (birth dose + series) | Yes (annual) |
| United States (2026) | 11 diseases (universal) | 2 doses MMR | Shared decision-making | Shared decision-making |
| Denmark | 10 diseases | 2 doses MMR | No (risk-based only) | No (risk-based only) |
| United Kingdom | 12 diseases | 2 doses MMR | Yes | No (risk-based only) |
| Germany | 13 diseases | 2 doses MMR | Yes | Recommended but not mandatory |
| Australia | 14 diseases | 2 doses MMR | Yes | Yes (annual for children) |
| Canada | 12-14 diseases (varies by province) | 2 doses MMR | Yes | Yes (annual) |
Data Source: Department of Health and Human Services Scientific Assessment, CDC International Comparison, December 2025
The international comparison conducted by US federal health officials revealed that the United States recommended vaccinations against 18 diseases in 2024, more than any peer developed nation examined. Denmark’s schedule covering 10 diseases represented the lower end of the range among wealthy nations, while most peer countries fell between 12-14 diseases in their routine childhood immunization schedules. This comparison became a central justification for the January 2026 US schedule revision.
All peer nations examined maintain 2-dose MMR vaccination as a universal recommendation, demonstrating international consensus on measles, mumps, and rubella prevention. However, significant variation exists for other vaccines: hepatitis B birth dose vaccination is not universally recommended in Denmark and some other European nations, which instead target high-risk groups. Similarly, annual influenza vaccination for all children is recommended in the United States, Canada, and Australia, but is limited to high-risk groups in the United Kingdom, Denmark, and Germany. The assessment found that countries without vaccine mandates achieved vaccination rates as high as the United States and other countries with vaccine mandates, suggesting that public trust and voluntary uptake can be effective when combined with accessible healthcare systems and strong provider recommendations.
HPV Vaccination Coverage Among Adolescents in the US 2024-2025
| HPV Vaccination Metric | Coverage Among Ages 13-17 | Details |
|---|---|---|
| At Least One Dose Initiated | 78.2% | Adolescents 13-17 years |
| Up to Date with HPV Series | 62.9% | Completed age-appropriate doses |
| Recommended Age for Initiation | 11-12 years | Can start at age 9 years |
| Previous Dose Recommendation | 2 doses (ages 9-14) | Through December 2025 |
| Revised Dose Recommendation (2026) | 1 dose | Effective January 2026 |
| Completion Rate for 3-Dose Series (Immunocompromised) | Variable | Still requires 3 doses |
Data Source: Centers for Disease Control and Prevention, National Immunization Survey-Teen, HHS Fact Sheet, January 2026
HPV vaccination coverage among adolescents ages 13-17 years shows that 78.2% have initiated the vaccine series with at least one dose, but only 62.9% are up to date with the complete series, representing a 15.3 percentage point gap between initiation and completion. This completion gap has been a persistent challenge in HPV vaccination programs, as the multi-dose requirement spread over months creates opportunities for adolescents to fall behind schedule.
The January 2026 CDC schedule revision addressed this challenge by reducing the recommended HPV doses from two doses to one dose for adolescents who begin the series at ages 9-14 years. This change follows scientific evidence demonstrating that one dose of HPV vaccine provides equivalent protection to two doses against HPV-related cancers. Several peer nations including the United Kingdom and Canada had already implemented one-dose HPV schedules with successful outcomes. The simplified one-dose recommendation is expected to improve completion rates and reduce the burden on adolescents and families, while immunocompromised individuals will still require a 3-dose series for adequate protection. HPV vaccination remains a universal recommendation for all adolescents in the revised 2026 schedule, continuing as one of the 11 diseases covered by routine childhood immunization.
Economic Impact of Childhood Vaccination in the US 2007-2024
| Economic Metric | Estimated Value | Time Period |
|---|---|---|
| Rotavirus Healthcare Cost Savings | $924 million | 2007-2011 (4 years) |
| Rotavirus Clinic Visits Prevented Annually | 280,000 visits | 2007-2011 average |
| Rotavirus Emergency Department Visits Prevented Annually | 62,000 visits | 2007-2011 average |
| Rotavirus Hospitalizations Prevented Annually | 40,000-50,000 hospitalizations | Current estimate |
| Median Reduction in Rotavirus Hospitalizations Post-Vaccine | 80% | Since 2007 |
| Measles Hospitalization Rate Among Unvaccinated | 1 in 5 cases (20%) | 2025 outbreaks |
| Pneumococcal Disease Cases Prevented Annually | 50,000+ cases | Current PCV program |
Data Source: Centers for Disease Control and Prevention, Economic Analysis of Vaccine Programs, MMWR Reports, 2007-2024
Childhood vaccination programs generate substantial economic benefits by preventing disease-related healthcare costs and productivity losses. Rotavirus vaccination alone saved $924 million in healthcare costs during its first four years of routine use from 2007-2011, while preventing approximately 280,000 clinic visits and 62,000 emergency department visits annually. These cost savings come in addition to the prevented suffering and potential deaths among infants and young children.
The 80% reduction in rotavirus hospitalizations since vaccine introduction in 2007 demonstrates the powerful population-level impact of high vaccination coverage. Currently, rotavirus vaccination prevents an estimated 40,000 to 50,000 hospitalizations each year, with each prevented hospitalization saving thousands of dollars in direct medical costs plus indirect costs from parental work absences. Similarly, pneumococcal conjugate vaccination prevents more than 50,000 cases of invasive disease annually, protecting children from meningitis, bloodstream infections, and pneumonia. The measles resurgence in 2025 provided a stark reminder of vaccination’s economic value, as outbreak response activities including contact tracing, quarantines, and post-exposure prophylaxis cost public health departments millions of dollars beyond the direct costs of treating 218 hospitalized patients.
Pertussis (Whooping Cough) Trends in the US 2019-2025
| Pertussis Statistics | 2019 | 2024 | 2025 | Primary Age Group Affected |
|---|---|---|---|---|
| Total Pertussis Cases Reported | 18,617 cases | 7,800+ cases | 13,000+ cases | Infants <1 year |
| Pertussis Deaths in Infants | 7 infant deaths | Variable | Variable | Primarily <6 months |
| DTaP Coverage Among Kindergartners | 95.0% | 92.3% | 92.1% (projected) | Ages 4-6 years |
| DTaP 4+ Doses by Age 24 Months | 84.0% | 82.7% | — | Ages 19-35 months |
| Tdap Booster Coverage Among Adolescents | 89.2% | 86.9% | — | Ages 13-17 years |
Data Source: Centers for Disease Control and Prevention, National Notifiable Diseases Surveillance System, National Immunization Survey, 2019-2025
Pertussis (whooping cough) remains a significant threat to infant health despite high overall vaccination coverage. The 13,000+ cases reported in 2025 represent a 67% increase from the 7,800+ cases in 2024, demonstrating pertussis’s cyclic pattern with epidemic peaks occurring every 3-5 years. Infants under 1 year of age, particularly those under 6 months who have not yet completed their primary DTaP vaccination series, face the highest risk of severe disease and death from pertussis.
The declining DTaP coverage among kindergartners from 95.0% in 2019 to 92.1% in 2024-25 contributes to increased pertussis circulation in communities, placing unvaccinated and partially vaccinated infants at higher risk through indirect exposure. Pertussis immunity wanes over time following vaccination, which is why adolescents require a Tdap booster around ages 11-12 years. However, Tdap coverage among adolescents declined from 89.2% in 2019 to 86.9% in 2024, creating additional gaps in community protection. Pregnant women are also recommended to receive Tdap during each pregnancy to provide passive antibodies to newborn infants before they are old enough to begin their own vaccination series at 2 months of age.
Varicella (Chickenpox) Vaccination Coverage in the US 2023-2025
| Varicella Vaccination Metric | Coverage Rate | Age Group | Year |
|---|---|---|---|
| 1 Dose by Age 24 Months | 93.3% | 19-35 months | 2021-2023 |
| 2 Doses Among Kindergartners | 92.1% | 4-6 years | 2024-25 |
| Varicella Cases Reported Annually | Less than 15,000 cases | All ages | 2024 |
| Varicella Cases Before Vaccine (1995) | 4 million cases annually | All ages | 1995 |
| Varicella Hospitalizations Prevented Annually | 10,500-13,500 hospitalizations | All ages | Current estimate |
| Varicella Deaths Prevented Annually | 100-150 deaths | All ages | Current estimate |
Data Source: Centers for Disease Control and Prevention, National Immunization Survey, Varicella Disease Surveillance, 2023-2025
Varicella (chickenpox) vaccination has achieved remarkable success in reducing disease burden since the vaccine’s introduction in 1995. Before vaccination, 4 million varicella cases occurred annually in the United States, resulting in approximately 10,500-13,500 hospitalizations and 100-150 deaths each year. Current annual case counts remain below 15,000 cases, representing a 99.6% reduction from pre-vaccine levels.
The two-dose varicella vaccination schedule provides strong protection, with the first dose administered at ages 12-15 months and the second dose at ages 4-6 years. Coverage of 92.1% for two doses among kindergartners in the 2024-25 school year approaches the 95% target needed for optimal community protection. However, varicella is highly contagious, and even small gaps in coverage can allow outbreaks to occur, particularly in schools and childcare settings. Breakthrough infections can occur in vaccinated individuals, but these cases are typically much milder with fewer lesions and shorter duration compared to infections in unvaccinated people. Varicella vaccination remains a universal recommendation in the January 2026 revised CDC schedule as one of the 11 diseases covered by routine childhood immunization.
Polio Vaccination and Eradication Efforts in the US 2024-2026
| Polio Metric | United States Status | Global Status |
|---|---|---|
| Polio Cases in US (2024-2025) | 0 cases (wild poliovirus eliminated 1979) | 12 wild polio cases globally (2024) |
| Polio Coverage Among Kindergartners 2024-25 | 92.5% | Variable by country |
| Polio Coverage by Age 24 Months (3+ doses) | 93.3% | — |
| Countries with Endemic Wild Polio | 0 countries | 2 countries (Pakistan, Afghanistan) |
| Polio Vaccination Status in Revised CDC Schedule | Universal recommendation | — |
| Target Coverage for Herd Immunity | 95% | 95% |
| States Below 90% Polio Coverage 2024-25 | 3 states | — |
Data Source: Centers for Disease Control and Prevention, SchoolVaxView, World Health Organization Global Polio Eradication Initiative, 2024-2026
The United States has remained free of wild poliovirus transmission since 1979, representing one of vaccination’s greatest public health triumphs. However, maintaining polio-free status requires sustained high vaccination coverage to protect against potential importation of the virus from countries where transmission continues. The 92.5% polio coverage among kindergartners in the 2024-25 school year falls 2.5 percentage points below the 95% target, creating vulnerabilities in some communities.
Globally, wild poliovirus remains endemic in only two countries—Pakistan and Afghanistan—with just 12 confirmed cases worldwide in 2024, bringing humanity closer than ever to complete polio eradication. However, the 3 US states with polio coverage below 90% among kindergartners demonstrate pockets of susceptibility where imported cases could potentially lead to outbreaks. Polio vaccination continues as a universal recommendation in the January 2026 revised CDC schedule, recognized as essential protection against a devastating disease that can cause permanent paralysis and death. The inactivated polio vaccine (IPV) used in the United States requires 4 doses administered at ages 2 months, 4 months, 6-18 months, and 4-6 years for complete protection.
Pneumococcal Conjugate Vaccine (PCV) Coverage in the US 2021-2025
| PCV Vaccination Metric | Coverage Rate | Details |
|---|---|---|
| PCV 4+ Doses by Age 24 Months | 84.9% | Children born 2020-2021 |
| PCV 4+ Doses by Age 24 Months (Previous Cohort) | 86.7% | Children born 2018-2019 |
| Change in Coverage | -1.8 percentage points | 2018-19 to 2020-21 cohorts |
| Invasive Pneumococcal Disease Cases Prevented Annually | 50,000+ cases | All ages |
| Pneumococcal Meningitis Cases Prevented in Children <5 | 700+ cases annually | Since PCV introduction |
| PCV Status in Revised CDC Schedule (2026) | Universal recommendation | One of 11 core vaccines |
Data Source: Centers for Disease Control and Prevention, National Immunization Survey-Child, Pneumococcal Disease Surveillance, 2021-2025
Pneumococcal conjugate vaccine (PCV) protects infants and young children from invasive pneumococcal disease, including meningitis, bloodstream infections, and pneumonia. Coverage of 84.9% for the 4-dose series by age 24 months among children born during 2020-2021 declined 1.8 percentage points from the 86.7% coverage achieved by children born during 2018-2019, continuing the pandemic-related disruption to routine childhood vaccination.
PCV prevents more than 50,000 cases of invasive pneumococcal disease annually across all age groups through direct protection of vaccinated children and indirect protection of unvaccinated individuals. Since PCV’s introduction, pneumococcal meningitis in children under 5 years has declined by more than 90%, preventing approximately 700 cases annually. The vaccine series consists of 4 doses administered at ages 2 months, 4 months, 6 months, and 12-15 months. PCV remains a universal recommendation in the January 2026 revised CDC schedule as one of the 11 core vaccines, reflecting international consensus on the importance of pneumococcal disease prevention in young children. The substantial reduction in invasive disease demonstrates the vaccine’s critical role in protecting the most vulnerable age group from life-threatening bacterial infections.
Haemophilus Influenzae Type B (Hib) Vaccination in the US 2021-2025
| Hib Vaccination Metric | Coverage Rate | Disease Impact |
|---|---|---|
| Hib Full Series by Age 24 Months | 80.3% | Children born 2020-2021 |
| Hib Full Series by Age 24 Months (Previous Cohort) | 82.5% | Children born 2018-2019 |
| Change in Coverage | -2.2 percentage points | Largest decline among infant vaccines |
| Hib Disease Cases Before Vaccine (1980s) | 20,000 cases annually | Children under 5 years |
| Hib Disease Cases Currently | Less than 50 cases annually | Children under 5 years |
| Hib Meningitis Reduction Since Vaccine | 99% reduction | Children under 5 years |
| Hib Status in Revised CDC Schedule (2026) | Universal recommendation | One of 11 core vaccines |
Data Source: Centers for Disease Control and Prevention, National Immunization Survey-Child, Hib Disease Surveillance, 2021-2025
Haemophilus influenzae type b (Hib) vaccination experienced the largest coverage decline among infant vaccines, dropping 2.2 percentage points from 82.5% for children born during 2018-2019 to 80.3% for children born during 2020-2021. This decline is particularly concerning because Hib vaccination represents one of the most dramatic vaccine success stories, reducing invasive Hib disease by 99% since the vaccine’s widespread use beginning in the early 1990s.
Before Hib vaccination, approximately 20,000 children under 5 years developed invasive Hib disease annually in the United States, with about 1,000 deaths and many survivors suffering permanent disabilities including hearing loss and developmental delays. Currently, fewer than 50 cases occur annually among young children. The Hib vaccine series typically consists of 3 or 4 doses depending on the vaccine brand, administered at ages 2 months, 4 months, 6 months (for some brands), and 12-15 months. Hib remains a universal recommendation in the January 2026 revised CDC schedule as one of the 11 core vaccines, reflecting its critical importance in preventing meningitis, epiglottitis, and other life-threatening infections. The low absolute coverage of 80.3% creates vulnerabilities for disease resurgence if coverage continues declining in future birth cohorts.
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