With childhood immunisation rates faltering and exemptions reaching record highs, experts emphasise the critical role of school nurses in reversing the trend through education, counselling, and improved access.
School nurses may be one of the most practical tools available to slow a worrying slide in childhood immunisation rates, according to a student nursing paper published by My American Nurse. The article argues that nurses who see children regularly in schools are well placed to answer parents’ questions, correct misinformation and make it easier for families to keep up with recommended vaccines.
That concern is backed by broader public health data. KFF reported that routine vaccination among U.S. kindergarten children fell from 95% in the 2019-20 school year to below 93% in 2023-24, while non-medical exemptions rose from 2.5% to 3.6%. CIDRAP likewise said exemptions have reached a record high, warning that the decline threatens herd immunity and leaves communities more vulnerable to outbreaks of vaccine-preventable disease.
Research cited in the nursing article suggests school-based education can help. A narrative review published in Annali di Igiene found that school immunisation projects have increased vaccination coverage among children and teenagers, while a separate review on PubMed said school nurses play a key role in vaccine surveillance, family education and efforts to overcome hesitancy. Other studies cited by the nursing authors found that targeted education and peer-led interventions improved vaccine acceptance and uptake, including a city-wide school vaccination programme and work by New York healthcare practices.
The trend is not uniform across the country. A 2024 study on ScienceDirect linked lower childhood vaccination rates with COVID-19 vaccine hesitancy, especially in rural and strongly Republican-leaning counties. Axios reported this week that Colorado’s kindergarten MMR coverage fell to 87.7% for the 2025-26 school year, well below the 95% level needed for herd immunity, as exemptions climbed to 4.7%. Against that backdrop, the case for training school nurses more fully in vaccine counselling and access support is becoming harder to ignore.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
