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The percentage of kindergarten students who have not received routine childhood vaccination rose again during the 2021-22 school year, federal health officials said Thursday, as the lingering COVID-19 pandemic disrupted efforts to get kids vaccinated.

Overall vaccination rates among kindergartners remain high, but coverage has dropped 2 percentage points from 95 percent in the pre-pandemic 2019-20 school year to 93 percent in 2021-22, according to new data from the Centers for Disease Control and Prevention (CDC).

“While this might not sound significant, it means nearly 250,000 kindergarteners are potentially not protected against measles alone,” said Georgina Peacock, director of the CDC’s Immunization Services Division.

Coverage for the measles, mumps and rubella (MMR) vaccine during both the 2020–21 and 2021–22 school years was the lowest in a decade. The CDC recommends children get two doses of the MMR vaccine, with the first dose at 12 to 15 months, and the second between 4 and 6 years old.

But there were declines in other routine childhood vaccines as well, such as diphtheria, tetanus and pertussis, polio and chickenpox.

“This is alarming and should be a call to action to all of us,” Sean O’Leary, the chairman of the American Academy of Pediatrics’s Committee on Infectious Diseases, told reporters Thursday

All states and the District of Columbia require children to be vaccinated against certain diseases, including measles and rubella, in order to attend public schools, though exemptions are allowed in certain circumstances, including for religious or philosophical purposes.

The CDC survey found that although 2.6 percent of kindergartners had an exemption for at least one vaccine, almost 4 percent of students who did not have an exemption were not up to date with their MMR shots.

The decline in childhood vaccine coverage comes on the heels of heated partisan fights over COVID-19 vaccine mandates and a distrust of public health authorities, continuing a trend that has disturbed health experts and officials.

Pockets of undervaccinated children within larger areas of high vaccination coverage can lead to outbreaks, CDC said. There have been cases of polio reported in New York, and a measles outbreak primarily among unvaccinated children sickened more than 80 kids in Ohio in December, sending 30 of them to the hospital.

According to the CDC, the trend of declining vaccinations is at least partly due to pandemic-related disruptions. Parents missed or skipped visits to the pediatrician and are still trying to catch up.

There were also disparity issues. According to a second CDC report released Thursday, children who are poor, who live in rural areas, who lack health insurance or who are Black or Hispanic are more likely to be unvaccinated by the time they are 2 years old.

The proportion of unvaccinated children was 8 times higher among uninsured kids than kids with private insurance, CDC found.

O’Leary noted that the vast majority of parents are still vaccinating their children. But the controversy and misinformation surrounding the COVID-19 vaccine has also spilled over to routine childhood shots.

For example, a Kaiser Family Foundation survey last month found 35 percent of parents of children under age 18 oppose school vaccine requirements, up from 23 percent in 2019.

“We have seen some hesitancy in vaccines during the pandemic related mostly, I think to the COVID vaccine. This could in some cases have translated over to routine vaccinations and that’s something that we’re watching very closely,” the CDC’s Peacock said.

“What we know though is that the way to impact that is for families to have conversations with their trusted doctors, health care providers, about the importance of vaccination,” she added.