Listen to article \u2022\u00a00:00 min<\/p>\n
Two years ago, every child in the kindergarten class at Eleanor Emlen Elementary in Mount Airy had vaccine protection against measles. <\/p>\n
A year later, the school\u2019s kindergarten immunization rate<\/a> had dropped to just 80%, putting students and the surrounding community at risk of an outbreak of the highly contagious disease. <\/p>\n Emlen is among more than two dozen Philadelphia-area schools that saw double-digit declines in kindergarten immunization rates last school year \u2014 in many cases because parents are increasingly refusing vaccines. <\/p>\n The affected schools span a diverse range of communities, from city neighborhoods like Mount Airy to the outlying suburbs. In Chester County<\/a>, for example, a small private school in Downingtown<\/a> saw its vaccination rates plunge by 20%.<\/p>\n Even as countywide immunization levels remain relatively high<\/a>, some 40% of kindergarten classrooms across the region became vulnerable to an outbreak during the 2025-26 school year, up from 33% the year prior, an Inquirer analysis of newly released state data found.<\/p>\n That means that at least 249 schools had vaccination rates below 95%, the level at which scientists say a population must be vaccinated to prevent the spread of measles, one of the most contagious diseases.<\/p>\n Of these, 98 Philadelphia-area schools reported measles vaccination rates below 90%, presenting an even greater risk to students.<\/p>\n A sharp increase in parents opting out of vaccination for religious or philosophical reasons continued to drive down vaccination rates; exemptions in this category rose by 15% in the latest two years for which data are available. <\/p>\n Pennsylvania is among a handful of states that allows parents to opt out of vaccine requirements for philosophical or religious reasons, often by simply signing a form. <\/p>\n The health department published more granular, school-level vaccination data<\/a> this summer for the first time, after reporting by The Inquirer and the Pittsburgh Post Gazette made this information public for the prior school year, exposing pockets of vulnerability within counties with overall high vaccination. <\/p>\n \u00bb READ MORE: More than 200 Philly-area schools vulnerable to measles outbreak<\/a><\/p>\n The new data<\/a> show the growing public health threat to the region from Pennsylvania\u2019s growing measles outbreak, in which two people in Lancaster County have died<\/a>, state officials reported Tuesday. They were the state\u2019s first measles-related deaths in three decades.<\/p>\n So far, nearly 400 cases have been diagnosed, with nearly half in Lancaster County<\/a>. The rapidly spreading outbreak is edging closer to densely populated Philadelphia. Chester County, just west of the city, has reported the second-highest number of cases in the state.<\/p>\n At a news conference on the measles deaths Tuesday, Gov. Josh Shapiro<\/a> stressed his concern about the rise in Pennsylvania parents opting out of vaccinations over the last 10 years. <\/p>\n \u201cIt has dramatically reduced community immunity in different areas of our Commonwealth,\u201d he said. \u201cToday, we see the consequences of a lack of immunization.\u201d <\/p>\n The new school-level data on vaccines, he said, allow \u201ceveryone to see their school\u2019s vaccination coverage and make informed decisions.\u201d Lawmakers have also said they hope that having more access to data<\/a> about their children\u2019s schools will make families more aware of risks within their communities and encourage them to vaccinate their children.<\/p>\n Emlen, which saw one of the steepest drops in protection, was one of 40 schools in the five-county region that reported 100% measles vaccination rates two years ago, only to drop below the 95% herd immunity threshold last year.<\/p>\n Philadelphia school officials say the changes at Emlen likely reflect increasing hesitancy among parents to immunize their children against measles, mumps, and rubella (MMR) and other diseases. State records show that most unvaccinated kindergarteners at Emlen have philosophical or religious exemptions.<\/p>\n Some fluctuations in kindergarten vaccination rates are typical from year to year, but the rise of anti-vaccine rhetoric<\/a> in federal leadership appears to be exacerbating fears around vaccination, said Kendra McDow, a pediatrician who serves as the Philadelphia school district\u2019s medical director.<\/p>\n \u201cWhat we\u2019re seeing is reflective of what I believe are local and national trends,\u201d McDow said. \u201cFamilies are confused, and they want to do right by their children.\u201d<\/p>\n \u00bb READ MORE: Inside Pa.\u2019s measles outbreak: A family rides out the virus, doctors treat severely ill children<\/a><\/p>\n In the latest federal vaccine maneuver \u2014 opposed by the medical establishment, prominent Democrats<\/a>, and Republican Sen. Bill Cassidy, a physician<\/a> \u2014 President Donald Trump<\/a> signed an executive order this month asking states to \u201cconsider updating\u201d laws to require fewer vaccinations for schoolchildren without any medical justification. He also advocated for splitting the MMR vaccine into three separate shots \u2014 even though no separate measles, mumps, or rubella vaccines are licensed in the United States. <\/p>\n The order came after a chaotic year in which Health and Human Services Secretary Robert F. Kennedy fired federal vaccination advisers and pushed to upend the federal vaccine schedule. Kennedy, a longtime anti-vaccine activist, has promoted false concerns<\/a> that vaccinations can lead to autism.<\/p>\n With Pennsylvania now experiencing its largest measles outbreak in three decades, Kevin Ressler, a healthcare nonprofit leader in suburban Philadelphia who was raised in Lancaster County, worries that declining vaccine rates reflect increasing political polarization.<\/p>\n \u201cYou don\u2019t have to be a scientist to recognize that\u2019s a problem,\u201d said Ressler, the CEO of Alliance for Health Equity, a Coatesville<\/a> nonprofit that works to improve access to health services. \u201cA lot of this is rooted in whether we are able to hold trusted relationships.\u201d<\/p>\n Philly-area counties all at risk <\/p>\n Philadelphia and its suburban counties overall remain well protected against measles, state officials say. The declines seen in the latest school year amount to less than 1% of all kindergarteners in each of the five counties in the area, an improvement from the drops that followed the COVID-19 pandemic.<\/p>\n But even small drops can be significant given the contagiousness of measles, which can linger in the air for hours and infect nine in 10 unvaccinated people who come into contact with it.<\/p>\n \u201cThe risk has definitely gone up because of lower vaccination numbers,\u201d said Rene Najera, the director of public health at the College of Physicians of Philadelphia.<\/p>\n Najera says slipping vaccination rates especially endanger vulnerable students and community members beyond the schools, like pregnant women, cancer patients, or babies too young to be vaccinated. Parents of high-risk children should speak with their pediatricians about the risks of attending a school with lower vaccination rates, he said.<\/p>\n Last year marked the first time in more than 10 years that no Philadelphia-area county had reported measles vaccination rates above herd immunity.<\/p>\n Bucks County<\/a> had the lowest MMR vaccination rate for kindergartners, at 93.7%, down by more than a half a percentage point from the year before. <\/p>\n Montgomery County<\/a>, the only county in the Philadelphia region with kindergarten vaccination rates at herd immunity two years ago, slipped just below the threshold in 2025, to 94.8% vaccinated. <\/p>\n About 94% of Delaware County<\/a> and Philadelphia kindergarteners were vaccinated last school year.<\/p>\n In Chester County<\/a>, the only Philadelphia-area county to report cases in the current outbreak, vaccination rates for kindergartners have held steady at 94.5% for the last two school years. Some schools in the county reported steep drops in MMR coverage ahead of the current outbreak, which has seen 40 cases confirmed since June.<\/p>\n At Windsor Christian Academy in Downingtown, only one in four kindergarteners were vaccinated last year at a school that exceeded the herd immunity threshold the year prior. About 14% of the class had religious exemptions for vaccination. School officials did not return a request for comment.<\/p>\n Caln Elementary School in Thorndale saw measles vaccination rates drop from 100% to 74% in a year. Officials at the school declined to comment. (Caln closed at the end of last school year, and most of its students are transferring to the newly built Doe Run Elementary<\/a> this year.)<\/p>\n Jeanne Franklin, Chester County\u2019s health director, said she is \u201cmoderately\u201d concerned about the current measles outbreak<\/a>, given that many of the county\u2019s most populous public schools still have high vaccination rates. <\/p>\n The school-level data improve the county\u2019s ability to identify schools with lower vaccination rates. <\/p>\n Chester County health officials talk to school nurses, principals, and other administrators before the start of every school year to remind them of what to do if they identify a case of measles.<\/p>\n Under county policy, a single measles case in a school will mean all unvaccinated students and staff must stay home for 21 days.<\/p>\n This year, conversations that are usually hypothetical have taken on more urgency.<\/p>\n The health department has urged schools to take stock of who within their school is unvaccinated and develop a plan for how they will teach unvaccinated students who are sent home and staff classrooms of absent teachers.<\/p>\n \u201cYou don\u2019t own getting them vaccinated,\u201d Franklin said she tells administrators. \u201cBut you have to think through these things.\u201d<\/p>\n Philly schools on alert <\/p>\n As the school district\u2019s lead health officer, McDow worries about the threat of measles so close by, but believes concerted efforts in the city have kept vaccination rates \u201cas high as they can be in this current climate.\u201d<\/p>\n She\u2019s also monitoring Philadelphia schools where the state data show declining vaccination coverage. (The publicly available school-level data does not include classes with fewer than 20 students, for privacy reasons, or schools that did not report to the state. About 90% of schools statewide reported data in 2025.)<\/p>\n In some cases, what looks like a decline can be explained by delays in data reporting due to administrative issues or staff absences. School vaccination records are reported to the state during the month of December.<\/p>\n