Vaccine Exemption Requests in Texas Surge as School Year Begins

For example, in the Austin school district during the 2024-25 school year, 79.6% of kindergarteners were up to date on the vaccine for measles, mumps and rubella, or MMR, a drop from 2020 when 96% were vaccinated. And in Gaines County, where the West Texas measles outbreak began in January, 77% of kindergartners were vaccinated the same year.

Texas leads the nation with the most kindergartners — more than 25,000 — who were not fully vaccinated against measles, followed by Florida and California, according to U.S. Centers for Disease Control and Prevention data released last month. The Texas measles kindergarten vaccination rate of 93.24% is the lowest it's been since at least 2011, ranking the state 18th nationally.

Vaccine supporters told lawmakers earlier this year that legislation to make the vaccine exemption form easier to obtain would inevitably drive down vaccination rates for school-age children.

The main nuisance for parents wasn’t that exemption forms had to be mailed to them by the Texas Department of State Health Services, said Waco ISD school nurse Lana Scully. Parents didn’t want to have to take the extra step of getting it notarized. That requirement will not change when the new downloadable form is made available next month.

“You know there’s two inconveniences of it, well, actually three” Scully explained. “One is you have to go to the health department, pick it up. One is you have to get it notarized. And the last one is they’re only good for two years. So that kind of weeds out who's got the strong feelings versus who doesn't want to get to the doctor.”

Scully said she has no issue with parents wanting fewer vaccinations for their child.

“If somebody really has a strong conviction, great,” Scully said. “That's your strong conviction, and you're doing what's best for you and your family … But if it's just, I don't feel like taking my kid to the doctor 'cause I'm sitting on the couch watching Wheel of Fortune, it's a lot easier to go get the shots.”

School challenges driving up vaccine delinquencies

Funding cuts for schools have meant fewer school nurses and health aides and a crushing workload for those who remain. There’s the constant managing of emergency health equipment, maintaining students’ daily medication regimens and caring for more kids with chronic illnesses.

Finally, there’s the year-round chase of parents for their child’s vaccination records — or vaccine exemption forms.

“It was a snap decision, but it was oncoming,” said Chanthini Thomas, a school nurse who abruptly retired from Bellaire High School in the Houston school district after 25 years in the profession. “This past year was the worst year I've ever had in school nursing.”

Historically, Texas public schools have been a stopgap to compel vaccinations. Students are required to be vaccinated to attend school unless they have a notarized exemption form or face being sent home until they have either.

As larger urban districts combat suburban ones for students, Texas school nurses are hearing often from districts, including Houston, not to let vaccination requirements prevent students from attending school. If every student without the required paperwork were denied entry to class, schools would lose out on its basic allotment funds for each student enrolled.

“There are some superintendents that will say, ‘All kids come to school. I don't care if they've got their vaccines or not,’” said Karen Schwind, a past president of the Texas Association of School Nurses.

In the 2024-25 school year, 2.7% of kindergarteners did not have records of the required doses of the measles vaccine and lacked an exemption.

“I have kids, been hounding them for two years,” Thomas recalled. “All I can do is send letters and call parents and beg.”

The Houston school district confirmed to The Texas Tribune in April that “at this time, we are not excluding students from learning based on vaccine status.” District officials more recently said their policy has not changed.

Rebecca Hardy, with Texans for Vaccine Choice, said her group “applauds any school that recognizes that being militant about vaccine paperwork simply makes no sense.”

“Whether families submit shot records, vaccine exemptions, or a mix of both, it’s still just paperwork,” she said. All of those things are not a “measure of a student’s health and certainly irrelevant to the core mission of schools: to educate, not operate as ad hoc health clinics.”

Public health departments report some vaccination dips

Each year, many of the state’s school age children who have no health insurance or who are covered by Medicaid turn to public health departments for their vaccinations. Dallas and Austin public health officials have reported some decreases in visits to summer vaccination clinics.

“We typically have like, you know, big lines and the waiting room is packed. Our whole lobby is packed,” said Dr. Phil Huang, the director of the Dallas County Health and Human Services Department. “This year, it has not been that way.”

In Texas, there are an estimated 111,000 undocumented children, all of whom do not qualify for state Medicaid health insurance coverage, attending school, which could be having an impact.