School leaders in Grandview, Mo., came close to canceling their back-to-school health fair this summer after years of low turnout. But they kept it on the calendar with some key tweaks, and it turned into a public health success: By the end, the local health department had administered 100 routine vaccinations to students.
“This is probably the first time since before COVID that I feel like it was really successful,” said Kenny Rodrequez, the superintendent of the 3,700-student district outside of Kansas City. “We all walked away really pleased.”
As school kicks into gear for the 2025-26 academic year, some health experts are worried about the potential for outbreaks of vaccine-preventable diseases that could sicken large numbers of children and force school closures.
Nationwide, childhood vaccine rates have been declining, with a greater portion of students seeking nonmedical exemptions from required vaccines—especially for the shot that protects against measles, mumps, and rubella. Meanwhile, the nation is still reeling from the largest outbreak of measles to take hold in a quarter century, with more than 1,300 cases—predominantly among those who are unvaccinated—and three deaths.
And the nation’s top health official, Health and Human Services Secretary Robert F. Kennedy Jr., has made highly public moves to plant doubts about vaccine safety and efficacy and shake up the nation’s vaccine infrastructure. (More quietly, he has endorsed recommendations that everyone ages six months and older receive flu shots, and his agency has kept COVID-19 shots on the vaccine schedule for children.)
It all amounts to worry that declining rates of vaccination plus new outbreaks could cause problems as kids head back to school.
“I think that it’s become pretty clear that the outbreaks, whether we’re talking about measles or pertussis or anything else, are not a matter of ‘if’ anymore,” said Lynn Nelson, the president of the National Association of School Nurses and the senior director of health services for schools in Tumwater, Wash. “It’s a matter of when it’s going to hit your community.”
While there’s not much school and district leaders can do about changes happening at the federal level, they can take steps to ensure their families are up to date on current health regulations and recommendations, and share accurate information about vaccines’ efficacy, Nelson said.
They can also stage local efforts—based on the trust they’ve built up in their communities—to boost vaccinations, which can pay off in the form of a community better protected against communicable diseases and less missed class time.
The back-to-school health fair can be a powerful public health tool
One common approach districts use is to host back-to-school health fairs like Grandview’s, where they partner with the local health department to offer required vaccines, usually without appointments and at no cost to families.
It’s not a new idea, but some districts have in recent years struggled to get families to participate.
In Grandview, district leaders considered canceling this year’s event after several years of low turnout. Organizers were growing frustrated with the amount of effort they put in to sponsor the event with little return, said Rodrequez, the Grandview superintendent.
But instead of giving up, Rodrequez and his team this year “reimagined” the event, bringing in more resources to entice more families. Athletics coaches and extracurricular leaders came to meet with families at this summer’s fair, which took place Aug. 2, and physicians were present to perform students’ physicals needed to participate in those activities. Rodrequez also brought in community partners to provide assistance with things like finding housing and food.
The payoff was huge, Rodrequez said.
In years past, just a handful of kids came in for their vaccines. This time, the health department administered more than 100 routine vaccinations, he said.
Vaccination clinics can keep kids in class
Not only does staying on top of students’ vaccines protect them from contracting preventable illnesses, it keeps them from missing important class time to kick off the new school year, Rodrequez said.
State laws—not federal law or individual district policies—dictate which vaccines are required for local students to be able to attend school and the reasons for which parents may opt their children out of receiving those vaccines.
The state vaccine requirements are typically based on recommendations from the U.S. Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices—all of whose members Kennedy abruptly dismissed in June.
All 50 states have vaccine requirements for children entering school, yet nearly all allow parents to opt children out of those vaccines for nonmedical reasons.
“We’re trying to prevent students from not being able to attend school,” Rodrequez said. “There’s a lot of things that we can help them with or at least give some grace on, but this is usually not one of them.”
It’s also important that school and district leaders are aware of the children in their community who aren’t vaccinated, whether because they are behind on their shots or have an exemption from commonly required vaccines, said Nelson of the School Nurses Association.
Those kids are at higher risk should an outbreak occur, she said.
For districts standing up their own health fairs or vaccine clinics, even providing vaccines that aren’t required, like the annual flu shot, can help keep kids in class, Nelson said. The 2024-25 flu season was the most severe in 15 years, she said, and it started earlier and lasted longer than usual.
More families may show up at a vaccine clinc for their children’s vaccines if other members of the family can get shots, too, Nelson said.
“It’s too early to really say what will happen this flu season,” she said, “but we want to do anything we can to avoid a repeat or worsening of last year.”
