September 21, 2026

Vaccination and Public Health at the Start of the School Year

WASHINGTON, D.C. – With the start of the school year and respiratory virus season, Doctors for America commends the American Academy of Family Physicians (AAFP), American Academy of Pediatrics (AAP), American College of Obstetricians and Gynecologists (ACOG), and the Infectious Diseases Society of America (IDSA) on providing evidence-based immunization guidance for patients spanning from birth to older adulthood, and including pregnant patients and those with compromised immune systems. These recommendations were informed by a structured, evidence-based review of vaccine safety and effectiveness for the 2026–2027 respiratory virus season conducted by the The Vaccine Integrity Project in collaboration with the American Medical Association (AMA). This collaboration is a critically important step in filling the information gap left by federal health agencies, ensuring that patients and physicians have access to clear, timely, and evidence-based vaccine recommendations. 

DFA continues to express concern about the Centers for Disease Control and Prevention’s (CDC’s) lack of federal leadership and vaccine misinformation, as well as the omission of documentation of important fatalities in the face of the ongoing measles outbreak. Last week, the Pennsylvania Department of Health announced 2 additional measles-associated deaths, bringing the total to 4 deaths in Pennsylvania in the past month. The CDC has yet to recognize these fatalities nor to inform the public of their significant risk to public safety.

Measles is one of the most contagious viruses, requiring a high degree of community or “herd immunity” to protect infants, children, and others who are unable to get the vaccine. However, because the measles vaccine is highly effective, every measles outbreak is wholly preventable with sufficiently high (>95%) community vaccination rates. The efficacy of this approach is demonstrated by the elimination of measles in the US in 2000, while the current ongoing outbreaks associated with decreasing vaccination rates illustrate the harms of deviating from this well-established public health practice. 

As physicians, we know the importance of shared-decision making and individual counseling to provide the best care to our patients. However, current federal policies which promote “shared clinical decision-making” as a replacement to established public health approaches to vaccine guidance are at odds with evidence-based expert recommendations and do a disservice to patients and providers, while putting communities at risk for preventable infectious diseases. 

All states allow medical exemptions from required school immunizations. With the exception of four states – California, Connecticut, Maine, and New York – most also permit religious or other nonmedical exemptions. A recent surge in non-medical vaccine exemptions has caused vaccination rates in many states to fall below the threshold required for herd immunity. While they claim to respect individual autonomy, judgment and freedom, these exemptions come at the cost of increased public health risk for the whole community, and a loss of freedom from disease protection and the security of herd immunity, with the greatest cost paid by newborns and infants. The start of the school year brings this issue to the forefront. As children gather at schools in the fall, they share infections which are brought home and soon spread throughout the community. Most of these infections are mild, but as witnessed during the 2025-2026 flu season, they can be deadly and devastating for families and communities. 

Exposure to measles can cause much more serious illness; acute measles is associated with chronic ear infections, hearing loss, pneumonia, and dehydration, resulting in hospitalizations and death. Measles infection can erase immune protection against other infections and, with a 5 to 10 year delay, can result in the fatal disease subacute sclerosing panencephalitis, for which there is no treatment.

The primary responsibility of any government is to provide for the security and safety of its residents. We are thankful for the tremendous efforts of medical societies and regional alliances of health leaders to fill information gaps with evidence-based recommendations. However, the statements of the President and his Secretary of Health and Human Services – and the silence of the new director of the CDC, Dr. Erica Schwartz – continue to generate public confusion about the value and safety of recommended vaccines. Federal health leaders, not just professional societies and regional collaboratives, have a moral and humanitarian responsibility to use their power and authority to promote trust in vaccines. DFA urges them to use that power and authority for the public good.

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About Doctors for America:

Doctors for America (DFA) is a national nonprofit that mobilizes over 40,000 physicians and medical trainees to advocate for policies that improve the health of patients and communities. Through advocacy training and action at the state and federal levels, DFA works to expand access to affordable care, strengthen community health and prevention, and advance health justice and equity. We do not accept funding from pharmaceutical, insurance, or for-profit health care entities, ensuring our work remains fiercely independent and patient-centered. DFA puts patients over politics–and over profits. Find out more at doctorsforamerica.org and on X @drsforamerica or Bluesky drsforamerica.bsky.social.

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