Iowa confirmed a new measles outbreak Monday, as children across the country head back to school — one of 38 outbreaks in 2026. The CDC counted 2,566 confirmed cases through August 13, the most since 1991, with cases reaching 46 states and Washington D.C. More than half the year's cases hit children and teenagers; more than 90 percent of those who got sick were unvaccinated or of unknown vaccination status. This school year, kindergarten MMR coverage fell to 92.4 percent — below the 95 percent threshold for herd immunity. Exemptions hit a new record at 4.2 percent, and 24 states came in above 5 percent. About 280,000 kindergartners began school without completing the MMR series.

Pediatricians: This Puts Infants and Immunocompromised Kids at Risk

The AAP says no exemptions, no exceptions — every unvaccinated child is a shared risk.

Vaccine exemptions don't just put one child at risk. They put every child who can't be vaccinated at risk too — infants under 12 months, immunocompromised patients — because those kids depend on the people around them being vaccinated. The American Academy of Pediatrics called Trump's August 10 executive order "unscientific and dangerous." The AAP also published a 2026 policy calling for eliminating ALL nonmedical exemptions from school requirements, arguing that rising exemptions are making schools less safe. One board-certified pediatrician said the EO is "based on no scientific basis, no new study, no new data, nothing."

Research shows children who fall behind on early vaccines are six to seven times more likely to miss the MMR by age two. More required appointments means fewer kids who finish the series. The MMR is 97 percent effective after two doses, and communities with 95 percent coverage rarely see outbreaks. The U.S. isn't close.

But the White House Says Parents Should Choose, Not the Government

Even Kennedy, who now endorses the MMR, says mandates are overreach.

Parents should decide what vaccines their children get. That's the administration's core argument. HHS Secretary Robert F. Kennedy Jr. reversed his longtime public position this month, telling CNN that parents should vaccinate their children against measles as cases hit a 35-year high. Then he added: "The government shouldn't force them to do it." The executive order frames the approach as "shared clinical decision making" — parents who want every vaccine on the old schedule can still get them, fully covered by insurance. In Florida, Governor Ron DeSantis and Surgeon General Joseph Ladapo have taken the logic furthest, calling limited vaccine requirements a matter of personal freedom as measles spreads. South Carolina — with the most permissive exemptions — has the highest statewide case total in 2026: 670 confirmed.

Still, Courts Will Almost Certainly Block the EO — Leaving States to Fight It Out

Gostin at Georgetown says state legislatures, not executive orders, control school vaccination requirements.

School vaccination requirements belong to states, not the president. Georgetown Law professor Lawrence Gostin said the EO "will not go into effect and will almost certainly be blocked by the courts." The individual vaccines the EO envisions don't exist yet, either — there are no standalone measles, mumps, or rubella shots approved in the U.S., and developing them would take years of clinical trials.

What does exist is a growing split between states. California eliminated nonmedical exemptions years ago. Texas, Florida, and South Carolina moved the other way — and their 2026 case counts show it.

Where This Lands

Pediatricians want to close the exemptions they say are fueling outbreaks; they see every unvaccinated child as a shared risk to the most vulnerable. The Trump administration says parents — not the government — should make the call, and frames the EO as a transparency move, not a retreat from vaccines. Legal experts say the EO probably doesn't survive the courts anyway; the real fight is in state capitals, where California and South Carolina have already gone opposite directions.

Sources