Vaccination rates among Nevada children at key ages declined again in the 2024-25 school year, according to new state data released Friday that shows the state’s kindergarten students have fallen even further from the threshold for herd immunity against measles, one of the most dangerous diseases for children.

The threshold to achieve herd immunity — when enough of a population is immunized that the ability of an infection to spread is limited — varies by disease, but the threshold for protection against measles is 95 percent. 

Advocates say Nevada’s declining vaccination rates mirror national trends and could have deadly consequences. The Centers for Disease Control and Prevention (CDC) reported in July that kindergartners’ coverage for all vaccinations decreased nationwide in 2024-25. The U.S. saw more measles cases in 2025 than in the past 30 years. The epicenter of the outbreak was West Texas, where two children died, both of whom were unvaccinated. 

Though Nevada remains one of nine states that has not seen any cases of the disease this year, public health advocates worry that statewide efforts to reverse declining vaccination trends are complicated by a rise in nonmedical vaccine exemptions, lack of trust in medical authorities, shifting federal rules on vaccine guidance and increasingly hostile anti-vaccine rhetoric from the Trump administration. 

Brian Labus, an epidemiology professor at UNLV who headed the university’s federally funded Nevada Vaccine Confidence and Demand Improvement project, told The Nevada Independent he remains hopeful about the state’s vaccination efforts but is concerned that rates are not high enough for particularly infectious diseases such as measles.

“People are getting their kids vaccinated,” Labus said. “But we need to have those high levels of immunization to provide the herd immunity that really keeps outbreaks from flaring up.” 

Nevada vaccine rates continue to fall

Nevada’s immunization requirements apply to new students and students entering kindergarten, seventh grade and 12th grade, including charter and private schools. 

Kindergarten students must be vaccinated against chickenpox (varicella), hepatitis A (HepA), hepatitis B (HepB), polio, tetanus-diphtheria-pertussis (DTaP) and measles, mumps and rubella (MMR). Beginning in seventh grade, students must also be vaccinated against meningitis (MenACWY). 

In Nevada, 91 percent of kindergarten students were vaccinated against at least one of these diseases in the 2024-25 school year. Individual vaccine rates ranged from 92.9 percent for HepB to 90.3 percent for DTaP. That was down from previous school years, with 92 percent of kindergartners being vaccinated in 2023-24 and 93 percent in 2022-23.

Vaccination rates for students in seventh grade also declined, down to 94 percent from 96 percent in 2022-23, while 12th graders’ vaccination rates saw minimal change.

Standardized data was unavailable prior to 2023, when the state first began reporting vaccinations on the kindergarten, seventh and 12th grade cohorts.

The 95 percent threshold required to achieve herd immunity from measles means 17 of every 18 community members must be vaccinated to prevent its spread. For other infectious diseases, herd immunity thresholds are slightly lower — at approximately 90 percent for mumps, 85 percent for polio and 84 percent for chickenpox. 

At least 95 percent of students in seventh and 12th grade in Nevada have received their MMR vaccine, but only 91.3 percent of kindergartners, slightly below the national average of 92.5 percent. 

Vaccinating at a later age “will still be as effective,” Labus said, “but doesn't provide as much protection. At the youngest ages, you are usually at the most severe risk for these diseases.”

‘It feels safer to trust what you're reading online’

More than 8 in 10 American parents reported being at least “somewhat” confident in the safety of MMR and polio vaccines, according to a September KFF poll. Medical research has shown that vaccines are safe. 

But experts who spoke with The Indy still raised concerns over accelerating vaccine skepticism, pointing to Americans’ declining trust in federal medical authorities such as the CDC and increasing reliance on social media for medical advice. 

Advocates also caution that vaccine doubts can gain momentum in a health care system that feels more complicated and expensive than ever. Lee McAllister, executive director of the Nevada Chapter of the American Academy of Pediatricians, said that because of reasons such as high cost or staff turnover, some families are unable to form a relationship with a pediatrician who would encourage them to vaccinate their children. 

“I would never fault parents for wanting to ask questions,” McAllister said. “But I do fault our health system here in Nevada for setting up systems where families don't have enough time with their doctor to ask those questions, and so it feels safer to trust what you're reading online than your own physician, because you don't know them as well as you should.” 

Medical research has found that physicians’ recommendations can influence parental decision-making and sway parents to vaccinate their children.

“My kids still have a pediatrician, but when they moved out of state, I never found one that I have the same type of relationship with,” said Rebecca Dirks Garcia, administrator of a large Facebook group for parents in the Clark County School District. 

“I definitely think there is kind of this disconnected medical system that exists in Southern Nevada,” Dirks Garcia said. “It feels like there’s a lot of upheaval on a regular basis.”

Nevada has a pediatrician shortage, ranking 49th in a 2023 assessment of the pediatrician-to-child ratio in each state. In an attempt to expand options, Nevada began allowing dentists to administer vaccine doses in 2023. 

McAllister said listening to medical experts is more necessary than ever, since the near-eradication of infectious diseases such as measles and polio has caused Americans to forget how dangerous these diseases can be. 

Prior to the introduction of the measles vaccine in the late 1960s, the U.S. saw around 4 million measles cases and 500 deaths annually. 

Dirks Garcia characterized increasing skepticism towards vaccines as “generational,” saying that her stepfather’s stories of fighting a childhood bout of polio gave her a strong sense of the benefits of vaccines. 

“That was hugely impactful for me because it’s something that happened to somebody that I knew and cared about,” Dirks Garcia said. A recent KFF poll found that parents under age 35 are more skeptical of vaccine safety than parents over age 35, and especially parents over age 50. 

New immunization coalition launching in December

As Nevada’s vaccination rates decline, its nonmedical exemptions are skyrocketing. Nevada allows nonmedical exemptions when parents express religious objections to vaccines. Medical exemptions require a physician’s signature on a request submitted by parents.

The share of Nevada kindergartners with nonmedical vaccine exemptions increased from 1.5 percent in 2011-12 to 6.7 percent in 2024-25, more than double the national nonmedical exemption rate for kindergartners.

The state — which last year terminated its relationship with an immunization-focused nonprofit over fiscal mismanagement — is hoping to reverse these trends. The Division of Public and Behavioral Health is accepting applications until Oct. 29 for an organization to “establish and lead” a new statewide immunization coalition launching in December.

Nevada’s vaccination efforts will continue to be overseen by the state’s immunization program, according to Vickie Ives, bureau chief of the state team that handles maternal, child and adolescent health. But the new coalition will serve as a “centralized site to efficiently address vaccine hesitancy,” Ives said, acting as a bridge between community members, medical providers and government authorities. 

In February, Gov. Joe Lombardo, a Republican, said vaccines should be a “personal choice.” His office did not return a request for comment from The Nevada Independent about the new immunization data.

Experts say state-level action on vaccines is especially critical amid federal policy shifts, which Labus said he was worried would “make people doubt vaccines.”

States generally rely on the CDC to guide their vaccination requirements, but this relationship has been complicated by the Trump administration’s stance on vaccines — including the agency’s recent recommendation that people speak with a clinician before receiving the COVID-19 vaccine. 

Last week, the CDC’s acting director called for the combined MMR vaccine, which protects children against measles, mumps and rubella, to be split into three shots. 

Labus said such a change could make some parents even more skittish. 

“Anything that we do to make getting vaccinated more difficult is obviously going to affect our rates,” he argued. “Even if it’s as simple as two needles instead of one, some parents could say, ‘I just don’t want my kid getting so many shots.’”

Dirks Garcia said in her Facebook group, debates over vaccines sometimes pop up and include participation from parents whose children are immunocompromised or have medical conditions that make them unable to receive vaccines. These children rely on their peers being vaccinated to protect them against infection.

“Sometimes we think vaccination is only a personal decision, and it is,” Dirks Garcia said. “But at the same time, the person you’re protecting isn’t only yourself but somebody else who can’t be vaccinated, somebody else who has a medical condition that needs that community protection.”