In states like Tennessee, Mississippi, and West Virginia, childhood vaccination rates have long been a point of pride, shining as public health success stories in regions often associated with poorer health outcomes. Yet, as vaccine skepticism rises across the nation, these once-glowing achievements are beginning to dim, causing concern among public health experts, parents, and healthcare professionals alike.
Jen Fisher, a mother from Franklin, Tennessee, knows firsthand the importance of vaccination. Her 12-year-old son, Raleigh, has a congenital heart condition that leaves him vulnerable to infections that other children might weather with little more than a day off school. Fisher, who ensures Raleigh receives all the recommended vaccinations, depends not only on his immunity but on the herd immunity of his peers to protect her son from potentially life-threatening illnesses like measles or flu.
“I want everyone to be vaccinated so that illnesses like measles, which were once eradicated, don’t come back,” Fisher said. “For children like Raleigh, who have compromised immune systems, even a mild illness can land us in the emergency room.”
For years, Tennessee has stood out for its relatively high childhood vaccination rates, despite being a state with some of the worst health statistics in the U.S. It is a state where life expectancy is among the lowest and chronic health conditions are common. Yet, thanks to strong vaccination policies, Tennessee had largely avoided some of the public health crises seen in other parts of the country. Mississippi and West Virginia, similarly conservative states, have also boasted high vaccination rates, raising eyebrows among experts who note that childhood vaccination requirements often don’t align with the other health challenges these states face.
According to James Colgrove, a public health professor at Columbia University, “The kinds of policies that states have don’t map neatly onto ‘red’ versus ‘blue’ or one region or another.” Despite the political landscape, these states had historically embraced childhood vaccination, perhaps because of their recognition of the far-reaching consequences of outbreaks.
However, in recent years, this positive trend has been threatened. The percentage of kindergartners exempted from one or more vaccines has been steadily rising. During the 2023-24 school year, the national exemption rate reached a record high of 3.3%, with 40 states and Washington, D.C., reporting increases in vaccine opt-outs. Non-medical exemptions have been the primary cause of this rise, with many parents choosing not to vaccinate based on personal or philosophical beliefs, rather than health concerns.
Both Tennessee and Mississippi saw increases in vaccination exemptions, a shift that has alarmed health experts. Public health advocates fear the growing momentum of the “health freedom” movement, which has gained traction in several states, could spell trouble for childhood vaccination efforts. The movement, which champions individual choice over government mandates, has been fueled by anti-vaccine rhetoric and high-profile figures like Robert F. Kennedy Jr., who has been a vocal critic of vaccine policies.
The rise of vaccine misinformation, amplified by social media and political figures, has led to an environment where fear and distrust of vaccines are spreading. As more parents opt out of vaccination requirements, public health experts worry that preventable diseases could return, threatening not only vulnerable children like Raleigh but the broader community as well.
As Jen Fisher continues to advocate for vaccines, she remains hopeful but cautious. “It’s frustrating to see this shift in attitudes,” she said. “But I believe that if we keep educating people about the risks, we can turn things around.” In the face of rising vaccine skepticism, the need for education and public health advocacy has never been more urgent. Only through a collective effort can the hard-won public health progress in states like Tennessee, Mississippi, and West Virginia be preserved.
