Statewide measles vaccination rates down, religious exemptions rise for fifth year in a row
Olivia Hayes
COLUMBIA, Mo. (KMIZ)
The Missouri Department of Health and Senior Service reports a drop in statewide measles MMR vaccination rates, while religious vaccination exemptions rise for the fifth year in a row.
This comes as measles outbreaks have occurred recently in South Carolina and Texas. DHSS requires students to receive two doses total, with the first dose administered anywhere between 12-15 months and final dose between 4-6 years old.
On Tuesday, DHSS warned travelers who were at St. Louis Lambert International Airport earlier this month to watch out for possible symptoms after someone who was diagnosed with measles traveled through the airport. The department said the infected person was at the airport between 5-7 p.m. Feb. 7 and was at Terminal 2, baggage claim and road a shuttle to the parking area. Those who may have came into contact with the person should be on alert until Feb. 28.
The Center for Disease Control and Prevention says measles symptoms begin with a high fever, a runny nose, a cough and red, watery eyes. Two to three days after those start, the CDC says tiny white spots may appear in your mouth. Not long after those symptoms start, a measles rash appears. It usually begins as flat red spots on the face at the hairline. They then spread downward to the neck, arms, legs and feet.
According to the CDC, when the rash appears, a person’s fever may spike to more than 104 degrees.
Dr. Laura Morris, with MU Health Care, explained people may not realize they have been exposed to measles and are experiencing symptoms until it’s too late.
“Because it’s airborne, most of the first symptoms of measles are actually very similar to other types of respiratory infection,” Morris said. “If you’re close enough to touch someone’s rash, you are close enough to be exposed to the droplets from their secretions, from their nose, from the air that they’re breathing out.”
According to DHSS, there was seven confirmed cases of measles in Missouri in 2025. No Missouri residents have reported confirmed cases yet for 2026.
“It’s probably only a matter of time,” said Nathan Koffarnus, an epidemiologist with Missouri DHSS. “Already in 2026, we’ve got over 900 cases [nationwide] in just a month and a half. So we’re going to almost certainly shatter last year’s numbers, which were already quite high.”
From the 2020-21 school year to the 2024-25 school year, the statewide Measles vaccines rate for kindergarteners dropped from 92.6% immunization to 90% immunization. For eighth graders, the rate dropped from 97.9% immunization to 96.1% immunization. Missouri DHSS says the threshold for herd immunit is 95% immunization.
“Herd immunity is this concept of you have to have a certain percentage of the population immune to a disease to keep it from just circulating, on a regular basis in the community,” Koffarnus said.
Morris said the state is at 90%, no longer meeting the threshold.
“If you’re not vaccinated, there’s about a nine-in-10 chance that if you’re exposed you will come down with measles,” Morris said.
The Immunization of School Children law requires Missouri students to get their immunizations to attend school, except those granted religious and medical exemptions. From the 2020-21 school year to the 2024-25 school year, the statewide religious exemption rates for kindergarten students rose from 2.3% to 4.8%.
“If they’re not vaccinated by kindergarten, then they’re probably not going to be,” Koffarnus said.
For eighth grade, the religious exemption rate rose from 1.6% to 3.4%.
“People that are taking advantage of those exemptions,” Koffarnus said. “People just need to think about the potential ramifications. If there is a case in your child’s school, and your child’s unvaccinated, they’re probably going to have to miss quite a bit of school because of that exposure.”
Morris said in states that have taken away the option religious exemption, vaccination rates have seen an increase.
“Most of the time it’s a philosophical or just a preference not to vaccinate their child,” Morris said. “When those philosophical exemptions are eliminated or discouraged, then the rates of vaccination go up and the cases of infections go down.”
Both Morris and Koffarnus say the most-critical risk lies in the communities severely below the recommended immunization threshold.
“Some counties are above 95% still and there are some pockets in areas where we’re in the 60s or 70s and so those are places that are very vulnerable,” Morris said.
“You’ve got these pockets of under protected people and if you do get measles introduced to that group, it’s really primed for not just one case, but many cases,” Koffarnus said.
While the vaccine is 95-97% lifetime effective after both doses, Morris said it’s still not full proof but it is still the best method of prevention.
“If hundreds of people are exposed, even vaccinated people, there can be breakthrough infections because 97% is still not 100%,” Morris said. “Anyone else who is exposed needs to follow the public health recommendations depending on their vaccination status, to potentially limit them from spreading to other people and that might mean isolating, even sometimes for weeks.”
She said staying aware of the world around you is also key to staying safe and healthy.
Countries outside of the United States are also experiencing a resurgence of measles and there are hotspots and outbreaks across the United States right now,” Morris said. “So pay attention to where you’re going, know the status of the people that you’re traveling with and take those standard precautions, but your vaccine will protect you.”
An uninsured child can get free vaccinations through the Vaccines for Children Program, funded by the CDC. Children can receive free immunizations through the program as long as they are Medicaid-eligible, do not have health insurance, are an American Indian or Alaskan Native, or are underinsured.
