ORLANDO, Fla. — The vaccination rate for Orange County kindergarteners hit a 20-year low this year, and experts fear that with fewer children immunized, outbreaks of infectious diseases are likely.

The percentage of pupils entering kindergarten fully vaccinated also has plummeted across the state and in other Central Florida counties, according to the Florida Department of Health, but Orange’s drop was among the steepest.

The percentage of Orange kindergarteners vaccinated against infectious diseases such as measles and polio was nearly 94% in 2016 and plummeted to about 85% in 2025. The county for many years exceeded the overall state vaccination rate but now is well below it.

In every Central Florida county, the kindergarten vaccination rate fails to reach 95% — the level, sometimes referred to as herd immunity, that makes it unlikely that a single infection will spark a disease cluster or outbreak.

The rate was about 86% in Lake and Osceola counties and 90% in Seminole County, all below where those counties were a decade ago.

The drop in vaccination rates is “alarming,” said Michael Muszynski, a pediatric infectious disease expert and professor emeritus at Florida State University’s College of Medicine.

“Once you get down in the 80s, like we are, we’re going to have an outbreak in Florida in the near future. Because that is really bad,” said Muszynski, who practiced at Orlando Health and Nemours Hospital for over 20 years.

This year, just under 89% of Florida kindergarteners were fully immunized with the state-required vaccines — well below the national average of 93%.

That figure has decreased every year since 2020, when the COVID-19 pandemic heightened many Americans’ distrust of mainstream medical advice.

The Florida Department of Health did not respond to requests for comment about the falling rates.

Florida law requires students be vaccinated for diphtheria, tetanus, pertussis, polio, measles, mumps, rubella, Hepatitis B and chickenpox before enrolling in school. However, the law also allows for exemptions for medical or religious reasons.

And getting a religious vaccine exemption in Florida is simple, requiring only that parents request and fill out a form from the health department. Such an exemption “must be issued upon request,” the state rules say, and “no other information should be solicited from the parent or guardian.”

On social media, parents worried about or opposed to vaccines share information and advice on how to obtain these exemptions and find pediatricians who will take unvaccinated children.

“No jab no school is not a thing in Florida. I can help you if you want to avoid vaccines for school and more,” one Volusia County mother posted to Facebook in late July, just ahead of the new school year.

More Florida parents than ever are using the state’s religious exemptions to get out of vaccinating their kindergarteners. In 2005, about 2% of Florida kindergarteners received a vaccine exemption for non-medical reasons — a figure that more than doubled by 2025, according to data from the National Center for Immunization and Respiratory Diseases.

Across the U.S., the share of children with exemptions from required vaccines rose to an all-time high of 3.6% in the 2024-25 school year. In Florida, the group of kids exempted from vaccine requirements was nearly double that at more than 6%. And in some Florida counties, the exemption rate is as high as 15%, according to state health data.

Muszynski thinks an increase in misinformation spread by those with anti-vaccine opinions in positions of power is partly to blame for fewer 5-year-olds starting school with all their shots.

For example, Florida’s Surgeon General Joseph Ladapo has sown doubt about mRNA COVID vaccines and did not recommend the measles vaccine to families or require unvaccinated students to stay home amid the 2024 measles outbreak in Weston.

U.S. Health and Human Services Secretary Robert F. Kennedy Jr. once blamed an ingredient in some vaccines for causing autism — a claim long debunked by medical studies.

The Florida Chapter of Children’s Health Defense, a nonprofit founded by Kennedy, amplifies vaccine misinformation with claims the COVID-19 vaccine killed 15 million people and injured almost a billion more.

It also shares information on how to get an exemption from Florida’s vaccine requirements. “It is critical to note that by law the Health Department cannot deny you a Religious Exemption for any reason,” its website says.

The pandemic broke many people’s trust in public health guidance, Muszynski said, and undermined their belief that vaccines, “the major accomplishment in medicine in the history of mankind,” have benefits that far outweigh any risks .

Vaccines, he said, greatly reduce the chance of catching or becoming seriously ill from a disease and have helped to all but eliminate many diseases from the United States. But because of vaccines’ success, many people are no longer familiar with the devastating impacts of diseases, such as polio, he said.

Jennifer Takagishi, a Tampa pediatrician and vice president of the Florida Chapter of the American Academy of Pediatrics, said with fewer children vaccinated those diseases may resurface.

“When the rate is low, we are at an increased risk of some of these diseases we have seen eliminated making a comeback,” she said.

In February 2024, an outbreak of measles spread through Manatee Bay Elementary School in Weston where 33 of the school’s 1,067 students lacked at least one shot of the two-dose measles vaccine.

By the end of the outbreak, the disease had spread to nine children.

“Vaccination declines we saw during the COVID-19 pandemic aren’t rebounding,” said Takagishi, adding that it may take a year or two before the lowered immunization rate is reflected in a rash of diseases.

Nationwide this year, 462 people have contracted measles compared with 77 in 2024, according to the Centers for Disease Control & Prevention.

Another vaccine given before kindergarten is for pertussis, or whooping cough, which young children are more prone to catching during the fall and winter months. Florida has already had a record number of whooping cough cases in 2025 — more than 1,100 cases compared with 391 in 2019, before the pandemic.

Children diagnosed with whooping cough, a respiratory infection, can lose their breath, have apnea spells, or vomit. Health experts expect to see a continued rise in cases if vaccine rates keep declining.

Jude Bruno’s son Jackson started kindergarten in Miami-Dade County this month, fully vaccinated.

“Yes, give him a shot, because we want what’s best for him,” he said.

Bruno, who is the president of the Florida Parent Teacher Association, said the organization worries that the continued decrease in kindergarten vaccine rates will lead to more school disruptions such as seen during last year’s measles outbreak in Broward, where students impacted by the outbreak were in and out of classes.

Bruno said he expects the Florida PTA to try and push lawmakers into addressing the issue during the upcoming Florida Legislative session, and said the PTA plans to take a more “fervent” stance on the issue if the rate continues to drop.

“It’s already dangerously low, and it going any lower will have ripple effects across our schools ecosystem,” he said.

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—South Florida Sun Sentinel Health Reporter Cindy Krischer Goodman contributed to this report.

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