1184: Back-to-School Vaccines

JOHN SHEEHAN: 

This is Public Health Review Morning Edition for Tuesday, August 11, 2026. I'm John Sheehan with news from the Association of State and Territorial Health Officials.

 

As students head back to school, vaccination remains one of the most effective ways to keep children and communities healthy. Today, in recognition of National Immunization Awareness Month, Michelle Fiscus, chief medical officer for the Association of Immunization Managers, joins us to discuss the current state of childhood immunization in the United States. She explains why most families continue to vaccinate their children, addresses the misconceptions fueling vaccine hesitancy, and shares strategies for building confidence through trusted messengers and community-based care. Dr. Michelle Fiscus, welcome to the show.

 

MICHELLE FISCUS: 

Thanks for having me.

 

SHEEHAN: 

So, Michelle, August is National Immunization Month. What is the current state of immunization in the United States, and what trends are you looking at for back-to-school season?

 

FISCUS: 

Well, I think the most important thing to understand is that the vast majority of parents choose to vaccinate their children as is recommended by CDC, AAP, and everyone else kind of in the vaccine universe here. We have seen a slow but steady decline in immunization rates across the country that tends to be variable based on your geography, and there are definitely zip codes and communities that have lower vaccination rates than other places in a particular jurisdiction. And we're watching that very closely. But I think the most important thing to know is that we are still a very highly vaccinated country.

 

SHEEHAN: 

Absolutely. And what should parents be thinking about, especially now as they look forward to the next school year?

 

FISCUS: 

I think parents have a lot coming at them, and the thing to know is that vaccines are the best tool that we have to prevent diseases that we can prevent in children. And there is a lot of information out there, and really finding a trusted source for that information and sticking with that source is probably the best thing to do for just your peace of mind when it comes to making decisions about your children's healthcare.

 

SHEEHAN: 

And what strategies have you seen work with respect to sort of increasing, you know, confidence in vaccines and making people feel trusted?

 

FISCUS: 

I think finding those trusted messengers and empowering them with the right messages is really important. I think people are more likely to take advice from people that live like they do, work like they do, look like they do, than maybe from some random stranger somewhere. And the other really important thing is for us to literally meet families where they are, and that means not only understanding where they come from when they have questions about vaccines, but also literally taking vaccines to where they and their children are to reduce as many barriers as we can to getting those kids vaccinated and making choosing vaccination the easiest choice.

 

SHEEHAN: 

Sure. And thinking holistically, you know, beyond families, but to the wider community and to, you know, healthcare providers and to programs that are trying to implement immunizations, what should what should they keep in mind as they work together to get this to get this happening?

 

FISCUS: 

You know, the last few years have been hard for parents. Like I said, there's a lot coming at them, and so parents are sitting in this space where they're trying to make the best possible decision for their child. And in some cases, they're looking at that as, well, I can decide to choose a vaccine against a disease I've never seen that might have some risks associated with it, or I can choose to leave my child vulnerable to a disease that I've never seen. And that's a really hard thing to struggle with if you're a parent and not sure about where you should be getting credible information about that choice. So I think we all need to come to those conversations with empathy, understanding that every parent is trying to make what they think is the best possible choice for the benefit of their child, while at the same time helping to explain why vaccinating their child again even against diseases that they've never seen is the safest and most important thing that they can do to protect them.

 

SHEEHAN: 

Yeah, what misconceptions are you coming up against as parents sort of navigate those decisions?

 

FISCUS: 

There are a lot of misconceptions around just the safety and the testing of vaccines. Vaccines are the most highly tested and regulated of any medication that we use. Certainly, more regulated and safer than any of the products that they might see being promoted by wellness influencers or others as alternatives to vaccinating their children. There are tons of fallacies and just flat out lies and rumors on social media, and there it is literally whack-a-mole. So, you know, as soon as we think we've debunked one, there's something else that comes up. And so again, you know, really stressing like find a credible resource that you like to go to for information, whether that's your child's healthcare provider, whether that's a school nurse, it could be a certain web page like healthychildren.org, which is from the American Academy of Pediatrics, or it could be something like Mayo Clinic or Children's Hospital of Philadelphia. Any of those children's hospital links are going to have credible information for you about vaccines. And CHOP, they have a Vaccine Education Center that has very short, plain-language resources that can answer just about any question you can think of as a parent about the vaccines that are recommended for your children.

 

JOHN SHEEHAN: 

And what vaccines should be top of mind for parents right about now?

 

FISCUS: 

Well, they're all really important, and obviously, we've had a smattering of flu cases around the United States that's going to eclipse records, even eclipse last year's record number of cases. But the thing I really want parents to think about is seasonal influenza vaccine. It is so important to get your child vaccinated against flu every single fall. We had 187 children die last year from flu. Those children are almost always unvaccinated, and usually these are healthy children, more so than they are even kids with a lot of complicated health history. So, it is a simple thing to do. These vaccines have been around forever. They are very safe, and the more people that we get vaccinated against flu, the better they work, because it reduces the amount of flu that we see circulating in things like your children's classroom. So, make sure you get them vaccinated. In pediatrics, we like to say flu before boo, which means get your flu shot before Halloween and make sure that your child is protected.

 

SHEEHAN: 

And you mentioned the declining rates of immunizations and the resultant outbreaks that we've seen. Seems like some pretty stark lessons can be drawn there.

 

FISCUS: 

You know, I think about these outbreaks that happen. You know, oftentimes they spark in a community of people who are tight-knit for whatever reason, whether that's social beliefs or socioeconomics or cultural, what have you. But I live in Maryland, and this past week, we've had several days of really hazy skies and smoke from the wildfires in Canada coming down, and that's kind of the way I think about these outbreaks, that, you know, they start as a smoldering event, maybe in a small community or a little population, but those are still people who get on airplanes, who use public transportation, who might need to go to the hospital or the doctor's office to get checked out because they're sick from one of these diseases. And so there are ample opportunities for those diseases to spread outside of those small communities. And we've seen that in places like South Carolina this last year, and now in Utah, where there have been hundreds and hundreds of cases of measles that started in maybe a small community and then had the opportunity to spread. That is the only goal of these diseases: is to replicate their viruses and spread to more people. And the best tool that we have to stop that from happening is to make sure that everyone is vaccinated so that we can all keep each other safer.

 

SHEEHAN: 

Yeah. You mentioned making sure to get that yearly flu shot. Any other practical steps that parents, caregivers, schools should be thinking about going into next year?

 

FISCUS: 

Well, to parents, I would plan ahead. You know, we in in pediatrics we start thinking about back to school about two weeks after the last school year ended. So we are already in back to school mode, usually by the middle of June. Don't wait until the last minute. If you have a child going to preschool, starting kindergarten, starting seventh grade, sometimes starting their sophomore or junior year of high school, there are probably required vaccines for their school entry. And so, you don't want to wait until the middle of August to try to get an appointment to get those done. Call their healthcare provider now, find out what vaccines they're due for, or you can call your local health department, they may be able to tell you what they're due for, and make sure you get those done so that you have a seamless entry to school this fall and you don't end up in one of those situations where you're excluded from school until you can get those vaccinations caught up.

 

SHEEHAN: 

Absolutely. Dr. Michelle Fiscus, thanks so much.

 

FISCUS: 

Thanks so much, John, appreciate it.

 

SHEEHAN: 

Dr. Michelle Fiscus is chief medical officer for the Association of Immunization Managers. Adverse childhood experiences, or ACEs, are traumatic events like abuse, neglect, and household substance misuse, and are linked to lasting health challenges, including chronic disease and mental health concerns. Jurisdictions can take policy actions to prevent ACEs by shaping economic, social, and institutional conditions.

 

Between January and March 2026, ASTHO engaged health agency leaders and staff in Kansas, Oregon, and Indiana to discuss policy successes, including how strategy and implementation decisions supported the state's overall goals of ACEs prevention. This ASTHO brief is part of its Voices from the Field Public Health Success Stories Hub. Find out more at the link in the show notes.

 

ASTHO welcomes new member, Honorable Bremmendy Jacklick, Minister of Health and Human Services for the Republic of the Marshall Islands. Bringing nearly three decades of nursing experience, he began his career as a clinic and public health nurse in Ebeye before serving as public health nurse chief in Majuro, where he led programs focused on disease prevention and community wellness.

 

This has been Public Health Review Morning Edition. I'm John Sheehan for the Association of State and Territorial Health Officials.