STUDENT IMMUNIZATION RATES SHOW MIXED RESULTS
News release from DoH, 25-116, October 2, 2025
HONOLULU — Vaccination rates among kindergartners in Hawaiʻi improved for the 2024-2025 school year compared to the 2023-2024 school year. However, religious exemptions continue to increase across grades K-12.
According to new data from the Centers for Disease Control and Prevention (CDC), Hawaiʻi kindergartner vaccination rates have been improving over the past three years, but they continue to lag behind the national averages.
| VACCINE |
COVERAGE 2022-23 |
COVERAGE 2023-24 |
COVERAGE 2024-25 |
| Hawaii |
National |
Hawaii |
National |
Hawaii |
National |
| DTP, DTaP or DT |
87.00% |
92.70% |
89.40% |
92.30% |
91.50% |
92.10% |
| Hepatitis B |
88.70% |
94.30% |
91.10% |
93.90% |
92.60% |
94.00% |
| MMR |
86.40% |
93.10% |
89.80% |
92.70% |
89.90% |
92.50% |
| Polio |
87.00% |
93.10% |
90.20% |
92.70% |
92.30% |
92.50% |
| Varicella |
84.40% |
92.90% |
89.10% |
92.40% |
89.50% |
92.30% |
According to the CDC, the religious exemption rate increased in Hawaiʻi from 5.3% for the 2023-2024 school year to 5.4% for the 2024-2025 school year, and from 3.1% to 3.4% nationally. The vaccination and exemption rate data reflect vaccination status for the start of the school year in 2024.
“It’s encouraging to see CDC data showing vaccination rates among Hawaiʻi kindergartners moving in the right direction,” said Dr. Kenneth Fink, Hawaiʻi Department of Health (DOH) director. “However, the religious exemption rate remains high and this preceded changes at the CDC, including to its Advisory Committee on Immunization Practices. At DOH we need to continue to work to be a trusted source and provide evidence-based recommendations so individuals can protect themselves, their loved ones and their community.”
Exemptions and other factors make it difficult to reach the desired 95% coverage target for herd immunity – a rate at which an infection is unlikely to spread from one person to another, thus protecting those who are not immunized – notably for measles.
Especially concerning is MMR coverage, which remains slightly below 90% at a time when high numbers of measles cases are breaking out on the mainland U.S. and worldwide. Two confirmed cases of measles were detected in Hawaiʻi in April 2025, followed by a wastewater sample detection of measles virus in August.
The DOH also collects self-reported, unverified school-by-school data on medical and non-medical exemptions, missing records, incomplete records and students not up-to-date on vaccinations. The numbers by school for the 2024-25 school year can be found in the latest Immunization and Examination Requirements Report Summary from the DOH. At least 20 more schools contributed to this year’s report than in the previous year.
These data show K-12 student religious exemption rates for the 2024-2025 school year of 4.9% statewide (9.1% for Hawaiʻi County, 3.3% for Honolulu County, 9.5% for Kauaʻi County, and 6.8% for Maui County) compared to a statewide religious exemption rate of 4.1% for the 2023-2024 school year. However, missing immunizations also contributed to the total percent of students not being up to date on immunizations. Statewide, 7.5% of kindergartners and 44.4% of seventh graders were missing immunizations, with the total not up to date of 15.6% and 51.6% respectively. Low vaccination rates of the diphtheria, tetanus and pertussis (whooping cough) vaccine, one of the seventh-grade requirements, is likely contributing to the current surge in pertussis cases.
“Too many of our students remain unprotected against serious diseases like measles and pertussis,” said State Epidemiologist Dr. Sarah Kemble. “With outbreaks increasing both here and worldwide, we urge families to review their children’s records and work with their healthcare providers to ensure they are up to date on all required immunizations.”
Among the results:
- Nearly 40,000 students statewide (20.7%) were not up to date with Hawaiʻi’s school-required immunizations. This figure includes students with exemptions, missing records, or incomplete vaccinations. This is a slight improvement from the 21.3% of students who were not up to date for the 2023-2024 school year.
- The gap is most pronounced among seventh graders, where more than half (51.6%) were not up to date, compared to 15.6% of kindergartners. The larger share of missing immunizations among older students is tied to additional seventh-grade requirements that were implemented in 2020 during the COVID-19 pandemic.
- Of the 399 schools reporting this year, three-quarters (76.4%) had more than 5% of their students not up to date and some schools reported much higher rates. Twenty-four schools reported having more than half their students behind on required vaccines and at six schools, more than 75% of students were not up to date.
Childhood immunizations are vital to protecting against serious diseases such as pertussis, measles and mumps. With record measles cases reported nationally and worldwide, as well as a recent surge of pertussis cases here in Hawai‘i, the DOH urges families to check their child’s vaccination records and make sure they are up to date.
To make it easier for families to access vaccines and other health services, the DOH is expanding its Healthy Hawaiʻi Partners Program (HHPP) to additional schools this year. HHPP brings schools, healthcare providers and community groups together to make it easier for families to get important health services close to home.
Last year, HHPP hosted 47 clinics. This year, more than 350 school-based wellness clinics developed in collaboration with community partners already are on the calendar. Services may include flu, COVID-19 and school-required immunizations, TB screenings, physical exams and wellness checks – not just for students, but for school staff and the whole community.
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