‘Perfect Storm’ For Infectious Diseases Brews As Kids Head Back To School

Back-to-school season could bring uncertainty to U.S. families hoping to stay healthy this year due to vaccination gaps and changes in federal health policy, a panel of physicians told reporters this week.

Multiple infectious diseases — especially respiratory viruses such as the flu, COVID-19 and RSV — are already circulating, which could lead to a mix of illnesses causing a surge in student absences, according to the experts with the College of American Pathologists.

This school year starts with “more of an infectious disease burden than maybe we’ve seen in years past,” said Dr. C. Leilani Valdes, the chair of Pathology and Laboratory Medicine at Citizens Medical Center in Victoria, Texas.

Even keeping track of infectious disease trends and where people are getting sick could be more difficult. The Centers for Disease Control and Prevention hasn’t said how, or if, it will provide surveillance on infectious diseases.

Both seasonal influenza and RSV severe enough to require a visit to the doctor are low and very low, respectively, in most places, while COVID-19 rates are ticking up in most of the country, according to the Centers for Disease Control and Prevention, COVID-19 activity is increasing in many parts of the country, with the new “razor blade variant” that causes severe sore throat.

At the same time, once-eradicated infectious diseases are making a comeback, especially measles. The U.S. is currently experiencing the largest measles outbreak since 2000, when federal health officials said the illness had been eradicated by vaccines. Before vaccines were available, measles caused an estimated 400 to 500 deaths a year.

Measles vaccination rates have slipped below the 95 percent required for “herd immunity” in some areas of the country. As of Aug. 5, there were 1,356 confirmed cases of measles in 41 jurisdictions.

Dr. Bobbi Pritt, a microbiologist at Mayo Clinic in Rochester, Minnesota, warned those and other factors create a “perfect storm” for the spread of preventable infectious diseases in America’s classrooms.

Vaccine Hesitancy Means Less Protection

The Centers for Disease Control and Prevention continues to recommend that children be vaccinated against childhood diseases such as measles, mumps and rubella, and pertussis, or whooping cough. However, Health and Human Services Secretary Robert F. Kennedy, who in the past has voiced concern about the CDC’s childhood vaccination schedule, replaced the CDC’s vaccine advisory committee with people whose views are more aligned with his own.

Vaccine hesitancy began creeping upward during the COVID-19 pandemic, years before Kennedy’s appointment earlier this year. About 92.5 percent of incoming kindergarteners were up-to-date on measles shots at the start of the 2024-25 school year, according to the CDC.

The percent of kids protected against diphtheria and pertussis was even lower, at 91.2 percent. More than half of U.S. states reported dips in coverage with the MMR, DTaP, polio and varicella vaccine compared to the year before, according to the CDC data.

On top of that, just under 15 percent of school-age children ages 6-17 were protected against COVID-19 at the end of the 2024-25 school year, and only 37 percent had gotten flu shots, though te CDC Data on the number of kids in that age group was more obscure, and the CDC doesn’t specifically recommend RSV vaccinations for that group.

In May, Kennedy announced the COVID vaccine had been removed from the recommended immunization schedule for children. The

“When we start the school year without the recommended vaccines, we’re raising the risks of things like measles, whooping cough and overlapping threats from COVID, RSV and influenza,” Pritt said.

1 Kid With Measles Can Infect 12-18

Small gaps in vaccination coverage for highly transmissible diseases such as measles and whooping cough can have an outsized effect, the experts said.

Measles is one of the most contagious infectious diseases and can spread easily through respiratory droplets or even from brief or indirect contact. One person with measles can transmit measles to between 12 and 18 people, said Dr. David Schwartz, a medical epidemiologist and CAP fellow.

Infectious diseases can spread easily to family members, such as grandparents and other older relatives, or those with compromised immune systems.

“As our children return to school this year, they’re exposed to a variety of microbial threats, and when they come home from school, they may bring not just homework, but infectious diseases,” Schwartz said. “They can transmit it to older adults, including grandparents and people who are immunocompromised. These are individuals who can have more severe outcomes.”

‘We Have Some Headwinds’

Restoring confidence in vaccines and raise awareness about how infectious diseases spread starts with a return to basics in U.S. classrooms, Valdes said.

“There are all kinds of ways to educate what herd immunity would mean with a second-grader,” she said. “It’s a challenging time, because we have some headwinds that are not in our favor. But we have good science that backs us up.”

“And the science supports the medicine,” Pritt said.

In her outreach work in Victoria, Valdes breaks down the subtleties of how infectious diseases spread with hand-washing competitions, hygiene songs and games. In one exercise, students form a circle around their teacher and hold hands — “after they’ve washed them,” Valdes emphasized — and the student playing the virus cannot break through and attack the teacher. But when even two children unlock hands, the virus is able to slip in.

Other strategies can be as simple as using a cough or sneeze as a cue to reinforce how important it is for students to wash their hands throughout the day.

“In particular, hand-washing in school is of paramount importance,” Schwartz said, explaining that 30 percent of diarrheal illnesses and 20 percent of respiratory illnesses can be eliminated if people properly wash their hands.

Also, parents should keep their kids home from school until they’re no loner contagious, and school districts should consider partnerships with local health departments and other agencies on such things as wastewater monitoring to stay ahead of emerging infectious diseases and trends.

Related

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