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Hamilton County Public Health says vaccination documentation is missing for about 26 percent of kindergartners. Officials say the gap makes it difficult to determine the county’s actual vaccination coverage. The issue comes as national kindergarten vaccine exemptions reached a record 4.2 percent during the 2025-26 school year.
Hamilton County vaccine records are missing for about 26 percent of kindergartners, local health officials say.
These recently recorded numbers are making it harder for officials to measure actual vaccination coverage as rates decline nationwide.
The documentation gap comes as federal data shows kindergarten vaccination coverage fell again during the 2025-26 school year. The Centers for Disease Control and Prevention (CDC) reported that exemptions from required school vaccines reached a record 4.2 percent nationwide.
Hamilton County vaccine records leave coverage unclear
Hamilton County Public Health says about 26 percent of kindergarten students lack vaccination documentation. The figure does not mean that 26 percent of children are unvaccinated. Health officials believe many children without records have received their required vaccines.
Dr. Steven Feagins, medical director for Hamilton County Public Health, discussed the documentation issue with WXIX-TV. He said the county’s reported numbers may look lower partly because schools have not submitted complete records. Feagins said officials have reason to believe many children without documentation are vaccinated.
The missing records create a challenge for public health officials. Accurate records help officials determine how many children have protection against vaccine-preventable diseases. They also help health departments respond quickly when an infectious disease reaches a school.
According to WXIX, Hamilton County reported a 0.1 percent medical exemption rate among kindergartners. The county reported a 3.5 percent nonmedical exemption rate based on submitted forms. That nonmedical rate remains below Ohio’s reported statewide rate.
Hamilton County Public Health also recently urged families to review routine childhood immunizations before the school year. The department said parents should work with pediatricians and school nurses to confirm that children meet Ohio’s school requirements. Read: Hamilton County Public Health’s childhood immunization guidance
Hamilton County vaccine records matter during measles investigations
Missing Hamilton County vaccine records can become especially important during a measles investigation. Public health officials need reliable vaccination information when determining which students may have been exposed.
Feagins said investigators may initially have to assume that a child without documentation lacks proof of vaccination. Officials can then search for records during the investigation. In some cases, the documentation eventually becomes available.
That process can complicate contact tracing. Contact tracing identifies people who may have been exposed to an infectious disease. Health officials use vaccination records to help determine who may need monitoring, testing, isolation or other measures.
Measles presents a particular concern because the virus spreads extremely easily. Hamilton County Public Health says measles can remain in an airspace for up to two hours after an infected person leaves. The department also says an infected person can spread measles before knowing they have the disease.
Local health officials have emphasized the importance of maintaining accurate vaccine documentation. Hamilton County Public Health provides a vaccine card or record request service through its epidemiology division. The department says its epidemiologists use health data to investigate infectious disease outbreaks and other community health issues.
For families, the issue is different from deciding whether a child received a vaccine. A child may have received the required doses while the school lacks documentation. That distinction makes the county’s 26 percent figure important to understand.
Ohio vaccine exemptions increased last school year
Ohio also recorded a higher kindergarten vaccine exemption rate during the 2025-26 school year. According to WXIX, the state’s exemption rate increased to 5.5 percent from 4.7 percent the previous year. Ohio ranked among the states with exemption rates above 5 percent.
Ohio allows certain exemptions from school vaccination requirements. Medical exemptions require certification from a physician. State rules also allow exemptions based on reasons of conscience, including religious convictions, according to Feagins’ comments reported by WXIX.
The Hamilton County figures differ from the statewide numbers. Local officials reported a 3.5 percent nonmedical exemption rate among Hamilton County kindergartners. However, the county’s missing documentation means officials cannot use the available records to describe overall vaccination coverage with complete confidence.
The distinction matters when comparing counties, school districts and states. A higher documented exemption rate does not necessarily mean every child without a record remains unvaccinated. Documentation practices can affect the figures reported to public health agencies.
The issue also comes as Ohio schools begin another academic year. School vaccination records help districts demonstrate compliance with state requirements. They also provide health departments with information needed during infectious disease investigations.
The Cincinnati Exchange previously reported on Cincinnati school rankings and district performance, including broader issues affecting local schools. The documentation issue adds a public health component to the challenges facing schools and families.
National kindergarten vaccine rates continue to fall
The local documentation problem comes against a broader national decline. CDC data released Aug. 17 showed vaccination coverage among kindergartners decreased during the 2025-26 school year.
Coverage for measles, mumps and rubella (MMR) fell to 92.4 percent nationally. Polio coverage also reached 92.4 percent, while diphtheria, tetanus and acellular pertussis (DTaP) coverage fell to 92 percent.
Varicella, commonly known as chickenpox, also saw a decline. The CDC data showed decreases for MMR, DTaP, polio and varicella in more than half of states.
Reuters reported that the national decline continued a trend that emerged after the COVID-19 pandemic. The news agency reported that vaccination coverage fell for all vaccines included in the CDC’s kindergarten data for the 2025-26 school year.
The national exemption rate also reached a new record. It increased to 4.2 percent from 3.6 percent the previous school year. That represents about 155,000 kindergartners nationwide.
The Associated Press reported that exemptions increased in 41 states and the District of Columbia. Most exemptions involved nonmedical reasons.
The CDC data shows why local documentation can matter when officials evaluate vaccination coverage. National and state estimates depend on information reported by schools and health authorities. Missing local records can make it harder to understand how many children have received required vaccines.
Measles remains a concern for Cincinnati-area health officials
Health officials are watching the vaccination trend closely because measles can spread rapidly through communities. Lower vaccination coverage can leave more people susceptible when the virus enters a school or community.
Hamilton County Public Health said Ohio and Kentucky have experienced measles outbreaks in 2026. The department also said the United States had recorded more than 2,300 confirmed measles infections through July 24.
Cincinnati Children’s doctors have also discussed the consequences of declining childhood vaccination rates. Dr. Felicia Scaggs Huang, a Cincinnati Children’s physician, has warned about the broader effects of vaccine-preventable diseases.
Those effects can extend beyond the initial illness. Children who become sick may miss school, while parents may need to miss work to provide care. Severe infections can also place additional demands on hospitals and healthcare systems.
The MMR vaccine remains the primary protection against measles. Hamilton County Public Health says the two-dose MMR series is 97 percent effective at preventing measles. One dose is 93 percent effective, according to the department.
The Cincinnati Exchange has also covered local healthcare developments, including the expansion of an Over-the-Rhine health center. Access to healthcare and reliable medical records can both affect how families maintain routine preventive care.
Missing vaccine documentation can affect public health response
The 26 percent documentation gap gives Hamilton County a more complicated picture than the national numbers alone suggest. Officials cannot assume that every child without a record remains unvaccinated. At the same time, they cannot treat undocumented vaccination status as confirmed protection.
That creates an administrative challenge for schools and health officials. Complete records allow public health investigators to make faster decisions during an outbreak. Missing information can require additional record searches and follow-up with families.
Hamilton County Public Health’s epidemiology division handles surveillance and investigation of infectious diseases. The department says its epidemiologists collect and analyze public health data to identify community health risks.
The county’s health officials therefore face two related issues. National vaccination coverage is declining, while incomplete local documentation makes the actual Hamilton County rate harder to measure.
For parents, the immediate issue is keeping children’s records current with their schools and healthcare providers. Families who cannot locate vaccination records can also contact Hamilton County Public Health about obtaining vaccine documentation.
The CDC’s national data shows that kindergarten vaccination coverage has continued to edge downward. Hamilton County officials say better documentation will help determine how much of the local picture reflects actual vaccination gaps and how much reflects missing paperwork.
FAQs
What does the 26 percent vaccine documentation gap mean?
Hamilton County Public Health says vaccination documentation is missing for about 26 percent of kindergartners. It does not mean that 26 percent of those children are unvaccinated.
What is Ohio’s kindergarten vaccine exemption rate?
Ohio’s kindergarten vaccine exemption rate rose to 5.5 percent during the 2025-26 school year, according to reporting by WXIX. The previous year’s rate was 4.7 percent.
What is the national kindergarten vaccine exemption rate?
The national exemption rate reached 4.2 percent during the 2025-26 school year. The CDC figure represents about 155,000 kindergartners and marks a record high.
Why are vaccination records important during a measles outbreak?
Vaccination records help health officials identify students who may have protection after exposure. Missing records can require investigators to conduct additional follow-up before determining a child’s vaccination status.
