As kids head back to school, vaccine confusion is everywhere. So what do families need to know?

Earlier this month, President Donald Trump signed an executive order “calling for more vaccine flexibility and research” and fewer childhood vaccinations. He issued the order months after trying to slash the childhood vaccine schedule. Some of these changes were blocked by a federal judge in March.

Meanwhile, U.S. kindergarten vaccination coverage fell again in the 2025-2026 school year, continuing a concerning downward trend since the pandemic, according to data from the Centers for Disease Control and Prevention.

And stalled vaccine advisory committee meetings have left Americans in even more immunization guidance limbo as we enter the fall.

Amid the uncertainty, health experts say one thing is clear: Vaccinations are essential for student safety.

“Back-to-school immunizations matter more in 2026 than they have in decades,” Dr. Julia Rosebush, an associate professor and pediatric infectious diseases specialist at the University of Chicago said during a press briefing on Aug. 21, organized by the Infectious Diseases Society of America. “As we send children back to the classroom this year, here is the bottom line: Routine vaccinations are proven to be safe and effective at preventing diseases with high rates of morbidity and mortality.”

Here’s what else to know.

Will flu, COVID shots be available?

Updated flu and COVID vaccines will be available this season, Dr. William Schaffner, professor of infectious diseases at Vanderbilt Health and spokesperson for the Infectious Diseases Society of America, told the University of Minnesota’s Center for Infectious Disease Research and Policy, adding that the medical insurance industry has said “they would cover those vaccines.”

Trump said his order does not force parents to limit vaccinations. “Parents can still choose to give their children all of the vaccinations if they wish,” he said Aug. 10 before signing the order. “They will be covered by insurance.”

The official CDC webpage for the flu, last updated in September 2025, still recommends the flu vaccine for “everyone 6 months and older in the United States, with rare exception.”

The most effective way to prevent serious illness from the flu is vaccination, according to the World Health Organization, CDC and other leading medical institutions. Currently, the CDC especially recommends the vaccine for people at higher risk, which includes those over 65, children younger than 2, pregnant people and people with underlying health issues ranging from asthma to obesity.

The CDC also generally recommends the vaccines be given from September to November, before cold and flu season kicks off, “ideally by October.”

Measles on the mind

As classrooms begin to fill, the U.S. is also experiencing its worst measles resurgence in more than three decades, leading to the nation being at risk of losing its measles elimination status.

While recent declines in vaccination coverage may sound like a “small shift,” Rosebush said, measles is “one of the most contagious diseases we know.”

“A single unvaccinated child in a school full of unvaccinated classmates can start an outbreak that spreads to dozens of families within days,” she explained. “The measles, mumps, rubella, or MMR vaccine … is safe, effective and remains our single best tool to stop this outbreak.”

Whooping cough concerns

Pertussis, more commonly known as whooping cough, is another back-to-school concern.

According to health professionals, declining vaccination rates, declining immunity and slow public health monitoring systems are the main causes of the most recent increase in cases. According to Johns Hopkins, 2025 saw the greatest number of whooping cough cases since 2012.

“Pertussis can circulate quietly in schools or infect older adults whose immunity has waned and can be devastating for infants who are too young to be fully vaccinated themselves,” Rosebush explained.

Vaccination rate declines

U.S. kindergarten vaccination coverage fell 0.1% during the 2025-2026 school year, continuing a downward trend that has seen declines every year except one since the onset of COVID-19, according to the latest CDC data.

Coverage ranged from 92% for the diphtheria, tetanus and acellular pertussis vaccine (DTaP) to 92.4% for the measles, mumps and rubella vaccine (MMR) and the polio vaccine, the CDC said.

The CDC said coverage for the MMR, DTaP, polio and varicella vaccines decreased in more than half the states from the previous year.

“It’s continuing a long trend in the wrong direction,” said John Grabenstein, a pharmacist who previously ran the Department of Defense’s vaccine programs for troops and their families.

Amid vaccine confusion and hesitancy, it can be hard for families to find scientifically accurate information, Infectious Diseases Society of America CEO Dr. Jeanne Marrazzo said during the briefing.

“Changes in federal guidance, and especially the recent executive order, have really muddied the waters and made it very difficult for people and families to find trustworthy information on vaccines,” she said, adding that medical societies like IDSA, American Academy of Pediatrics, American College of Physicians and American Association of Family Practitioners “remain committed to reviewing the evidence base and to providing patients and physicians with evidence-based recommendations.”

Contributing: Mary Walrath-Holdridge, Ken Alltucker, Janet Loehrke and Michael Loria, USA TODAY; Reuters