Back-to-school vaccines: Engaging families, providing clarity and protecting kids

The state's one-sided approach to the vaccine debate has never been more clear than in today's email to providers. It's full of source links, but unfortunately is not itself available as a link. (As far as I can find, that is. If you know differently, please advise.)

About half of the links are available at the Aug 17 MDHHS press release.
https://www.michigan.gov/mdhhs/inside-mdhhs/newsroom/2026/08/17/vaccine-rec

Conspicuously lacking in both: the waiver so frequently referenced here. More about that in the reply to follow.

Back-to-school vaccines: Engaging families, providing clarity and protecting kids
Public Health Bulletin for Health Care Providers - August 2026

Dear colleagues,  

With vaccine-preventable diseases (VPDs) like measles and whooping cough already circulating in Michigan and the school year starting, now is the time to engage families in serious conversations, providing support and guidance regarding their child(ren)’s immunizations.

In December 2025, the Michigan Department of Health and Human Services (MDHHS) issued a Standing Recommendation supporting vaccine recommendations grounded in rigorous scientific evidence and transparent decision-making. The Standing Recommendation advises clinicians to continue following the evidence-based childhood immunization schedule produced by the American Academy of Pediatrics (AAP), which has been endorsed by 12 leading medical and health care organizations including the American Academy of Family Physicians (AAFP), American College of Obstetricians and Gynecologists, American Medical Association, as the standard of care for immunization practices in our state.

While a federal executive order was recently issued on changes to the childhood immunization schedule, please note that MDHHS continually reviews evidence regarding vaccine safety and effectiveness, and there is no new data to support changes to the vaccine schedule at this time. Combination vaccines, including the MMR (measles, mumps and rubella) vaccine, have a long history of safety and effectiveness and can reduce the number of injections that children need.

The back-to-school season is a natural check-in point for families and their health care providers — and the clock is ticking. Many school districts have already begun classes, including Detroit and Grand Rapids. Encourage parents and caregivers to schedule back-to-school health care appointments now and ask them about catching up on any missed doses and getting this year’s flu vaccine.

Together we can work to ensure all Michigan kids are protected from VPDs before they return to the classroom. Thank you for your continued partnership and for providing excellent care.

Sincerely,

Natasha Bagdasarian, MD, MPH, FIDSA, FACP
Chief Medical Executive, State of Michigan

Sarah Lyon Callo, MS, PhD
Senior Deputy Director and State Epidemiologist, MDHHS Public Health Administration

Key points on Executive Order
Executive Order 14420 was signed Monday, Aug. 10, directing federal agencies to adopt “gold‑standard childhood vaccine recommendations” for Americans.

It recommends reducing the schedule from 18 to 11 routine vaccines, e.g., shifting vaccines like hepatitis A, influenza, COVID‑19 into “high‑risk” or “shared decision-making” categories.
It calls for splitting the combined MMR vaccine into separate measles, mumps and rubella doses and spacing out immunizations across multiple visits. However, this order serves as federal guidance only.
Michigan’s position — no changes
Childhood vaccine recommendations remain the same.
Michigan continues to endorse the AAP’s childhood immunization schedule.
Robust vaccine safety and effectiveness data.
The AAP, AAFP, U.S. Centers for Disease Control and Prevention (CDC) and peer-reviewed research consistently affirm the safety and high efficacy of the current childhood vaccine schedule.
Insurance coverage.
State laws continue to mandate coverage of all routine childhood vaccines — no changes to policies or billing standards in Michigan.
Waiver process.
Michigan’s established medical and non-medical waiver procedures remain unchanged — there have been no alterations to eligibility or submission requirements.
Bottom line for providers
Continue administering the full AAP/AAFP-recommended childhood vaccine schedule.
Vaccines remain covered by insurance under state-regulated plans.
There are no changes to the waiver process or school entry requirements.
If families express concerns about vaccine schedule alterations linked to the federal executive order, reassure them that Michigan’s standards have not changed and remain focused on safety and effectiveness.

The big picture
Keep the big picture in mind as you approach vaccine and VPD discussions, and help Michigan parents, caregivers and kids prepare for school.

Measles and whooping cough
The U.S. just recorded its worst measles rates in 35 years.
As of August, the country has already reported more measles cases in 2026 than in all of 2025, the highest annual totals since measles was declared eliminated in the U.S. in 2000.
Michigan has identified two measles outbreaks so far this year in Washtenaw and Ottawa counties, representing 78% of the state’s cases.
Pertussis (whooping cough) also remains a concern.
There have been 122 cases reported in Michigan as of May 31, including 33 infants under 2 years of age.
Severe complications are common with pertussis: one in three babies who contract it require hospitalization, one in five will develop pneumonia and some develop seizures or brain swelling.
Statewide vaccination is not high enough to prevent outbreaks of these highly contagious diseases.
In Michigan, MMR vaccine coverage among children 19 to 35 months stands at just 75.7%.
Diphtheria, tetanus and pertussis (DTaP) vaccine coverage is 67.8%.
Both are below the levels needed to prevent outbreaks.
Influenza (flu)
Recent flu seasons have hit children especially hard.
At the peak of the last season in Michigan, one in four emergency department visits among children ages 5 to 12 years were flu-related, and 12 pediatric deaths were confirmed — the second-highest total on record (2024-25 remains the highest at 14 deaths).
Despite this severity, childhood flu vaccination coverage has fallen to an all-time low of 19.4% in Michigan.
Children ages 6 months through 8 years receiving the flu vaccine for the first time need two doses spaced at minimum four weeks apart.
It is recommended to start the series now so they can complete both doses before respiratory illness season peaks. All children 9 years and older are recommended to receive a flu vaccine in October.

COVID-19
COVID-19 also presents substantial risks for children.
During last season’s peak, 421 children were hospitalized in Michigan. COVID-19 is especially risky for infants. Of the five confirmed COVID-19-associated pediatric deaths in Michigan, the median age was just 9 months.
Despite this risk, only 3% of Michigan children received a COVID-19 vaccine last season.
Current AAP recommendations call for unvaccinated children ages 6 to 23 months to receive two doses, spaced four to eight weeks apart.
Children ages 2 through17 years are recommended to receive one COVID-19 vaccine in October. Updated guidance is expected to be released by AAP on Wednesday, Sept. 2.

Key points
Michigan’s school vaccine waiver rate is the highest since 2013, leaving school systems at a greater risk for disruption and missed class time; and children who cannot be vaccinated for medical reasons or who are immunocompromised are more vulnerable.

Let's not go back in time.
In 1952, the U.S. saw more than 57,000 cases of polio; in 1958, there were 763,000 cases of measles nationwide. Vaccines made those numbers — and those diseases — history. With vaccination rates now falling, that history is threatening to repeat itself. Infants, young children and medically vulnerable kids face the highest risk of severe illness, hospitalization and death from these diseases.
Every missed or delayed vaccine is a missed opportunity to protect a child and their entire classroom.
Michigan is following AAP-recommended immunization schedules.
Talk to parents about which vaccines their child or children need.
If asked about recent updates to the U.S. childhood immunization schedule, please refer to MDHHS’s statement issued on Jan. 6.

Action steps
Provide parents with a copy of their child’s immunization record.
Encourage parents to know their child's risk: look up a school's immunization and waiver rates on the MDHHS website.
Remind them to check the vaccination status of every child in the household, not just the youngest. Nearly half of this year’s national measles cases are kids and teens ages 5 to 19 years.
Ask parents about catching their children up on any missed doses and ask about this year's flu vaccine during their appointment.
Direct parents and caregivers to visit IVaccinate.org for accurate, evidence-based vaccine information.
Sign up for the Michigan Health Communications Initiative’s monthly newsletter and search the resource library at any time for the information your community needs most. Social media content, printable flyers and other resources are available for download across a variety of health topics. All resources are free to use and share — no attribution required.
Review trends for VPDs and immunization rates on MDHHS Immunization Data and Statistics webpage.