Parents who talk to other parents about vaccinating their children are, by a margin of roughly three to one, telling them to do it.
That is the central finding of a nationally representative survey of 1,315 U.S. parents published in PLOS One and summarized by CIDRAP. More than one-third, 36%, reported encouraging other parents to vaccinate. Twelve percent reported discouraging it.
The finding creates an obvious tension. National kindergarten MMR coverage has fallen from 95.2% in the 2019 to 2020 school year to 92.5% in 2024 to 2025, according to CDC data, leaving roughly 286,000 kindergartners without documented protection that year.
Stated attitudes and measured behavior are moving in opposite directions. The survey does not resolve why, and it is worth being honest that nobody has established which explanation dominates.
What the Survey Measured and What It Did Not
The researchers surveyed parents of children aged 9 to 12 in 2025 about immunization advocacy, meaning conversations with other parents rather than decisions about their own children.
Among parents who encouraged vaccination, the most common subjects were measles, cited by 50%, and influenza, cited by 44%. Their most common methods were personal rather than statistical: 47% described their own child's vaccine experience to family and friends, 38% shared data about vaccine effectiveness, and 35% offered a direct recommendation.
Among parents who discouraged vaccination, the focus was different. Fifty-three percent raised perceived problems with COVID-19 vaccines and 41% with flu vaccines. Only 10% mentioned the measles vaccine.
The authors described that gap as an asymmetry, writing that "vaccine encouragers most often focused on measles vaccine" while those discouraging vaccination seldom did.
Two limitations belong here rather than buried later. This survey covers parents of 9- to 12-year-olds, not parents of infants or kindergarteners, which is precisely the population that drives the coverage statistics. And it measures self-reported talk, not vaccination status. People report their behavior imperfectly, particularly on socially charged topics.
Why Attitudes and Coverage Can Move Apart
Several explanations are plausible, and the honest position is that the evidence does not yet rank them.
One is access. Getting a child fully vaccinated requires an appointment during working hours, transportation, insurance or a program that covers the visit, and often a follow-up visit weeks later. A supportive parent who cannot get to a clinic produces the same statistic as a refusing one.
A second is paperwork. Kindergarten coverage figures reflect documentation, not immunity. A child vaccinated at a clinic that never transmitted records to a school, or whose family moved between states with different registries, can appear unvaccinated in the data. Utah, for example, reports that its kindergarten figure combines students with an MMR exemption and those missing documentation.
A third is concentration. National averages hide local pockets. A state at 92.5% can contain districts far below that level, which is where outbreaks actually start. Broad parental support nationally does not prevent a chain of transmission in a single community with 80% coverage.
A fourth is exemption policy, which varies by state and has been loosening in some legislatures.
None of these is mutually exclusive, and the survey was not designed to distinguish among them.
Why the Measles Asymmetry Matters Now
The one place the survey offers a clear practical read is measles.
Encouraging parents talk about measles more than any other vaccine. Discouraging parents almost never do, concentrating instead on COVID-19 and flu shots. That means the vaccine most implicated in current U.S. outbreaks faces comparatively little organized parent-to-parent opposition.
The authors suggested that public health efforts should consider partnering with parent advocates specifically on measles vaccination.
The timing is relevant. MedicalDaily has reported that vaccine exemption rates are driving the worst measles year in decades and that seven states carry most of the 2026 case load as classrooms prepare to refill.
What Families Can Do With This
The most transferable finding is about method. Parents who successfully encouraged others did not lead with statistics. Nearly half described their own child's experience. That is a low-conflict approach available to anyone.
For a household, the concrete steps are ordinary. Check whether every family member has documentation of two MMR doses, since a record gap is as consequential at a school office as a missed shot. Ask a pediatrician or pharmacist about catching up before the school year rather than after an exposure notice arrives. Families without insurance can ask about the federal Vaccines for Children program, which covers vaccine costs for eligible children through participating providers, though an administration fee may apply.
Parents in outbreak states should ask specifically about early dosing for infants aged 6 to 11 months, which some state health departments now suggest discussing. An early dose does not replace the standard two-dose series.
What is not useful is treating a disagreement with another parent as a debate to be won. The survey suggests personal experience travels further than argument.
What Happens Next
The CDC updates national measles case counts weekly and publishes kindergarten coverage data annually through its SchoolVaxView tool, which allows parents to look up state and district figures rather than relying on national averages.
Researchers would need studies that link stated attitudes to verified immunization records to determine how much of the coverage decline reflects refusal versus access and documentation problems. That work has not been done.
The confirmed finding is that supportive parents outnumber discouraging ones by roughly three to one in this survey, and that they concentrate on measles. The most affected group is families in communities where coverage sits below the 95% threshold. The reasonable action is to verify records before the school year. The central uncertainty is why measured coverage keeps falling while stated support remains high.
Frequently Asked Questions
What did the survey find? Among 1,315 parents surveyed in 2025, 36% reported encouraging other parents to vaccinate their children and 12% reported discouraging it.
Who was surveyed? Parents of children aged 9 to 12. The findings do not necessarily describe parents of infants or kindergarteners, whose decisions drive kindergarten coverage statistics.
Which vaccines did parents talk about? Encouragers most often raised measles, at 50%, and flu, at 44%. Discouragers most often raised COVID-19 vaccines, at 53%, and flu vaccines, at 41%, with only 10% mentioning measles.
If most parents are supportive, why is coverage falling? The survey cannot answer that. Plausible contributors include appointment and transportation barriers, incomplete school records, concentrated local pockets of low coverage, and state exemption policies.
Does the survey measure whether children were actually vaccinated? No. It measures self-reported conversations with other parents, not immunization status.
What is the current kindergarten MMR coverage rate? National coverage fell from 95.2% in the 2019 to 2020 school year to 92.5% in 2024 to 2025, below the 95% level associated with community protection.
What can a parent do before the school year starts? Confirm documentation of two MMR doses for each family member, ask a clinician about catch-up doses, and check local coverage through the CDC's SchoolVaxView tool rather than relying on national figures.
