MEASLES CONTINUES TO SPREAD around the country. The federal government last week reported that so far this year, there were 2,093 measles cases in 41 U.S. jurisdictions, plus 11 among international visitors. That’s close to the 2,288 cases recorded in all of 2025 – which was by far the highest annual number of measles cases in the 21st century.
As concern grows, advocates for legislation intended to boost childhood vaccinations in Massachusetts have their fingers crossed that the bill, after being filed four times, will finally make it to passage this year.
The legislation – first proposed in 2019 – would eliminate a parent’s ability to claim a “religious exemption” from school vaccine requirements.
“We’re more optimistic than we’ve ever been before,” said Katie Blair, director of Massachusetts Families for Vaccines. Based on her conversations with legislators, Blair said, “It sounds like it has good momentum.”
The main reason for the optimism is how far and fast the bill progressed this session compared to the past. But with legislative leaders declining to tip their hand publicly, and the deadline for legislative action approaching, the bill’s future is far from certain.
Meanwhile, the number of religious exemptions increased in 2025, and in some schools and communities, vaccination rates are lower than needed to prevent an outbreak.
The first bill to ban religious exemptions in 2019 “didn’t go anywhere,” Blair said. In the next two sessions the bill was approved by only one committee, and fairly late in the session. This time, the bill had advanced through two key committees by July of last year, “so very early comparatively!” Blair wrote in an email.
And a July 2025 poll of 1,015 Massachusetts voters found that 70 percent support the bill.
Massachusetts law requires that children be vaccinated against several infectious diseases, including measles, before they can attend school in the state. It allows two exceptions: for children who might be hurt by vaccination because of a documented medical condition, and for those whose parent or guardian states that vaccination conflicts with their “sincere religious beliefs.” No major religion prohibits vaccination, and the religious exemption has become a catchall for parents who object for a variety of reasons.
The bill (H.2554) would eliminate the religious exemption, allowing exemptions only for doctor-supported medical reasons. It was reported favorably out of the Joint Committee on Public Health in July of last year – much earlier than in previous sessions. It then went through the Joint Committee on Health Care Financing, which this past April recorded its recommendation that the bill pass. Now, the bill awaits action in the House Ways and Means Committee.
Legislative leaders have been mostly silent on the issue. Senate President Karen Spilka said in September said she would “take a look” at the bill, but she and House Speaker Ron Mariano declined CommonWealth Beacon’s request for comment.
The window for action is rapidly closing. Under legislative rules, both branches need to approve all major legislation and begin House-Senate negotiations over final language by July 31. That leaves only six weeks – a span in which the agenda already features plenty of other business to tackle, including energy affordability legislation – for top Democrats in the House and then the Senate to surface and approve potentially controversial vaccine bills.
Massachusetts has had two cases of measles this year; in both instances, the sick individuals contracted the illness outside the state and did not spread it when they returned. Additionally, a person with measles passed through Logan Airport in April, leading a Somerville family who had been there to quarantine.
Dr. Everett Lamm, co-chair of the Immunization Initiative Committee of the Massachusetts Chapter of the American Academy of Pediatrics, noted that the bill is needed to protect vulnerable residents – young and old alike.
“Removing non-medical exemptions strengthens herd immunity and safeguards, not just for kids,” he said. “There are many adults who are vulnerable in our communities as well, who are most at risk of severe illness.”
Maine, Connecticut, New York, and California are the only states that have taken that route, prohibiting non-medical exemptions. They were also the only states, among 33 analyzed in a recent Rand study, to experience a statistically significant increase in vaccination rates with the measles-mumps-rubella (MMR) vaccine. A study in JAMA Pediatrics this year also found that rates for several vaccines went up in those four states, including a 4 percent increase in MMR uptake.
And Connecticut boasts the highest kindergarten measles vaccination rate in the country at 98.3 percent.
In Massachusetts, the MMR rate for kindergarteners is not far behind – 96.5 percent – and residents here have a long history of embracing vaccines. The state’s Childhood Vaccine Program provides all recommended vaccines for free to every child.
But there are reasons for concern. Exemptions have increased from 1.3 percent in 2024 to 1.6 percent in 2025, and longstanding geographic differences are worsening. Seven of the 14 counties are below the 95 percent rate needed for herd immunity to measles, up from five the year before, and some individual schools have rates well below herd immunity, which occurs when enough people are vaccinated to prevent a disease from spreading.
“That means in those classrooms and in these communities, an outbreak isn’t a hypothetical,” Rep. Andy X. Vargas, sponsor of the bill, said in a statement.
On Martha’s Vineyard, where the measles immunization rate has long hovered below herd immunity, and where people from around the world come to visit, pediatrician Sonya Stevens worries about the one case that could trigger an outbreak. “It’s not if it’s going to happen,” she said. “It’s when.”
Asked if he shared Stevens’s worries, Public Health Commissioner Robbie Goldstein said, “There are a lot of things that keep me up at night, and measles is one of them.”
But he said he’s hopeful that a measles outbreak would be contained because people would cooperate with quarantine and other requirements.
Meanwhile, Goldstein said he never passes up an opportunity to speak out in favor of vaccination, and the state has been holding webinars and other educational efforts to counteract misinformation. Every school with a low measles vaccination rate gets a letter from the DPH urging them to review their records and reach out to families who are not meeting the requirements.
In a new initiative, Goldstein said, the department has been engaging with workers in the Women, Infants & Children Nutrition Program and in a postpartum home visiting program to incorporate discussions about vaccines. “Folks probably don’t want me to show up in a white coat with my big Commissioner of the Department of Public Health sign to tell them what to do about vaccines,” Goldstein said, but they might respond to advice from local, trusted sources.
Candice Edwards, founder and executive director of Health Action Massachusetts, a nonprofit advocacy group that opposes eliminating the religious exemption, said that in many schools with low vaccination rates, exemptions are not the main problem. Rather, she said, some students are simply out of compliance without ever filing an exemption.
“Eliminating the religious exemption would effectively expel a small percentage of children from school” without addressing those who “are attending school without required vaccinations and without any exemption,” Edwards said in a statement. The excluded “students would remain part of the broader community; they simply would not be in the classroom. … If the goal is to strengthen public health, the focus should remain on proven strategies: supporting school nurses, improving follow-up, expanding access to care, and rebuilding trust in the healthcare system — particularly in communities where gaps persist.”
The seven counties with kindergarten measles vaccination rates below the 95 percent needed for herd immunity are: Franklin (89.7 percent), Dukes (91.2 percent), Berkshire (92.6 percent), Nantucket (94.1 percent), Suffolk (94.2 percent), Hampden (94.2 percent), and Hampshire (94.8 percent) – primarily the more rural parts of the state.
The state is slated to receive $162 million through the federal Rural Health Transformation Program that will go toward boosting access to primary care in rural areas, which will help improve access to vaccines, Goldstein said.
The bill enjoys wide support in the medical community, with endorsements from the Massachusetts Medical Society and the Massachusetts Chapter of the American Academy of Pediatrics (MCAAP).
Doctors have noticed a change in recent years in attitudes toward vaccines that were once accepted with few or no questions. Even if they’re not actively opposed to vaccines, parents are often confused and overwhelmed with misinformation, said Lamm, of the MCAAP. “Families want to protect their children, and with clear information and easy access, we can get vaccination rates back to where they need to be,” he said.
Not only have more parents been raising questions about vaccines, fewer are convinced by their doctor’s explanations in response, said Dr. Lloyd D. Fisher, a Worcester pediatrician who is medical director of the MCAAP’s Immunization Initiative. Social media posts can be emotionally compelling even when devoid of evidence, he said.
So while the legislation could help, much of the work happens in one-on-one conversations in the exam room.
Fisher said he now starts that conversation earlier, mentioning in a newborn visit that vaccinations will start at two months. That opens the door to any questions or doubts. Then it becomes an ongoing discussion at every visit, even if the parent is refusing the shots.
Pediatricians, Fisher said, “want to make sure that the parents who are questioning or have concerns feel heard and that we can address all those concerns.”
Amanda Egan Poirier, a nurse practitioner with Northern Berkshire Pediatrics in North Adams, says eliminating the religious exemption “makes sense” for the long term – but she has reservations about its short-term ramifications. “I worry about pushing a population that already feels a little bit anti-establishment in a way that makes it feel like the control is out of their hands,” she said.
“I actually have experience in not trusting,” Egan Poirier said. Years ago, she insisted that her first child get vaccinated on a spaced-out schedule because she feared harm from giving too many vaccines at once. At the time she was a registered nurse. Later she went back to school to become a nurse practitioner and deepened her knowledge of science. Her next child was vaccinated on the recommended schedule.
Parents have “this really strong drive to make sure you’re making the right decision for your child,” she said. Describing that pressure “to be perfect, to get it right” amid so much contradictory information, Egan Poirier said: “I definitely don’t envy parents today.”
CommonWealth Beacon reporter Chris Lisinski contributed to this report.
