Virginia schools prepare for new year with measles on their radar

Across Virginia, children are organizing their new school supplies while school nurses and administrators prepare for the health challenges of a new year.

This year, school leaders are paying particular attention to vaccination records, especially for measles, mumps and rubella.

“We definitely want to be more vigilant about checking immunizations at the beginning of the school year,” said Felicia Preston, director of pupil personnel with Martinsville Public Schools.

Quickly identifying students without documentation of two doses of the MMR vaccine is important both for preventing measles and responding if a case is confirmed at school.

Preston has worked in the school district for 20 years. During that time, measles has never been a concern, she said. Aside from COVID-19, the only other infectious disease that caused comparable concern was the norovirus. 

Vaccination rates in Martinsville Public Schools are high, according to Preston and state data. But this year, school nurses plan to monitor vaccination records more closely than usual.

That heightened attention comes after a summer measles outbreak in Buckingham County spread into Cumberland County and pushed Virginia’s case numbers to levels not seen in decades.

The state has gone five consecutive weeks without a new reported measles case, according to the state health department’s measles dashboard. But as the school year begins and children spend more time in classrooms and other congregate settings, unvaccinated students could face a higher risk of exposure. Schools with lower vaccination rates could also be more vulnerable to outbreaks.

Focus on immunizations for public school is important. Even RFK Jr. changed his tune.

All 50 states and Washington, D.C., require children attending public school to receive two doses of a vaccine that protects against measles, although states differ in the exemptions they allow.

Virginia requires two doses of the MMR vaccine for school attendance. Children typically receive the first dose at 12 months of age and the second between ages 4 and 6.

Virginia allows exemptions for children with certain medical conditions as well as religious exemptions. 

The most significant barrier parents face to getting their child vaccinated before school starts is primary care capacity, Preston said. It can take weeks for an appointment if the child is not established with a pediatrician. But students could be excluded from school if they do not update their vaccinations, unless they qualify for an exception. 

Public health officials generally consider vaccination coverage of at least 95% necessary to maintain community protection against measles. High vaccination rates also help protect infants who are too young to receive their first routine MMR dose and people whose immune systems cannot adequately respond to vaccines.

Vaccination hesitancy has increased in Virginia and across the country amid conflicting messages about vaccines from federal officials, including U.S. Health and Human Services Secretary Robert F. Kennedy Jr. 

But Kennedy told CNN earlier this month that “parents should get their children vaccinated for measles. The measles vaccine is effective.” His comments marked a shift from some of his earlier rhetoric questioning the safety and effectiveness of the MMR vaccine. 

Preston said the recent measles outbreaks in Virginia have been surprising.

“The focus on immunizations before coming into public school is so very important. It is communicated to school divisions on the regular how important that is, so it is very surprising that we are dealing with this in this day and age,” Preston said. 

Martinsville schools have consistently high measles vaccination rates, so Preston may not have much to worry about in her district. But state data shows that other elementary schools in the region have substantially lower vaccination rates.

Between 85% and 95% of kindergartners at Meadow View Elementary and G.W. Carver Elementary in Martinsville had received both MMR doses in 2025, according to state data. At Mount Olivet Elementary, also in Martinsville, 75% to 84% of kindergartners had received both doses, although the school has a much smaller enrollment than the other two.

Some schools closer to the Buckingham County outbreak also reported vaccination rates below the 95% threshold.

At Appomattox Primary School, between 85% and 94.9% of kindergartners had received both MMR doses in 2025.

In Amherst County, Madison Heights Elementary School, the county’s largest elementary school, reported that 75% to 84.9% of kindergartners had received both doses. Other elementary schools in the county, which have smaller enrollments, reported rates ranging from about 65% to 95%.

Some schools in Lynchburg, Bedford have very low vaccination rates

Lynchburg has reported three measles cases this year, while neighboring Campbell and Bedford counties have reported one and two confirmed cases, respectively. 

Although the numbers remain low, several elementary schools in the area reported vaccination rates below the 95% threshold in 2025, according to state data.

Heritage Elementary School in Lynchburg, which has more than 100 students, reported that fewer than 65% of kindergartners had received both MMR doses. R.S. Payne Elementary and Sandusky Elementary reported rates of 75% to 84.9%.

Bedford Primary School, a public school serving children from preschool through first grade, reported that 85% to 94.9% of kindergartners had received both doses.

Those vaccination rates matter not only because of the risk of an outbreak at school, but also because measles can have consequences long after the initial infection.

Measles can have long-term effects

Dr. Emily Wong, a pediatrician who represents the western region of the Virginia Chapter of the American Academy of Pediatrics, has recommended that some parents consider an early measles vaccination for infants younger than 12 months who live in or near an outbreak area.

The routine first MMR dose is given at 12 months because younger babies may not develop as strong an immune response to the vaccine, Wong said. An early dose can provide additional protection for infants at higher risk of exposure, although children who receive an early dose still need the routine doses later.

Wong has worked with several families in her Charlottesville practice to arrange earlier vaccinations. Some of her patients live near the border of Albemarle and Buckingham counties, where the measles outbreak continues.

Protecting infants and young children is especially important because measles can cause serious complications, Wong said.

The most common serious complication in children is pneumonia. More rarely, measles can cause encephalitis, or inflammation of the brain, which can lead to neurological damage, seizures and death.

Another extremely rare complication is subacute sclerosing panencephalitis, or SSPE, a progressive and fatal disease of the central nervous system that can develop years after a measles infection.

As measles cases accumulate in the U.S., Wong said, she worries that more children could eventually experience these rare complications.

“I’m worried for the infants and young children who are being exposed and what’s going to happen to them now and then the possible complications later on from measles,” she said. 

Wong said that parents may also have questions about vaccinating their children against a disease that many Americans have never encountered. 

Measles was eliminated from the U.S. in 2000, meaning there has been no continuous transmission of the disease for a year or more. But outbreaks can still occur where the virus is brought into the country and spreads among people who are not immune. 

Even Wong has never treated a child with measles during her career or at her practice with the University of Virginia in Charlottesville. 

“We’ve done such a good job of preventing and eliminating this disease that people don’t see the threat,” Wong said. “I think that’s the trouble with prevention and preventative medicine in general, when you don’t see the problem anymore, you don’t see the value in trying to prevent it.”