In the 2021-2022 school year, 91.7% of Florida students provided proof of immunization, the lowest for the state in a decade. The national average for the same year was 93%, according to the CDC.

A measles outbreak in Florida has gripped the state, with confirmed cases popping in two counties even as the state’s top doctor flouts federal health guidance.

Nine total cases have been confirmed across Broward and Polk counties, according to the Florida Department of Health.

Amidst the outbreak, Florida Surgeon General Joseph Ladapo has contradicted medical guidance by telling parents they could decide whether or not to send their kids back to the schools with confirmed cases.

Ladapo has previously called for a halt to the COVID mRNA vaccines, which federal health officials have repeatedly said are safe and effective. Validating vaccine hesitancy has been a staple of Florida Gov. Ron DeSantis’ administration, and that hesitancy has trickled down to routine immunizations for schools, experts said.

Required immunization reporting for kindergarteners collected by the Florida Department of Health show the extent of that hesitancy over the last five years, as more kindergarteners go to school unvaccinated against measles.

More: Map: See where measles cases are being reported across the US

Florida map shows waning immunization rates over 5 years

The county-specific data does not include the Florida Virtual School, where 83.8% of the 681 students provided proof of vaccination. The report also warns about some limitations of the data caused by outliers and incomplete data collection from private schools. Florida Department of Health did not immediately provide an update on data from the 2022-2023 school year.

Florida reports falling vaccine rates in school kids

Florida students in kindergarten through sixth grade are required to submit a form certifying they have the required vaccines, including two doses of the measles, mumps and rubella (MMR) shot.

The percentage of kindergarten students who submitted the form fell to 91.7% in the 2021 to 2022 school year, according to a Florida Department of Public Health report. That’s lower than the national average, 93%, for the same year, and lower than the average in Florida five years prior, which came in at 94.1%.

It was the lowest rate since the 2010-2011 school year, the report stated, citing the pandemic as playing a “significant role” in the drop. The coverage goal is 95%, which just more than a quarter of counties met or exceeded in 2021-2022.

Children who do not submit the form must have an exemption on file: either a temporary medical exemption, a permanent medical exemption or a religious exemption. More than 3% of students claimed a religious exemption in the 2021-2022 school year, the highest ever, the report stated.

35 measles cases reported in 15 states nationwide

Measles cases have been popping up around the country amid dropping rates of vaccination. The national vaccination average for kindergarteners has dropped approximately two percentage points since before the pandemic.

The Centers for Disease Control and Prevention reported 35 total cases this year in 15 states as of Feb. 22:

• Arizona
• California
• Florida
• Georgia
• Indiana
• Louisiana
• Maryland
• Minnesota
• Missouri
• New Jersey
• New York
• Ohio
• Pennsylvania
• Virginia
• Washington

In 2023, there were 58 total cases, according to the CDC.

Contributing: Ken Alltucker, Zac Anderson, John Kennedy, Eduardo Cuevas USA TODAY Network