NASN Reaffirms Commitment to Evidence-Based Childhood Immunization as Students Return to School
August 11, 2026
The National Association of School Nurses (NASN) is deeply concerned by the August 10 executive order concerning the nation's childhood immunization schedule. Decisions that affect the health of children and school communities must be guided by transparent, rigorous scientific review and the best available evidence. Changes to longstanding vaccine recommendations should occur through transparent, established scientific and clinical review processes that include independent expert evaluation.
NASN's position has not changed.
In its October 2025 position statement, Immunization and Vaccination Requirements, NASN states that school immunization requirements should align with the best available, scientifically rigorous evidence. The position statement identifies reputable professional organizations, including the American Academy of Pediatrics (AAP) and the American Public Health Association (APHA), as sources state leaders can consult for scientifically backed, trustworthy information that safeguards the health of school-age youth and communities.
As students start the school year, this is not an abstract policy debate for schools.
School nurses are reviewing immunization records, helping families understand state requirements, identifying students who need catch-up vaccination, and preparing schools to prevent and respond to communicable disease. The August 10 executive order also advises states and territories to consider updating laws and regulations governing immunization requirements for school enrollment and attendance. Conflicting recommendations can create confusion for families, complicate school health practice, and undermine confidence in vaccines that have protected generations of children.
“School nurses see the consequences of vaccine-preventable illness in real time — students missing school, families missing work, medically vulnerable students placed at greater risk, and learning disrupted. Childhood vaccine recommendations should be driven by rigorous evidence and expert review. School nurses need clear, credible guidance so they can help families make informed decisions and keep students healthy, safe, and ready to learn.”
— Lynn Nelson, MSN, RN, NCSN, NASN President
The fragmentation of vaccine guidance is already significant.
As of May 4, 2026, KFF reports that 29 states and the District of Columbia rely on sources other than CDC/ACIP for at least some childhood vaccine recommendations; 27 of those 30 jurisdictions do so for all childhood vaccines. This patchwork increases the potential for confusion as families, clinicians, and schools navigate different recommendations across jurisdictions. Importantly, states continue to determine school-entry vaccination requirements; federal recommendations and state school requirements are not the same thing.
School nurses remain trusted health professionals in their communities.
School immunization requirements remain governed by applicable state and local laws and regulations, and school nurses should continue to follow those requirements. At the same time, families and school communities need access to clear, credible, evidence-based information. NASN will continue equipping school nurses with evidence-based resources to answer families’ questions, support vaccine confidence, and protect the health and learning of every student. NASN’s existing immunization resources emphasize the school nurse’s role in educating families, supporting vaccine access, reducing absenteeism, and maintaining safe school environments.
Immunization is fundamental to keeping students healthy, safe, in school, and ready to learn.
Policy changes that create uncertainty around childhood vaccination can have consequences far beyond the health care system, including preventable illness, missed school days, disruptions to learning, and increased burden on school communities. NASN urges policymakers at every level to protect evidence-based immunization decision-making, communicate changes clearly and transparently, and consider the real-world impact of vaccine policy on students, families, and schools.