A record share of U.S. kindergartners missed required vaccinations last school year, with 4.2% holding an exemption for at least one vaccine, up from 2.2% a decade earlier, according to CDC data released Monday.

President Donald Trump’s executive order, signed last week, urges states to give parents more information and options, but it does not itself change state mandates; instead it directs the Departments of Justice, Education and Health and Human Services to condition federal funding on compliance with new federal guidelines.

While all 50 states require certain vaccines for school attendance and allow medical exemptions, the vast majority also permit non‑medical exemptions for religious or personal reasons, and many states have seen exemption rates climb above 5%, with the overall exemption share the highest on record.

Public‑health experts warn that rising non‑medical exemptions could spark disease outbreaks, as measles cases have reached a 35‑year high, and note that any changes to exemption laws must be enacted by state legislatures, a process that may take months. The MMR coverage among kindergartners slipped only marginally, from 92.5% to 92.4%, still far below the 95% level needed for herd immunity.