Six-year-old Naomi starts school this week.
“I’m kind of nervous,” she said, “but really excited and really nervous. My bubbe told me that teachers feel excited and nervous, too.”
Nearly nine in ten of Virginia’s 177 measles cases so far this year occurred in the middle part of the state. In Albemarle County, where Naomi lives, fewer than 90% of kindergartners got the MMR vaccine.
Naomi is fully vaccinated against measles. Her mom, Claire Payton, decided to get got Naomi’s three-year-old sister, Lena, the second measles shot early. Lena starts preschool next week.
“We got her four-year MMR at two, in consultation with our pediatrician because we sort of saw this coming on the horizon, and we wanted our kids to be safe,” Payton said. “It’s horrifying. I think people don’t remember what measles did because they haven’t seen what it can do to children and to families. They think it’s not necessary to keep on fighting it. Like many things, you have to protect your victories.”
In Albemarle, Amherst, Bedford, Greene, Madison, and Rockingham counties, between 81 and 89% of kindergartners are fully vaccinated against measles—rates that fall below the 95% needed to establish herd immunity. Central Virginia now ranks second in the nation for the most measles cases in 2026.
To understand how herd immunity works, picture a hundred sheep in a pen.
“And one of those sheep, unfortunately, has measles," UVA nurse practitioner and professor Jessica Keim Malpass explained. "If you imagine 95% of the sheep, so 95 of the sheep are immunized against measles, if you’re imagining the immunized ones kind of surrounding the one that actually has a disease.”
Malpass cares for kids with cancer, a group that’s often too sick to get vaccines and is especially vulnerable to highly contagious diseases like measles.
“Typically, it’s protective enough, where, in a whole community setting, those 95 immunized sheep would kind of surround the one with the disease, protecting it, offering, as a buffer, to those like maybe like my patients who can’t get immunized or that baby that’s six months old and cannot get immunized yet. When that number drops below that threshold," she said, "there’s less of that buffer, so if you’re encountering more people who are not immunized, the chances that they’re going to encounter that disease increases.”
Virginia kids entering schools are required to have the MMR vaccines, but more parents are trying to opt out, something.
Betsy Looney, school nurse coordinator for the Richmond Diocese’s two dozen private schools, sees it a lot.
“If a parent comes in, and says, ‘I want to do a religious exemption, I’ve decided not to vaccinate my child,’ I ask them to bring the parents in and really have a personal conversation and find out,” explained Looney, immediate past president of the Virginia Association of School Nurses and appointed by the General Assembly as the public health expert on the School Services Committee. “The majority of the time, the parents will say, ‘Oh, ok, I will go and get vaccinated.’ Sometimes, honestly, it’s not that they’ve decided not to do it, it’s that they don’t know where to go, or how to do it, because they don’t have a primary care provider.”
The American Academy of Pediatrics recommends babies get their first dose of MMR between 12 and 15 months, and a second dose between their 4th and 6th birthdays.
Earlier this year, the General Assembly declared August as Immunization Awareness Month. Anyone in Virginia who need vaccines or information about them can contact their local health department.
