Morgantown mom Ashley Lambert is sitting in the living room with her family. Photo: Purity Siror/WVU News
West Virginia has long been known for strict childhood vaccination requirements, particularly among school-age children. For decades, the only way around them was a medical exemption certified by a doctor.
However, recent changes at both the state and federal levels are reshaping how vaccine decisions are made in the state.
Earlier this year, the Centers for Disease Control and Prevention proposed a new childhood immunization schedule, reducing the number of routinely recommended vaccines.
The proposal reclassified childhood vaccines into three categories. Vaccines such as COVID-19, influenza, and rotavirus were removed and categorized as high risk or for shared decision-making. This update, following the presidential memorandum, reduced the number of routinely recommended childhood vaccines from 17 to 11 and was described by the administration as scientific, evidence-based, and data-driven.
The new guidance states that all types of insurance will provide coverage, so parents will not have to pay anything out of pocket. In West Virginia, where vaccination policy has historically been strict, that reframing has sparked some conversations.
Governor Patrick Morrisey signed a proposed bill in January 2025, allowing religious and philosophical exemptions, marking a major shift in the state.
These developments have led to an ongoing debate and concerns among families, pediatricians and public health officials on how the vaccine guidance should be translated and its impacts in Monongalia County and across the state.
The bar chart shows three updated vaccine recommendation categories: routinely recommended for all children, high-risk group, and shared clinical decision.
Parents in Morgantown Navigating the Change
Emily, a mother of two girls, asked to use a pseudonym to protect her and her children's privacy, said she experienced differences in vaccination requirements after moving to West Virginia from Uganda.
When enrolling her children in school, Emily said officials reviewed their previous vaccination records and recommended additional shots before enrollment.
“There are quite many vaccinations here that we are supposed to take,” she said. “When we came here, they looked at what they had taken, and there were some vaccinations they recommended.”
Emily said she relies on medical professionals for guidance.
“I trust the pediatrician because they explain what vaccines a child is supposed to take at a certain stage,” she said. “I believe they are trained, and they really have the right information.”
She said she sometimes researches vaccines online but does not know how to distinguish between credible and fake sources.
“Actually, I do not differentiate,” Emily said. “I just go to Google.”
Ultimately, she said school requirements influence her decisions most.
“The school’s rules do matter to me,” she said. “I just follow the school rules.”
Alashtay Lambert, 32, is a mother of two young children in Morgantown. She said she was unaware that federal vaccine guidance had recently changed.
“I actually have not heard,” Lambert said. “I try not to do a lot of research because I get overwhelmed.”
Lambert said she relies primarily on her pediatrician when making decisions about vaccinating her children, ages 4 and 1. Still, she said, people’s opinions can influence how she perceives vaccines.
“My mom is extremely anti-vax, and she has very strong opinions on it,” Lambert said. “I’ve had to go my own direction and not let her opinions make me scared.”
State Policies Vs. Federal Guidelines
At the Mon County Health Department, the immediate impact has been subtle. Dr. Brian Huggins said that’s because he believes most families don’t realize there’s been a change.
“We actually haven’t gotten a lot of feedback from people about this,” Huggins, health officer for the Mon County Health Department, said. “Those conversations usually don’t happen until someone is sitting down with a provider.”
Huggins said most families coming into county clinics are focused on meeting school and daycare immunization requirements, which remain unchanged under current state law, even after the new federal recommendations.
“For most parents, the question is still: What do I need to do for my child to
attend school?” he said.
Dr. Brian Huggins, Public Officer. Photo Credit: Mon County Department of Health.
That focus, he added, does not necessarily reflect indifference, but how vaccine decisions are often made at the point of care, not in response to federal and state policies.
Delegate Kathie Crouse, who advocated for the 2025 bill signed by Gov. Morrisey expanding exemptions, said the change reflects the importance of parental rights.
“I believe parents have a fundamental right to make medical decisions for their children,” Crouse said. “That includes the ability to accept or refuse vaccines based on religious beliefs, personal convictions, or individual health concerns.”
She said that because federal recommendations keep changing, it is important to stay flexible.
“Any time recommendations change, it reinforces the importance of allowing flexibility and parental choice,” she said.
But for a pediatric infectious disease specialist, the shift in guidance has significant implications
“This change is very upsetting,” said Dr. Kathryn Moffett of WVU Medicine. “It makes it sound like these vaccines aren’t really needed, when the science behind them is extremely strong.”
Moffett said the revised framework deviates from long-standing recommendations
by the American Academy of Pediatrics and risks introducing doubt into the clinical
realm that has traditionally been grounded in trust.
Dr. Kathryn Moffett. Photo Credit: WVU Medicine
“It opens a wedge of mistrust,” she said. “Parents may start questioning what their pediatrician is recommending, even though those recommendations are based on decades of rigorous scientific evidence.”
She noted that vaccination discussions already compete with many other concerns during pediatric visits, from nutrition to safety, expanding the conversation and the need for clarity.
Beyond the new policy implications, both experts raised concerns about disease trends that underscore the stakes of vaccination decisions. Moffett cited a recent increase in pertussis cases in West Virginia, including severe infections among infants.
“The most serious disease occurs in babies under one year old,” she said. “We are seeing children sick enough to require intensive care.”
While West Virginia maintains some of the highest vaccination rates in the country among kindergarten-aged children, she emphasized that coverage among younger children, particularly those not yet in daycare, is inconsistent.
U.S. map showing childhood vaccine coverage by state (2024), ranging from 58% to 83%. Source: United Health Foundation.
Huggins echoed those concerns, noting that outbreaks in neighboring states heighten the risk of cross-border transmission.
“It’s probably not a matter of if anymore, but when,” he said. “From a public health standpoint, our responsibility is to be prepared to respond.”
Both officials identified misinformation, especially on social media, as a growing challenge shaping how families interpret vaccination guidance as they consume information from different sources, both credible and unreliable.
“There’s a growing distrust of traditional institutions,” Huggins said. “People are relying more on social media, friends, and family for information.”
To address that, he said, local health departments emphasize transparency, including discussing vaccination risks and explaining how adverse events are tracked and studied. Moffett said that trust remains the foundation of vaccination decision-making, even as national guidance evolves.
“But I think it is a relationship. And when it's all said and done and the door is closed, and it's the parent and the physician or the nurse practitioner, we have to earn their trust,” she said. “That relationship matters.”
Lambert said she wishes doctors discussed potential risks in more detail when it comes to vaccinating her kids.
“I wish she would give me a real percentage of people who have negative reactions,” she said. “It would make me feel like I know what I’m getting into with my kids.”
Still, she says, she’ll follow her doctor’s recommendations for her children when making these decisions moving forward.