As families across the United States prepare for the new school year, pediatricians, public health officials, and parents are facing a host of challenges—some old, some alarmingly new. From declining childhood vaccination rates and mental health risks linked to smartphones, to the urgent need for water safety education for children with disabilities, the back-to-school season in 2025 is marked by both hope and heightened concern.
According to a recent report by KGO in San Francisco, vaccination rates among California’s kindergarteners are teetering on the brink of a critical threshold. “We’re on the cusp of going below 95% in California,” said Dr. Peter Chin-Hong, an infectious disease expert at UCSF. “In the rest of the country they’re already below 95% after being well above 95% for many years.” For years, the 95% mark has served as a benchmark for herd immunity, the so-called forcefield that keeps outbreaks of dangerous diseases at bay. Now, as rates slip, the risk of resurgent illnesses grows.
“Moving below 95% means that we’ll have more disease in the population because we don’t have that forcefield of herd immunity anymore so it can get through and can spread it to another person,” Dr. Chin-Hong explained. The consequences are not theoretical. Diseases that had all but vanished from pediatricians’ practices—measles and polio among them—are making a comeback. “Many of us have had to go back to learn about these diseases because we haven’t seen them until this year,” he admitted.
Children entering kindergarten are required to be vaccinated against a range of illnesses, including measles, whooping cough, and polio. Yet, as Dr. Chin-Hong noted, exemptions are on the rise, possibly due to increased vaccine hesitancy or other factors. “One will have to wonder if some of the exemptions are not the same that would have passed a few years ago,” he said.
Complicating matters, the Trump administration announced just last week that it will cut annual COVID-19 vaccine availability for healthy young adults and children, instead prioritizing older adults and those with health risks. The move has left many parents and doctors uncertain about what the fall will bring. “We’re not really sure what will happen in the fall with kid vaccines and COVID,” Dr. Chin-Hong said. “Right now it’s available. The fall vaccine is going to be very similar to the one we have now, so for concerned parents you can consider getting that shot particularly if the child hasn’t had one in the last year or so.”
Against this backdrop, the American Medical Association (AMA) is urging parents and physicians to double down on back-to-school health basics. Dr. Pareen Shah Thakral, a pediatrician at Texas Children’s Pediatrics Fannin, told the AMA, “Health and learning are deeply connected. After all, pediatricians can help identify and address physical, emotional and behavioral health concerns that impact a child’s ability to succeed in the classroom.”
Dr. Thakral recommends that parents schedule a back-to-school physical if their child hasn’t had a well-child checkup in the past year, as such visits can help catch vision or hearing problems that might otherwise hinder learning. She also emphasizes the importance of keeping children up to date on all recommended immunizations, including the annual flu vaccine. “I encourage parents to schedule a visit with their pediatrician to make sure their child is current on all recommended immunizations because pediatricians and family physicians are here to answer any questions,” Dr. Thakral said.
Beyond vaccinations, Dr. Thakral stresses the value of healthy routines. “Parents should fuel their child’s morning with a wholesome breakfast, such as fruits, whole grains and protein-rich foods,” she said, noting that good nutrition, sleep, and exercise all help strengthen the immune system. She also urges parents to promote proper hand hygiene and respiratory etiquette—simple steps like hand washing and covering coughs or sneezes can go a long way in preventing the spread of infections.
As the new academic year approaches, parents are also being reminded to help their children transition smoothly from summer break by gradually adjusting bedtimes and establishing consistent nighttime routines. “Other actions that can support better sleep habits include ensuring a comfortable and soothing sleep environment, limiting screen time before bed, and promoting daytime physical activity,” Dr. Thakral advised.
But the health concerns facing school-aged children extend beyond the physical. According to KTTC in Rochester, a recent study published in the Journal of the American Medical Association found that increased smartphone use among children under 13 is linked to higher risks of suicidal behaviors. The study, which tracked 4,285 children with an average age of 10, revealed that one-third were addicted to social media or smartphones beginning at age 11. The findings are sobering: children with higher smartphone addiction face a greater risk of suicide-related outcomes compared to their peers with less screen time.
Dr. Joshua Stein, a child and adolescent psychiatrist at Prairie Care, shared his perspective on the risks. “One is the craving to use it, the loss of engagement and time...One is developing negative viewpoints of oneself. We see kids who are preyed upon,” Dr. Stein said. He strongly advises against giving smartphones to children under 13 and recommends minimal screen time to support healthy development. “By offering phones for boredom, offering phones for distraction constantly, we undermine their ability to develop those skills and that will carry with them into adulthood and beyond.”
Meanwhile, some parents face challenges that are both unique and urgent. As WGBH reported, children with autism are at a dramatically higher risk of accidental drowning—160 times more likely than other children, according to the National Autism Association. Dimarylee Valentin, whose four-year-old son Amir has autism, struggled to find swim lessons that could meet his needs until she discovered Swim Angelfish, a program designed for children with sensory and developmental challenges.
Amir’s experience is not isolated. In 2024, drownings among children with autism spiked nationwide, with tragedies reported in Massachusetts as recently as June and January 2025. In response, the Massachusetts Department of Developmental Services launched a public awareness campaign to educate families and caregivers about water safety for children with disabilities. “It’s a community responsibility,” said Commissioner Sarah Peterson. Swim Angelfish, co-founded by occupational therapist Cindy Freedman, offers specialized instruction to help children learn vital safety skills—like tolerating water on their faces and holding onto the pool’s edge—that can make all the difference in an emergency.
Freedman encourages parents to build routines around water safety, such as always asking permission before entering water, practicing with flotation devices, and getting to know neighbors and local first responders. “If you’re a parent or a caregiver taking your swimmer who might be highly attracted to the pool, my number-one tip would be [to] familiarize them with a rescue tube,” Freedman said.
For parents navigating this complex landscape, the message from experts is clear: stay vigilant, stay informed, and don’t hesitate to reach out for support—whether it’s from pediatricians, teachers, or community programs. The new school year brings new opportunities, but also new risks. Only by working together can families, schools, and communities ensure every child’s safety, health, and readiness to learn.
