On August 10, President Donald Trump signed an executive order that recognizes immunizations for 11 diseases as recommended for all children, places several other immunizations in high-risk or shared clinical decision-making categories, and calls for separate measles, mumps, and rubella vaccine components once those products are available. The order also recommends, to the maximum extent feasible, administering childhood immunizations at separate medical visits and advises states to review school-entry immunization requirements. Major medical and public health organizations have raised concerns that these changes are not supported by established scientific review. NASN’s position remains unchanged: school immunization requirements should align with the best available scientific evidence. 

The policy shift comes as measles activity is at its highest level in 35 years. As of August 6, 2026, 2,465 confirmed measles cases had been reported nationwide, surpassing the 2,289 cases reported in all of 2025. Children and adolescents account for the majority of cases, and most cases have occurred among people who were unvaccinated or whose vaccination status was unknown. Kindergarten MMR coverage was 92.5% in the 2024-2025 school year, below the approximately 95% level associated with community protection. View the Johns Hopkins U.S. Measles Tracker. 

As students return to school, school nurses are central to reviewing immunization records, helping families understand state requirements, identifying students who may need follow-up, and supporting school preparedness when cases or exposures occur. 

Department of Education Issues Updated Guidance on Nursing Degrees

On July 10, the U.S. Department of Education clarified its interim guidance on graduate nursing programs. For purposes of federal graduate student loan limits, programs within the four-digit Classification of Instructional Programs (CIP) categories that include the Master of Science in Nursing (MSN) and Doctor of Nursing Practice (DNP) are treated as professional programs when they award the same credential. The designation is temporary while litigation continues and follows a June 25 federal court order blocking the Department’s narrower definition of a professional degree. PhD nursing programs remain outside the interim professional-degree list. 

Congress is also considering a longer-term legislative solution. The bipartisan Nursing Is a Professional Degree Act (H.R. 8691/S. 4568) would ensure that post-baccalaureate nursing students qualify for the higher federal loan limits available to professional-degree students.

Ask Congress to protect access to advanced nursing education through NASN’s Action Center.

NASN Endorses the MediKids Act

NASN has joined health and child advocacy organizations in endorsing the MediKids Act (S. 5037), introduced by Senator Andy Kim (D-NJ). The bill would make people under age 26 eligible for Medicaid regardless of income, automatically enroll newborns with an option to opt out, and provide continuous eligibility through age 26. Ensuring children and young adults have consistent access to health care supports student health, well-being, attendance, and academic success.

Senate HELP Committee Advances Title VIII Nursing Workforce Reauthorization

On July 22, the Senate Committee on Health, Education, Labor, and Pensions (HELP) advanced the Title VIII Nursing Workforce Reauthorization Act of 2025, as amended. The bill would reauthorize Title VIII Nursing Workforce Development Programs through fiscal year 2030, supporting nursing education, workforce development, scholarships, loan repayment, and retention.  

The committee adopted amendments from Senator Lisa Murkowski (R-AK) to establish a nurse faculty demonstration program and from Senator Lisa Blunt Rochester (D-DE) to strengthen nursing workforce centers, incorporating policies from two ANA-endorsed bills.  

The committee action is an important bipartisan step toward strengthening the nursing workforce and addressing critical shortages. However, the legislation still requires passage by both the full Senate and the House.

Urge Congress to pass Title VIII reauthorization through NASN’s Action Center.

Public Health Groups Challenge FDA Tobacco Enforcement Guidance 

On July 14, a coalition of public health organizations, pediatricians, and parents filed a federal lawsuit challenging the FDA's recent enforcement guidance that allows certain e-cigarette and nicotine pouch products to be marketed without required marketing authorization.  

The lawsuit asserts that the FDA’s enforcement guidance, issued in May 2026, violates federal law by permitting the marketing of unauthorized tobacco products – including products the FDA itself has repeatedly found pose a substantial risk to youth. 

The lawsuit, which was filed in the U.S. District Court for the District of Maryland, argues that the FDA’s guidance: 

• Violates the Tobacco Control Act by allowing new tobacco products to be marketed without the agency’s scientific review and prior authorization required by law. 
• Violates the Administrative Procedure Act because the agency bypassed public notice and comment requirements before issuing the policy. 
• Is “arbitrary and capricious” because it provides no meaningful justification for creating an enforcement safe harbor or changing the agency’s longstanding approach to flavored products, which the FDA has consistently identified as a major driver of youth use. 

The plaintiffs are the Campaign for Tobacco-Free Kids, American Academy of Pediatrics, American Cancer Society Cancer Action Network, American Heart Association, American Lung Association, Truth Initiative, Parents Against Vaping, a pediatrician with expertise in adolescent tobacco use, and a parent of two children who became addicted to nicotine after using flavored e-cigarettes. 

For more information, you can find the press release here.  

Missouri Enacts Legislation Affecting School Health

On July 13, Governor Mike Kehoe signed House Bill 2372, an omnibus health care bill that takes effect August 28, 2026. The Missouri Association of School Nurses (MASN) legislative committee supported provisions of particular importance to school nurses through member education, outreach, and testimony. The effort also reflects collaboration with organizations including the Missouri Chapter of the American Academy of Pediatrics and the Missouri Nurses Association. 

• Epinephrine delivery systems. The law updates statutory references from “epinephrine auto-injector” to “epinephrine delivery system.” The broader terminology can accommodate additional FDA-approved delivery options, including needle-free nasal epinephrine, consistent with other applicable requirements. This gives school nurses and trained school personnel additional options for responding to anaphylaxis. 
• Food allergy policies in child care. Elijah’s Law will require licensed child care providers to adopt food-allergy prevention and emergency-response policies by July 1, 2028. 
• Alpha-gal syndrome. The law makes alpha-gal syndrome a reportable condition in Missouri and requires the state to report annually on its incidence. 

States Continue to Modernize School Epinephrine Laws

During the 2026 legislative sessions, at least seven states enacted or signed legislation broadening school epinephrine laws beyond traditional auto-injectors: Florida, Idaho, Illinois, Missouri, Ohio, South Dakota, and Tennessee. These laws use broader terms such as “epinephrine delivery system” or explicitly allow nasal epinephrine, helping state policy keep pace with FDA-approved emergency medication options. 

State laws and effective dates vary. As of June 4, 2026, 26 states had laws in effect using broader terms such as “epinephrine delivery systems” or “epinephrine devices,” and additional state laws were scheduled to take effect during 2026. School nurses should follow state-specific rules, district protocols, training requirements, and medical oversight as implementation proceeds.

NASN Expands Support for State Advocacy

Many of the policies with the greatest day-to-day impact on school nursing are decided in state capitols. Earlier this year, NASN expanded its state advocacy capacity by partnering with Sage Solutions, led by government relations professional Sage Bauer, to provide strategic advocacy support to NASN affiliates. 

With most 2026 state legislative sessions concluded, the fall is an important planning period for 2027. NASN and Sage Solutions will work with affiliates to identify policy priorities, educate newly elected and returning lawmakers, strengthen relationships, and prepare legislative strategies before sessions convene. 



Affiliates interested in developing a 2027 advocacy plan can contact [email protected] to schedule a strategy conversation with Sage. 

NASN Member Opportunity

Applications Open for the 2027 ANHE Environmental Health Nurse Fellowship

The Alliance of Nurses for Healthy Environments (ANHE) is accepting applications for its 2027 Environmental Health Nurse Fellowship, running January through December 2027. The year-long program prepares nurses to partner with communities on environmental health challenges at the intersection of climate and health equity through mentorship, training, peer learning, and project work. 

ANHE will select 18 nurse fellows. Participants receive a $1,000 project stipend and free nursing continuing education for fellowship webinars and convenings. Applications are due September 4, 2026, and applicants will be notified of decisions by October 16. Learn more and apply.

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