Background: In 2000, endemic measles was declared eliminated in the US. However, a proliferation of anti-vaccination sentiment over the last decade has led to measles’ re-emergence, with 2019 experiencing the most measles cases in the US since 1992. Rising rates of non-medical exemptions (NMEs) and low vaccination coverage in the state of Michigan prompted an administrative vaccine policy change in 2015, mandating that parents attend an in-person vaccine education session prior to obtaining a non-medical exemption waiver. Despite the enactment of this policy, Michigan experienced a large measles outbreak in 2019. Methods and materials: This study used school-level data from the Michigan Department of Health and Human Services from 2008–2018. School addresses were geocoded in ARCGIS and up-to-date vaccination and NME waiver rates were aggregated at the school district, county, and state level for kindergarten and seventh grade, when mandatory vaccinations are assessed. Spatial lag regression models were used to assess risk factors while accounting for spatial autocorrelation. Results: The statewide vaccine waiver rate increased from 2008–2014, reaching a high of 5.84%, which fell to 3.58% in 2015 after the enactment of Michigan's new policy. However, since 2015, waiver rates have again been steadily increasing, reaching 4.54% in 2018. Up-to-date vaccination rates among kindergarteners were consistently below herd immunity thresholds from 2009–2018. There was significant geographic heterogeneity at the county level, where NME rates reached a high of 19.5% in 2013, corresponding to county-level vaccination coverage of 76%. While overall NME rates decreased in 2015 after the policy change, this change was heterogeneous across the state, with persistent county-level clusters of high exemption rates remaining. Conclusion: Despite Michigan's 2015 policy change, from 2008-2018, waiver rates remained high enough to allow measles to circulate and cause outbreaks. State-wide average estimates showed a reduction in waiver rates after this policy change, yet finer-scale data at the county- and school-level show wide variability obscured by this aggregation. Recent research has shown the potential for such pockets of low vaccination coverage to contribute to disease outbreaks, and thus these clusters present a risk of continued disease transmission and future outbreaks in Michigan.