US Faces Risk of Measles Resurgence Amid Declining Vaccination Rates

Measles Risk Rises as US Vaccination Rates Decline

The United States, which declared measles eliminated in 2000, is at risk of seeing the disease become endemic again if childhood vaccination rates continue to decline. A new study published in the journal JAMA warns that the country could face up to 51 million measles cases over the next 25 years if vaccination rates drop by 50%.

Current Vaccination Rates and Thresholds

According to the study, the current state-by-state measles vaccination coverage in the US ranges from 87.7% to 95.6%. However, experts emphasize that at least 95% of a community needs to be vaccinated with two doses of the measles-mumps-rubella (MMR) vaccine to prevent outbreaks. The vaccination rate for kindergartners has fallen to 92.7% for the 2023-24 school year, according to the US Centers for Disease Control and Prevention (CDC).

Potential Impact of Declining Vaccination Rates

The study modeled various scenarios based on vaccination trends:

• If vaccination rates drop by 10%, the US could see 11.1 million measles cases over 25 years.
• A 50% decline in vaccination rates could result in 51.2 million measles cases, along with 9.9 million rubella cases, 4.3 million poliomyelitis cases, and 197 diphtheria cases.
• Such a steep decline could lead to 10.3 million hospitalizations and 159,000 deaths, as well as long-term complications like neurological damage and birth defects.

Why Measles Is a Unique Threat

Measles is one of the most contagious diseases, with one infected person capable of spreading the virus to up to 20 others in a susceptible population. This high transmissibility makes it particularly challenging to control. Additionally, the MMR vaccine has faced public skepticism due to debunked claims linking it to autism, further complicating vaccination efforts.

Localized Outbreaks and Vulnerable Populations

In 2025 alone, there have been 10 reported measles outbreaks in the US, resulting in at least 800 cases. One significant outbreak in Texas, New Mexico, and Oklahoma accounted for 624 cases and two deaths, primarily among unvaccinated populations. Vulnerable groups include infants under 12 months who are too young for vaccination and immunocompromised individuals.

Regional Differences in Vaccination Coverage

The study highlighted disparities in vaccination rates across states. For instance, Massachusetts maintains high vaccination rates and is considered low-risk, while states like Texas and California face higher risks due to declining vaccination rates and increased travel-related exposure.

Potential Solutions and Public Health Recommendations

Despite the alarming trends, the study offers hope. A 5% increase in vaccination rates could reduce the number of measles cases to just 5,800 over 25 years, far below the threshold for endemic spread. Researchers urge parents to consult pediatricians for accurate information about vaccine safety and efficacy. Public health campaigns and policy interventions are also critical to reversing the decline in vaccination rates.

Broader Implications for Vaccine-Preventable Diseases

While measles poses the most immediate threat, other vaccine-preventable diseases like rubella, polio, and diphtheria could also resurge if vaccination rates continue to fall. For example, a 35% drop in vaccination rates could make rubella endemic, while a 40% drop could lead to the return of polio in half of the modeled scenarios.

The findings underscore the importance of maintaining high vaccination coverage to prevent the resurgence of diseases that were once eradicated or well-controlled in the US. Public health officials, policymakers, and healthcare providers must work together to address vaccine hesitancy and ensure widespread immunization to protect future generations.