Measles in the United States during the postelimination era

Amy Parker Fiebelkorn1, Susan B Redd, Kathleen Gallagher

  • 1Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. AParker@cdc.gov

Abstract

Insights

Measles elimination in the US was maintained from 2001-2008 due to high measles-mumps-rubella (MMR) vaccination rates. However, international travel and personal belief exemptions pose challenges to continued measles prevention.

Area of Science:

  • Epidemiology
  • Public Health
  • Immunization

Background:

  • Measles was eliminated in the US in 2000 following a successful vaccination program.
  • Prior to vaccination, measles affected entire birth cohorts.

Purpose of the Study:

  • To review US measles surveillance data and vaccination coverage during the postelimination period (2001-2008).
  • To identify challenges to maintaining measles elimination.

Main Methods:

  • Reviewed confirmed measles cases reported to the CDC.
  • Analyzed national measles-mumps-rubella (MMR) vaccination coverage data.
  • Examined vaccination status and exemption reasons for US-resident measles cases.

Main Results:

  • 557 measles cases and 38 outbreaks reported in the US (2001-2008), with 42% imported.
  • Highest incidence in infants (6-11 months) and young children (12-15 months).
  • 65% of US-resident cases were preventable (vaccine-eligible but unvaccinated), with 68% citing personal belief exemptions (2004-2008).

Conclusions:

  • Sustained high MMR vaccination coverage maintained measles elimination from 2001-2008.
  • International travel and unvaccinated clusters due to personal belief exemptions challenge ongoing elimination efforts.

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