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Measles-mumps-rubella (MMR) vaccination coverage in a large Ohio pediatric network remained below the 93% herd immunity threshold 20 months after a measles outbreak. This highlights ongoing immunity gaps and the need for targeted public health strategies.

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Area of Science:

  • Public Health
  • Epidemiology
  • Immunization

Background:

  • Sustaining measles elimination in the US depends on high vaccination coverage.
  • Postelimination measles outbreaks reveal persistent immunity gaps, particularly in underimmunized communities.
  • Understanding vaccination trends post-outbreak is crucial for public health preparedness.

Purpose of the Study:

  • To evaluate changes in measles-mumps-rubella (MMR) vaccination coverage.
  • To assess coverage following a large postelimination measles outbreak in a major US pediatric primary care population.

Main Methods:

  • A repeated, surveillance cross-sectional study was conducted in a central Ohio pediatric primary care network.
  • Approximately 150,000 children younger than 15 years were analyzed at three time points: outbreak onset, 12 months, and 20 months post-outbreak.
  • MMR vaccine receipt was assessed based on Centers for Disease Control and Prevention guidelines, with a focus on timely vaccination and coverage by age 84 months. Children of Somali descent were analyzed as a subgroup.

Main Results:

  • Timely MMR vaccine dose 1 coverage remained unchanged at 53.6% at 20 months post-outbreak.
  • Timely MMR vaccine dose 2 coverage increased modestly from 57.9% to 60.2%.
  • Overall receipt of at least one MMR dose by 84 months increased slightly to 77.9%. Children of Somali descent consistently showed significantly lower timely MMR vaccine dose 1 coverage.

Conclusions:

  • Despite a modest increase in second MMR dose coverage, overall MMR vaccination rates remained well below the 93% herd immunity threshold 20 months after the measles outbreak.
  • Persistent, population-wide immunity gaps underscore the need for sustained, equity-focused public health strategies to maintain measles elimination.
  • Targeted interventions are necessary to address disparities in vaccination coverage among specific communities, such as children of Somali descent.