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January 31, 2020

Large Majority of US Adults Say Benefits of Measles Vaccine Outweigh Risks

Author Affiliations
  • 1Consulting Editor, JAMA Health Forum and JAMA
JAMA Health Forum. 2020;1(1):e200088. doi:10.1001/jamahealthforum.2020.0088

Despite the United States’ near loss of its measles elimination status in 2019, fueled by outbreaks in underimmunized communities, an overwhelming majority of US adults—88%—say the benefits of the measles-mumps-rubella (MMR) vaccine exceed the risks, according to a Pew Research Center survey reported this month.

Although that figure remains unchanged since the group’s previous survey on this issue in 2016, the proportion of adults who regard the MMR vaccine’s preventive health benefits to be very high grew by 11 percentage points between 2016 and 2019, from 45% to 56%. A majority of US adults—69%—consider the risk of side effects from the vaccine to be either low or very low, about the same as in 2016.

However, the survey found significant differences based on race/ethnicity, education level, and age. Attitudes about the MMR vaccine are less positive among black and Hispanic individuals compared with white individuals, with 74% of black adults and 78% of Hispanic adults saying the vaccine’s benefits outweigh the risks, compared with 93% of white adults. Similarly, 36% of black adults and 48% of Hispanic adults rate the vaccine’s preventive health benefits as very high, compared with 61% of white adults. In addition, 46% of black adults and 45% of Hispanic adults say the risk of side effects from the vaccine is medium or high, compared with 23% of white adults.

Adults in the United States with higher levels of education or higher household income are more likely to have more positive views of MMR vaccination and to perceive the risks as low. Of US adults with a postgraduate degree, 93% rate the vaccine’s health benefits as very high or high, and just 14% view the risks as medium or high. In comparison, 68% of those with a high school education or less rate the health benefits as very high or high, and 39% consider the vaccine-related risks as high or very high. The survey also notes that baby boomers are more likely to have an overall positive view of measles vaccination (91%) compared with gen X adults (85%) or millennials (86%).

Most US adults (82%) say they support mandatory measles vaccination for public school attendance, whereas 16% say that whether to vaccinate for measles should be a parental decision, even if that may create health risks for others—a finding similar to that reported in the 2016 survey. Support for parental choice is higher among parents of minor children (21%, vs 13% of those who are not parents of minor children) and among lower-income adults (21%, vs 9% of higher-income adults).

Only state legislatures have the authority to require vaccinations in certain settings, such as schools. As noted in a JAMA Forum article, “Until recently, only 2 states, Mississippi and West Virginia, prohibited all nonmedical (religious, philosophical, or both) exemptions; they have nationally leading MMR immunization rates of about 99%.” Currently, according to the National Conference of State Legislatures, 45 states and Washington, DC, grant religious exemptions for people who have religious objections to immunizations, and 15 states “allow philosophical exemptions for those who object to immunizations because of personal, moral or other beliefs.”

Although an uptick in overall positive views of the MMR vaccine is encouraging, 2019 was marked by the largest number of US measles cases in more than 25 years, with 1282 cases documented in 31 states, according to the Centers for Disease Control and Prevention.

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