In the US, despite high rates of coverage (>90%) at the national level for at least 1 dose of measles, mumps, and rubella (MMR) vaccine, the size and number of measles outbreaks has increased.1 This rise in measles incidence has provoked a variety of policy changes aimed at improving vaccine coverage. Given this response, it is imperative for public health officials and policy makers to understand the contribution of vaccine refusal to the changing epidemiology of measles. In a previous review,2 we reported that unvaccinated individuals made up the majority (56.8%) of cases in measles outbreaks and that more than two-thirds (70.6%) of unvaccinated individuals who were age-eligible for vaccination had a nonmedical exemption to vaccination. In this article, we update the previous review and describe the added role of measles importation, which was not previously covered, to further characterize the association between vaccine refusal and measles epidemiology in the US.
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Phadke VK, Bednarczyk RA, Omer SB. Vaccine Refusal and Measles Outbreaks in the US. JAMA. 2020;324(13):1344–1345. doi:10.1001/jama.2020.14828
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