[Skip to Content]
[Skip to Content Landing]
Views 12,915
Citations 0
JAMA Insights
Clinical Update
August 14, 2020

Vaccine Refusal and Measles Outbreaks in the US

Author Affiliations
  • 1Division of Infectious Diseases, Emory University School of Medicine, Emory University, Atlanta, Georgia
  • 2Department of Epidemiology, Emory University, Atlanta, Georgia
  • 3Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
  • 4Emory Vaccine Center, Emory University, Atlanta, Georgia
  • 5Yale Institute for Global Health, Yale University, New Haven, Connecticut
  • 6Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, Yale University, New Haven, Connecticut
  • 7Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, Connecticut
  • 8Yale School of Nursing, Orange, Connecticut
JAMA. 2020;324(13):1344-1345. doi:10.1001/jama.2020.14828

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.

Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words
    ×