Coronavirus Hot-Spots Could Have Future Measles Outbreaks

The findings of an extensive review published in JAMA indicate that ‘unvaccinated individuals continue to constitute the majority of cases in measles outbreaks.’

Published on August 14, 2020, this study suggests that a large and growing population may be susceptible to the measles virus if the Measles-Mumps-Rubella (MMR) vaccine coverage remains suboptimal, during the context of the COVID-19 disease pandemic.

A separate study published on June 28, 2020, found routine vaccination coverage has declined in all milestone age cohorts during 2020. For the 16‐month age cohort, coverage with all recommended vaccines declined, with measles‐containing vaccination coverage decreasing about 8%, from 76.1% in May 2019 to 70.9% in May 2020.

Data from previous measles outbreaks showed 10.6% of infected individuals had a history of receiving measles-containing vaccines, 75.5% had no history of vaccination, and 13.9% had unknown vaccination status.

From an availability perspective, various monitoring systems have already identified reductions in the number of doses of measles-containing vaccines that have been ordered.

As of May 15, 2020, the Vaccine Tracking System indicates a notable decrease in orders for measles-containing vaccines.

These changes in population-level measles susceptibility pose a risk for larger and wider future outbreaks that could have substantial immunologic and public health costs.

The JAMA researchers commented these findings have important implications for vaccine policy. Vaccine refusal is not the only reason but continues to be a significant reason for the reemergence of measles in the post-elimination era.

And, most measles outbreaks in the USA are directly related to international importation of measles by travelers who acquired measles in countries where the disease remains endemic.

As an example, the 2018-2019 measles outbreak in New York City, the largest such outbreak in the USA in nearly 30 years, was directly connected to international travelers and their under-vaccinate families.

‘Measles importation continues to be the precipitant of US measles outbreaks, but the proportion of imported cases has been steadily declining, indicating the increasing contribution of sustained domestic measles transmission.’ 

When considering resource allocation for immunization programs and practice, policymakers need to account for the individual- and population-level immunologic effects of measles resurgence, as well as the considerable public health resources required to investigate and control measles outbreaks.’

Furthermore, ‘policy tools proven to increase vaccine acceptance, such as increasing the difficulty of obtaining vaccine exemptions, as well as evidence-based communication and persuasion strategies, are needed to reduce the rates of vaccine refusal in the USA,’ concluded the JAMA study.

MMR vaccine discounts in the USA are sponsored by GoodRx. 

PrecisionVaccinations publishes measles outbreak news.