Project Details

Leveraging digital surveillance to identify gaps and inequities in Measles-Mumps-Rubella vaccination

Benjamin Rader, PhD, MPH

Summary

BACKGROUND: Measles is a highly infectious and deadly pediatric disease, posing significant health risks to children, particularly with declining MMR vaccination rates. In 2022, it was estimated that between 9 and 15 million U.S. children were susceptible to measles due to inadequate immunization. GAP: Misinformation surrounding the Measles-Mumps-Rubella (MMR) vaccine has fueled vaccine hesitancy, causing MMR vaccine coverage rates to drop. However, highly resolved geographic and demographic details MMR vaccine refusals are often unavailable and state-level vaccination data is usually collated retrospectively. HYPOTHESIS: We will test the null hypothesis that vaccination rates are consistent across the population. METHODS: MMR vaccination data will be collected via a digital participatory surveillance platform and then analyzed with small area estimation techniques to identify and map communities with low vaccination rates. RESULTS: We found significant demographic and geographic disparities in MMR vaccination rates, including children of parents who received at least 1 dose of the COVID-19 vaccine had higher MMR vaccination rates (80.8%) than did children of unvaccinated parents (60.9%; odds ratio [OR] = 1.84; 95% confidence interval [CI] = 1.68, 2.00. We found higher MMR vaccination rates in the Northeast and Midwest United States. We also found that children 0-5 were less likely to be vaccinated than children older than 5. IMPACT: Following the identification of communities with suboptimal MMR vaccination rates, targeted interventions and revised vaccination policies can be developed to address specific concerns, potentially enhancing vaccine uptake. By focusing efforts in high-risk areas, the findings have the potential to reduce the probability of a measles outbreak in children, thereby directly contributing to the prevention of related morbidity and mortality. Website Link: https://accelerator.childrenshospital.org/

Publications:

Zhou EG, Cantor J, Gertz A, Elbel B, Brownstein JS, Rader B. Parental Factors Associated With Measles–Mumps–Rubella Vaccination in US Children Younger Than 5 Years. Am J Public Health. 2025;115(3):369-373. doi:10.2105/AJPH.2024.307912. PMID: 39818999.

Rader B, Walensky RP, Rogers WS, Brownstein JS. Revising US MMR Vaccine Recommendations Amid Changing Domestic Risks. JAMA. Published online March 14, 2025. doi:10.1001/jama.2025.3867. PMID: 40085113

Walensky RP, Rader B, Brownstein JS. In the wake of measles outbreaks, vaccine guidelines must be updated. Stat News. March 21, 2025. https://www.statnews.com/2025/03/21/measles-outbreaks-mmr-vaccine-guidelines-infants-travel/