Measles Could Become Endemic in US Within 20 Years Due to Declining Vaccination Rates
A Stanford University study forecasts that measles may become endemic in the US within two decades if current vaccination rates persist. With declining immunization among kindergarteners, the model predicts over 850,000 measles cases, 170,000 hospitalizations, and 2,500 deaths in 25 years. The research underscores the critical importance of increasing vaccination coverage to prevent a resurgence of this highly contagious disease.
Recent research from Stanford University reveals a concerning trend: measles is likely to become endemic in the United States within the next 20 years if current vaccination rates remain unchanged. This projection is based on a comprehensive computer model that simulates disease spread across states, factoring in vaccination coverage, demographics, and disease characteristics.
The study estimates that over the next 25 years, the US could experience more than 850,000 measles cases, resulting in approximately 170,000 hospitalizations and 2,500 deaths if vaccination rates do not improve. This is a stark warning given that measles was declared eliminated in the US in 2000, meaning there was no continuous transmission for over a year.
The decline in vaccination rates among US kindergarteners—from 95% in 2019–2020 to about 93% in 2022–2023—has contributed to this risk. Measles is highly contagious, with one infected individual capable of transmitting the virus to 12 to 18 others. The model used a basic reproduction number of 12 to reflect this contagiousness.
Importantly, the model also explored scenarios where vaccination rates dropped by 10%, which could lead to over 11 million measles cases in 25 years. Conversely, a 5% increase in vaccination coverage could reduce cases to just 5,800, demonstrating the profound impact of immunization efforts.
The study also assessed the risk of other vaccine-preventable diseases such as rubella, polio, and diphtheria becoming endemic. Due to their lower contagiousness and current vaccination levels, these diseases are unlikely to reestablish themselves unless vaccination rates fall dramatically.
One limitation of the model is its assumption of uniform vaccination rates within states, which may overlook localized pockets of low immunization that can trigger outbreaks. The recent measles outbreak in Texas, with over 600 cases and multiple fatalities, exemplifies how such clusters can undermine herd immunity.
Experts emphasize the urgency of increasing vaccination coverage to prevent measles from becoming endemic again. While the full consequences of declining immunization may take years to manifest, proactive public health strategies are essential to interrupt transmission and protect vulnerable populations.
This study serves as a critical reminder that sustained vaccination efforts remain the cornerstone of infectious disease control. As measles threatens to regain a foothold in the US, leveraging data-driven models and targeted immunization campaigns will be vital to safeguarding public health.
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