Declining Childhood Vaccination May Increase Risk for Vaccine-Preventable Infections
WEDNESDAY, April 30, 2025 -- Declining childhood vaccination rates may increase outbreaks of eliminated vaccine-preventable infections within the United States, leading to a return to endemicity, according to a study published online April 24 in the Journal of the American Medical Association.
Mathew V. Kiang, Sc.D., from Stanford University in California, and colleagues estimated the number of cases and complications in the United States under scenarios of declining childhood vaccination using a simulation model to assess the importation and dynamic spread of vaccine-preventable infectious diseases during a 25-year period.
The researchers noted that at current state-level vaccination rates, measles may reestablish endemicity, with an estimated 851,300 cases over 25 years based on the simulation model (83 percent of simulations). The model estimates 11.1 million cases of measles over 25 years under a scenario with a 10 percent decline in measles-mumps-rubella (MMR) vaccination, while a 5 percent increase in MMR vaccination would result in an estimated 5,800 cases. Under current levels of vaccination, other vaccine-preventable diseases are unlikely to reestablish endemicity. The model predicts 51.2 million cases of measles over a 25-year period, 9.9 million cases of rubella, 4.3 million cases of poliomyelitis, and 197 cases of diphtheria if routine childhood vaccines declined by 50 percent. In this scenario, measles and rubella became endemic at 4.9 and 18.1 years, respectively, while poliovirus returned to endemic levels in 56 percent of simulations at an estimated 19.6 years.
"These findings support the need to continue routine childhood vaccination at high coverage to prevent resurgence of vaccine-preventable infectious diseases in the United States," the authors write.
Several authors disclosed ties to relevant organizations.
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