Declining vaccination rates in the United States pose a significant public health challenge, particularly regarding measles and mumps, according to a recent study published in the Journal of the American Medical Association. The research highlights a national decrease in MMR (measles/mumps/rubella) vaccinations among American children since the onset of the COVID-19 pandemic, raising concerns about the re-emergence of these highly contagious diseases.
The study, led by senior researcher Lauren Gardner, a professor at Johns Hopkins Whiting School of Engineering, revealed that an alarming 78 percent of U.S. counties have reported drops in MMR vaccination rates. This widespread decline is particularly concerning given that only four of the 33 states studied—California, Connecticut, Maine, and New York—showed increases in MMR vaccinations. These findings coincide with recent measles outbreaks across the U.S., with over 1,000 cases reported this year in 31 jurisdictions, underscoring the immediate threat posed by waning vaccine coverage.
Gardner and her team developed a novel county-level MMR vaccination database, complementing existing state and national data from the U.S. Centers for Disease Control and Prevention (CDC). This granular dataset, which tracked MMR vaccination rates for kindergarteners from 2017 to 2024, is crucial for a nuanced understanding of the country’s vaccination landscape. The analysis revealed that the average county-level vaccination rate plummeted from 93.9% pre-pandemic to 91.2% post-pandemic, representing an average decline of approximately 2.7 percentage points. This trend moves the nation further away from the 95% vaccination rate necessary to achieve herd immunity against measles, a highly virulent infectious disease. The CDC estimates that an unvaccinated individual exposed to measles has up to a 90% chance of infection, and the airborne virus can remain viable in a room for up to two hours after an infected person has departed.
The implications of these declining vaccination rates are particularly dire for Black patients, who often face systemic barriers to healthcare access and historically rooted medical mistrust. While the study itself did not disaggregate data by race or ethnicity, existing literature and public health data consistently demonstrate that health disparities disproportionately affect Black communities.
Measles vulnerabilities for Black patients
Several factors contribute to this increased vulnerability. Black patients may experience lower vaccination rates due to a combination of socioeconomic determinants, including limited access to healthcare facilities, transportation challenges, and inconvenient clinic hours. Furthermore, historical and ongoing experiences of medical racism, discrimination, and unethical medical experimentation (such as the Tuskegee Syphilis Study) have fostered deep-seated distrust in the medical system among some Black individuals. This distrust can manifest as vaccine hesitancy, even when evidence overwhelmingly supports vaccine safety and efficacy. Misinformation and disinformation regarding vaccines, amplified through social media and community networks, can further exacerbate these concerns.
Healthcare professionals must adopt culturally competent and trauma-informed approaches when engaging with Black patients about vaccinations. This includes acknowledging historical injustices, actively listening to concerns, and providing clear, accurate, and empathetic information about vaccine benefits and risks. Building trust requires time, consistent engagement, and a commitment to addressing social determinants of health that impact vaccine access. Collaborating with community leaders, faith-based organizations, and trusted messengers within Black communities can also be instrumental in disseminating accurate information and promoting vaccine uptake.
Moreover, healthcare systems must actively work to dismantle systemic barriers to vaccination. This includes expanding access to vaccination services in community settings, offering flexible appointment times, and providing transportation assistance. Addressing economic disparities that prevent families from prioritizing routine healthcare, including vaccinations, is also critical. Without targeted interventions and a concerted effort to address historical inequities and current access challenges, the resurgence of preventable diseases like measles will continue to disproportionately burden vulnerable populations, including Black children and their families. The findings of this study serve as an urgent call to action for healthcare professionals and policymakers to redouble efforts in promoting and facilitating universal vaccination coverage to protect all communities.