title: Estimating the Number of Measles-Susceptible Children and Adolescents in the United States Using Data From the National Immunization Survey-Teen (NIS-Teen).
abstract: Despite high measles vaccination rates in the United States, imported measles cases have led to outbreaks in the United States. These outbreaks have not led to sustained measles transmission; however, with each birth cohort of children not fully vaccinated against measles, measles-susceptible individuals accumulate in the population. The total number of measles-susceptible children and adolescents in the United States is unknown. We used age-specific measles vaccination data from the National Immunization Survey-Teen (2008-2013) to estimate the number of measles-susceptible children aged 17 years or younger, accounting for vaccine effectiveness, infant protection from maternal antibodies, and loss of immunity following childhood cancer treatment. Approximately 12.5% of US children and adolescents are susceptible to measles, with the highest levels of susceptibility being observed in children aged 3 years or younger (24.7% are susceptible to measles). In sensitivity analyses, we found that a sustained decrease in measles vaccination coverage from 91.9% (2013 level) to 90.0% (2009 level) would add nearly 1.2 million susceptible children and adolescents (thus making 14.2% of those aged 17 years or younger susceptible to measles). This reemphasizes the need for high measles vaccination coverage to support population-level immunity and prevent reestablishment of indigenous measles transmission in the United States.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Bednarczyk
authors.forename: Walter A
authors.initials: WA
authors.lastname: Orenstein
authors.forename: Saad B
authors.initials: SB
authors.lastname: Omer
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D004198:Disease Susceptibility / Q000453:epidemiology / Q000276:immunology; D019538:Health Care Surveys / Q000706:statistics & numerical data; D006801:Humans; D032521:Immunity, Herd; D017589:Immunization Programs / Q000592:standards / Q000706:statistics & numerical data; D007223:Infant; D008457:Measles / Q000453:epidemiology* / Q000276:immunology / Q000517:prevention & control; D008458:Measles Vaccine / Q000008:administration & dosage; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage*; D014481:United States / Q000453:epidemiology
chemical_list: D008458:Measles Vaccine; D022542:Measles-Mumps-Rubella Vaccine
keywords: disease susceptibility; immunization; measles; measles-mumps-rubella vaccine