Impact of alternative measles-containing vaccines on childhood up-to-date immunizations in the United States, 2023
1
Department of Epidemiology, University of Iowa, Iowa City, United States
2
Department of Internal Medicine, University of Iowa, Iowa City, United States
3
Centre for Population Health Sciences, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Global measles outbreaks have been ongoing due to suboptimal vaccine coverage levels and reduced population-level immunity. While current US guidelines recommend standard combination vaccines (MMR/MMRV) and discourage the use of the alternatives, several alternative vaccines may be utilized for non-clinical reasons. We examine the impact of alternative measles vaccines on up to date (UTD) vaccine coverage for childhood immunizations.
METHODS:
The National Immunization Survey-Child is a nationally representative US survey that gathers information from parents with children aged 19-35 months and their physicians about their children’s immunization history. Using the 2023 survey, we calculated prevalence of receipt of each type of measles-containing vaccine (and zero-dose children). We compared mean vaccination time in days between groups using t-tests. After restricting our sample to those who received an alternative or standard combination vaccine, we used an adjusted logistic regression model to explore the association between alternative measles vaccine usage and 18-dose UTD status for all recommend childhood immunizations by household interview date.
RESULTS:
91.8% of children received a measles vaccine. 0.5% of vaccinated children received measles-only or measles-rubella alternative vaccines. Overall, average timeliness was similar among those that received alternative and standard measles vaccines (402 vs. 403 days, respectively). However, only 75.8% were UTD on childhood vaccinations. After adjusting for child’s age group, income, census region, race/ethnicity, sex, number of children in household, the odds of being UTD was 50% (OR=0.50; 95% CI:0.25-0.98) lower in children receiving the alternative vaccines compared to those receiving combination vaccines.
CONCLUSIONS:
Overall measles vaccination was below the 95% target. Children who received alternative measles vaccines were significantly less likely to be UTD with all childhood immunizations. These findings suggest that children who receive alternative measles vaccines may be vulnerable to other vaccine-preventable diseases aside from mumps and rubella, making them at risk for future outbreaks.
Global measles outbreaks have been ongoing due to suboptimal vaccine coverage levels and reduced population-level immunity. While current US guidelines recommend standard combination vaccines (MMR/MMRV) and discourage the use of the alternatives, several alternative vaccines may be utilized for non-clinical reasons. We examine the impact of alternative measles vaccines on up to date (UTD) vaccine coverage for childhood immunizations.
METHODS:
The National Immunization Survey-Child is a nationally representative US survey that gathers information from parents with children aged 19-35 months and their physicians about their children’s immunization history. Using the 2023 survey, we calculated prevalence of receipt of each type of measles-containing vaccine (and zero-dose children). We compared mean vaccination time in days between groups using t-tests. After restricting our sample to those who received an alternative or standard combination vaccine, we used an adjusted logistic regression model to explore the association between alternative measles vaccine usage and 18-dose UTD status for all recommend childhood immunizations by household interview date.
RESULTS:
91.8% of children received a measles vaccine. 0.5% of vaccinated children received measles-only or measles-rubella alternative vaccines. Overall, average timeliness was similar among those that received alternative and standard measles vaccines (402 vs. 403 days, respectively). However, only 75.8% were UTD on childhood vaccinations. After adjusting for child’s age group, income, census region, race/ethnicity, sex, number of children in household, the odds of being UTD was 50% (OR=0.50; 95% CI:0.25-0.98) lower in children receiving the alternative vaccines compared to those receiving combination vaccines.
CONCLUSIONS:
Overall measles vaccination was below the 95% target. Children who received alternative measles vaccines were significantly less likely to be UTD with all childhood immunizations. These findings suggest that children who receive alternative measles vaccines may be vulnerable to other vaccine-preventable diseases aside from mumps and rubella, making them at risk for future outbreaks.
| eISSN: | 2654-1459 |
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