Estimating and modeling the number of children susceptible to measles in light of COVID-19 Pubblico

Abstract

Measles elimination hinges on vaccination levels remaining above certain thresholds. The current global pandemic has resulted in a decline of childhood vaccinations, including measles vaccinations. This study’s goal is to estimate the number of children aged 0-18 susceptible to measles currently and model potential susceptibility rates in decreased vaccination scenarios, utilizing survey responses from the CDC’s national NIS-Teen survey.

Participants were respondents to the survey conducted by the CDC between the years 2008-2017 that also had provider-verified vaccination documentation. The exposure of interest was vaccination with a measles-containing vaccine, and the age at which they were vaccinated for all doses given. Using the age at vaccination, age-based probabilities of vaccination were compiled and used to model population levels of immunization and immunity vs susceptibility.

Currently 9,136,434 children (12.9%) are estimated to be susceptible to measles, with 61,642,824 (87.1%) children immune. With conditions mimicking pandemic-level vaccination rates, 15,121,801 children (21.4%) would be susceptible to measles if no attempt at catch-up is made, or 9,448,396 children (13.3%) if a mild attempt is made. Models based on increased vaccine hesitancy also show increased susceptibility at national levels, with a 10% increase in hesitancy nationally resulting in 14,697,783 children (21%) susceptible to measles, irrespective of pandemic vaccination levels.

Current levels of immunity, nationally, remain slightly below herd immunity thresholds based on data. If rates continue to remain depressed at current levels, our models indicate population-level immunity to measles will continue to move further from herd immunity thresholds.

Table of Contents

Abstract .............................................................................. 4

Literature Review ................................................................. 6

Literature Review References ............................................... 13

Thesis ................................................................................ 16

Thesis References ................................................................ 32

Figures ............................................................................... 37

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Parola chiave	Measles COVID-19 Vaccine MMR Vaccine Uptake
Committee Chair / Thesis Advisor	Robert Bednarczyk, PhD, Emory University

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