Black CL

Bloch AB

Breiman L

Chen PW

Cocoros N

Cole P

Curtis C Robinette

Dorell C

Elam-Evans LD

Gastanaduy PA

Green M

Grigg MA

Hassidim A

Kodagoda D

Measles—United States

National Vaccine Advisory Committee

Salmon DA

Smith PJ

Objective.We evaluated the extent to which children and adolescents were not vaccinated against measles (“unvaccinated”), clustering within U.S. counties, and factors associated with unvaccination, including parents' vaccine-related beliefs and missed opportunities.Methods.We analyzed data from the 2010–2013 National Immunization Survey (NIS) and NIS-Teen Survey of households with 19- to 35-month-old children and 13- to 17-year-old adolescents, respectively. We used provider-reported vaccination histories to assess measles vaccination status.Results.In 2013, 7.5% of children and 4.5% of adolescents were unvaccinated against measles. Four-fifths (80.0%) of unvaccinated children lived in counties containing 41.9% of the nation's children, and 80.0% of unvaccinated adolescents lived in counties containing 30.4% of the nation's adolescents. Multivariable statistical analyses found that 74.6% of children who were unvaccinated against measles missed being vaccinated for reasons other than parents' negative vaccine-related beliefs, and 89.6% could be deemed as having at least one missed opportunity for being vaccinated against measles because they were administered at least one dose of other recommended vaccines after 12 months of age. Among adolescents, multivariable analyses found that only demographic factors, not vaccine-related parental beliefs, were independently associated with being unvaccinated.Conclusions.Reasons other than negative vaccine-related beliefs, including missed opportunities, accounted for the vast majority of unvaccinated children and adolescents.</jats:sec

Philip J. Smith

Edgar K. Marcuse

Jane F. Seward

Zhen Zhao

Walter A. Orenstein

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Public Health Reports

Children and Adolescents Unvaccinated against Measles: Geographic Clustering, Parents' Beliefs, and Missed Opportunities

Children and Adolescents Unvaccinated against Measles: Geographic Clustering, Parents' Beliefs, and Missed Opportunities

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