Published 26 August 2019
A University of Pittsburgh Graduate School of Public Health study found that large and small cities in Texas are becoming increasingly vulnerable to measles outbreaks due to more parents exempting their children from required vaccinations. Texas is the largest state by population that allows parents to opt their children out of vaccinations for nonmedical reasons making it an interesting place to study measles outbreaks. If the vaccination rate among students in Texas continues to decrease in schools with undervaccinated populations, the potential number of cases associated with measles outbreaks is estimated to increase exponentially. The 2018 vaccination rates in multiple metropolitan areas may permit large measles outbreaks, which could infect not only vaccine refusers but also other members of the population. These findings, published in JAMA Open Network on August 21, 2019, indicate that an additional 5% decrease in vaccination rates, which have been on a downward trend since 2003, would increase the size of a potential measles outbreak by up to 4,000% in some communities.
The Texas Pediatric Society asked the University of Pittsburgh Graduate School of Public Health to model Texas using FRED (Framework for Reconstructing Epidemiological Dynamics), a software platform developed at the Pitt Graduate School of Public Health as a tool for creating simulation models of dynamic processes in human social systems. FRED allows researchers to see how measles could spread from person to person. According to lead author, David Sinclair, "If policy stays as it is and there is no change in the public's perspective of vaccinations and the importance of vaccinating their children, then the potential measles outbreaks will only get worse". When there is "geographic clustering" of unvaccinated people, potential outbreaks get worse.