Editing MMR vaccine (section)

===Measles===
[[File:Measles US 1938-2019.png|upright=1.3|alt=Measles cases 1944-1963 followed a highly variable epidemic pattern, with 150,000-850,000 cases reported per year. A sharp decline followed the introduction of the first measles vaccine in 1963, with fewer than 25,000 cases reported in 1968. Outbreaks around 1971 and 1977 gave 75,000 and 57,000 cases, respectively. Cases were stable at a few thousand per year until an outbreak of 28,000 in 1990. Cases declined from a few hundred per year in the early 1990s to a few dozen in the 2000s. | thumb | Measles cases reported in the [[United States]] fell drastically after the introduction of the measles vaccine.]]
Before the widespread use of a vaccine against [[measles]], rates of disease were so high that infection was felt to be "as inevitable as death and taxes."<ref>{{cite journal | vauthors = Babbott FL, Gordon JE | title = Modern measles | journal = The American Journal of the Medical Sciences | volume = 228 | issue = 3 | pages = 334–361 | date = September 1954 | pmid = 13197385 | doi = 10.1097/00000441-195409000-00013 }}</ref> Reported cases of measles in the United States fell from hundreds of thousands to tens of thousands per year following introduction of the vaccine in 1963. Increasing uptake of the vaccine following outbreaks in 1971, and 1977, brought this down to thousands of cases per year in the 1980s. An outbreak of almost 30,000 cases in 1990 led to a renewed push for vaccination and the addition of a second vaccine to the recommended schedule. Fewer than 200 cases have been reported in the US each year between 1997 and 2013, and the disease is no longer considered endemic there.<ref>{{cite journal | title = Summary of notifiable diseases, United States, 1993 | journal = MMWR. Morbidity and Mortality Weekly Report | volume = 42 | issue = 53 | pages = i-xvii; 1–73 | date = October 1994 | pmid = 9247368 | url = <!-- Official URL --> https://www.cdc.gov/mmwr/PDF/wk/mm4253.pdf | access-date = 26 January 2020 | url-status = live | archive-url = https://web.archive.org/web/20201024200449/https://www.cdc.gov/mmwr/PDF/wk/mm4253.pdf | archive-date = 24 October 2020 | author1 = Centers for Disease Control and Prevention (CDC) }}</ref><ref>{{cite journal | vauthors=((Centers for Disease Control and Prevention (CDC))) | title=Summary of Notifiable Diseases --- United States, 2007 | journal=MMWR Morb. Mortal. Wkly. Rep. | volume=56 | issue=53 | date=July 2009 | url=<!-- Official URL --> https://www.cdc.gov/mmwr/pdf/wk/mm5653.pdf | access-date=26 January 2020 | archive-date=24 October 2020 | archive-url=https://web.archive.org/web/20201024200418/https://www.cdc.gov/mmwr/PDF/wk/mm5653.pdf | url-status=live }}</ref><ref>{{cite book | publisher = U.S. [[Centers for Disease Control and Prevention]] (CDC) | title = Epidemiology and Prevention of Vaccine-Preventable Diseases | veditors = Hamborsky J, Kroger A, Wolfe S | edition = 13th | location = Washington D.C. | year = 2015 | isbn = 978-0990449119 | url = https://www.cdc.gov/pinkbook | access-date = 9 September 2017 | archive-date = 30 December 2016 | archive-url = https://web.archive.org/web/20161230001534/https://www.cdc.gov/vaccines/pubs/pinkbook/index.html | url-status = live }}</ref>

The benefit of measles vaccination in preventing illness, disability, and death has been well documented. The first 20 years of licensed measles vaccination in the US prevented an estimated 52 million cases of the disease, 17,400 cases of [[intellectual disability]], and 5,200 deaths.<ref>{{cite journal | vauthors = Bloch AB, Orenstein WA, Stetler HC, Wassilak SG, Amler RW, Bart KJ, Kirby CD, Hinman AR | title = Health impact of measles vaccination in the United States | journal = Pediatrics | volume = 76 | issue = 4 | pages = 524–532 | date = October 1985 | pmid = 3931045 | doi = 10.1542/peds.76.4.524 | s2cid = 6512947 }}</ref> During 1999–2004, a strategy led by the [[World Health Organization]] and [[UNICEF]] led to improvements in measles vaccination coverage that averted an estimated 1.4 million measles deaths worldwide.<ref name="pmid 16528234">{{cite journal | title = Progress in reducing global measles deaths, 1999-2004 | journal = MMWR. Morbidity and Mortality Weekly Report | volume = 55 | issue = 9 | pages = 247–249 | date = March 2006 | pmid = 16528234 | url = <!-- Official URL --> https://www.cdc.gov/mmwr/pdf/wk/mm5509.pdf | access-date = 26 January 2020 | url-status = live | archive-url = https://web.archive.org/web/20210305135803/https://www.cdc.gov/mmwr/pdf/wk/mm5509.pdf | archive-date = 5 March 2021 | author1 = Centers for Disease Control and Prevention (CDC) }}</ref> Between 2000 and 2018, measles vaccination resulted in a 73% decrease in deaths from the disease.<ref name="WHO Measles Fact Sheet" />

Measles is [[Endemic (epidemiology)|common]] in many areas of the world. Although it was declared eliminated from the US in 2000, high rates of vaccination and good communication with people who refuse vaccination are needed to prevent outbreaks and sustain the elimination of measles in the US.<ref name=Parker/> Of the 66 cases of measles reported in the US in 2005, slightly over half were attributable to one unvaccinated individual who acquired measles during a visit to [[Romania]].<ref>{{cite journal | title = Measles--United States, 2005 | journal = MMWR. Morbidity and Mortality Weekly Report | volume = 55 | issue = 50 | pages = 1348–1351 | date = December 2006 | pmid = 17183226 | url = <!-- Official URL --> https://www.cdc.gov/mmwr/pdf/wk/mm5550.pdf | access-date = 26 January 2020 | url-status = live | archive-url = https://web.archive.org/web/20210126050729/https://www.cdc.gov/mmwr/PDF/wk/mm5550.pdf | archive-date = 26 January 2021 | author1 = Centers for Disease Control and Prevention (CDC) }}</ref> This individual returned to a community with many unvaccinated children. The resulting outbreak infected 34 people, mostly children and virtually all unvaccinated; 9% were hospitalized, and the cost of containing the outbreak was estimated at $167,685. A major epidemic was averted due to high rates of vaccination in the surrounding communities.<ref name=Parker>{{cite journal | vauthors = Parker AA, Staggs W, Dayan GH, Ortega-Sánchez IR, Rota PA, Lowe L, Boardman P, Teclaw R, Graves C, LeBaron CW | title = Implications of a 2005 measles outbreak in Indiana for sustained elimination of measles in the United States | journal = The New England Journal of Medicine | volume = 355 | issue = 5 | pages = 447–455 | date = August 2006 | pmid = 16885548 | doi = 10.1056/NEJMoa060775 | s2cid = 34529542 | doi-access = free }}</ref>

In 2017, an outbreak of measles occurred among the Somali-American community in Minnesota, where MMR vaccination rates had declined due to the misconception that the vaccine could cause autism. The US [[Centers for Disease Control and Prevention]] recorded 65 affected children in the outbreak by April 2017.<ref>{{cite journal | vauthors = Hall V, Banerjee E, Kenyon C, Strain A, Griffith J, Como-Sabetti K, Heath J, Bahta L, Martin K, McMahon M, Johnson D, Roddy M, Dunn D, Ehresmann K | title = Measles Outbreak - Minnesota April-May 2017 | journal = MMWR. Morbidity and Mortality Weekly Report | volume = 66 | issue = 27 | pages = 713–717 | date = July 2017 | pmid = 28704350 | pmc = 5687591 | doi = 10.15585/mmwr.mm6627a1 | url = <!-- Official URL --> https://www.cdc.gov/mmwr/volumes/66/wr/pdfs/mm6627.pdf | access-date = 26 January 2020 | url-status = live | archive-url = https://web.archive.org/web/20200802231920/https://www.cdc.gov/mmwr/volumes/66/wr/pdfs/mm6627.pdf | archive-date = 2 August 2020 }}</ref>