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The Role of Children Whose Parents Decline Vaccination in a Measles Outbreak


In January 2008, an unvaccinated 7-year-old boy returned to San Diego from Switzerland, where he had unknowingly become infected with measles. He infected his unvaccinated older sister and younger brother with measles. He then exposed classmates at his charter school, where 11 percent of the children were unvaccinated for measles. In the end, more than 800 people were exposed to the virus, and 11 additional cases were attributed to this measles exposure.

The study, “Measles Outbreak in a Highly Vaccinated Population, San Diego, 2008: Role of the Intentionally Undervaccinated,” published in the April issue of Pediatrics (released online March 22), found that despite high community vaccination coverage, measles outbreaks can and do occur in clusters of children whose parents decline vaccination. This creates a major cost for public health agencies who must engage in outbreak response programs, and to families who must quarantine children to prevent further spread of measles.


The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit