Unvaccinated Kids at Risk of Measles During International Travel

MedicalResearch.com Interview with:

Emily Parker Hyle, M.D. Assistant Professor of Medicine Massachusetts General Hospital

Dr. Emily Parker Hyle

Emily Parker Hyle, M.D.
Assistant Professor of Medicine
Massachusetts General Hospital

MedicalResearch.com: What is the background for this study?

Response: We found that many children who were planning to travel internationally were eligible for MMR vaccination prior to departure but often did not receive it – especially if they were aged 6 months to 6 years. That is because most children do not routinely receive their first dose of MMR till 12-15 months of age and their second dose of MMR till 4-6 years of age. However, ACIP recommendations are different for children who are traveling internationally. The risk of being infected with measles is much higher outside of the US, so it is recommended that children older than 1 year have had 2 MMR vaccinations and that children 6-12 months receive 1 MMR vaccination prior to travel. MMR vaccination is a safe and effective way to greatly reduce the risk of measles infection. 

MedicalResearch.com: What are the main findings? 

Response: We reviewed the clinical practices at 29 clinical sites that provide pretravel consultations and are part of the Global TravEpiNet (GTEN) Consortium — in almost 20% of the 14,000 pretravel encounters that included pediatric international travelers, the child was eligible for MMR vaccination prior to travel. However, almost 60% of these MMR-eligible pediatric travelers were not vaccinated at the encounter because providers often didn’t recommend MMR vaccination and guardians refused when MMR vaccination was offered.

MedicalResearch.com: What should readers take away from your report?

Response: Providers should consider MMR vaccination for eligible children who will be traveling internationally, which includes destinations such as Europe. Parents and guardians should ask their childrens’ pediatricians about MMR vaccination prior to international travel.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Future research should include an investigation of different strategies for provider and guardian education regarding MMR vaccination for pediatric travelers – it is of vital importance that we improve uptake of the ACIP recommendations for MMR vaccination of pediatric travelers to reduce measles illness among US children and to reduce measles outbreaks.

MedicalResearch.com: Is there anything else you would like to add?

Response: Children who travel internationally without measles immunity are at increased risk for being infected with measles, which can cause severe and even life-threatening illness, especially for very young children. Imported measles cases also can provoke further outbreaks of measles within the US, putting others at risk as well. In fact, pediatric travelers comprise only 10% of all international travelers but account for almost 50% of all measles importations to the US over the past ten years. And measles is on the rise again globally with more measles cases reported in 2019 than in 2018 as per a WHO report released this week. We can do a better job of protecting vulnerable children by being sure that they have received MMR vaccination prior to possible exposure during travel. 

No disclosures.


Hyle EP, Rao SR, Bangs AC, et al. Clinical Practices for Measles-Mumps-Rubella Vaccination Among US Pediatric International Travelers. JAMA Pediatr. Published online December 09, 2019. doi:https://doi.org/10.1001/jamapediatrics.2019.4515


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Last Updated on December 9, 2019 by Marie Benz MD FAAD