Quantifying the Declining Rate of Measles, Mumps, and Rubella Vaccine Administration in Harris County Due to the COVID-19 Pandemic and Analyzing the Vaccination Gaps by Racial Stratification of Patients

Background: Despite vaccines being attributed to the eradication of smallpox and prevention of many possibly fatal diseases, public confidence in vaccines has been on the decline, and the COVID-19 pandemic has further increased the vaccination gap across the world. A study done by the Michigan Care Improvement Registry compared age-recommended vaccination rates for patients from the years of 2016-2019 and the year 2020. The study showed that in the 16-month age cohort, children obtaining measles vaccine coverage declined from 76.1% in May 2019 to 70.9% in May 2020. An analysis by Scientific American showed only 44.7% of the number of vaccines administered in March 2019 were administered in March 2020 in the state of Texas.

Methods: The Quality Improvement sector of the Health Technology department at the UT Health Science Center approved the project and collected data across UT Health primary pediatric care clinics in Harris County. The data points included all the pediatric appointments of patients who were eligible for the MMR 1 and 2 vaccines in 2019 and 2020. The data displayed which eligible patients for the MMR 1 and 2 vaccines received the vaccine at their appointment. The data was analyzed for overall trends of Harris County, and then subdivided by patient racial groups.

Results: From 2019 to 2020, the MMR1 vaccination rate decreased from 52.15% to 43.55%, and the MMR2 vaccination rate decreased from 55.70% to 45.57%. Combining years 2019 and 2020, the percentage of eligible patients who did not receive the MMR1 vaccine consisted of 28.04% Caucasian, 22.05% African American, 17.11% Hispanic, Latino, or Latin American, 1.34% Asian or Pacific Islander, and 31.46% Other. The percentage of eligible patients in 2019 and 2020 who did not receive the MMR2 vaccine consisted of 28.05% Caucasian, 16.25% African American, 21.76% Hispanic, Latino, or Latin American, 1.75% Asian or Pacific Islander, and 32.18% Other. The demographic labeled “other” consisted of not answered and not specified patients.

Conclusion: Overall, there was a clear decline in the rate of MMR vaccinations to eligible patients from 2019 to 2020. This indicates that the COVID-19 pandemic is potentially playing an even greater role in public health than previously thought due to increasing the possibility of a measles epidemic occurring in Harris County. Stratifying the data by race demonstrated which demographics were more prone to vaccination gaps. Patients who selected not answered/not specified and Caucasian patients were the most likely to experience a gap in vaccine administration leading to an increased chance of measles outbreaks in these groups of patients. This is valuable knowledge for providers to be aware of which groups are more predisposed to vaccine gaps, so the healthcare team can help close the gap through a targeted approach of care.