Migrants should be vaccinated for measles at U.S. ports of entry

A young resident of the largest shelter for newly arrived migrants in Chicago was recently diagnosed with measles, pushing our rightfully concerned city into action.

Within 16 hours, the Chicago Department of Public Health brought together a team of vaccinators, screeners and health care providers to verify the vaccine status of the nearly 1,900 shelter residents and vaccinate those without proof of vaccination. Nearly all the shelter residents were vaccinated by the end of the weekend.

University of Illinois Chicago’s outbreak response team, which we co-lead, is part of the response. As more cases emerge, our team and others are fanning out across the city to ensure the 11,000-plus newest members of our community are vaccinated.

Now is the time to put measures in place to prevent, not just react, to outbreaks like this.

The people we encounter are willing to get vaccinated. Most adults report they were vaccinated already but had not brought vaccine cards when they migrated north. Parents are grateful that their children are receiving vaccines that will protect their health.

The MMR vaccine for measles, mumps and rubella is a real workhorse. Developed in 1971, the two doses given at 12 to 15 months of age and again at age 4 to 6 years, provide high levels of lifetime immunity for a lifetime against these diseases that used to cause serious illness and death.

Worldwide, vaccination with measles has averted over 57 million deaths in the past two decades. The historic low in global child mortality announced this week by the United Nations Inter-agency Group for Child Mortality Estimation is partially due to the work of this vaccine, as well as others.

In 2000, the U.S. eliminated measles, for a brief time. To reach that goal again, we need to achieve 95% vaccine coverage so those of us who are vaccinated provide herd immunity for those too young to get vaccinated or those rare folks with a serious illness that renders vaccines ineffective.

In the U.S., the majority of unvaccinated people are those who refuse to get vaccinated due to their personal beliefs, leaving room for the virus to take hold and spread to those who are not yet fully vaccinated. According to the Centers for Disease Control and Prevention, most cases in the U.S. are a result of international travel by unvaccinated people who bring it home. And, there is always a potential for further spread in pockets of unvaccinated people here.

The COVID-19 global pandemic resulted in many missing vaccine doses due to a lack of accessible care and interruptions in vaccine distribution. At the end of 2022, the World Health Organization estimated that 40 million children worldwide had missed a dose of the measles vaccine. We are still working here and abroad to catch up to our pre-pandemic rates.

Outside the U.S., political instability, economic insecurity and corruption negatively impact health infrastructure, resulting in lower vaccination rates. Venezuela, where most of the migrants come from, used to have relatively high vaccination rates but, due to instability, vaccination rates have plummeted and measles cases have increased. The same forces pushing people to come to the U.S. in search of a better life have resulted in the new arrivals being left susceptible to contracting measles during this outbreak.

While the causes leading to reduced vaccination rates are a complex mix of individual beliefs and systemic failures, and the results severe — including an outbreak of a serious disease — we know what to do to prevent future outbreaks. We need to offer vaccines to all new arrivals to the U.S. at ports of entry. And we need to convince those already living here to join us to achieve 95% vaccination rates and get our measles-free status again.

Rebecca Singer is a registered nurse and clinical assistant professor at University of Illinois Chicago College of Nursing and a Public Voices fellow of The OpEd Project. Stockton Mayer is an infectious disease physician and clinical assistant professor at the University of Illinois Chicago College of Medicine and co-lead of UIC’s Outbreak Response Team.

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