A new study by Stanford University researchers warns that measles, a disease once declared eliminated in the United States, is on track to become endemic again within the next two decades if vaccination rates do not improve. As reported by Wired, the findings paint a troubling picture of the country’s public health trajectory amid a backdrop of declining childhood immunizations and growing vaccine hesitancy.
Using advanced computer modeling, the Stanford epidemiologists found that in 83% of simulations, current vaccination levels would lead to measles becoming consistently present—endemic—in the U.S. over the next 25 years. The model projects more than 850,000 cases of measles during that period, including an estimated 170,000 hospitalizations and 2,500 deaths. The study was published in the Journal of the American Medical Association.
“If we continue on this path, measles isn’t just going to be something we hear about during rare outbreaks—it could become part of daily public health life again,” said lead author Mathew Kiang, an assistant professor of epidemiology and population health at Stanford.
The alarming projection comes as national MMR (measles, mumps, rubella) vaccination coverage among kindergarteners has dropped from 95% in the 2019–2020 school year to around 93% in 2022–2023, according to CDC data. In some states, rates are even lower. The researchers modeled outcomes using these state-level differences and other key factors such as vaccine efficacy, population demographics, and disease importation risks.
A further 10% decline in measles vaccination rates could lead to a staggering 11.1 million cases over 25 years, the model suggests. Conversely, a 5% increase in vaccination coverage would reduce expected cases to just 5,800.
Experts say these findings should serve as a wake-up call. “This isn’t just a theoretical possibility. This is a strong, data-driven forecast,” said Dr. Jeffrey Griffiths, professor of public health at Tufts University, who was not involved in the study. “It’s a warning of what lies ahead if we don’t reverse the trend.”
This warning is underscored by the largest measles outbreak in Texas since 1992, currently underway with over 600 cases, 64 hospitalizations, and two deaths. The outbreak was traced to a community with historically low vaccine uptake, illustrating how pockets of under-vaccination can trigger widespread outbreaks.
The study also assessed the risk of other previously eliminated diseases—rubella, polio, and diphtheria—returning under similar conditions. While measles was found to be the most likely to become endemic again, rubella and polio could reestablish themselves if vaccination rates fall by 35–40%. Diphtheria posed the least risk but still remains a threat if immunization efforts weaken significantly.
One limitation of the model, as noted by Wired, is its assumption of uniform vaccination rates across states. It does not account for the often stark differences in vaccine coverage between communities—a critical factor in real-world outbreaks. For instance, the West Texas measles surge has been concentrated in a Mennonite community with notably low vaccination rates.
While some believe public health action can still prevent a resurgence, the time to act is now. “The model actually suggests that we may not see immediate fallout,” Kiang said. “But over time, these gaps in vaccination coverage are going to catch up with us.”
The study arrives amid broader political and cultural debates around childhood immunizations. U.S. Health and Human Services Secretary Robert F. Kennedy Jr. has signaled a review of the nation’s vaccination schedule—further fueling concerns among scientists and public health officials.
“This is a crucial moment,” said co-author Nathan Lo, a Stanford physician and infectious disease expert. “We can still change the trajectory, but that will require clear communication, strong leadership, and restoring public trust in vaccines.”
