Declining MMR Rates Rely on Collaboration for Path Forward

Pediatricians are calling for stronger collaboration as measles, mumps, and rubella (MMR) vaccine coverage among young children continues to decline. National coverage among kindergartners has slipped to 92.5%, with some counties dropping to between 21% and 50%. This erosion of public health is already yielding serious consequences across the country, as pockets of unvaccinated individuals leave entire communities exposed to preventable outbreaks.

In part 2 of our interview series on measles and ongoing vaccine developments, Molly O’Shea, MD, FAAP, practicing pediatrician and owner of Birmingham Pediatrics & Wellness Center in Bloomfield Hills, Michigan, provides nuance from the perspective of a provider meeting with both children and their parents.

“Over 300,000 children are going to be entering kindergarten this year, relative to last year, without MMR [coverage],” she told Drug Topics®. “There will be a large number of those kids who will ultimately miss a couple of weeks of school, miss playing their sports, and really not have the opportunity to just do the normal childhood things they could have had they opted in to [vaccinate].”

Drug Topics will be covering developments on measles and vaccine policy with 3 experts throughout the week, culminating in a full-length episode of Over the Counter this Thursday afternoon, featuring a variety of insights from all 3.

READ MORE: How Pharmacists Can Address Measles Misinformation with Patients

The resurgence of the virus has reached a critical level in the US, as 2025 recorded the highest case count since 1991, and 2026 remains on pace to surpass that total. Federal data show that 3134 confirmed cases have been reported in 2026, which is a major jump from the 2289 cases seen in the full year of 2025.^1,2

The Growing Clinical Threat of Measles

The physical toll of this highly contagious virus has translated into tragic patient outcomes.

Two unvaccinated children with no prior health conditions died in Texas last year, and Pennsylvania recently reported 2 deaths in unvaccinated residents, including a newborn baby. These deaths serve as a harsh warning that measles is not a mild illness but a severe disease where approximately 1 in 1000 infected individuals will die.^1,3

Pharmacists find themselves on the front lines of this crisis because they see patients much more frequently than pediatricians. This frequent contact gives pharmacy professionals a unique chance to encourage vaccination and guide parents who are hesitant due to misinformation.

However, this critical role comes with a heavy workload, meaning that a joint effort between pediatricians and pharmacists is essential to ease the burden on local clinics.

The measles virus is extremely infectious and spreads easily through airborne transmission. It can live for up to 2 hours in the air after an infected person has left a room.⁴

Pharmacists must be aware of the classic presentation, which begins with a high fever, cough, runny nose, and red eyes before a blotchy, maculopapular rash spreads from the face down to the rest of the body. Common complications include diarrhea and ear infections, while severe complications include pneumonia and a progressive neurological disorder called subacute sclerosing panencephalitis, which can develop years later.^1,4

Collaboration in the Community Pharmacy

The American Academy of Pediatrics (AAP) recommends routine vaccination using a 2-dose series of live vaccines, starting at 12 to 15 months and followed by a second dose at 4 to 6 years of age. Pharmacists can administer these vaccines, which include M-M-R II and PRIORIX, which are considered interchangeable by the Advisory Committee on Immunization Practices (ACIP).^3,4

Additionally, when families visit a pharmacy for routine shots like an influenza vaccine or a tetanus booster, pharmacists can reinforce the importance of returning to a physician for primary care visits.

Partnering with local pediatricians allows pharmacists to direct families back to a primary care medical home where a holistic approach to child wellness can occur. Well-child visits are crucial for addressing developmental concerns, mental health initiatives, and behavioral issues that fall outside the scope of a pharmacy visit.

By working collaboratively, these health care professionals can present a unified front to dismantle vaccine hesitancy and rebuild the eroding shield of community immunity.⁴

READ MORE: Immunization Resource Center

REFERENCES

1. Measles. American Academy of Pediatrics. June 26, 2026. Accessed September 4, 2026. https://www.aap.org/en/patient-care/measles/

2. Measles cases and outbreaks. CDC. September 4, 2026. Accessed September 4, 2026. https://www.cdc.gov/measles/data-research/index.html

3. Measles outbreaks: common questions & how to protect your child. Healthychildren.org. August 31, 2026. Accessed September 4, 2026. https://www.healthychildren.org/English/safety-prevention/immunizations/Pages/how-to-protect-your-children-during-a-measles-outbreak.aspx

4. Sucher AJ, Swanson K, Bomba L, et al. Preventing and managing measles. US Pharmacist. 2023;48(8):33-37. https://www.uspharmacist.com/article/preventing-and-managing-measles