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Vaccines
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Vaccines and Immunization: Measles, Mumps, and Rubella
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Vaccines and Immunization: Measles, Mumps, and Rubella

A special issue of Vaccines (ISSN 2076-393X). This special issue belongs to the section "Epidemiology and Vaccination".

Deadline for manuscript submissions: 31 March 2027 | Viewed by 8163

Special Issue Editor

Dr. Nobuhiko Okabe

E-Mail Website
Guest Editor
Kawasaki City Institute for Public Health, Kawasaki City 210-0821, Kanagawa, Japan
Interests: infectious diseases; pediatric infectious diseases; virology; immunization

Special Issue Information

Dear Colleagues,

Measles, mumps, and rubella are viral diseases with many complications. Measles can become severe and often lead to death, mumps are associated with hearing loss, and rubella infection in pregnant women can cause fetal infection and CRS at high rates. Fortunately, the number of cases has dropped dramatically in countries and regions where vaccines are widely used. However, the COVID-19 pandemic, poverty, and conflicts have significantly impacted vaccination efforts. In areas where immunization rates have declined, a resurgence of these diseases is also affecting neighboring countries. Moreover, while measles, mumps, and rubella have typically been viewed as childhood diseases, recent epidemiological trends show that their impact extends to adults and the elderly. This Special Issue aims to explore the future of these diseases, focusing on advancements in understanding their pathology and virology, changes in the epidemiological landscape, and progress in developing future vaccines.

We look forward to your contributions and insights on this important topic.

Dr. Nobuhiko Okabe
Guest Editor

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Vaccines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • measles
  • mumps
  • rubella
  • SSPE
  • hearing loss
  • CRS
  • immune mechanism
  • epidemiology
  • resurgence
  • life-course immunization

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Published Papers (5 papers)

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Research

17 pages, 1498 KB  
Article
Taiwan’s Strategy Toward Measles Elimination
by Fu-Tien Lin, Chin-Hui Yang, Wen-Yueh Cheng and Jean-Yun Chang
Vaccines 2026, 14(4), 361; https://doi.org/10.3390/vaccines14040361 - 17 Apr 2026
Viewed by 515
Abstract
Background: Sustaining measles elimination in the post-elimination era presents increasing challenges due to global resurgence and waning vaccine-induced immunity. We aimed to evaluate epidemiological trends, vaccination strategies, and population immunity associated with achieving and maintaining measles elimination in Taiwan. Methods: We conducted a [...] Read more.
Background: Sustaining measles elimination in the post-elimination era presents increasing challenges due to global resurgence and waning vaccine-induced immunity. We aimed to evaluate epidemiological trends, vaccination strategies, and population immunity associated with achieving and maintaining measles elimination in Taiwan. Methods: We conducted a comprehensive analysis of national surveillance data from 1991 to 2024, including case notifications, viral genotypes, vaccination coverage rates, and surveillance performance indicators. Three population-based seroprevalence surveys conducted between 2002 and 2020 were reviewed to assess age-specific immunity. Descriptive analyses were performed to characterize long-term epidemiological and immunological trends. Results: From 1993 to 2024, the annual number of measles cases remained consistently below 50, except in 2019. Vaccination coverage for both MMR1 and MMR2 has exceeded 95% since 1998, with MMR1 coverage remaining above 97% between 2009 and 2024. Genotyping evidence confirms the interruption of endemic transmission since 2006; furthermore, as of 2024, no continuous chains of transmission lasting longer than 12 months have been recorded. National seroprevalence surveys monitoring measles-specific IgG antibodies revealed declining antibody levels among adolescents and young adults, with seropositivity as low as 36.7% in specific cohorts. Despite this, transmission following importations has remained limited, with minimal secondary spread. Conclusions: Taiwan has successfully sustained measles elimination through high vaccination coverage, robust surveillance, and targeted interventions. Although serological evidence indicates waning immunity, epidemiological data suggest preserved population-level protection, likely mediated by immunological memory. Targeted booster strategies for high-risk groups may be more appropriate than universal additional dosing in post-elimination settings. Full article
(This article belongs to the Special Issue Vaccines and Immunization: Measles, Mumps, and Rubella)
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14 pages, 539 KB  
Article
The Status of Measles and Rubella Outbreak Detection, Early Alerts, and Response in Eastern Mediterranean Region (EMR), 2023
by Eman Elmahdy, Eltayeb Elfakki, Amany Ghoniem, Basma M. Saleh, Frank Mahony and Quamrul Hasan
Vaccines 2026, 14(3), 272; https://doi.org/10.3390/vaccines14030272 - 20 Mar 2026
Viewed by 781
Abstract
Background: Measles and rubella remain major public health concerns in the Eastern Mediterranean Region (EMR), despite regional elimination goals. In 2023, the region experienced an increase in measles outbreaks. This study assessed outbreak detection and response challenges in either case definition or [...] Read more.
Background: Measles and rubella remain major public health concerns in the Eastern Mediterranean Region (EMR), despite regional elimination goals. In 2023, the region experienced an increase in measles outbreaks. This study assessed outbreak detection and response challenges in either case definition or data analysis, in addition to gaps in laboratory and genotyping data integration to improve preparedness and response. Method: A retrospective epidemiological study was conducted using official World Health Organization (WHO) data on measles and rubella (MR) in EMR countries, from 1 January to 31 December 2023. Routine MR surveillance line list, genotyping data and supplemental immunization activity (SIA) reported by countries were used. Results: In 2023, 1206 suspected measles outbreaks were reported in 13 countries; 942 (78%) were confirmed. Rubella accounted for 158 confirmed outbreaks. Children under 5 years old comprised 76% of cases, with 62% zero dose. Timely detection was achieved in only 46% of outbreaks, with wide national variation. Genotype B3 predominated, but missing genotyping data limited verification. Six immunization campaigns occurred; however, outbreaks persisted due to high zero dose, limited targeting, and delayed responses. Conclusions: Persistent immunity gaps, under detection, inconsistent genotyping, and delayed response hindered MR control in EMR. Strengthening surveillance, integrating epidemiological and molecular data, expanding targeted supplementary immunization activities, and ensuring timely response are essential tasks. Standardized outbreak definitions, capacity building, and regular subnational analyses remain critical to regional elimination goals. Full article
(This article belongs to the Special Issue Vaccines and Immunization: Measles, Mumps, and Rubella)
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19 pages, 1472 KB  
Article
Timeliness and Equity: An Analysis of Measles Herd Immunity in a Regional Area of Australia
by Megan Whitley, Katrina Clark, Michelle Butler, Peter Murray, Hannah Briggs, Sharon Saxby and David N. Durrheim
Vaccines 2026, 14(1), 1; https://doi.org/10.3390/vaccines14010001 - 19 Dec 2025
Viewed by 1119
Abstract
Background: Global declines in immunisation rates and a resurgence in measles pose a threat, even in countries like Australia that have achieved elimination status. National coverage in Australia is measured at static timepoints, so it is unclear at what age children received their [...] Read more.
Background: Global declines in immunisation rates and a resurgence in measles pose a threat, even in countries like Australia that have achieved elimination status. National coverage in Australia is measured at static timepoints, so it is unclear at what age children received their vaccines. This may permit the emergence of immunity gaps, leaving children susceptible to measles between those reporting timepoints. Methods: A cross-sectional retrospective analysis was conducted using routinely collected data from the Australian Immunisation Register for children residing in Hunter New England Local Health District (HNELHD), New South Wales, born from 1 January 2015 to 1 June 2019 as a quality improvement initiative. Coverage, age at immunisation, and on-time immunisation were described by demographic, local geographic and age variables. Reverse survival analysis was conducted to determine the timing of achieving 95% MCV2 coverage. To ensure the cultural integrity of the research, an Aboriginal researcher co-led the design, analysis and interpretation of results. Results: The analysis included 53,390 children. Measles coverage exceeded the national and international target of 95% MCV2 coverage, with coverage in Aboriginal children surpassing national rates for all children. Pockets of low coverage were identified in several smaller geographic areas and subpopulations. Median age of MCV1 receipt was 375 days (IQR: 369–390 days), and MCV2 was 560 days (IQR: 551–583 days). More recent birth cohorts had earlier immunisation. On-time immunisation rates were high, and most children receiving measles immunisation late were still immunised within six months of the schedule date. The 95% MCV2 coverage threshold was achieved at 1582 days of age. Conclusions: Robust measles immunisation coverage and timeliness were found in HNELHD, Australia. Timeliness data analysis is a useful adjunct to static coverage data in understanding immunisation protection. Improving immunisation data availability, accessibility, and timeliness offers potential to better inform targeted public health activity. Full article
(This article belongs to the Special Issue Vaccines and Immunization: Measles, Mumps, and Rubella)
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17 pages, 1948 KB  
Article
Eliminating Measles: Factors That Contribute to Re-Establishing Transmission
by Emily Gibson, David N. Durrheim and Patrick O’Connor
Vaccines 2025, 13(11), 1125; https://doi.org/10.3390/vaccines13111125 - 31 Oct 2025
Viewed by 2162
Abstract
Background/Objectives: Since 2016, 14 countries previously verified to have eliminated endemic measles transmission have lost their elimination status. To explore whether there were identifiable risk factors for re-establishing measles transmission in these countries, a narrative review of the literature was undertaken. This [...] Read more.
Background/Objectives: Since 2016, 14 countries previously verified to have eliminated endemic measles transmission have lost their elimination status. To explore whether there were identifiable risk factors for re-establishing measles transmission in these countries, a narrative review of the literature was undertaken. This identified several potential factors: national vaccination coverage, age at first and second measles-containing vaccine dose, the country’s socioeconomic status, surveillance quality, bordering countries endemicity status, supplementary vaccination campaigns just prior to elimination verification, population density, island status, and tourism volume. Methods: World Health Organization (WHO) vaccination and surveillance data were utilized, together with public-facing datasets from the World Bank and the United Nations. An exploratory analysis was undertaken with descriptive epidemiology used for comparing countries where elimination was sustained with those where endemic measles transmission was re-established. Regression modelling was then undertaken with those factors identified as of potential importance. Conclusions: Both descriptive epidemiology and regression modelling indicated that the most important factor is vaccination coverage, although the quality of vaccination coverage estimates from different data sources should be considered. Low–middle income socioeconomic status and bordering endemic countries increased the risk of re-establishment of measles transmission for verified countries. Without coordinated global efforts towards measles eradication, it will be challenging for some countries to maintain elimination. Full article
(This article belongs to the Special Issue Vaccines and Immunization: Measles, Mumps, and Rubella)
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18 pages, 849 KB  
Article
Seroprevalence of Measles-, Mumps-, and Rubella-Specific Antibodies in Future Healthcare Workers in Serbia: A Cross-Sectional Study
by Ana Banko, Andja Cirkovic, Vladimir Petrovic, Mioljub Ristic, Vladimir Vukovic, Dobrila Stankovic-Djordjevic and Danijela Miljanovic
Vaccines 2025, 13(7), 700; https://doi.org/10.3390/vaccines13070700 - 27 Jun 2025
Cited by 4 | Viewed by 2640
Abstract
Background/Objectives: Measles, mumps, and rubella (MMR) continue to pose a significant public health challenge due to insufficient immunization coverage. This study aimed to provide the first seroprevalence data against MMR and to explore self-reported immunity among future healthcare workers (HCWs) in Serbia, including [...] Read more.
Background/Objectives: Measles, mumps, and rubella (MMR) continue to pose a significant public health challenge due to insufficient immunization coverage. This study aimed to provide the first seroprevalence data against MMR and to explore self-reported immunity among future healthcare workers (HCWs) in Serbia, including women of childbearing age. Methods: We included 1296 future health care workers (HCWs) aged 19 to 29, born in Serbia. All HCWs supplied a blood sample for serology and filled in a questionnaire. Antibodies were measured using an enzyme immunoassay against measles, mumps, and rubella (MMR). Results: Anti-measles, -mumps, and -rubella seronegativity rates were 25.6%, 26.5%, and 4.4%, respectively, among future HCWs in Serbia. The mumps seronegativity rate was significantly higher in the oldest (27–29-year) age group, accompanied by significantly lower anti-mumps IgG GMCs in the same age group compared to younger participants (p = 0.035 and p < 0.001, respectively). Anti-mumps seronegativity also increased significantly across birth cohorts, from the youngest to the oldest (p = 0.004). Furthermore, anti-mumps IgG antibody GMCs were significantly higher among females, those who attended nursery/kindergarten, and unvaccinated individuals (p = 0.050, p = 0.020, and p = 0.005, respectively). Finally, older age and unvaccinated status were identified as independent factors associated with anti-measles and anti-mumps seronegativity among future HCWs in Serbia. Conclusions: The cross-sectional seroprevalence data revealed insufficient seroprotection in this population of particular importance, i.e., future HCWs, and women of childbearing age. These results strongly support the national recommendations for the mandatory vaccination of these populations. Identified immunity gaps should be closed promptly by strategic, targeted serologic screening, followed by vaccination of those lacking MMR antibodies. Full article
(This article belongs to the Special Issue Vaccines and Immunization: Measles, Mumps, and Rubella)
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