County, district and community-level measles transmission in the United States in 2013−2025
Nature Medicine·
- DOI
- 10.1038/s41591-026-04561-w
- PMID
- 42613442
- PMCID
- —
- OpenAlex
- W7203661506
- Study type
- Mathematical modelling
- Publisher
- Springer Science and Business Media LLC
- Article type
- journal-article
- Integrity
- current
Why this research matters now
The abstract indicates potential relevance for assessing measles vulnerability and for considering vaccination and outbreak-monitoring approaches at school and district levels. These implications are model-based and do not establish that a current surveillance signal has been confirmed.
Structured evidence summary
Research question
The study examines how measles transmission risk varies across school, district, county, and state spatial scales in the United States, using vaccination data and a transmission model.
Study design
This is a mathematical modelling study based on a multiscale vaccination database covering 2013-2025. The database includes more than 50,000 schools, 13,000 districts, and 3,000 counties across 45 states and Washington, DC.
Population and setting
The setting is the United States, including 45 states and Washington, DC, with analysis at school, district, county, and state levels. The data span 2013-2025 and include school and jurisdictional vaccination information.
Main findings
The model estimated that school-level effective reproduction numbers exceeded the epidemic threshold in 2022-2023, while this pattern was not visible in aggregated county-level surveillance. Estimated average susceptibility increased from about 5% to 10% after the pandemic, and boundary-related spillover was estimated to raise transmission potential in some well-vaccinated counties.
Public-health relevance
The abstract indicates potential relevance for assessing measles vulnerability and for considering vaccination and outbreak-monitoring approaches at school and district levels. These implications are model-based and do not establish that a current surveillance signal has been confirmed.
Important limitations
The findings are based on a transmission model and a database covering 45 states and Washington, DC, rather than all US jurisdictions. The supplied material does not provide the model assumptions, validation procedures, uncertainty estimates, or full data-construction details; interpretation is therefore limited to the supplied single-article abstract and metadata and requires the original paper for decision-grade assessment.
GIDS interpretation
The article is discoverable in contexts related to measles, vaccination, surveillance, outbreak investigation, and transmission dynamics in the United States. It provides contextual evidence about modelled spatial transmission risk, not confirmation of a live surveillance event or signal.
Related GIDS surveillance
Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.
Evidence relationships
This article has 12 auditable classifier relationships to diseases, places, topics, and study design.