BACKGROUND: Between 2000-2024, unvaccinated international travelers were the source of most measles cases and outbreaks in the U.S. In Minnesota, the Somali-American community is particularly high-risk for measles due to low MMR vaccination uptake. We assessed MMR vaccine status in international pediatric travelers in Minnesota.
METHODS: We conducted a cross-sectional study of MMR status among pediatric travelers age 6 months to <18 years seen for pre-travel consultation from 10/1/2015-12/31/2024 at 3 community-based travel clinics within a large Minnesota health system. We stratified travelers into 3 age groups (6-<12 months, 12 months-<4 years, and 4-<18 years) based on MMR vaccination recommendations. We collected traveler age, sex, race/ethnicity, Medicaid coverage, preferred language, need for interpreter, reason for travel, travel destination, and departure date. We evaluated prevalence of pediatric travelers up-to-date with MMR for international travel prior to departure date by sociodemographic and travel related variables.
RESULTS: Among 27,534 pre-travel consultations, 23,549 (85.5%) travelers were up-to-date for international travel with MMR vaccine by their anticipated departure date. Travelers to Somalia (N=2,656) and Kenya (N=5,175) had the lowest percentage of being up-to-date (75.6% and 78.6%) compared with other destinations. Travelers with Somali as their preferred language (N=3,087) had the lowest percentage of being up-to-date (74.3%) compared with other language groups. Travelers requesting a language interpreter (N=3,019), visiting friends and relatives (N=17,877), and with Medicaid coverage (N=11,415) had a lower percent of being up-to-date for MMR compared with other groups (78%, 83.1%, and 79.9%).
CONCLUSIONS: MMR status among pediatric travelers varied by sociodemographic and travel characteristics. Travelers to Somalia and those with Somali as their preferred language had the lowest percent of MMR vaccines. Ongoing efforts are needed to improve MMR vaccine uptake especially among international pediatric travelers who may be at higher risk of infection based on travel characteristics.