While a series of measles outbreaks across the United States has focused public attention on the importance of vaccination as a key public health strategy, recent reporting by the Centers for Disease Control and Prevention shows that overall uptake of measles vaccines (MMR and MMRV) has declined in recent years.

A new study from the University of Minnesota School of Public Health (SPH) provides additional information on why some parents are choosing not to vaccinate their children against common—and largely preventable—diseases like measles. Using data from over 310,000 children born in Minnesota between 2017 and 2021, SPH researchers linked birth certificate records with immunization data to examine how a child’s first MMR dose by 24 months old varied by the parent’s race, ethnicity, and socioeconomic background.

The study, published in Behavioral Medicine, found:

• Ethnic disparities in MMR vaccination uptake. Minnesota children born to Somali and Ethiopian parents had the lowest rates of on-time MMR vaccination—33% and 68%, respectively—compared to 88% among Mexican-American children and 85% among white children. These disparities remained significant even after adjusting for socioeconomic factors, suggesting that cultural and informational barriers are a factor driving decision making.
• Disparities in education levels and socioeconomic backgrounds. Children whose parents had less than a high school education, used Medicaid or WIC, or received inadequate prenatal care were also less likely to be vaccinated on time.
• Limitations of broad racial categories. The study found that broad racial categories like “Black” obscure critical intra-group differences. For example, Somali children, often grouped under “Black,” had much lower vaccination rates than African American or Liberian children

“When reporting this kind of data, health departments tend to collapse racial or ethnic groups into broad categories like ‘Black’ or ‘Hispanic,’ which can mask the wide variation of vaccination rates within these larger groups—and complicate public health efforts to communicate with these communities in a more targeted way,” says Inari Mohammed, SPH epidemiologist and lead author. “To combat the misinformation and distrust that tends to drive down vaccination rates among certain communities, we need more specific data like this that can help inform culturally tailored public health campaigns.”

The authors recommend that public health agencies collect more granular ethnic data to identify at-risk populations and expand culturally informed outreach initiatives—such as training trusted community figures to serve as vaccine advocates.

Future research should evaluate the effectiveness of these interventions and continue to explore the root causes of vaccine hesitancy, particularly within communities that have been historically targeted with medical misinformation.