Measles remains one of the most contagious infectious diseases, spread by coughing and sneezing, and even a small drop in vaccination coverage can lead to an outbreak. As of 2026, California is reporting the highest annual measles cases in seven years. In response to this growing concern, researchers began investigating gaps in measles-related knowledge and vaccination rates.
A study led by the University of California, Riverside found significant gaps in knowledge, vaccination status, and acceptance of the measles-mumps-rubella (MMR) vaccine among patients visiting emergency departments across the United States.
Published in American Journal of Emergency Medicinethis study investigates how misinformation and access barriers contribute to low vaccination rates, raising concerns as the measles outbreak continues.
“We found that a significant proportion of emergency department patients lacked accurate knowledge about measles and the MMR vaccine,” said medical student Alexandra Eftimy, co-lead author of the paper.
Many participants reported that they did not know their vaccination status or had not received any vaccinations. Additionally, vaccine hesitancy due to misconceptions about safety and necessity also remains a persistent problem. ”
Alexandra Eftimie, University of California Riverside School of Medicine
This study used survey data from 2,459 adult patients (April-December 2024) across 10 emergency departments in the United States to assess MMR vaccination status, knowledge, and willingness to vaccinate in a diverse population.
“We identified important disparities in undervaccination related to factors such as race, language, insurance status, and access to primary care,” said Sahish Marireddy, an undergraduate neuroscience student and co-lead author of the paper. “These disparities particularly highlighted how systemic barriers shape both vaccine access and health literacy among diverse populations.”
Researchers highlighted that the findings demonstrate how emergency departments can serve as important “safety net” care hubs for underserved populations who may not have access to vaccines or health care in traditional formats.
“This really presents an opportunity for health systems to leverage the emergency department not only for emergency care, but also as a space to provide accessible, evidence-based public health interventions and improve vaccine equity,” Malireddy said. “By using the emergency department as a point of intervention, health systems may be able to reach populations who otherwise would not receive preventive care.”
Researchers were surprised to find that patients so often do not have access to clear, reliable information.
“Many gaps stem from systemic barriers such as limited literacy tools, language differences, insurance issues, and stigma,” Malireddy said. “They show how culture and access shape responses to symptoms, shift the focus from individual misconceptions to structural inequalities, and highlight our responsibility to make medical knowledge accessible and actionable for marginalized communities.”
Senior author Dr. Robert Rodriguez, professor of medicine at the UCR School of Medicine, outlined practical, low-burden steps emergency departments can take to increase MMR vaccination rates.
“While most emergency departments may not be able to administer the MMR vaccine, they can serve as high-impact hubs for testing and education, especially for underserved populations,” he said. “They can inform patients about the importance of the MMR vaccine and guide them to available options, including clinics and pharmacies where they can receive it.”
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University of California Riverside School of Medicine
Reference magazines:
Marilady, S. others. (2026). Gaps in knowledge, receipt, and acceptance of measles, mumps, and rubella vaccines in a national sample of emergency department patients. American Journal of Emergency Medicine. DOI: 10.1016/j.ajem.2026.03.022. https://www.sciencedirect.com/science/article/abs/pii/S0735675726001452?via%3Dihub.
