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How declining MMR vaccination rates put future generations at risk

Ambika Sharma, Onyi Oligbo, and Katrina Green, MD
Conditions
July 17, 2025
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We thought we had moved on from diseases like rubella. But as measles makes a comeback, rubella may not be far behind, and this time, it could harm the next generation before it’s even born. Most people today have never seen a baby born with congenital rubella syndrome, a condition that causes blindness, deafness, heart defects, and developmental delays. That’s not because it stopped happening—it’s because vaccination kept rubella from returning.

Rubella, also known as German measles, usually causes a mild illness in adults: rash, low-grade fever, and joint pain. But when contracted during pregnancy, it can be devastating. In the 1964–65 U.S. epidemic, more than 20,000 pregnancies ended in severe birth defects or miscarriage after maternal rubella infection. That’s why the MMR vaccine, which prevents measles, mumps, and rubella, has been a pillar of public health since the 1970s. Yet with MMR vaccination rates declining, largely due to misinformation and mistrust, we risk repeating history.

The recent measles outbreak in Texas reminds us how easily forgotten diseases can return, and for people who are pregnant or plan to be, that risk isn’t abstract.
That’s why physicians and patients should routinely discuss vaccine history during regular checkups. The CDC recommends two doses of the MMR vaccine in childhood: First at 12 to 15 months, then at 4 to 6 years. However, many adults don’t realize they’re still eligible. Not knowing your immunity status shouldn’t be a barrier; your health care provider can order a simple blood test to check your immunity. For those who weren’t vaccinated as children, getting the MMR vaccine later in life still offers meaningful protection, especially for future parents.

This issue is further complicated by the politicization of vaccines and the erosion of public trust in medical institutions. When vaccines are treated as talking points instead of tools, patients are left to make life-altering decisions without clarity. To address this, public officials should set aside partisan differences and work with the health care community to protect the safety of future generations.

However, addressing vaccine hesitancy requires more than polite agreement. It requires courage and transparency. We have more than 50 years of data showing the MMR vaccine works, with two doses offering near-total protection against measles and rubella. Serious side effects are incredibly rare, and despite years of scrutiny, no credible study has ever found a link between the MMR vaccine and autism. These facts have been tested and reaffirmed because the stakes are too high to get them wrong.

As physicians, we don’t just witness disease, we bear witness to its absence. If rubella comes back, it won’t be because we lacked the science; it will be because we forgot what it was for. Each healthy newborn is a quiet testament to what widespread vaccination makes possible. Current efforts to undermine established evidence of vaccine safety only widen the gap between science and misinformation. Protecting future generations begins with the choices we make today.

Physicians will remain vigilant in educating the public that vaccination offers proven protection. But our efforts are strongest when supported by lawmakers committed to science and by communities willing to listen. Together, we can help ensure a healthier world for the next generation. Rubella may feel like a disease of the past, but if we don’t act now, its consequences will define our future.

Ambika Sharma and Onyi Oligbo are medical students. Katrina Green is an emergency physician.

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