Travelers to the US are encouraged but not required to receive vaccinations. In addition, vaccinations are also not required but recommended for US citizens who travel abroad and then return to the US. However, legal immigrants are required to receive a myriad of vaccinations, including measles.
Vaccination rates in many South American countries are higher than in the US. Unfortunately, vaccination rates in the US are declining. The percentage of US counties achieving the 95% measles vaccination rate required for herd immunity has dropped from 50% to 28%.
According to the World Atlas, the US ranks 103rd out of 192 countries in MMR vaccination, with a vaccination rate of 92%, well below the 95% threshold needed to achieve herd immunity. Our World In Data lists the US measles vaccination rate as lower than that of China, Cuba, Sri Lanka, the Maldives, Brazil, Armenia, Belarus, Rwanda, Panama, the Russian Federation, Bangladesh, Costa Rica, and Chile, to name a few. The World Atlas lists 27 countries with vaccination rates of 99%.
Twenty-seven countries are listed as having vaccination rates of 99%. Johns Hopkins Bloomberg School of Public Health reports the US measles vaccination rate (MMR) at 92%.
The gold standard for immunization tracking is the CDC, but unfortunately, the most recent data available is from 2022. At that time, more than 1 dose of MMR was reported at rates between 90.2% and 92.5%. Apparently, the CDC no longer tracks this data on a federal level. In January of 2026, the Centers for Medicare and Medicaid Services (CMS) stopped requiring states to report childhood vaccination rates. Medicaid covers about 49% of all children in the US.
In addition, vaccination rates across the US are not uniform; they vary widely. And those who do not believe in vaccinations often share common religious or political beliefs and tend to congregate with one another.
There is little doubt that diseases can enter through our border. The COVID-19 pandemic has taught us that borders are leaky, and the more infectious a virus is, the harder it is to prevent its entry into a country. With highly infectious diseases, even one person can cause a massive outbreak. Measles is the most infectious disease known to humanity, even more so than COVID-19.
Two years ago, measles was not a major issue in the US. Now, we are on the verge of losing our measles elimination status. Borders are leaky, and focusing on international travel is important. Still, it makes little sense to focus on illegal immigration as the primary driver of outbreaks during a time when illegal immigration is falling, and rates of measles are skyrocketing.
In addition, legal international travelers, both US citizens and foreign visitors, are not required to receive vaccination and too often have been documented as the source of measles outbreaks.
As I have repeatedly stated, we do not live in a fishbowl, which is why public health is so vitally important. Vaccinations are key to regaining our society’s measles protection. Our federal government needs to resume tracking vaccination rates and promote the highly effective, time-tested measles vaccine.