Chris A Gentry, George Kurdgelashvili, Robert H Scofield
As measles reemerges, certain populations were identified that may be at higher risk of infection and transmission, particularly those with immune compromise.
BACKGROUND: The 2025 United States (US) measles outbreak supports concerns that measles may have significant resurgences. The study's objectives were to characterize measles serologic testing rates, estimate measles IgG seronegativity rates, and determine independent variables associated with seronegativity across the US Veterans Health Administration (VHA).
METHODS: A nationwide retrospective, observational study was conducted collecting data from veterans with measles IgG antibody testing performed from January through June in 2024 (pre-outbreak) and 2025 (outbreak). Endpoints included determining independent variables associated with 1) measles IgG testing within the outbreak period versus the pre-outbreak period, and 2) measles IgG seronegativity within the outbreak period.
RESULTS: 16,446 veterans had measles IgG testing in the outbreak period, a 60.3% increase in the testing rate compared to the non-outbreak period. Seronegativity was found in 1,220 (11.9%) veterans in the non-outbreak period and 1,509 veterans (9.18%) in the outbreak period (p<0.0001). Independent variables associated with seronegativity included age 64 years or below (OR 5.65, 95% CI 4.59-6.94), Janus kinase inhibitor use (OR 3.54, CI 1.24-10.1), and immunodeficient condition (OR 3.10, CI 2.34-4.11).
CONCLUSIONS: As measles reemerges, certain populations were identified that may be at higher risk of infection and transmission, particularly those with immune compromise.