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Vax4All: One Shot at Health

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Parents and children in 4 elementary and middle schools located in San Francisco will participate in the program.

Partnering with schools in both San Francisco Unified School District (SFUSD) ensures targeted outreach in areas with significant health disparities.

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8 Parent Measels Education Ambassadors

1 MEP training curriculum

400 parents (20 people per training) trained in MEP

8 interviews of Measels Education Ambassadors on local news

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Vaccine hesitancy can lead to breakouts, undermining years of progress. Within the Bay Area, outbreaks have also occurred as a result of individual belief exemptions, concerns over vaccine safety, and influences by anti-vaccine groups. These outbreaks not only affect unvaccinated populations but also compromise herd immunity and pose risks to at-risk groups, more specifically infants. (Dastagir, M. (2023, August 23). Childhood vaccination has saved millions of lives, but rising hesitancy could reverse decades of progress. Center for American Progress.)

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Sarah Nadeau Associate Director, Media Relations

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Childhood Vaccination Has Saved Millions of Lives, but Rising Hesitancy Could Reverse Decades of Progress

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Growing vaccine hesitancy, driven by misinformation and disinformation, threatens the health of American children and communities.

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Program Activities Phase 1: Program Development (Months 1-3)

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Program Activities Phase 1: Program Development (Months 1-3)

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Hire staff

Partner with 4 elementary schools within the San Francisco Unified School District (SFUSD) that serve communities with low vaccination rates and high linguistic diversity.

Identify a space on the school campus for parents to educate each other

Purchase materials such as flip charts, printed handouts, culturally appropriate visual aids, and basic refreshments to support training and outreach.

Develop a Measles Educational Program (MEP) curriculum that includes modules on vaccine science, addressing hesitancy, communication strategies, and outreach methods. The curriculum will be tailored for parent-to-parent learning and available in English, Spanish, and Chinese.

Recruit 8 parents total (2 per school) from the 4 SFUSD elementary schools to serve as Measles Education Ambassadors, with language fluency in either Spanish or Chinese to support targeted outreach in those communities.

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Program Activities Phase 2: Program Implementation (Months 4-21)

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Program Activities Phase 2: Program Implementation (Months 4-21)

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Train Parent Vaccine Educators (Strategy #1)

We will recruit 8 bilingual Parent Measles Education Ambassadors (4 fluent in Chinese, 4 fluent in Spanish) from the parent community across 4 local elementary schools in a low-vaccination urban district. Each school will provide two ambassadors, ensuring school-level familiarity and cultural-linguistic alignment.

These ambassadors will participate in a 2-week intensive training program during the first two weeks of the school year. Training will occur in person, 2 hours per day, Monday through Friday (total of 20 hours). Sessions will be led by a bilingual health educator and cover:

Measles transmission and vaccine safety

Health literacy basics

Community outreach strategies

How to lead peer discussions

Developing culturally relevant educational materials

During the second week, ambassadors will co-develop multilingual flyers, pamphlets, and messages for a social marketing campaign, with guidance from a health communications consultant.

Measels Education Ambassadors Conduct Parent Meetings(Strategy #2)

Each ambassador will organize and lead biweekly parent group meetings at their respective school, rotating leadership responsibilities. These meetings will:

Take place twice per month (every other week)

Be held on weekday mornings with free breakfast provided

Include 20 parents per group, recruited through flyers, school announcements, and word-of-mouth

Cover measles prevention, vaccine facts, and clinic availability

Last for 10 months, continuing throughout the school year

The goal is for each ambassador to lead 10 sessions per school year, engaging approximately 80–100 unique parents per school through repeated participation and word-of-mouth growth.

Conduct Social Marketing Campaign (Strategy #3)

Throughout the year, Measles Education Ambassadors will participate in a coordinated social marketing effort that includes:

Media advocacy training during the initial two-week session

Securing at least 4 media appearances (local radio, print, or TV) across the year to raise awareness

Distributing multilingual pamphlets and infographics via students and community bulletin boards

Messaging will be community-informed, addressing common myths, emphasizing safety, and promoting available vaccine clinics.

Pop-up Vaccine Clinic (Strategy #4)

Two pop-up clinics will be hosted per school, for a total of 8 clinics. These will be conducted:

In Month 5 (January) and Month 10 (June) of the school year

At each of the four participating schools

During school hours and parent-friendly times (e.g., 8am–11am and 2pm–5pm)

Staffed by bilingual nurses and public health professionals

Open to students, parents, and caregivers

Clinics will be publicized through the parent meetings, flyers, and media efforts to ensure high turnout. The goal is to reduce structural barriers and provide on-site access to the MMR vaccine.

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Program Activities Phase 3: Closing (Months 20-21)

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Program Activities Phase 3: Closing (Months 20-21)

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Hold school community "Vaccination" party to highlight increased vaccination rates at the end of the program

Hold graduation ceremony for the Measels Education Ambassadors

Conduct evaluation activities

Develop final report about the Vax4All program

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1. Decrease or reduce the number of measles cases in the Bay Area within 2.5 years by addressing parental vaccine hesitancy and increasing childhood vaccination rates.

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Here in the U.S., about 1 in 5 unvaccinated people will require hospitalization from measles. In 2024, that rate was even higher—about 40% of people with measles were hospitalized.

(Johns Hopkins Bloomberg School of Public Health. (2025, February 5). What to know about measles and vaccines.)

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Johns Hopkins Bloomberg School of Public Health

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A measles outbreak in the southwestern United States continues to grow as public health officials work to contain the spread and boost vaccination rates. At a time of rampant mis- and disinformation about vaccines, public health experts worry outbreaks like this may only become more common.

The current outbreak began in late January, and as of February 25, Texas has confirmed 124 cases -the majority in Gaines County-and nine cases are confirmed in neighboring Lea County, New Mexico . A death reported on February 26 is the first death from measles in the U.S. since 2015.

"Most of the cases are occurring in a Mennonite community that largely homeschools, so there would not be school vaccine mandates," explains , MD, MPH, a professor in Epidemiology and executive director of the International Vaccine Access Center .

In this Q&A, he explains the key facts about measles, how it spreads, and why high vaccination rates are so important to keeping outbreaks from occurring.

Measles is a highly contagious disease caused by measles virus. It typically causes a cough, red eyes, high fever, and rash, but it can lead to more severe health problems.

Yes. Here in the U.S., about 1 in 5 unvaccinated people will require hospitalization from measles. In 2024, that rate was even higher-about 40% of people with measles were hospitalized . Measles can also lead to more severe issues, including pneumonia, encephalitis, brain damage, and pregnancy complications. Complications of measles can occur in anyone, including in healthy children and adults.

Scientists have found that measles wipes out the body's memory of bacteria and viruses. This weakens your immune system, making you more likely to get sick from other diseases. This effect can last for years.

Measles can also be deadly. In 2023 alone, an estimated 107,500 people globally died from measles-mostly unvaccinated or under-vaccinated children under 5.

How does measles spread?

Measles spreads through the air and via droplets. You can get measles by breathing air contaminated by an infected person or touching an infected surface. The measles virus can stay in the air for several hours after an infected person coughs or sneezes; it does not require close contact with an infected person to transmit.

Measles is one of the most contagious infectious diseases. In a completely susceptible population, one person with measles will infect an average of 12-18 other people.

Who is at the highest risk for contracting measles?

Anyone who has not had two doses of the measles, mumps, and rubella (MMR) vaccine, or has not previously contracted measles, is susceptible.

In the U.S., this includes most children under 12 months old, before they've received their first MMR vaccine dose. There are also people who cannot receive the MMR vaccine and thus are susceptible to measles. This includes people with certain medical conditions or severe allergies, people who are immunocompromised, and people who are pregnant or planning to become pregnant soon.

At what age should my child get the MMR vaccine?

In the U.S., the first dose of the MMR vaccine is recommended at 12-15 months of age. Between 93% and 95% of children will be protected by that dose. The second dose is recommended at 4-6 years old, generally right before children enter kindergarten, and about 97% of children will be fully protected following that second dose.

Can a child get the MMR vaccine earlier than 12 months old?

The MMR vaccine can be given to children as young as 6 months of age. The CDC recommends children 6-11 months receive the MMR vaccine before traveling internationally, but it does not provide clear guidance for outbreaks in the U.S. An MMR vaccine given at 6-11 months is given in addition to the two recommended doses, not as a replacement dose.

If you live in or will be traveling to an area in the U.S. where an outbreak is occurring, talk to your pediatrician about whether your young child should receive a dose of the MMR vaccine outside of the recommended schedule. This can also include children who have received their first recommended MMR dose but are not yet at the recommended age for their second dose. According to the CDC, it is possible to get a second dose earlier, as long as it is at least 28 days after the first dose. Your health care provider can help you weigh any factors that could increase your child's risk of exposure to measles, including measles activity and vaccination levels in your local community.

If the measles shot is so effective, why do I keep hearing about people getting sick from measles?

The problem is that not everyone is vaccinated. Because measles is so contagious, it relies on at least 95% of a community to be vaccinated. In the U.S., about 91% of U.S. children ages 19-35 months have been vaccinated. However, coverage in some communities is much lower, putting them at greatest risk.

Why have U.S. measles vaccination rates dropped in recent years?

There are a number of compounding factors, one of which is actually how effectively we've vaccinated against measles in the past. Strong immunization programs undermine themselves: When vaccination rates are high, the disease goes away. As a result, people aren't as concerned about it and don't see the necessity to vaccinate.

Every parent wants to make the right decision for their child. Between the historically low rates of measles in the U.S. and the prevalence of mis- and disinformation about childhood vaccines, some parents underestimate the risk of measles and overestimate the risk of the vaccine.

Is the measles vaccine dangerous for my kids or me?

No, the MMR vaccine protects has been exhaustively studied and proven safe.

How long after vaccination does it take to build protection?

After receiving the MMR vaccine, your body takes time to create antibodies, which is what provides you protection if you are exposed to the virus in the future. As with most vaccines, it takes about two weeks to build up to full protection.

I got measles vaccinations as a kid. Am I covered for life?

Most but not all people vaccinated against measles are protected for life, and the chance of being protected increases with a second dose of measles vaccine. Those who develop a protective response to measles vaccine are thought to be covered for life as there is no evidence this protection is lost with age.

Adults who were vaccinated for measles between 1963 and 1968 should check their vaccination history to determine which vaccine they received. During that time, a version of the vaccine that used an inactivated form of the virus was available that was found to not be as effective and was ultimately withdrawn. Only about 600,000-900,000 people in the U.S. received that vaccine in the years it was available-a very small percentage of the current population.

How do I know if I'm protected against measles?

Your best bet is to check your vaccination records. If you don't have access to your vaccination records and otherwise can't recall whether you were vaccinated, the easiest thing to do is to get another dose. It is not harmful to get an additional dose of measles vaccine, even if you've been vaccinated previously or have natural immunity from prior infection.

Older adults who were born before 1957 are presumed to have naturally induced immunity, because they were likely exposed to measles before vaccines became available.

There are also blood tests that can measure antibodies to the measles virus. These tests are helpful for people who are immunocompromised or have another condition that prevents them from receiving the MMR vaccine. These tests are also common for ensuring health care workers are protected, especially those working in children's wards or in areas with increased risk of measles exposure.

I've heard it's better for children to get measles from another kid than to get a measles shot. Is that true?

No. Measles is a dangerous disease and the vaccine is very safe. The risks of severe illness, death, or lifelong complications from measles infection far outweigh the generally mild side effects some people experience following vaccination. Serious reactions to the MMR vaccine are rare.

Where can I get a measles shot?

You can get measles vaccinations at doctors' offices, clinics, and government health centers. In communities where outbreaks are occurring, local health departments may also offer MMR vaccination clinics to help boost protection. Check with your local or state health department for more information.

How can I keep track of measles activity in my area?

The CDC website is a good resource for keeping track of national trends and outbreaks. State health departments, which report up to the CDC, are another great resource. In states where outbreaks are occurring, local and state health departments may provide more frequent updates to warn communities about outbreaks and recommend precautions or resources.

Where can I learn more about measles?

For more information, visit the CDC's pages on and vaccination . You can also learn about the virus and its impacts globally from the WHO's measles fact sheet .

Aliza Rosen is a digital content strategist in the Office of External Affairs at the Johns Hopkins Bloomberg School of Public Health.

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What to Know About Measles and Vaccines | Johns Hopkins Bloomberg School of Public Health

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Experts worry that misinformation and falling vaccination rates could cause measles outbreaks to become more common in the U.S.

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International Travel: Over 90% of cases have been linked to international travel

Clusters of Unvaccinated Individuals: Certain communities in the Bay Area have significant numbers of unvaccinated people, leading to higher susceptibility to outbreaks.

Previous Outbreaks: Historical outbreaks, such as the one linked to Disneyland in 2014-2015, highlight the region's vulnerability due to under-vaccination.

(Aliferis, L. (2024, February 15). Why are Bay Area health officials warning about measles? KQED News.)

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Why Are Bay Area Health Officials Warning About Measles? | KQED

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Amid a national rise in measles cases, local officials are urging the Bay Area to be vigilant for symptoms, especially after travel.

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In Sonoma, low vaccination rates according to race/ethnicity are much higher for those who identify as whites by 63% and those who identify as Hispanics 27%. Although parents' views of vaccination don't play a large role, missing vaccination opportunities was one of the bigger issues in the county.

(SJSU An Analysis of Kindergarten Childhood Diseases Vaccination Rates and Practices in Bay Area Counties)

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Extent of the problem (how many people and how bad is this issue)

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Extent of the problem (how many people and how bad is this issue)

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Before the COVID-19 pandemic, the vaccination rates for measles, mumps, and rubella were over 98% in California. But, in 2021, this number was barely over 95%, being 95.1%. In Bay Area schools, it was reported that 54 schools had rates below 95% among kindergarteners. Demonstrating that this number could easily drop below the threshold, as public health officials struggle to keep up with this number.

(MSN News. (2024, March 1). As Texas outbreak grows, California’s measles vaccination rate struggles to recover after pandemic. MSN.)

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As Texas outbreak grows, California’s measles vaccination rate struggles to recover after pandemic

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Before the pandemic, the rate of kindergarten students who received their measles, mumps, and rubella vaccination had reached just over 98% statewide, but dropped to 95.1% amid the pandemic.

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Children are particularly vulnerable to measles, as seen in the global rise of cases by 79% in 2023, with over 130,000 deaths—mostly among children. Young children, especially those under five, face the highest risk of severe complications such as bacterial pneumonia, encephalitis, and long-term immune suppression. With 61 million fewer vaccine doses distributed between 2020 and 2022, many children remain unprotected, increasing their risk of infection, hospitalization, and even death.

(Cedars-Sinai Staff. (2024, February 20). Measles makes a comeback: What parents need to know. Cedars-Sinai.)

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Measles Makes a Comeback: What Parents Need to Know

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A highly contagious childhood disease once eradicated by vaccination has made a comeback.Globally, measles cases increased by 79% in 2023, according to the World Health Organization. In 2022, WHO estimated that measles killed more than 130,000—most of them children. In the U.S., during the first two months of 2024, nearly two dozen cases have…

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Children require 2 doses of the MMR vaccine. Once at 12-15 months and the 2nd dose at 4-6 years old. Older children, adolescents, and adults should also get the vaccine if they don't show signs that they're immune. People who are traveling internationally should be fully vaccinated. Infants that are also travelling should be vaccinated at 6-11 months. and the 2nd dose after their first birthday. Those with an increased risk of mumps will be notified if an additional dose is needed. Those already with 2 doses don't need an additional unless notified. For the MMRV vaccine, children at 12-15 months should get their 1st dose, and their 2nd dose can be taken at 4-6 years old. It can also be given 3 months after their first dose.

(Centers for Disease Control and Prevention. (2024). Measles vaccines. U.S. Department of Health & Human Services.)

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Two doses of the MMR vaccine are recommended by doctors as the best way to protect against measles, mumps, and rubella.

Children may get 2 doses of MMRV vaccine instead.

MMR & MMRV vaccines usually protect people for life against measles and rubella; but immunity against mumps may decrease over time.

Introduction

The best way to protect against measles is to get the measles, mumps, and rubella (MMR) vaccine. Children may get the measles, mumps, rubella, and varicella (MMRV) vaccine instead, which protects against chickenpox too.

Most people who are vaccinated with MMR & MMRV will be protected for life. Vaccines and high rates of vaccination have made these diseases much less common in the United States.

Available vaccines

There are two vaccines that protect against measles, mumps, and rubella. Both MMR and MMRV vaccines may be given at the same time as other vaccines.

MMR

Contains a combination of measles, mumps, and rubella vaccines.

Two MMR vaccines are available for use in the United States: M-M-R II and PRIORIX. Both are recommended similarly and considered interchangeable.

MMRV

Contains a combination of measles, mumps, rubella, and varicella (chickenpox) vaccines.

This vaccine is only licensed for use in children who are 12 months through 12 years of age.

Recommendations

Both MMR and MMRV vaccines may be given at the same time as other vaccines. Your healthcare provider can give you more information about each and which to get.

MMR

Children need 2 doses of MMR vaccines:

Older children, adolescents, & adults -Also need 1 or 2 doses of MMR vaccine if they don't have evidence of immunity. Doses should be separated at least 28 days apart.

Anyone traveling internationally-Should be fully vaccinated before traveling. Infants 6-11 months old should get 1 dose of the MMR vaccine before travel. Then they should get 2 more doses after their first birthday.

People at increased risk for mumps during a mumps outbreak-An additional dose of MMR may be needed. Public health authorities will notify you if you are at increased risk and should receive this extra dose. If you already have 2 doses of MMR, it's not necessary to seek out vaccination; unless the authorities tell you that you are part of this group.

MMRV

Children 12 months through 12 years of age may be given 2 doses of MMRV vaccine. Each dose is usually given at:

After exposure to measles, mumps, or rubella

If you don't have immunity against these diseases and become exposed to them, talk with your doctor about getting MMR vaccine. It is not harmful to get MMR vaccine after being exposed to measles, mumps, or rubella. Doing so may possibly prevent later disease.

If you get MMR vaccine within 72 hours of initially being exposed to measles, you may get some protection; or have milder illness. In other cases, you may be given a medicine called immunoglobulin (IG) within 6 days of being exposed to measles. This provides some protection against the disease or illness is milder.

Unlike with measles, MMR has not been shown to be effective at preventing mumps or rubella in people already infected.

Why getting vaccinated is important

The MMR vaccine protects your child from measles, mumps, and rubella, potentially serious diseases caused by viruses. Almost everyone who has not had the MMR vaccine will get sick if they are exposed to those viruses. The vaccine keeps your child from missing school or childcare; and you from missing work to care for your sick child. Vaccination also limits the size, duration, and spread of outbreaks.

For measles: MMR vaccine protects your child from getting an uncomfortable rash and high fever from measles.

For mumps: MMR vaccine protects your child from getting a fever and swollen glands under the ears or jaw from mumps.

For rubella: MMR vaccine prevents your child from getting a rash and fever from rubella. The vaccine also prevents your child from spreading rubella to a pregnant woman whose unborn baby could develop serious birth defects or die if the mother gets rubella.

Who should get vaccinated

MMR vaccination is important for children as well as adults who do not have evidence of immunity. These include:

Students at post-high school educational institutions

Healthcare personnel

International travelers

People of childbearing age before they get pregnant

Groups at increased risk for mumps because of a mumps outbreak

Who shouldn't get vaccinated

Some people should not get the MMR vaccine, or they should wait. People should check with their healthcare provider about whether they should get vaccine if they:

Has had an allergic reaction after a previous dose of MMR or MMRV vaccine, or has any severe, life-threatening allergies.

Are or may be pregnant. Wait to get MMR vaccine until after you are no longer pregnant. Avoid getting pregnant for at least 1 month after getting MMR vaccine.

Have a weakened immune system due to disease or medical treatments; or have a family member with a history of immune system problems.

Have ever had a condition that makes them bruise or bleed easily.

Have recently had a blood transfusion or received other blood products. You might be advised to postpone MMR vaccination for 3 months or more.

Have tuberculosis.

Have gotten any other vaccines in the past 4 weeks.

Are feeling unwell or severely ill. Your doctor can advise you.

Additionally, people should wait to get the MMRV vaccine and tell their provider if they:

Have a history of seizures, or has a parent, brother, or sister with a history of seizures.

Are taking or plans to take salicylates (such as aspirin).

The vaccine is safe and effective

MMR vaccine is very safe and is effective at preventing measles, mumps, and rubella. Vaccines, like any medicine, can have side effects. These are usually mild and go away on their own.

There is no link between the MMR vaccine and autism. Scientists in the United States and other countries have carefully studied the MMR vaccine. None has found a link between autism and the MMR vaccine.

It is safe for breastfeeding women to receive MMR vaccination. Breastfeeding does not interfere with the response to MMR vaccine; and the baby will not be affected by the vaccine through breast milk.

While MMR provides effective protection against mumps for most people, immunity against mumps may decrease over time for some people. They may no longer be protected against mumps later in life.

Some vaccinated people may still get measles, mumps, or rubella if they are exposed to the viruses. It could be that their immune system didn't respond as well as they should have to the vaccine; their immune system's ability to fight the infection decreased over time; or they have prolonged, close contact with someone who has a virus. However, disease symptoms are generally milder in vaccinated people. They are also less likely to spread the disease to other people.

Possible side effects

Most people don't have any side effects from the vaccine. The side effects that do occur are usually mild, and may include:

Soreness, redness, or swelling where the vaccine was given

Fever

Mild rash

Temporary pain and stiffness in the joints

More serious side effects are rare. These may include high fever that could cause a seizure.

Finding and paying for the vaccine

Your or your child's doctor's office is usually the best place to receive recommended vaccines. Vaccines may also be available at pharmacies, workplaces, community health clinics, health departments, or schools, or religious centers.

Vaccine costs

There are a few ways to cover the cost of vaccines:

Health insurance

Most health insurance plans cover the cost of vaccines. However, you may want to check with your insurance provider before going to a healthcare provider. Check for cost information and for a list of in-network vaccine providers.

Vaccines for Children Program

Your children may be able to get no-cost vaccines through the Vaccines for Children (VFC) Program. This program helps families of eligible children who may not be able to afford or have access to vaccines.

Frequently asked questions

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Learn about measles vaccine basics, who should get it, when to get it, and why it's important.

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Why are people not taking preventative measures?

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Why are people not taking preventative measures?

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Understaffed healthcare facilities are one of the main causes for vaccine hesitancy. In Sonoma, programs that discuss the importance of vaccines are usually done by nurses that go out to schools. Understaffed healthcare facilities mixed with misinformation spread by the anti-vaxx movement in Sonoma means that there isn't a strong stream of information that gets to parents, which eventually leads to lower rates of vaccination among children in the bay area, but particularly in Sonoma.

(SJSU An Analysis of Kindergarten Childhood Diseases Vaccination Rates and Practices in Bay Area Counties)

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An Analysis of Kindergarten Childhood Disease Vaccination Rates a

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Causes of the problem (ecological model)

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Causes of the problem (ecological model)

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When utilizing the ecological model to discuss vaccine hesitancy, many social drivers cause these perceptions. Some of these are

Fear of autism from vaccines (despite being debunked)

Philosophical, moral, or religious reasons

Misinformation provided on social media

Physician trust and healthcare-provided information

Lenient vaccine exemptions in schools

Cultural and community norms as communities will commonly hold the same beliefs

(National Library of Medicine. (2023). Why Parents Say No to Having Their Children Vaccinated against Measles: A Systematic Review of the Social Determinants of Parental Perceptions on MMR Vaccine Hesitancy. PubMed Central.

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Why Parents Say No to Having Their Children Vaccinated against Measles: A Systematic Review of the Social Determinants of Parental Perceptions on MMR Vaccine Hesitancy

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Ongoing outbreaks of measles threaten its elimination status in the United States. Its resurgence points to lower parental vaccine confidence and local pockets of unvaccinated and undervaccinated individuals. The geographic clustering of hesitancy…

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In the year 2000, measles had been declared eradicated in the United States. Yet cases are resurging across the United States, primarily affecting unvaccinated children, in the past month one child has died. There are numerous sources providing misinformation about this disease including the United States' newest Secretary of Health and Human Services, Robert F. Kennedy Jr., who disregards the impacts of measles believing that outbreaks are fabricated and used for vaccine profit. They also believe that everyone should have a choice of whether or not to be vaccinated. However, places that have fewer restrictions on vaccines seem to be the areas where outbreaks are occurring. With a prominent figure of health in the United States normalizing measles and spreading misinformation, we may see that people will be even more hesitant to receive the vaccine for themselves or their children since authoritative figures are stating that vaccines should not be obligatory and are not needed to protect themselves.

(New York Times. (2025, February 28.) In Texas Measles Outbreak, Signs of a Riskier Future for Children.)

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Among children born during 1994–2023, routine childhood vaccinations will have prevented approximately 508 million cases of illness, 32 million hospitalizations, and 1,129,000 deaths, resulting in direct savings of $540 billion and societal savings of $2.7 trillion.

(Centers for Disease Control and Prevention. (2024). Health and Economic Benefits of Routine Childhood Immunizations in the Era of the Vaccines for Children Program — United States, 1994–2023. U.S. MMWR Morb Mortal Wkly Rep.)

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Good job on your problem description. You present alot of compelling information in thoughtful posts. You bring up many important points and cover the main issues. Your problem description needs to be edited to eliminate all repetition of points -- you make the same or closely related points across multiple posts. It will help if you re-order your posts so that the first posts focus on describing the problem and the extent of the issue. Then you should talk about vaccine hesitancy and its causes.

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1. Increase in the vaccination rates for parents and children in the Bay Area by 1 year (behavior)

2. Increase in the access and availability of clinics that provide measles vaccinations for parents and children in the Bay Area by 1 year (circumstances)

3. Increase in the number of people who share their knowledge about measles and its outcomes with their community in the Bay Area by 1 year (behavior)

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1. Parents will believe that getting the vaccine is beneficial for themselves and their children as well as helping out other people in the Bay Area by 3 months (attitude)

2. Able to provide resources to parents with accurate information as well as share the knowledge to spread awareness for its efficacy in the Bay Area by 3 months (knowledge)