Uneven vaccination Rates Across New York City

New York City faces a persistent challenge: ensuring uniform protection against measles across its diverse neighborhoods. City data reveals important disparities in MMR (measles, mumps, and rubella) vaccination rates, leaving some communities vulnerable as measles outbreaks continue to surface in other parts of the United States and Canada. As of March 2025, certain ZIP codes in Staten Island and manhattan’s Hell’s Kitchen exhibit particularly low vaccination rates among young children, raising concerns among public health officials.

specifically, the data indicates that no ZIP code across Staten Island exceeds a 74% MMR vaccination rate for children aged 24 to 35 months. This makes Staten Island the borough with the lowest overall protection against measles. The benchmark for herd immunity, which safeguards individuals too young to be vaccinated or those who cannot receive vaccines for medical reasons, is 95%, according to the state health department.

The ZIP code 10309, encompassing Rossville and Village Greens on Staten Island, reports the lowest MMR vaccination rate for 2-year-olds, with only 65% of children between 24 and 35 months having received thier first dose. In Manhattan, three ZIP codes within Hell’s Kitchen also show vaccination rates below 70%. Additionally, the 11414 ZIP code, covering Howard Beach in Queens, falls into this concerning category, according to city data.

Citywide, approximately 81% of children between 24 and 35 months have received their first MMR shot. However, rates fluctuate considerably, ranging from 65% to 99% across different ZIP codes. This patchwork of protection creates potential vulnerabilities for outbreaks, particularly in areas with densely populated and interconnected communities. The implications extend beyond individual health, impacting school attendance, parental work schedules, and the overall economic well-being of affected communities.

“There are numbers that are still deeply troubling,”

Gov. Kathy Hochul said last week

This statement was made following the confirmation of the state’s fourth measles case in 2025. Gov. Hochul has urged clergy and other community leaders to actively promote vaccination throughout New York, recognizing their influential roles in shaping public health perceptions and behaviors.

Tailoring Approaches to Community Needs

Experts emphasize that a one-size-fits-all approach to boosting vaccination rates will not suffice. the reasons behind low vaccination rates are multifaceted and vary across different communities. Addressing these specific concerns is crucial for effective intervention.

“the issue with the Hell’s Kitchen rate might potentially be very different from the issue with the Staten Island rate, which may be different from Williamsburg,”

said Dr.Adam Ratner, director of the Division of Pediatric Infectious Diseases at NYU Langone’s Hassenfeld Children’s Hospital.

This highlights the need for targeted strategies that consider the unique cultural, socioeconomic, and informational landscapes of each community. For example, in some areas, vaccine hesitancy might stem from misinformation spread through social media, while in others, access to healthcare services may be a primary barrier. Understanding these nuances is essential for developing effective public health campaigns.

Notably, three ZIP codes in Williamsburg, which were subject to a vaccine mandate by then-Mayor Bill de Blasio during the 2018-2019 measles outbreak, now have MMR vaccination rates between 70% and 76% for children aged 24 to 35 months. While this represents an advancement, these rates still fall short of the 95% herd immunity threshold. The legacy of the 2018-2019 outbreak serves as a stark reminder of the potential consequences of inadequate vaccination coverage and the importance of sustained public health efforts.

Areas of High Vaccination Coverage

In contrast to areas with low vaccination rates, some neighborhoods in New York City demonstrate exceptional protection against measles. Queens’ Breezy point neighborhood boasts a 99% MMR vaccination rate for children between 24 and 35 months old, as does the area surrounding JFK Airport. These high-performing communities serve as positive examples, illustrating the effectiveness of vaccination and the feasibility of achieving widespread protection. Analyzing the factors that contribute to these high rates could provide valuable insights for replicating success in other areas.

“Measles is the most contagious disease that we know of and consequently, you need very high vaccination rates to prevent outbreaks,”

Ratner said.

This underscores the critical importance of maintaining high vaccination coverage to prevent the resurgence of measles, a disease that can lead to severe complications, particularly in young children.

Impact of School Vaccination Rules

New York City benefits from stringent school vaccination requirements, which mandate that nearly all children entering kindergarten have received two doses of the MMR vaccine. The state’s regulations do not allow for religious exemptions, further strengthening the city’s defense against measles outbreaks. The U.S. Centers for Disease Control and Prevention (CDC) recommends that children receive their first dose of the MMR vaccine between 12 and 15 months of age.

while these measures contribute to high vaccination rates among school-aged children, they do not fully address the gaps in coverage among younger children, particularly those between 24 and 35 months old. These early years are crucial for establishing immunity and preventing the spread of measles within communities. therefore, targeted interventions are needed to reach parents and caregivers of young children and encourage timely vaccination.

Addressing Vaccine concerns

On Staten Island, some parents express concerns about vaccine safety and potential side effects. Some prefer “natural immunity,” or mistakenly believe that vaccines can cause autism. These beliefs, often fueled by misinformation and unsubstantiated claims, can lead to vaccine hesitancy and lower vaccination rates.

Dr. Anna Cornish, the medical director of ambulatory pediatrics at Northwell Health’s staten Island University Medical Center, emphasizes the importance of patient education. Pediatricians at the hospital actively engage with parents, addressing their specific concerns and providing accurate information about the MMR vaccine.

For example, when parents express a preference for natural immunity, Dr. Cornish explains that contracting measles can “lead to severe complications, hospitalizations, long-term health problems, even possibly death.” This direct and evidence-based approach helps parents make informed decisions about their children’s health.

Dr. Cornish advocates for broader vaccine education initiatives in schools and other community settings. By providing accessible and reliable information,health officials can empower individuals to make informed decisions and dispel myths surrounding vaccines.

Current Measles Cases and Risk Factors

As of March 2025, New York has reported four measles cases, including three in New York City. While health officials have not yet detected signs of community transmission, the presence of these cases underscores the ongoing risk of outbreaks, particularly in undervaccinated areas.

According to the city health department, measles vaccination coverage is the most critical factor in determining a community’s risk for an outbreak. However, other factors also play a significant role. If an individual contracts measles while traveling and returns to an undervaccinated community, the size of any subsequent outbreak will depend on several factors, including the number of people directly exposed, the population density of the area, and the effectiveness of the public health response, according to the CDC.

The CDC reports that most large measles outbreaks in the United States between 2021 and 2023 occurred in undervaccinated communities characterized by close-knit social networks and high population density. This highlights the importance of addressing vaccination gaps in densely populated urban areas like New York City.

Currently, outbreaks are ongoing in Texas and New Mexico, as well as in the Canadian provinces of Ontario and Quebec. These ongoing outbreaks serve as a reminder of the continued threat posed by measles and the need for vigilance in maintaining high vaccination coverage.

Addressing Counterarguments and Misconceptions

One common counterargument to widespread vaccination is the belief that measles is a mild disease and that natural immunity is preferable. Though, this argument ignores the potential for severe complications, which can include pneumonia, encephalitis (brain swelling), and even death. The CDC estimates that for every 1,000 children who get measles, one or two will die from it. Vaccination offers a safe and effective way to protect against these potentially devastating outcomes.

Another misconception is that vaccines cause autism. This claim has been thoroughly debunked by numerous scientific studies. The original study that sparked this controversy was retracted due to fraudulent data, and the author lost his medical license. Leading medical organizations, including the American Academy of Pediatrics and the World Health Institution, have affirmed the safety and efficacy of the MMR vaccine.

practical Applications and Future Directions

To improve measles vaccination rates in New York City and prevent future outbreaks, the following strategies should be considered:

• Targeted outreach: Develop culturally sensitive and linguistically appropriate educational materials to address specific concerns and misconceptions within undervaccinated communities.
• Improved access: Expand access to vaccination services by offering mobile clinics,evening and weekend hours,and partnerships with community organizations.
• Provider education: Provide ongoing training and resources to healthcare providers to ensure they can effectively communicate the benefits of vaccination and address patient concerns.
• Social media campaigns: Utilize social media platforms to disseminate accurate information about measles and vaccines, and to counter misinformation.
• Community partnerships: Collaborate with community leaders, faith-based organizations, and schools to promote vaccination and build trust.

By implementing these strategies and addressing the root causes of vaccine hesitancy,New York City can strengthen its defenses against measles and protect the health of all its residents.

Measles Vaccination Rates by ZIP Code

*Data as of March 2025