Abstract
Introduction: Vaccine-preventable diseases continue to represent a significant public health problem worldwide. Among them, measles, rubella, and mumps maintain their epidemiological relevance due to their high transmissibility and the potential to generate outbreaks in contexts of insufficient vaccination coverage. In Paraguay, the MMR (measles, mumps, rubella) vaccine is part of the national immunization schedule, as variations in coverage can influence the transmission dynamics of these diseases.
Objective: To analyze the impact of measles, mumps, and rubella (MMR) vaccination on the incidence of measles, rubella, and mumps in Paraguay during the period 2020–2025.
Methodology: An observational, ecological, retrospective, and cross-sectional study was conducted using secondary data from Paraguay's national epidemiological surveillance and vaccination records for the period 2020–2025. The sample consisted of reported cases of measles, rubella, and mumps, as well as annual MMR vaccination coverage records reported by the Ministry of Public Health's Expanded Program on Immunization. A descriptive analysis of the variables was performed using frequencies, percentages, and temporal trends. Furthermore, the evolution of vaccination coverage was compared with the incidence of the diseases during the study period to identify potential epidemiological associations.
Results: Measles, mumps, and rubella (MMR) vaccination coverage decreased from 88% in 2020 to 85% in 2021, followed by a gradual recovery to 95% in 2024 and 94% in 2025. The incidence of measles and rubella remained at zero cases for almost the entire study period, with only 0.2 cases of measles recorded in 2025. Regarding mumps, the incidence increased from 12.5 cases in 2020 to 18.7 in 2022, coinciding with the years of lowest vaccination coverage, and subsequently decreased to 8.9 cases in 2025 as immunization rates improved. The results show an inverse relationship between MMR vaccination coverage and mumps incidence.
Conclusion: The decline in MMR vaccination coverage was associated with an increase in mumps cases, while meals and rubella remained under control. Maintaining high vaccination coverage is essential to prevent the resurgence of vaccine-preventable diseases.
References
1. Pérez Centurión VT, Cousirat L, Araya S, Benítez I, Villafañe M, León D, et al. Impact of the new intervention model to increase vaccination coverage in Paraguay, 2023Impacto de um novo modelo de ação para aumentar as coberturas vacinais no Paraguai, 2023. Rev Panam Salud Publica [Internet]. 2024;48:e96. Disponible en: http://dx.doi.org/10.26633/RPSP.2024.96
2. Couto MT, Barbieri CLA, Matos CC de AS. Considerations on the impact of COVID-19 on the individual-society relationship: from vaccine hesitancy to the clamor for a vaccine. Saúde Soc [Internet]. 2021;30(1). Avaliable at: http://dx.doi.org/10.1590/s0104-12902021200450
3. Carvalho WRI, Souza GC de, Simões P, Teixeira TNA, Santos TCD, Merlini RHC, Impact of low measles vaccination rates in the context of the COVID-19 pandemic in Brazil. Braz J Infect Dis [Internet]. 2021;25(101529):101529. Avaliable at: http://dx.doi.org/10.1016/j.bjid.2020.101529
4. Silva BC, Pinto FF, Salgado RM, Araujo I. Impact of Vaccination Against Polio, Measles, and Yellow Fever in Brazil from 2012 to 2022. Res Soc Dev [Internet]. 2024;13(9):e12813946932. Avaliable at: http://dx.doi.org/10.33448/rsd-v13i9.46932
5. Chaves BS, Castro Cássia Francisca Silva de, Azevedo IFS de, Negreiros ILG, Rêgo Maria Gabrielle Correia, Mendonça PLG, et al. Challenges and strategies in measles vaccination: Control and eradication. Res Soc Dev [Internet]. 2024;13(8):e7413846563. Avaliable at: http://dx.doi.org/10.33448/rsd-v13i8.46563
6. Lima GT, Brito AG, Vargas GLM, Ferreira JD, Silva PI de O, Segundo JTM, et al. The impacts of the changing epidemiological profile of measles in Brazil. Brazilian Journal of Health Review [Internet]. 2020;3(3):5973-81. Avaliable at: http://dx.doi.org/10.34119/bjhrv3n3-155
7. Nascimento LMD, Araújo AC de M, de Souza PCA, Matozinhos FP, da Silva TPR, Fernandes EG. Brazilian Ministry of Health strategy to increase vaccination coverage at bordersEstrategia del Ministerio de Salud de Brasil para aumentar las tasas de cobertura de vacunación en las fronteras. Rev Panam Salud Publica [Internet]. 2024;48:e31. Avaliable at: http://dx.doi.org/10.26633/RPSP.2024.31
8. De Carvalho VB, Pinto VTBC, da Silva NFR, de Oliveira SEA, de Alencar LS, Maia FL de A. Analysis of inmmunizations and their Brazilian Unified Health System (SUS) from 2018 to 2022. Braz J Infect Dias [Internet]. 2023;27(103084):103084. Available from: http://dx.doi.org/10.1016/j.bjid.2023.103084
9. Aragão PHL, Veiga IG da, Reis R de NR, Hanna LMO, Silva NKN da, Acatauassú ST. Effect of vaccination on the control of measles and rubella incidence in children under 5 years of age. Delos [Internet]. 2024;17(60):e2286. Available from: http://dx.doi.org/10.55905/rdelosv17.n60-088
10. Pérez Centurión VT, Cousirat L, Araya S, Benítez I, Villafañe M, León D, et al. Impact of the new intervention model to increase vaccination coverage in Paraguay, 2023. Rev Panam Salud Publica [Internet]. 2024;48:e96. Available from: http://dx.doi.org/10.26633/RPSP.2024.96
11. Machado D. Coverage of vaccination against COVID-19 in MERCOSUR countries. Acad [Internet]. 2023;6(1):42-50. Available from: http://dx.doi.org/10.57201/academic.6.1.3700
12. Le-Corre N, Barría S, López T, Martínez-Valdebenito C, Contreras AM, Ferrés M. Parotiditis in Chile: clinical and molecular characterization of two cases in a highly vaccinated population. Rev Chilena Infectol [Internet]. 2018;35(2):198–203. Available from: http://dx.doi.org/10.4067/s0716-10182018000200198
13. Havers FP, Campbell AP, Uyeki TM, Fry AM. Commentary: A historical review of centers for Disease Control and prevention antiviral treatment and postexposure chemoprophylaxis guidance for human infections with novel influenza A viruses associated with severe human disease. J Infect Dis [Internet]. 2017;216(suppl_4):S575–80. Available from: http://dx.doi.org/10.1093/infdis/jix065
14. Szymczak JE. Are surgeons different? The case for bespoke antimicrobial stewardship. Clin Infect Dis [Internet]. 2019;69(1):21–3. Available from: http://dx.doi.org/10.1093/cid/ciy847
15. Handanagic S, Finlayson T, Burnett JC, Broz D, Wejnert C, National HIV Behavioral Surveillance Study Group. HIV infection and HIV-associated behaviors among persons who inject drugs - 23 metropolitan statistical areas, United States, 2018. MMWR Morb Mortal Wkly Rep [Internet]. 2021;70(42):1459–65. Available from: http://dx.doi.org/10.15585/mmwr.mm7042a1
16. Haber P, Moro PL, Ng C, Dores GM, Perez-Vilar S, Marquez PL, et al. Safety review of tetanus toxoid, reduced diphtheria toxoid, acellular pertussis vaccines (Tdap) in adults aged ≥65 years, Vaccine Adverse Event reporting System (VAERS), United States, September 2010-December 2018. Vaccine [Internet]. 2020;38(6):1476–80. Available from: http://dx.doi.org/10.1016/j.vaccine.2019.11.074
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2026 Adelina Antonia Medina Martinez, Elba Beatriz Barrios De Giménez, Violeta Ramona Zelada López, Zuny María González Cáceres (Author)