In 2000, the U.S. declared measles “eliminated.” Now, in 2025, we are seeing the highest number of cases in more than 30 years. In response, Dr. Chelsea Kettering (Navajo) and the VaxUp team gathered with 12 women—mothers, daughters, and Navajo elders—around a table in Tuba City, Arizona on the Navajo Nation. Together, they reviewed sample radio ads, flyers, and newspaper inserts as they prepared for a back-to-school outreach campaign, encouraging parents and community members to check with their providers about vaccination status.

The campaign draws on findings from the VaxUp study, a community-based participatory research project in partnership with the Navajo Nation, Tuba City Regional Health Care Corporation (TCRHCC), and Northern Navajo Medical Center (NNMC). Its goal: to build vaccine confidence and improve service delivery among Navajo communities.

“With the VaxUp study, we were interested in understanding the reasons why people do or do not get vaccinated from both the health system standpoint as well as the community level standpoint,” said Dr. Kettering, an epidemiologist with JHCIH. One key finding: strong community commitment to vaccination is the best way to protect others. With measles outbreaks occurring in the region, reinforcing vaccination norms on Navajo Nation, despite misinformation online, may help strengthen vaccine commitment among community members.

“When I was younger, my grandparents stressed the importance of getting an education and coming back and serving my community,” said Dr. Kettering, who is Diné (Navajo). “I am passionate about this work because it not only strives to improve the lives and wellbeing of my relatives, it also strengthens systems for the future.”

Back in the focus group, laughter filled the room. Did the illustrated middle-aged man due for pneumonia, shingles, flu, and COVID-19 vaccines look right or was he too young? Too old? Someone said how 50 is the new 35. Another joked, “My mind says I’m 21.”

“The flyers told a story that didn’t need further prompting from a research team,” recalled Dr. Kettering. “They allowed people to talk about the message and weave a narrative about the subject at hand—getting vaccinated to prevent the spread of an infectious disease and protect yourself.”

Interested in partnering or learning more about our VaxUp work? Get in touch with Kathleen Grealish.