In 2000, the measles was declared officially eliminated in the United States. Infections still occurred, but they were rare, originated outside the country, and was not in circulation within our nation's borders. In 2025, our country is at severe risk of losing this elimination status. In today's post, we will look at the dangers of backsliding on our elimination of measles and what we as a nation must do to keep this and other infectious diseases at bay.
For centuries, getting the measles was a childhood rite of passage. Sweeping through the nation every 2-3 years, this highly infectious virus (Morbillivirus hominis) would spread like wildfire, reaching almost every single child at some point of their childhood (every infected person can spread it to 12-18 susceptible hosts). For the vast majority of these children, measles involved 10 days of fever, respiratory symptoms, and an itchy rash. Our collective memory of the measles, therefore, may downplay the virus as a harmless childhood inconvenience with no long-term impacts. What we may not remember is that during each wave of infection 48,000 children would be hospitalized with pneumonia, bronchitis, corneal ulcers, or encephalitis and that 400-500 children would die. Globally, this number is even more chilling: 2-6 million child deaths during each epidemic.
Thankfully, in 1962 a vaccine was developed which would result in a global 25% reduction in mortality in children under 5. Efforts to increase access to the vaccine across nations has saved an estimated 94 million lives since 1974. The current two-dose vaccine (a part of the MMR vaccine) provides a 97% protection against measles. So why doesn't the story end there?
Vaccine hesitancy is either a delay or refusal of vaccines despite access to immunization opportunities. According to the American Academy of Pediatrics (AAP), the MMR (measles-mumps-rubella) vaccine is the immunization most often declined by vaccine hesitant parents. Vaccine-hesitant parents most often cite safety concerns due, in part, to a fraudulent study published decades ago that purported to link the MMR vaccine to autism. The combination of misinformation spread online with a lack of trust in health authorities, plus the general public's lack of experience with and knowledge about measles compounds vaccine hesitancy. As a result, pockets of unvaccinated children serve as outbreak zones that can lead to circulates of measles within a community. Once herd immunity is not in place, measles spreads without constraints and the result is children become sick, some develop dangerous complications, and some will even die.
Studies show that while parents may not have trust in the medical authorities (government agencies, pharmaceutical companies, scientific researchers), they do have trust in their own medical professionals and their own social networks. As a member of your own community, you have the opportunity to be the person that defends vaccine safety with your friends and neighbors. You can be the trusted voice that helps explain how measles can harm an individual child as well as how it can harm the community at large. You can be voice to defend high-quality research and how it differs from online commentaries and unfounded conclusions.
Without a doubt, speaking up to defend vaccines can be a challenge in today's world of social media influencers, news scare tactics, and conflicting advice from government agencies. All we can do is stay focused on the science and how best to explain that science to an audience in a way that they can feel safe enough to ask questions, safe enough that their concerns are being addressed, and ultimately, safe enough to get their children vaccinated.