Why This Measles Outbreak Is Different

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In 2000, the CDC declared that measles had been eliminated from the United States. But now America is at risk of losing that status: A measles outbreak has sickened more than 150 people in Texas and New Mexico since late January. An unvaccinated school-aged child recently died from measles in Texas—the first known death from measles in America in about a decade, and the first child to die from the disease since 2003. I spoke with my colleague Katherine J. Wu, who covers science and health, about why vaccination is the only way to prevent the spread, and how a surge in illnesses that had previously faded from American life could reshape childhoods.

Lora Kelley: Why is measles so reliant on vaccines to prevent its spread?

Katherine J. Wu: Measles is arguably the most contagious infectious disease that scientists know about. Researchers have estimated that, in a population where there’s zero immunity to measles, one infected person is going to infect roughly 12 to 18 other people. That is extremely high. In most cases, it is a respiratory infection that’s going to cause fever, cough, and rash, but it can also restrict breathing, cause complications such as pneumonia, and be deadly.

This is a disease that requires really, really high levels of vaccination to keep it out of a community, because it’s so contagious. Researchers have estimated that you want to see vaccination rates in the 95 percent range to protect a community. If you start to dip just a bit below that threshold, like even 92 percent or 90 percent, you start to get into trouble. Lower uptake creates an opening for the virus to start spreading. And the more unvaccinated people there are, the faster the virus will spread, and the more people will get seriously sick.

Lora: Health and Human Services Secretary Robert F. Kennedy Jr. said last week that this recent outbreak is “not unusual” and pointed to past measles outbreaks. How do you view this current outbreak relative to other times when cases spiked, such as the 2019 outbreak in New York?

Katherine: The current outbreak actually is not as big as the 2019 New York one yet. And we almost lost our elimination status for measles then. But there are ways in which I would argue that this one is worse than the 2019 outbreak. An unvaccinated kid has died. We haven’t had a reported measles death in this country in about a decade. If the situation worsens, that death might only be the first.

Lora: Could people who are vaccinated be affected by a measles outbreak?

Katherine: The MMR vaccine, which protects against measles, mumps, and rubella, generally provides immunity from measles for decades. But there are kids who are not old enough to be fully vaccinated against measles (kids get one shot at 12 to 15 months and then again at 4 to 6 years old). And it’s rare, but some people, including immunocompromised people, might not respond well to vaccination and may not be protected by it. Also, as people get further from their vaccination date, they may be more vulnerable to the disease. The more measles is around, the more vulnerable even the vaccinated population will be.

Lora: Measles hasn’t been a big issue in this country for a long time. What tools does America have to fight this disease if it resurges in a big way?

Katherine: Because this disease spreads so quickly, the main tool we’ve used to fight it is vaccination. And if people are letting that go, we’re in trouble. There are no antivirals for measles. Doctors generally just have to do what they can to manage the symptoms. Plus, health-care workers aren’t used to diagnosing or dealing with measles cases anymore, which makes it easier for outbreaks to get out of control.

Lora: How might the recent layoffs at federal agencies focused on public health and disease affect America’s ability to respond to outbreaks?

Katherine: I do worry that a lot of the public-health workforce is slowly getting hollowed out, including at the CDC. We’re going to lose our ability to prevent and stop epidemics—we saw resources that researchers rely on to track outbreaks temporarily disappear from the CDC website in January and February, for example. If people’s attitudes keep shifting away from childhood vaccination, a whole other host of diseases could creep in. In refusing the MMR vaccine, you are by definition also refusing protection against the mumps and rubella.

And RFK Jr. has made rampant speculations about the MMR vaccine being more dangerous than the disease itself, which is completely untrue. This week, he published an op-ed on the Fox News website acknowledging the importance of vaccinating against measles but also framing vaccination as a “personal” choice, and described nutrition as “a best defense against most chronic and infectious illnesses.” I can promise that no multivitamin will work against measles as well as the MMR vaccine, which has been proved safe and effective at protecting people from disease. Measles, meanwhile, can kill.

Lora: What would more frequent outbreaks mean for America’s kids and their childhood?

Katherine: In the world kids live in now, when they get sick with a disease they catch from other children, it’s not that big of a deal most of the time. Measles outbreaks are just so different from the colds picked up from day care or the stomach bugs you catch at Disneyland. If we choose to let measles and other vaccine-preventable diseases come back, there will be more childhood mortality. Kids might get pneumonia more often. They might be hospitalized more often. Some might grow up with permanent brain damage. Childhood will not only be about whether a kid is going to get a good education or make enough friends. It will once more be about whether a kid can survive the first few years of their life.

Here are three new stories from The Atlantic:

Today’s News

The Trump administration imposed 25 percent tariffs on most imports from Canada and Mexico, and doubled tariffs for China. In response, Canada put 25 percent tariffs on billions of dollars of American goods, Mexico will announce retaliatory tariffs on Sunday, and China will add tariffs on some American imports on March 10.
Donald Trump will deliver a speech to a joint session of Congress tonight at 9 p.m. ET, in which he is expected to lay out his vision for his second term.
Ukrainian President Volodymyr Zelensky wrote that last week’s Oval Office meeting was “regrettable” and proposed a partial cease-fire with Russia to resume peace negotiations.

Evening Read

When America Persecutes Its Teachers

By Clay Risen

Several states, most notably Florida, have ordered schools and colleges to restrict or eliminate courses on gender, while groups such as Moms for Liberty have rallied parents to police curricula and ban books from school libraries. Ideological battles over education may be proxies for larger conflicts—Communism in the ’40s and ’50s; diversity, equity, and inclusion today. But such fights are particularly fierce because of how important schools are in shaping American values. To control the country’s education system is, in no uncertain terms, to control the country’s future.

Read the full article.