As measles continues to spread nationwide, hospitals and health officials are pouring more money into efforts to increase vaccinations, testing and surveillance of the disease. The funds include a surprise $100 million infusion in recent weeks to states from the Centers for Disease Control and Prevention.
As of Oct. 2, the United States had recorded nearly 4,000 measles cases, the highest by far in decades. About one-quarter of those cases have occurred in Pennsylvania, where state officials say five people with the virus have died. But nearly every state has reported cases this year, including New York, where the governor on Monday declared measles a statewide health emergency.
Some state officials welcomed the funding from the C.D.C., released in two $50 million tranches in August and September, as a bulwark against future outbreaks.
“Our state has not yet seen a large outbreak as in some other states, like Pennsylvania or South Carolina, but we fully expect to see more cases here,” said Dr. Scott Harris, the state health officer at the Alabama Department of Public Health. Alabama received $300,000 for measles immunization programs and $600,000 for surveillance and diagnoses, he said.
The funding is intended for immunization programs and for efforts to improve measles surveillance, including diagnoses of severe infections and cases in pregnant women and infants. Measles infections at birth had been extremely rare in the United States, but two of the Pennsylvania deaths were thought to have resulted from such cases.
The infusion of funds “comes at a time when public health funding and staffing has been cut, so it is sorely needed,” said Claire Hannan, executive director of the Association of Immunization Managers, which represents state and local officials.
“It’s very difficult to hold special vaccination clinics, alert the public, stop transmission and conduct other response activities without preparation,” she said, adding that some health departments may use the money to identify where immunization rates need the biggest boost. At least 95 percent of people in a community need to be vaccinated to stem the spread of measles.
Some public health experts noted that the C.D.C. has not launched the sort of publicity campaigns it typically would in outbreaks to increase immunizations.
“In a normal time, C.D.C. and even higher up in H.H.S., people would be talking about measles — what a severe disease it is, how easy it is to prevent, how effective and safe the vaccine is,” said Dr. Andrew Pavia, a pediatric infectious disease specialist in Utah, which has reported more than 500 cases this year.
“We’re not seeing that,” Dr. Pavia said.
Some experts attributed the measles outbreaks to misinformation from officials about the safety of vaccines, which have exacerbated declining vaccination rates.
In August, President Trump called for the measles, mumps and rubella vaccines, which are given together as a single shot, to be split into their separate components. He claimed, with no evidence, that “together, there could be a possibility they’re quite lethal.”
Health Secretary Robert F. Kennedy Jr. has also repeatedly questioned the safety of the combination shot for measles, mumps and rubella, falsely claiming that the vaccine can be fatal and that it contains fetal debris.
At a Wall Street Journal event on Wednesday, Dr. Erica Schwartz, the new director of the C.D.C., denied that Mr. Kennedy had ever made such remarks. And she added that “the measles, mumps, rubella vaccine is absolutely safe, absolutely effective.”
Beyond that, however, Dr. Schwartz has not made clear public statements urging parents to vaccinate their children.
As cases emerge in every corner of the country, hospitals have escalated their preparations for potential outbreaks.
Dr. Neil Hockstein, the surgeon general for Delaware, said the state health department was setting up mobile vaccination units in the parking lots of local businesses and extending hours at state clinics so that more people could get vaccinated.
In other states, hospitals are conducting drills to simulate care for measles patients and training their staffs to identify symptoms.
“We are certainly on our toes waiting for the cases to come,” said Dr. Elizabeth Hammershaimb, a pediatric infectious disease specialist at the University of Maryland Golisano Children’s Hospital in Baltimore. She added that the hospital started purchasing more measles vaccines this summer to build up its stock.
In Connecticut, Yale New Haven Health has also taken stock of its measles vaccine inventory, largely to ensure there are enough doses available to lower the risk in people who have been exposed and have not yet been vaccinated, said Dr. Scott Roberts, an infectious disease doctor at the health system.
Hospitals also said they were assessing their supply of immunoglobulin, an antibody treatment that reduces the risk of serious illness in those who cannot be vaccinated, including infants, pregnant women and some severely immunocompromised individuals.
“You can go from rarely, if ever, using it to having, say, a doctor’s office in which 15 infants were exposed and you need 15 doses overnight,” Dr. Pavia said. “That can be a challenge.”
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