The news that an outbreak in Texas has caused the nation’s first confirmed measles death in a decade — an unvaccinated child — is as unsurprising as it is tragic. Spreading largely in rural Mennonite communities that typically have low vaccination rates, the outbreak has already grown to at least 124 cases since late January. Almost all of them are children.
Parents whose children got infected but survived are no doubt grateful that their family was spared. But startling research about the virus unfortunately tells a new and very different story, recasting what was previously known about how measles works and making clear why the Trump administration’s approach to vaccines is nowhere even close to meeting the moment.
That research, conducted over the past decade by the immunologist and medical doctor Michael Mina and others, revealed that measles destroys immune cells. Even people who recover from the virus lose much of their immune memory, and therefore the protection they had acquired from prior infections or vaccines to all the other childhood illnesses. This leaves survivors more vulnerable to many other diseases for years afterward. Worse, these victims may now face those childhood diseases, to which they lost immune protections, as older children, which puts them more at risk for complications.
Before vaccines were introduced, Mina told me, earlier measles infections may have been implicated in as many as half of all childhood deaths from all infectious diseases. Which, given these findings, would mean the true harm of measles is far greater than its death toll, and the legacy of this outbreak may still be felt years after it’s officially contained.
It’s not just those families that opt out of vaccinations who are at risk. Measles is one of the most transmissible diseases known to humanity. Children don’t get their first vaccine dose until after 12 months, and full protection doesn’t kick in until they get their booster, usually when they’re between 4 and 6. Like other vaccines, it is less effective for elderly people whose immune systems aren’t as robust, and aren’t as helpful or even a possibility for people who are immunosuppressed because of other factors such as cancer treatments.
Overall, the vaccine is highly effective and the rare breakthrough cases — a few in a thousand exposures — tend to be mild. The Centers for Disease Control and Prevention warns, however, that those cases can be vectors for the illness.
The only guaranteed way to protect people from this deadly disease is to keep it from circulating in the first place. But nationwide, vaccination rates have been trending downward, producing such large pockets of vulnerable people that outbreaks in one community can now bleed over to another, the way pockets of dry kindling in a forest can help start a conflagration that consumes it all.
Already, there are cases across the border from Texas in New Mexico that may turn out to be related. If the disease starts circulating more widely, a great many people will be at risk — regardless of their or their communities’ beliefs about vaccines.
A newly circulating virus would mean some unvaccinated people would encounter measles for the first time in adulthood, when the danger it poses is much higher. This effect was evident in World War I, when healthy young conscripts from rural areas had their first exposure to the disease in Army training camps. The result was the worst outbreak the military had seen in almost a century. Thousands of soldiers died.
During Robert F. Kennedy Jr.’s confirmation hearings for health secretary, Senator Bill Cassidy, Republican of Louisiana, practically begged him to acknowledge, however grudgingly, that vaccines don’t cause autism. It was the easiest layup ever, but Kennedy just wouldn’t go there. Maybe not so surprising, given that he had previously told a podcaster that he considers it his duty to tell random strangers that they shouldn’t vaccinate their babies. Cassidy, a medical doctor by training, voted to confirm him anyway.
Since then, Kennedy has had a lot to say about the need to investigate the childhood vaccinations schedule (“nothing is going to be off limits”), claiming that despite decades of widespread use and study it had somehow been “insufficiently scrutinized.” He stopped a sensible public awareness campaign during one of the most severe flu seasons ever, and canceled a key vaccine committee meeting, which may endanger the availability of flu vaccines next year. And he talked about instituting an “informed consent” model for parents that emphasizes vaccines’ possible side effects and no doubt would discourage the vaccinations that have protected Americans from the ravages of infectious disease that in earlier centuries were just a standard part of life.
I might run out of not just column space but an entire newspaper if I tried to list all the false and misleading claims Kennedy made about vaccines in his many speeches and books. Even so, I was shocked this week as I watched him brush off the Texas outbreak as no big deal. The situation there is “not unusual,” he said, even as he doubled the known death toll without explanation. About 20 people have been hospitalized, he said, “mainly for quarantine,” a fact that the chief medical officer of the Lubbock hospital where the child died quickly refuted. “We’re watching it,” Kennedy said, with a casual wave of the hand.
You can probably guess which word he didn’t say.
During a deadly outbreak, we’d ordinarily hope for a clear, direct call for parents to vaccinate their children. But this is the man who, during a 2019 measles outbreak in Samoa that killed 83 people (79 of them children), actively worked to undermine public trust in the one thing that would have helped most. America, brace yourself.
Right now, the United States has an official verification from the World Health Organization as a measles-free country, which makes it easier for its residents to travel abroad. If these outbreaks continue we may lose that designation, and other countries may begin to require proof of measles vaccination before letting Americans enter. That choice would be hard to argue with.
The situation in Texas may be the wake-up call that gets some holdouts to bring their children to the doctor and request the protection they need and deserve. In 2015, when an unvaccinated 6-year-old died a horrible, prolonged death from the “strangulation disease” of diphtheria, the distraught parents vaccinated their surviving child, while lamenting they’d been conned by anti-vaxxers.
We should do what we can to spare other families from having to learn such a brutal lesson.
All governors should be launching campaigns to increase measles vaccination coverage, but some states are led by people who promote falsehoods. And some Americans live deep in echo chambers where most of what they hear about vaccines are lies and disdain. It won’t be possible to reverse all this quickly. Perhaps the best we can do is inform parents skeptical of vaccines what they’re risking, before it’s too late.
The post The Texas Measles Outbreak Is Even Scarier Than It Looks appeared first on New York Times.
