Mend cracks in defense against measles

Opinion editor's note: Editorials represent the opinions of the Star Tribune Editorial Board, which operates independently from the newsroom.

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One of the COVID-19 pandemic's lasting lessons is how quickly a pathogen can circumnavigate the globe.

Distance isn't a defense when air travel routinely narrows the gap between continents to mere hours. An outbreak in a far-flung location can become a public health crisis in the United States with frightening speed.

That's why a new report on measles from the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC) is cause for alarm. Measles cases and deaths rose significantly worldwide from 2021 to 2022, a disturbing trend fueled by declining vaccination rates.

Boosting vaccination rates is an urgent world health challenge, particularly in the low-income countries hit hardest by measles' resurgence. But action is imperative in Minnesota as well.

Parents need to ensure their children are protected against measles, which can cause serious illness. State lawmakers also have a role to play, with the upcoming session a chance to pass an overdue reform to stem sliding vaccination coverage here.

Unfortunately, there are some who misguidedly dismiss measles as a little more than a childhood rash. The reality is far more sobering.

The WHO dubs measles one of the world's most contagious diseases, making it very difficult to protect the unvaccinated. Measles is spread by contact with secretions sneezed or coughed out by someone infected. But it can also be contracted just by "breathing the air that was breathed by someone with measles," the agency states.

Measles is also contagious four days before a rash appears, meaning someone who doesn't know they're ill can spread it.

There is no specific treatment once someone is infected, other than symptom care. About 1 in 5 people infected is hospitalized, according to the CDC. Complications include pneumonia and encephalitis, which in turn can leave a child deaf or with intellectual disabilities. While deaths are rare in the United States, the same is not true in other countries.

The new WHO/CDC findings underscore this tragic reality. From 2021 to 2022, estimated measles cases rose 18%, from 7.8 million to 9.2 million. Estimated measles deaths rose 43% during the same time period, from 95,000 to 136,200.

Unsurprisingly, the agencies found that measles vaccine coverage worldwide is at its lowest since 2008. From 2000-2019, global coverage for a first dose of measles vaccine rose from 72% to 86%. It declined to 81% in 2021, the lowest coverage in more than a decade. A likely factor: the COVID-19 pandemic, which disrupted public health vaccination efforts.

Fortunately, measles cases in the U.S. have not mirrored the global increase. Forty-one cases have been reported nationally in 2023, according to CDC stats. There were 121 cases in 2022 and 49 cases in 2021. But the U.S. isn't immune from larger outbreaks. In 2019, 1,274 cases were confirmed in 31 states.

Unfortunately, CDC data indicates that U.S. vaccination trends are heading in the wrong direction. Measles vaccination coverage for kindergartners in the 2011-12 school year was 94.7%. In the 2022-23 school year, it was 93.1%.

Drilling into CDC data for Minnesota-specific information gives more cause for concern. A decade ago, 96.3% of the state's kindergartners were vaccinated against measles. For the 2022-23 school year, it was 87.6%. That's bigger drop than seen nationally, one that leaves children at risk. Measles remains relative rare thanks to vaccination, but the global figures show how quickly this virus can resurface and spread if defenses continue to weaken.

"Not getting kids vaccinated is the equivalent of putting them in the back seat without buckling them up, driving 90 miles an hour and running red lights," Minnesota infectious disease expert Michael Osterholm told an editorial writer.

Again, families have a responsibility to seek out credible information about vaccinations. That means talking to a medical provider. But state lawmakers could take another vital step: ending the state's "personal belief" exemption.

The policy allows parents to opt out of school-aged vaccinations for nonmedical reasons. That puts other kids at risk, particularly those with weakened immune systems or babies who aren't yet old enough to have gotten all their shots.

The Legislature previously considered ending this exemption but backed off after protests by the state's small, loud and well-funded anti-vaccine lobby. Minnesota's sliding measles vaccine coverage is further evidence that lawmakers need to find the fortitude to act.