This measles outbreak was entirely avoidable

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A measles outbreak in West Texas and New Mexico has killed a child and sickened more than 130 people, and public health experts fear it’s only the beginning. It’s an entirely avoidable health emergency fueled by weaknesses in our vaccine force field.

It’s also not hard to imagine this type of emergency becoming much worse, much faster if Robert F. Kennedy Jr., secretary of the Department of Health and Human Services, further undermines the safety of and access to the measles, mumps and rubella vaccine.

Troubling signs are already emerging that Kennedy, notorious for his vaccine misinformation, might influence the Centers for Disease Control and Prevention’s messaging and vaccine recommendations.

Members of Kennedy’s Make America Healthy Again inner circle have dismissed the measles threat. Health care entrepreneur Calley Means, who is helping to shape and implement the MAHA agenda, complained on CNN last week about the media’s focus on the Texas outbreak. “Day after day, it’s breathless — it’s breathless coverage of five measles cases,” he said, suggesting chronic disease is meanwhile being ignored.

There’s a reason for that “breathless” coverage. Measles is both scarily contagious and easily preventable.

After someone with measles coughs or sneezes — or even breathes — tiny droplets of the virus hang in the air like ghosts for up to two hours, waiting to infect anyone who wanders by.

Moreover, people with measles — most often children — typically get very sick with a fever, cough and sore throat before the telltale rash sets in. So far, 18 of the 124 Texans infected have been hospitalized, according to state health officials. The majority of the cases are unvaccinated children, who are susceptible to pneumonia and, more rarely, brain swelling that can cause permanent damage. Two or three out of every 1,000 children with measles will die. One of the hospitalized Texas patients, an unvaccinated child, died Tuesday night.

That’s why, with even a few cases, public health officials race to retrace patients’ steps and who they might have encountered. The goal is to warn vulnerable people so they can take steps to minimize their risk of serious infection and quarantine to prevent further spread. Most at risk are those too young or too immunocompromised to be protected by the MMR vaccine.

Each cluster becomes more dangerous as vaccination rates in the U.S. soften. Measles was officially eradicated in the U.S. in 2000, but maintaining that status means ensuring that roughly 93-95% of the population is vaccinated.

Although Texas’ childhood vaccination rate is just over 94%, its outbreak started in Gaines County, where some 18% of kindergartners have vaccine exemptions. That creates a pocket of vulnerability that can allow the disease to rip through a community and spread into neighboring areas.

“Even at a low level, we could get some endemic spread,” former FDA Commissioner Scott Gottlieb said Sunday on “Face the Nation,” pointing to low levels of MMR vaccination in several states, including Idaho, Alaska, Wisconsin and Minnesota. “The U.S. could be at risk of losing its measles elimination status, which would have more profound implications on things like travel advisories that could be initiated from other countries.”

The worry is that these numbers — and the opportunity for measles and other infectious diseases to spread — could get much worse. Kennedy has spent years railing against the safety of the MMR vaccine (and falsely connecting it to autism) and now has the power to act on his beliefs.

Despite Kennedy’s lukewarm assurances during his Senate confirmation hearings that he would not take away Americans’ vaccines, early signs raise concerns. Sweeping job cuts at HHS this month targeted CDC employees, including those in a critical public health training program. The CDC also appears to have pulled an ad campaign to improve the country’s dismal flu vaccination rates, a move that came at the tail end of a brutal outbreak and rising pediatric flu deaths.

More worrisome was the indefinite postponement of a meeting of a CDC committee on vaccines, originally scheduled for this week. The Advisory Committee on Immunization Practices recommends who, when, and how often people should get specific vaccinations, advice that directly affects access and insurance coverage.

While the MMR vaccination was not on ACIP’s agenda, punting the committee’s discussion has ominous undertones. Some are concerned the delay could be related to an executive order issued by Trump last week calling for the heads of government agencies “to identify and submit to the president additional unnecessary governmental entities and federal advisory committees that should be terminated on grounds that they are unnecessary.”

Any measles outbreak is serious, yet Kennedy’s influence amid weakened vaccine acceptance raises the stakes. Public health officials like to say that measles can spread like wildfire. I worry that the U.S. will soon have a lot more kindling.