Measles cases expected to spread cross-country due to vaccination gaps, high travel
by Lauren Turman
Nearly 25 years after measles was eliminated in the United States, cases have been starting to resurface. (CDC)
Nearly 25 years after measles was eliminated in the United States, cases have been starting to resurface. According to the CDC, almost two dozen measles cases have been reported since December 1, with the first cases being found in the northeast.
Dr. Taylor Nelson, an infectious disease physician with MU Health Care, said measles is one of the most transmissible diseases and will likely continue to spread through the Midwest and to the West Coast. Though the disease was eradicated in the U.S., If an unvaccinated person goes to a country where a disease is still common, becomes infected, and brings it back, they can spread the virus to other unvaccinated people. She said high travel and a largely unvaccinated population are causing an uptick in numbers.
Although the numbers were lower during the first year of COVID, we've now seen an incline again over the last couple of years," Nelson said. "And I think primarily the reason is because people are not getting vaccinated, not vaccinating their kids as much as we were when those initial measles vaccination efforts were happening. And so we're seeing more pockets of people who are susceptible to the infection."
Nelson said that with COVID-19, herd immunity, or the number of the population that will have to be immune to keep measles from spreading, will likely be very. When asked about vaccine fatigue among adults, she said creating a plan with a primary care physician will help things seem more manageable.
"I still do think they're one of the best medical inventions if not the best medical invention we've had right in the last century," she said, "So these things are these things that can protect you from your primary care doctor or a physician that you trust and come up with a schedule on. What do we need to address first? You don't have to get all of them at one time, but what's the most important, what's the most pressing? What can we get done now? What can we potentially do in the future?"
Measles' Initial symptoms include fatigue, runny nose, coughing, and fever. Later, a full-body rash will likely develop. In severe cases, severe complications can lead to death. If you contract measles, doctors say the virus has to run its course since there is no specific antiviral treatment.
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Respiratory syncytial virus (RSV) is a respiratory virus causing infection in the lungs, nose, and throat.
RSV affects all ages including young infants and infects about 64 million people globally each year.
While RSV symptoms normally feel just like those of the common cold in adults and older children, it can be a much more serious disease in older adults, young children, and babies.
Researchers report that RSV is the most common cause of hospitalization of infants in high-income countries.
The respiratory infection is responsible for about 3.6 million lower respiratory tract hospitalizations in young children each year, with 1.4 million of those in children ages 0 to 6 months.
For this reason, the Centers for Disease Control and Prevention (CDC) and the American College of Obstetricians and Gynecologists (ACOG) both recommend pregnant people receive an RSV vaccine to help immunize their babies from the disease before birth.
Of the two RSV vaccines currently available, only one vaccine Pfizers Abrysvo is approved by the Food and Drug Administration (FDA) and European Commission for use in pregnant people.
The American College of Obstetricians and Gynecologists recommends the Abrysvo vaccine for people who are 32 to 36 weeks pregnant during the peak RSV season, which is from September to January in the U.S.
A pregnant woman who receives (the) RSV vaccine in the last trimester weeks 32 to 36 will develop antibodies against RSV that will be passed to the fetus and protect the infant against RSV, Dr. Edward Liu, chief of infectious diseases at Hackensack Meridian Jersey Shore University Medical Center in New Jersey explained to Medical News Today.
Some infants are more susceptible to develop severe RSV symptoms that can lead to hospitalization, requiring oxygen and/or mechanical ventilation to help them breathe, added Chanique Ecby, clinical assistant professor at the University of Houston Andy and Barbara Gessner College of Nursing. Due to infants being so vulnerable, Abrysvo, the RSV vaccine for pregnant women, should be given to help provide antibodies that will protect the newborn against severe RSV disease after birth.
The Abrysvo vaccine prevents lower respiratory tract disease and severe lower respiratory tract disease caused by RSV in infants from birth through 6 months of age.
Babies are protected by RSV at birth if the pregnant individual received the vaccine at least two weeks prior.
Dr. Sherry Ross, a board-certified OB/GYN and womens health expert at Providence Saint Johns Health Center in Santa Monica, CA, spoke with MNT about RSV vaccines effectiveness:
The effectiveness of the RSV vaccine in protecting a baby may vary depending on when the vaccine was given to the pregnant woman and the underlying health and lung conditions of the baby.
In a study published in April 2023 of 3,500 pregnant individuals who received Abrysvo, the vaccine helped reduce the risk of severe lower respiratory tract disease by 81.8% within 90 days after birth and 69.4% within 180 days after birth, compared to those who received a placebo.
Additionally, in a subgroup of pregnant individuals receiving the vaccine during 32 to 36 weeks of pregnancy, lower respiratory tract disease risk was lowered by 34.7%, and severe lower respiratory tract disease risk was reduced by 91.1% within 90 days after birth when compared to those who received the placebo.
Dr. Patricia Faraz, a board-certified OB/GYN at The Womens Hospital at MemorialCare Saddleback Medical Center in Laguna Hills, CA, told MNT the advantage of taking the vaccine during pregnancy allows a baby to be born with immunity and immediate protection, as long as the mom received a vaccine for greater than 14 days before the baby is born.
Basically by giving it to the mom, youre reducing one less vaccine that the baby needs to receive, and they have immediate immunity at birth, Dr. Faraz added.
The FDAs approval of Abrysvo for pregnant people was based on the results of a phase 3 clinical trial evaluating the vaccines safety and effectiveness.
Potential side effects from the RSV vaccine are common and similar to other vaccines including injection site discomfort, headache, muscle pain, and nausea, Dr. Ross explained. There are no side effects to the unborn baby.
Dr. Faraz noted that so far, pregnant people under her care receiving the vaccine have only experienced minimal side effects:
The most common side effects would be pain or soreness at the injection site, and then other common side effects that have been reported are headaches, nausea, and muscle pain. Honestly, within my group of patients, I havent heard anybody complain about anything yet so far its been well tolerated.
There may be some instances in which a pregnant individual would not be able to receive the RSV vaccine.
For example, according to the CDC, the RSV vaccine should not be given to pregnant people who are less than 32 weeks pregnant. The FDA has this stipulation marked as a warning on the prescribing information for Abrysvo.
Early in the pregnancy before week 32, (the) RSV vaccine is not recommended as there are reports of preterm delivery, Dr. Liu explained.
A pregnant woman may be unable to receive the RSV vaccine if she has a history of severe allergic reaction to any component of the vaccine, Ecby added.
If a pregnant person is unable to get the RSV vaccine during pregnancy, Dr. Ross said the individual would be a perfect candidate to receive nirservimab, which gives RSV antibodies directly to the baby after birth to protect against RSV infections:
Nirsevimab gives RSV antibodies directly to the baby after birth, adding longer protection than the 6 months that the RSV vaccine affords a newborn. One disadvantage of nirsevimab is it may be harder to get, especially during the high-risk seasons of fall and winter.
Dr. Faraz said monoclonal antibodies can also be given to babies if they are born earlier than the two weeks needed for the vaccine to provide immunity:
In a case where the baby was born, like lets say a week after the mom was given the vaccine, that baby may still be a candidate to receive monoclonal antibodies after birth. This is (also) an option if you have a baby who was born with a cardiac defect. Even if the mom has been vaccinated, you could still administer the antibodies to the baby for added protection or a baby that severely immunocompromised.
Overall, all medical experts MNT spoke with agree that if a pregnant individual is able to take the RSV vaccine, they should.
RSV is an infection that for years we know is a risk to small babies and infants, Dr. Faraz said. Their immunity is weak and RSV is super common, especially when there are multiple children in the household its just going to be so easy for that baby to get exposed.
Getting the RSV vaccine, between 32 and 36 weeks of pregnancy, is another way to ensure healthcare providers and pregnant women have done everything to give a baby the healthiest start in life, right out of the gate, Dr. Ross added.
There are no protective vaccines against RSV for babies as their immune systems are not mature, Dr. Liu commented. RSV seasons are unpredictable and can be severe regionally. RSV can be a serious infection for babies and taking the RSV vaccine can protect the baby.
If you meet the criteria for the vaccine, give your unborn child a fighting chance to be healthy during RSV season, Dr. Ecby concluded.
By Amy Maxmen January 29, 2024
Rates of routine childhood vaccination hit a 10-year low in 2023. That, according to the Centers for Disease Control and Prevention, puts about 250,000 kindergartners at risk for measles, which often leads to hospitalization and can cause death. In recent weeks, an infant and two young children have been hospitalized amid an ongoing measles outbreak in Philadelphia that spread to a day care center.
Its a dangerous shift driven by a critical mass of people who now reject decades of science backing the safety and effectiveness of childhood vaccines. State by state, theyve persuaded legislators and courts to more easily allow children to enter kindergarten without vaccines, citing religious, spiritual, or philosophical beliefs.
Growing vaccine hesitancy is just a small part of a broader rejection of scientific expertise that could have consequences ranging from disease outbreaks to reduced funding for research that leads to new treatments. The term infodemic implies random junk, but thats wrong, said Peter Hotez, a vaccine researcher at Baylor College of Medicine in Texas. This is an organized political movement, and the health and science sectors dont know what to do.
Changing views among Republicans have steered the relaxation of childhood vaccine requirements, according to the Pew Research Center. Whereas nearly 80% of Republicans supported the rules in 2019, fewer than 60% do today. Democrats have held steady, with about 85% supporting. Mississippi, which once boasted the nations highest rates of childhood vaccination, began allowing religious exemptions last summer. Another leader in vaccination, West Virginia, is moving to do the same.
An anti-science movement picked up pace as Republican and Democratic perspectives on science diverged during the pandemic. Whereas 70% of Republicans said that science has a mostly positive impact on society in 2019, less than half felt that way in a November poll from Pew. With presidential candidates lending airtime to anti-vaccine messages and members of Congress maligning scientists and pandemic-era public health policies, the partisan rift will likely widen in the run-up to Novembers elections.
Dorit Reiss, a vaccine policy researcher at the University of California Law San Francisco, draws parallels between todays backlash against public health and the early days of climate change denial. Both issues progressed from nonpartisan, fringe movements to the mainstream once they appealed to conservatives and libertarians, who traditionally seek to limit government regulation. Even if people werent anti-vaccine to start with, Reiss said, they move that way when the argument fits.
Even certain actors are the same. In the late 90s and early 2000s, a libertarian think tank, the American Institute for Economic Research, undermined climate scientists with reports that questioned global warming. The same institute issued a statement early in the pandemic, grandly called the Great Barrington Declaration. It argued against measures to curb the disease and advised everyone except the most vulnerable to go about their lives as usual, regardless of the risk of infection. Tedros Adhanom Ghebreyesus, director-general of the World Health Organization, warned that such an approach would overwhelm health systems and put millions more at risk of disability and death from covid. Allowing a dangerous virus that we dont fully understand to run free is simply unethical, he said.
Another group, the National Federation of Independent Business, has fought regulatory measures to curb climate change for over a decade. It moved on to vaccines in 2022 when it won a Supreme Court case that overturned a government effort to temporarily require employers to mandate that workers either be vaccinated against covid or wear a face mask and test on a regular basis. Around 1,000 to 3,000 covid deaths would have been averted in 2022 had the court upheld the rule, one study estimates.
Politically charged pushback may become better funded and more organized if public health becomes a political flashpoint in the lead-up to the presidential election. In the first few days of 2024, Floridas surgeon general, appointed by Republican presidential candidate and Florida Gov. Ron DeSantis, called for a halt to use of mRNA covid vaccines as he echoed DeSantis incorrect statement that the shots have not been proven to be safe and effective. And vaccine skeptic Robert F. Kennedy Jr., who is running for president as an independent, announced that his campaign communications would be led by Del Bigtree, the executive director of one of the most well-heeled anti-vaccine organizations in the nation and host of a conspiratorial talk show. Bigtree posted a letter on the day of the announcement rife with misinformation, such as a baseless rumor that covid vaccines make people more prone to infection. He and Kennedy frequently pair health misinformation with terms that appeal to anti-government ideologies like medical freedom and religious freedom.
A product of a Democratic dynasty, Kennedys appeal appears to be stronger among Republicans, a Politico analysis found. DeSantis said he would consider nominating Kennedy to run the FDA, which approves drugs and vaccines, or the CDC, which advises on vaccines and other public health measures. Another Republican candidate for president, Vivek Ramaswamy, vowed to gut the CDC should he win.
Todays anti-science movement found its footing in the months before the 2020 elections, as primarily Republican politicians rallied support from constituents who resented pandemic measures like masking and the closure of businesses, churches, and schools. Then-President Donald Trump, for example, mocked Joe Biden for wearing a mask at the presidential debate in September 2020. Democrats fueled the politicization of public health, too, by blaming Republican leaders for the countrys soaring death rates, rather than decrying systemic issues that rendered the U.S. vulnerable, such as underfunded health departments and severe economic inequality that put some groups at far higher risk than others. Just before Election Day, a Democratic-led congressional subcommittee released a report that called the Trump administrations pandemic response among the worst failures of leadership in American history.
Republicans launched a subcommittee investigation into the pandemic that sharply criticizes scientific institutions and scientists once seen as nonpartisan. On Jan. 8 and 9, the group questioned Anthony Fauci, a leading infectious disease researcher who has advised both Republican and Democratic presidents. Without evidence, committee member Marjorie Taylor Greene (R-Ga.) accused Fauci of supporting research that created the coronavirus in order to push vaccines: He belongs in jail for that, Greene, a vaccine skeptic, said. This is like a, more of an evil version of science.
Taking a cue from environmental advocacy groups that have tried to fight strategic and monied efforts to block energy regulations, Hotez and other researchers say public health needs supporters knowledgeable in legal and political arenas. Such groups might combat policies that limit public health power, advise lawmakers, and provide legal counsel to scientists who are harassed or called before Congress in politically charged hearings. Other initiatives aim to present the scientific consensus clearly to avoid both-sidesism, in which the media presents opposing viewpoints as equal when, in fact, the majority of researchers and bulk of evidence point in one direction. Oil and tobacco companies used this tactic effectively to seed doubt about the science linking their industries to harm.
Kathleen Hall Jamieson, director of the Annenberg Public Policy Center at the University of Pennsylvania, said the scientific community must improve its communication. Expertise, alone, is insufficient when people mistrust the experts motives. Indeed, nearly 40% of Republicans report little to no confidence in scientists to act in the publics best interest.
In a study published last year, Jamieson and colleagues identified attributes the public values beyond expertise, including transparency about unknowns and self-correction. Researchers might have better managed expectations around covid vaccines, for example, by emphasizing that the protection conferred by most vaccines is less than 100% and wanes over time, requiring additional shots, Jamieson said. And when the initial covid vaccine trials demonstrated that the shots drastically curbed hospitalization and death but revealed little about infections, public health officials might have been more open about their uncertainty.
As a result, many people felt betrayed when covid vaccines only moderately reduced the risk of infection. We were promised that the vaccine would stop transmission, only to find out that wasnt completely true, and America noticed, said Rep. Brad Wenstrup (R-Ohio), chair of the Republican-led coronavirus subcommittee, at a July hearing.
Jamieson also advises repetition. Its a technique expertly deployed by those who promote misinformation, which perhaps explains why the number of people who believe the anti-parasitic drug ivermectin treats covid more than doubled over the past two years despite persistent evidence to the contrary. In November, the drug got another shoutout at a hearing where congressional Republicans alleged that the Biden administration and science agencies had censored public health information.
Hotez, author of a new book on the rise of the anti-science movement, fears the worst. Mistrust in science is going to accelerate, he said.
And traditional efforts to combat misinformation, such as debunking, may prove ineffective.
Its very problematic, Jamieson said, when the sources we turn to for corrective knowledge have been discredited.
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UK measles outbreak reveals need to boost child vaccine uptake
Outline the factors that have led to a fall in the uptake of the measles vaccine
Examine how the UKs rate of measles infections compares to other European countries
Lower uptake of the measles vaccine is driven by issues of access not vaccine hesitancy. Discuss
Alasdair Monteith, Gordonstoun
The Centers for Disease Control and Prevention is urging health care providers to be on alert for patients with symptoms of measles a virus declared eliminated in the U.S. in 2000 after nearly two dozen cases have been reported across the country in the past month.
Between Dec. 1 and Jan. 23, the CDC has been notified of 23 measles cases, including seven direct importations by international travelers and two outbreaks with more than five cases each, according to a letter the federal agency sent to clinicians last week.
Most of the cases were among children and teenagers who had not been vaccinated against the virus, and nine of them were reported by the health department in Philadelphia a city a two-hour drive from Baltimore. Additionally, the Virginia Department of Health notified people earlier this month that they may have been exposed to measles if they were at Dulles International Airport on Jan. 3 or at Ronald Reagan Washington National Airport on Jan. 4.
The outbreak may be scary, said Dr. Theresa Nguyen chair of pediatrics at the Greater Baltimore Medical Center in Towson but its important for parents not to panic.
Instead, she said, the message is, Get your children vaccinated.
The measles vaccine used today which also protects people against mumps and rubella was approved by the Food and Drug Administration more than 50 years ago. But the nationwide MMR vaccination rate has fallen by two percentage points over the past two school years, after sitting firmly at 95% for 10 years. In Maryland, the child vaccine exemption rate increased by 0.4 percentage points from the 2021-22 school year to the 2022-23 school year.
Measles, a very contagious, viral illness characterized by a cough, runny nose and pinkeye, hasnt been endemic in the U.S. in more than 20 years. But in 1998, the progress made in convincing parents to vaccinate their children was jeopardized by the publication of a flimsy study that suggested getting the MMR vaccine may predispose a child to developing autism.
The journal that published the study has since retracted it, and Andrew Wakefield the papers lead author is now barred from practicing as a physician in the United Kingdom. But the vaccine hesitancy seeded by his research persists today, Nguyen said. And since the coronavirus pandemic, vaccine hesitancy has only grown, she added.
Nguyen recently sent a letter of her own to GBMCs pediatricians, asking them to be aware of the increase in cases and to add measles to the list of viruses that may explain a childs fever or cough.
It also needs to be easy for families to vaccinate their children, said Dr. Esther Liu, chair of the department of pediatrics at the University of Maryland Baltimore Washington Medical Center in Glen Burnie.
The hospitals community outreach program is working with a local elementary school to help parents ensure that their children are caught up on their vaccines before an outbreak begins, Liu said.
The CDC recommends that all children get two doses of MMR vaccine. Children should receive the first dose when theyre 12 to 15 months old and the second dose when theyre 4 to 6 years old.
However, Liu said, its important for parents to know that their child can be vaccinated when theyre as early as 6 months old if they are planning to travel to a country where measles is common, their child has been exposed to the virus, or there is an outbreak nearby.
For parents who are nervous about vaccines, Liu recommended that they check out healthychildren.org a parenting website run by the American Academy of Pediatrics. The website has easy-to-understand and well-researched articles about a number of topics, including the risks and benefits of vaccines.
Despite the recent measles outbreaks, the virus is much less common than it once was. Between 1989 and 1991, outbreaks many of them clustered in areas where immunization rates were low sickened more than 55,000 Americans and killed 123.
For comparison, between 2022 and 2023, 179 cases were reported to the CDC. Nguyen may have seen people with measles when she was a young child living in Vietnam, she said, but she certainly hasnt seen any patients with the virus since she became a physician.
But the success of vaccines considered to be one of the greatest public health advancements in history can have some ironic consequences, Liu said.
As parents, we want to protect our kids. Thats a very natural response, she said. Because we dont see the devastation of these actual illnesses because we have better control in this country, I think its easier to fear the vaccine more than the illnesses.
I really tell parents, she continued, Make sure you understand what it is that were trying to protect your child from.
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After routine childhood vaccinations fell during the pandemic, public health officials across the country are working to get Canadian students back up to date on immunizations for serious yet preventable diseases.
In southwestern Ontario's Waterloo region alone, public health officials said they s ent letters to the families of 32,000 elementary and secondary school students, about a third ofpupils in the region's public and Catholic schools,notifying them that they are at risk of suspension over incomplete immunization recordsfor preventable diseases like measles, chickenpox and whooping cough.
When public health staffintroducedCOVID-19 testing and vaccinations during the pandemic in 2020, routine immunization programs for students across the country fell behind, according to a 2021 study. As well, 19 to Zero, anot-for-profit coalition of medical and public health experts that facilitates vaccination, conducted a national surveyin fall 2021thatpointed to 300,000 children who missed or delayed routine immunizations.
When large numbers of kids are missingthe protection vaccination provides, the outcome can be deadly, public health experts say.
Shannon MacDonald, an associate professor of nursing at the University of Alberta in Edmonton, co-authored the 2021 study as part of her research into supporting immunization best practices.
Meningococcal infection is one example of a disease that is preventable through routine vaccinations. MacDonald called meningococcus a disease that can kill children, youth and young adults.
MacDonald and her team found immunizationamong adolescentsin Alberta for meningococcal coveragefell from nearly 87 per centin the 2017-18 school year to about 55 per cent at the height of pandemic school closures in 2020-21.
MacDonald says thatsince schools are places where kids gather for much of the day, it's critical that public health knows who is and isn't vaccinated in case of an outbreak. That's when it's common practice for provinces and territories to keep vulnerable, unvaccinated students out of school.
"If you have low vaccine coverage in a school setting, all it really takes is one case of meningococcus or measles into a school setting and you potentially have an outbreak situation."
Ideally, MacDonald says, if a case appears in aschool, it doesn't spread because a substantial portion of studentsareprotected through vaccination coverage.
Bacteria that cause meningococcal disease are spread through direct contact with secretions from the nose and mouth. Symptomscan include fever, intense headache, nausea and often vomiting, stiff neck and a purplish,pinpoint rash. In rare cases it can lead tobrain or blood infections andresult incomplications like hearing loss, brain damage and loss of limbs.
David Aoki, director of infectious diseases and chief nursing officer for Region of Waterloo Public Health, attributes the high number of students with out-of-date immunization recordsto apause in vaccinations due to the COVID-19 pandemic. He says this led to more students starting elementary school needing vaccines they previously would have receivedbefore starting school.
"We are trying to play catch up," Aoki said.
In Alberta, there was initially a drop in coverage for infant vaccines that rebounded by fall 2020. But that wasn't the case for older children, particularly for immunizations that require more than one dose, saidMacDonald, the U of Anursing professor.
Depending on the province, students are typically supposed to receive two doses of HPV vaccines starting in Grade 6 or 7,one in the fall and one in the spring.
"HPV vaccine coverage in the first year of the pandemic plummeted to about five per cent of kids getting two doses of the vaccine instead of what we typically see, which is around 70 per cent of kids," MacDonald said of Alberta's coverage.
The rates fell for both HPVvaccine doses, according to Alberta's immmunization dashboard.
In Ontario and New Brunswick, immunizations are required to attend school, unless families receive an exemption. Since vaccination schedules and rules on immunizations that are needed to attend school differfrom province to province,it's difficult to compare rates.
There is no national vaccine registry. How vaccinations are rolled out is also different depending on the province. Alberta and Quebec, for instance, run largely school-based programs, whereas Ontario takes a more mixed approach, providing some vaccines through school programswhile others are delivered atphysicianoffices or bypublic health.
Epidemiologist Marilou Kiely of Quebec's public health institute called school-based programs an efficient and equitable way to reach children and teens with vaccinations.
Quebec's public health nurses conducted catch-up vaccination clinicsduring the summer and vaccination coverage largely recovered, shesaid.
"In 2021, we have seen that the general attitudes regarding vaccination were the same that we had in previous surveys," Kiely said.
She noted thatQuebec continues tomonitor the impact of the pandemic on vaccination coverage, including hesitancy.
In order to attend school in Ontario, students must be immunized against nine illnesses unless they have a valid exemption:
New Brunswick also requires students to have the same nine immunizations to attend school unless they have an exemption.
WATCH | The race to vaccinate against polio after New York outbreak:
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Receiving a notice from a local public health unit doesn't always mean the student hasn't been vaccinated, Aoki said, notingit could just be that theirrecords aren't up to date, for instance if they wereimmunizedby a family physician and didn't report it to public health.
Many parents may not realize they haveto send theirchild'supdated vaccination status to public health, a spokesperson for Windsor's public health unit said.
"We don't want to suspend," Aoki said, which is why parents are given months to get their children immunized and update their records. "We do this process to ensure safety."
WATCH | Thousands of Ont. students behind in vaccinations:
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Amina Zafar covers medical sciences and health topics, including infectious diseases, for CBC News. She holds an undergraduate degree in environmental science and a master's in journalism.
NEW YORK -- The recent measles outbreak in Philadelphia is raising concerns about a similar situation happening here.
Our CBS News Innovation Lab has found measles vaccination rates aren't quite where they need to be across the country.
From Philadelphia to New Jersey, cases of measles are being reported, prompting concern among health experts nationwide.
"I think it's very alarming that these diseases we used to know are now coming back at a time when we actually have very effective vaccines against them," Dr. Wafaa El-Sadr said.
El-Sadr, a professor of epidemiology and medicine at Columbia Public Health, is an internationally renowned expert on infection disease and a professor at Columbia University. She remembers life before vaccines stopped the spread of dozens of deadly diseases.
"I've had people in my own family who've had polio, people in my own family with diphtheria and measles. So I have a personal experience with the devastation of these diseases. So it's ironic to me that now we have these vaccines, and we remain hesitant to take advantage of them," El-Sadr said.
She said vaccine hesitancy, often fueled by misinformation on social media and a widening distrust of medical experts post-pandemic, is becoming an epidemic of its own.
"Side effects of vaccines, do they work, do they not work. I think this vaccine hesitancy is alarming because it tells me if we don't address this hesitancy we're going to see more and more of these outbreaks in the future," El-Sadr said.
The question is: How?
"It's not just about going into a community with low vaccination rates and saying 'Go get vaccinated.' It's about saying 'What's important to you?'" New York City Health Commissioner Dr. Ashwin Vasan said. "And then we can talk about how vaccination and childhood vaccinations are a foundational element of building health for our children."
Vaccination data analyzed by the CBS News Innovation Lab shows New York state has 98% MMR vaccination rate.
In Connecticut, the rate is 95.7%
In New Jersey, where health officials have documented a single case of measles, that number is 94%, which is just 1% below the rate needed for herd immunity. That's when a large portion of a community becomes immune to a disease, typically through vaccines. If enough people are resistant to the cause of the disease, it has nowhere to go.
"We all take actions to help prevent the spread of disease. So we want to ensure people who might have been in contact with that case have been vaccinated," New Jersey State Epedimiologist Tina Tan said.
Preventing the spread is essential, because measles is highly contagious.
According to the Centers for Disease Control and Prevention, if one person has measles, up to 90% of people close to that person who are not immune will also become infected.
"We want to be able to protect not only ourselves, but also our community at large," Tan said.
Health officials say the goal is complete immunity, meaning a 100% vaccination rate among children and adults, to ensure the diseases of our past stay there.
When we say 98% of people are vaccinated against measles, that might seem high, but even a fraction of a percentage point fewer people vaccinated can change what's known as herd immunity. Steven Stock will have more about that in a special report airing Tuesday.
Jessica Moore is an Emmy Award-winning anchor for the weekend evening newscasts on CBS 2 and WLNY 10/55. Moore joined the stations in July, 2016.
The United Kingdom is facing a measles outbreak, while cases have also popped up in a few U.S. states in recent weeks, leading to health authorities on both sides of the pond to issue urgent warnings.
The virus, which was declared eliminated in the U.S. in 2000, is a wake-up call for the importance of vaccination to personal and public health. The U.K. only recently reachieved measles elimination status in 2021 after having lost the distinction in 2018.
Unlike COVID-19 vaccines, which help prevent serious illness but don’t prevent infection, the measles vaccine is almost 100 percent effective in preventing infection. And almost everyone who has been recently infected in the U.K. and U.S. is not vaccinated against measles.
The Centers for Disease Control and Prevention (CDC) on Thursday advised health care providers to be alert for potential measles symptoms, which include a rash; cough; sore or swollen eyes; and flu-like symptoms. Providers should also be aware of patients who have recently traveled abroad.
“Measles cases often originate from unvaccinated or undervaccinated U.S. residents who travel internationally and then transmit the disease to people who are not vaccinated against measles,” the CDC’s alert stated.
“The increased number of measles importations seen in recent weeks is reflective of a rise in global measles cases and a growing global threat from the disease.”
(Precision Vaccinations News)
According to the U.S. CDC Yellow Book 2024, an internationaltraveler's risk for acquiring Yellow Fevervirus is determined by their immunization status and destination-specific and travel-associated factors.
Since about thirty countries require proof of a pre-arrival yellow fever vaccination, many travelers have questions about the vaccine's long-termefficacy.
On January 22, 2024, the Lancet Global Health recently published results from a systematic review aimed at assessing the necessity of a booster vaccination based on the long-term (10+years) immunogenicity of primary yellow fever vaccination in travelers and in residents of yellow fever-endemic areas, as well as in specific populations, including children and immunocompromised individuals.
The gathered evidence suggestedthat a single dose of yellow fever vaccineprovides lifelong protection (overall seroprotection rate 94%) in travelers.
However, in people living with HIV and young children (<2 years), booster doses might still be required because lower proportions of vaccinees were seroprotected tenor more years post-vaccination.
The pooled seroprotection rate was 47% in children and 61% in people living with HIV.
Lower observed seroprotection rates among residents of yellow fever endemic areas were partly explained by the use of a higher cutoff for seroprotection that was applied in Brazil. No conclusions could be drawn for the sub-Saharan Africaregion.
The CDC says most people infected with yellow feverdo not get sick or have only mild symptoms. People who get sick will start havingsymptoms36 days afterinfection.
According to the CDC, about 12% of people with symptoms develop serious illnesses.
The study was registered with PROSPERO, CRD42023384087. No industry conflicts of interest were disclosed.
HUNDREDS of children in the UK could die of a brain-swelling measles complication if the current outbreak is not taken more seriously, an expert has warned.
Professor Tom Solomon, chair of Neurology at the University of Liverpool and director of The Pandemic Institute, has said thatunless more kids are vaccinatedagainst measles, up to 1,500 could lose their lives to encephalitis.
He said: "It is a tragedy that in 2024, we have measles in the UK.
"Inevitably, there will be children who develop measles encephalitis and are at risk of death or brain damage.
"This disease is completely preventable by vaccination.
"We must do everything we can to get people vaccinated."
Some 1,603 measles cases were reported in England and Wales in 2023, compared with 735cases in 2022 and 360 in 2021.
Meanwhile, NHS figures show more than 3.4million children under the age of 16 are unprotected againstmeasles, meaning they are at high risk of catching the bug and developing serious complications.
"This [low vaccine uptake] could result in 10,000 cases of encephalitis, potentially causing 1,500 early deaths," the professor told The Sun.
Encephalitis is a rare complication of measles that happens when the virus "enters the brain".
"The body tries to fight this infection, and there is inflammation and swelling; this is called encephalitis," Prof Tom added.
Typical encephalitis symptoms include confusion and seizures. These usually come on when the classic measles rash emerges.
Gemma Larkman-Jones, from South London, shared how herlittle boy Samuel passed away aged sixfrom a rare and slow-progressing form of encephalitis calledsubacute sclerosing panencephalitis(SSPE) thatstrikessufferers years after they were first infected with measles.
Up to three children out of every 1,000 who get measles will develop encephalitis - and up to 15 per cent of those will die.
For those who survive, up to a quarter (25 per cent) will be left with permanent brain damage.
And one in 25,000 children with measles will develop SSPE, which almost always leads to death.
Encephalitis can occur in children either during or after a measles infection
It usually comes on during the rash phase of measles or several years later in the form of subacute sclerosing panencephalitis (SSPE).
Symptoms include:
It's important to act fast if your symptoms become more serious.
You should dial 999 immediately to request an ambulance if you or a loved one has symptoms (even if they don't also have measles).
For more information on Encephalitis, go to theEncephalitis Internationalwebsite.
Source: NHS
Whilemeaslesusually triggers cold-like symptoms,other complications include blindness,pneumonia and meningitis.
The bug has no specific treatment, but it can be prevented with themeasles, mumps and rubella (MMR) jab.
Unvaccinatedchildrenwho come into contact with measles are currently being advised to stay at home for 21 days.
This is because measles is very contagious, with a patient typically passing the viral infection on to 20 others.
Many people have forgotten how serious measles can be"
It can spread to others through coughing and sneezing or touching contaminated surfaces.
To keep measles at bay, 95 per cent of children must be vaccinated.
But recent NHS data shows only 84.5 per cent of childrenin England had received the second MMR dose by their fifth birthday.
Coverage in London is particularly low, at just 73 per cent, with Hackney in east London at 56.3 per cent, followed by Camden in north London at 63.6 per cent.
Urgent, "concerted action" is needed to tackle the virus to stop its spread, according to health specialists and the UK Health Security Agency (UKHSA).
Earlier this month, Birmingham Childrens Hospital reported being inundatedwith the mostmeaslescases it had seen in decades.
Professor Helen Bedford, an expert in child public health at University College London, previously told The Sun, people "had forgotten how serious this disease [measles] can be because they've never seen them".
In 2017, the UK was declared measles-free after vaccination rates hit the 95 per cent threshold.
But, the country lost that status in 2018 after a drop in vaccination rates led to a resurgence of the virus across Europe.
Tens of thousands of children missed out on the MMR vaccine in the 1990s because of the now-debunked autism fearsraised by discredited medic Andrew Wakefield.
Kids are offered their first dose at age one and their second at three years at four months, just before they start school.
However, if they, or any one else, has missed any jabs, they can catch up at any time through their GP surgery.
If you don't know if you or your child isn't up to date with their jabs, call your GP for an appointment.
MEASLES is highly contagious and can cause serious problems in some people.
The infection usually starts with cold-like symptoms, followed by a rash a few days later. Some people may also get small spots in their mouth.
The first signs include:
Small white spots may then appear inside the cheeks and on the back of the lips a few days later.
A rash tends to come next. This usually starts on the face and behind the ears before spreading to the rest of the body.
The spots are sometimes raised and join together to form blotchy patches. They are not normally itchy.
The rash looks brown or red or white skin. It may be harder to see on darker skin.
Source:NHS
