Set aside for a moment the public-health danger posed by the return of measles, and focus on people, because that is where the problem lies. Declared eliminated in the United States in 2000, measles is having outbreaks in six locations; this year already marks the second-highest case count in two decades. That’s because some people made a decision to not get vaccinated or to not vaccinate their children. It was a negligent decision, and in many cases also an inexcusably ignorant one, that endangered neighbors and strangers alike in quotidian public spaces — schools, stores and airports.
Preventing the spread of measles requires about 95 percent of a population to be properly vaccinated with the measles vaccine, usually starting with the first dose at 12 months through 15 months of age, and the second dose at 4 through 6 years old. The vaccine has proved safe and highly effective. But when pools of people neglect to get immunized or don’t stay up to date, they become vulnerable. According to public-health officials, measles is one of the most contagious viruses on Earth; you can catch it just by being in a room where a person with measles has been, up to two hours later. One alert that just went out in Rockland County, New York, listed an Uber car, two taxis and a supermarket as potential exposure sites.
The outbreak in Rockland County was first met with an executive order barring unvaccinated children from schools, then when the outbreak progressed, it was followed by a state of emergency that bars children and teenagers who are not vaccinated from public places.This measure, which has been temporarily blocked by a local judge, is drastic but arguably necessary. As of Wednesday, there were 161 confirmed cases, and 83.2% of them were unvaccinated individuals. This single outbreak is larger than the total number of cases that occurred in the United States in 2017. The total U.S. case count so far this year, 387, has surpassed last year’s nationwide total of 372.
In many cases, measles outbreaks are traced to travelers from elsewhere in the world where the disease is still endemic. In 2018, three outbreaks in New York state, New York City and New Jersey happened largely in unvaccinated Orthodox Jewish communities, triggered at first by travelers who brought measles back from Israel, where a large outbreak has been underway. Orthodox Jewish leaders said there was no religious edict against vaccination but that some people in the community may have become susceptible to anti-vaccination hysteria that has cropped up elsewhere, based on unfounded fears that vaccines cause autism.
This phenomenon, which the World Health Organization has called “vaccine hesitancy” and listed as one of the 10 major threats to global public health, thrives on suspicion, distrust of government and misinformation. The best antidote is to broadcast far and wide the wisdom of vaccination, to protect not only oneself — but also everyone else.