PUBLIC HEALTHQ&A: Measles May Be Making a Comeback in the U.S.
Childhood vaccination rates have been falling in the United States, and as expected, lower levels of immunity have resulted in a resurgence of measles cases, including a recent outbreak in western Texas. If immunization rates drop further, measles and even other wiped-out diseases—such as rubella and polio—could make a comeback in the United States.
Childhood vaccination rates have been falling in the United States, especially since the start of the COVID-19 pandemic. Lower levels of immunity have resulted in a resurgence of measles cases, including a recent outbreak in western Texas that infected more than 620 people, leading to 64 hospitalizations and the deaths of two children.
If immunization rates drop further over a prolonged period of time, measles and even other wiped-out diseases—such as rubella and polio—could one day make a comeback in the United States, according to a new study by researchers at Stanford Medicine and other universities.
The study, which was published in JAMA, used large-scale epidemiological modeling to simulate the spread of infectious diseases in the United States at various childhood vaccination levels.
Even at current immunization rates, researchers predict that measles may become endemic again—circulating in the U.S.—within two decades; with small declines in vaccination, this could happen more quickly. However, small increases in vaccine coverage would prevent this.
Lead author Mathew Kiang, ScD, assistant professor of epidemiology and population health, and senior author Nathan Lo, MD, Ph.D., assistant professor of infectious diseases, hope the study will provide useful data for decision makers setting vaccine policy.
Stanford Reportspoke with Kiang and Lo to learn more.
Why did you think this research was important?
Nathan Lo: We’ve seen a worrisome pattern of decreasing routine childhood vaccinations. There was a disruption to health care services during the pandemic, but declines preceded this period and have accelerated since then for many reasons. People look around and say, “We don’t see these diseases.
Why should we vaccinate against them?” There’s a general fatigue with vaccines. And there’s distrust and misinformation about vaccine effectiveness and safety.
Mathew Kiang: As vaccinations decline, the effect won’t be immediate. We wanted to know: when will we see the impact of decisions being debated and made now?
Lo: Specifically, we wanted to look at some key diseases that have been eliminated from the U.S. through vaccination, which means they’re not spreading within the country on an ongoing basis. These include measles, polio, rubella and diphtheria, which can have awful complications, like lifelong paralysis, birth defects and death.
