Vaccine misinformation abounds as measles spreads; 1 in 10 cases lead to infections that can cause learing loss

Photo from iStock/Getty Images Plus via KFF Health News

By Amy Maxmen and Céline Gounder
KFF Health News

Measles is on the rise in the United States. In the first quarter of this year, the number of cases was about 17 times what it was, on average, during the same period in each of the four years before, according to the Centers for Disease Control and Prevention. Half of the people infected — mainly children — have been hospitalized.

It’s going to get worse, largely because a growing number of parents are deciding not to get their children vaccinated against measles as well as diseases like polio and pertussis. Unvaccinated people, or those whose immunization status is unknown, account for 80% of the measles cases this year. Many parents have been influenced by a flood of misinformation spouted by politicians, podcast hosts, and influential figures on television and social media. These personalities repeat decades-old notions that erode confidence in the established science backing routine childhood vaccines. KFF Health News examined the rhetoric and explains why it’s misguided:

The "No-Big-Deal" trope: A common distortion is that vaccines aren’t necessary because the diseases they prevent are not very dangerous, or too rare to be of concern. Cynics accuse public-health officials and the news media of fear-mongering about measles even as 19 states report cases.

For example, an article posted on the website of the National Vaccine Information Center — a regular source of vaccine misinformation — argued that a resurgence in concern about the disease “is ‘sky is falling’ hype.” It went on to call measles, mumps, chicken pox, and influenza “politically incorrect to get.”

Measles kills roughly 2 of every 1,000 children infected, according to the CDC. If that seems like a bearable risk, it’s worth pointing out that a far larger portion of children with measles will require hospitalization for pneumonia and other serious complications. For every 10 measles cases, one child with the disease develops an ear infection that can lead to permanent hearing loss. Another strange effect is that the measles virus can destroy a person’s existing immunity, meaning they’ll have a harder time recovering from influenza and other common ailments.

Measles vaccines have averted the deaths of about 94 million people, mainly children, over the past 50 years, according to an April analysis led by the World Health Organization. Together with immunizations against polio and other diseases, vaccines have saved an estimated 154 million lives globally.

Some skeptics argue that vaccine-preventable diseases are no longer a threat because they’ve become relatively rare in the U.S. That is true, due to vaccination, but this reasoning led Florida’s surgeon general, Joseph Ladapo, to tell parents that they could send their unvaccinated children to school amid a measles outbreak in February. “You look at the headlines and you’d think the sky was falling,” Ladapo said on a News Nation newscast. “There’s a lot of immunity.”

As this lax attitude persuades parents to decline vaccination, the protective group immunity will drop, and outbreaks will grow larger and faster. A rapid measles outbreak hit an undervaccinated population in Samoa in 2019, killing 83 people within four months. A chronic lack of measles vaccination in the Democratic Republic of the Congo led to more than 5,600 people dying from the disease in massive outbreaks last year.

The ‘You Never Know’ trope: Since the earliest days of vaccines, a segment of the public has considered them bad because they’re unnatural, compared to nature’s bounty of infections and plagues. “Bad” has been redefined over the decades. They blame vaccines for ailments ranging from attention-deficit/hyperactivity disorder to autism to immune system disruption. Studies don’t back the assertions.

Skeptics also argue that their claims remain valid because vaccines haven’t been adequately tested. In fact, vaccines are among the most studied medical interventions. Over the past century, massive studies and clinical trials have tested vaccines during their development and after their widespread use. More than 12,000 people took part in clinical trials of the most recent vaccine approved to prevent measles, mumps, and rubella. Such large numbers allow researchers to detect rare risks, which are a major concern because vaccines are given to millions of healthy people.

To assess long-term risks, researchers sift through reams of data for signals of harm. For example, a Danish group analyzed a database of more than 657,000 children and found that those who had been vaccinated against measles as babies were no more likely to later be diagnosed with autism than those who were not vaccinated. In another study, researchers analyzed records from 805,000 children born from 1990 through 2001 and found no evidence to back a concern that multiple vaccinations might impair children’s immune systems.

Nonetheless, people who push vaccine misinformation, like independent presidential candidate Robert F. Kennedy Jr., dismiss massive, scientifically vetted studies. For example, Kennedy argues that clinical trials of new vaccines are unreliable because vaccinated kids aren’t compared with a placebo group that gets saline solution or another substance with no effect. Instead, many modern trials compare updated vaccines with older ones, because doctors consider it unethical to keep children in danger by giving them a sham vaccine when the protective effect of immunization is known. In a 1950s clinical trial of polio vaccines, 16 children in the placebo group died of polio and 34 were paralyzed, said Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia and author of a book on the first polio vaccine.

The ‘Too-Much-Too-Soon’ trope: Several best-selling vaccine books on Amazon promote the risky idea that parents should skip or delay their children’s vaccines. Paul Thomas wrotes in The Vaccine-Friendly Plan that “All vaccines on the CDC’s schedule may not be right for all children at all times,” and says children who have followed “my protocol are among the healthiest in the world.”

Since the book was published, Thomas’ medical license has been temporarily suspended in Oregon and Washington. The Oregon Medical Board documented how Thomas persuaded parents to skip CDC-recommended vaccines, and reported that he “reduced to tears” a mother who disagreed. Several children in his care came down with pertussis (whooping cough) and rotavirus, diseases easily prevented by vaccines, the board said. Thomas recommended fish-oil supplements and homeopathy to an unvaccinated child with a deep scalp laceration, rather than an emergency tetanus vaccine. The boy developed severe tetanus, landing in the hospital for nearly two months, where he required intubation, a tracheotomy, and a feeding tube to survive.

The CDC's vaccination schedule is tailored to protect children at their most vulnerable points in life and minimize side effects. The combination measles,-mumps-rubella vaccine isn’t given for the first year of a baby’s life because antibodies temporarily passed on from their mother can interfere with the immune response. And because some babies don’t generate a strong response to that first dose, the CDC recommends a second one around the time a child enters kindergarten because measles and other viruses spread rapidly in group settings. Delaying MMR doses much longer may be unwise because data suggests that children vaccinated at 10 or older have a higher chance of adverse reactions, such as a seizure or fatigue.

About a dozen other vaccines have discrete timelines, with overlapping windows for the best response. Studies have shown that MMR vaccines may be given safely and effectively in combination with other vaccines.

They Don’t Want You to Know’ trope: Kennedy suggests that scientific institutions oppress dissenting voices on vaccines for nefarious reasons. His running mate, lawyer Nicole Shanahan, has campaigned on the idea that conversations about vaccine harms are censored and the CDC and other federal agencies hide data due to corporate influence.

Such claims aren’t new, but the anti-vax movement has long had an outsize voice. The most listened-to podcast in the U.S., “The Joe Rogan Experience,” regularly features guests who cast doubt on scientific consensus. Last year on the show, Kennedy repeated the debunked claim that vaccines cause autism.

Far from ignoring that concern, epidemiologists have taken it seriously. They have conducted more than a dozen studies searching for a link between vaccines and autism, and repeatedly found none. “We have conclusively disproven the theory that vaccines are connected to autism,” said Gideon Meyerowitz-Katz, an epidemiologist at the University of Wollongong in Australia. “So, the public-health establishment tends to shut those conversations down quickly.”

Federal agencies are transparent about reactions that vaccines can cause. And the government has a program to compensate individuals whose injuries are scientifically determined to result from them. About 1 to 3.5 out of every million doses of the measles-mumps-rubella vaccine can cause a life-threatening allergic reaction; a person’s lifetime risk of death by lightning is estimated to be as much as four times as high.

“The most convincing thing I can say is that my daughter has all her vaccines and that every pediatrician and public health person I know has vaccinated their kids,” Meyerowitz-Katz said. “No one would do that if they thought there were serious risks.”

Measles, which can lead to complications and even death, threatens to come back; vaccine is 97% protective against it

Photo by Pro-Stock Studio, iStock/Getty Images

By Dr. Nicholas Van Sickels
University of Kentucky

Over two decades ago, measles – a highly contagious and potentially deadly childhood disease – was declared eliminated in the United States. As of April 18, at least 125 measles cases have been recorded nationwide this year – more than double the amount of cases observed in all of 2023.

Measles most commonly affects unvaccinated children, and 20 to 40% of infected children require hospitalization. Ear infections, pneumonia, long-term neurologic issues and even death can occur. In general, most will recover, but some will have complications from the infection.

The sharp increase in cases is due to:

• A national and international decline in measles vaccination rates.
• International travel to areas with active outbreaks.
• The extreme contagiousness of the measles virus. On average, one infected person can infect nine to 10 other people, if unvaccinated.

Experts still consider measles to be eliminated in the U.S. but that could change if we don’t continue to take proper preventative measures. In response to the increase in cases, the Centers for Disease Control and Prevention has issued warnings to health professionals and the general public throughout the spring.

How do I protect myself from measles?

Fortunately, the best tool for preventing a measles infection is still highly effective. Measles is almost entirely preventable through vaccination. One dose of measles, mumps, and rubella (MMR) vaccine is 93% protective. Two doses – the recommended number – are 97% protective against the disease.

Because of the inherent contagiousness of measles, 95% or more of a population needs to be vaccinated for the entire population to be protected from an outbreak. Currently the U.S. has 93.1% vaccination coverage.

 
Kentucky has 91.6% coverage (of greater than one dose of MMR vaccine).

This last week of April is World Immunization Week – a good opportunity to discuss the importance of measles vaccination with family and friends, especially those who are planning to travel internationally or to parts of the U.S. where a measles outbreak is active. The latest tracking of measles cases and more information about the disease can be found on the CDC’s measles webpage.

What are the symptoms of measles?

• Measles symptoms typically include: Fevers (can be very high)
• Cough
• Runny nose
• Red eyes

After the above symptoms, the characteristic red rash appears, starting from the head and spreading downward.

People with measles are thought to be contagious from about four days prior to developing the rash to four days after the onset of the rash (with the onset being day zero).

What to do if you think you’ve been exposed: If you’re concerned you or your child have been exposed to measles, contact your health care provider immediately.

Many of us, fortunately, have never seen a case of measles in our lifetime. With a renewed focus on prevention, hopefully, we never will.

Nicholas Van Sickels, M.D., is infectious-disease specialist and director of infection prevention and control at UK HealthCare.

State's health chief urges parents to get kids vaccinated against measles, the most contagious disease, which can do great harm

By Melissa Patrick
Kentucky Health News

A highly contagious childhood disease that was declared eliminated in the United States in the year 2000 is making a comeback, largely driven by a declining vaccination rate in the country.  

"Unfortunately, as the measles vaccination rate has decreased, it's just one of those things where folks are opting out of vaccination more often, we're starting to see the increase of measles in the United States," Dr. Steven Stack, commissioner of the Kentucky Department for Public Health, said at a Feb. 29 press conference. 

In Kentucky, about 90% of the state's kindergarteners are vaccinated for measles, mumps, and rubella "and that has to be 95% or higher to stop transmission," said Stack. 

Stack spent the bulk of his time talking about a disease that he said most people in our country, including health-care providers, have never seen. Further, he said, it is a disease that is "virtually, entirely vaccine-preventable." 

"If you are vaccinated, you almost certainly will get no symptoms from measles," he said. "In fact, the vaccine is so effective, you won't get sick at all and you don't transmit the virus." 

Stack said symptoms of measles include a cough, congestion, fever that may go up to 104 degrees, and a full-body rash. The Centers for Disease Control and Prevention also mentions sore, red eyes that may be sensitive to light; watery or swollen eyes; small greyish-white spots in the mouth, and a loss of appetite. 

"You feel miserable," said Stack, adding, "In the unlucky ones, the complications are pneumonia, diarrhea, ear infections, and even sometimes brain swelling that can lead to things like seizures, developmental disabilities and other permanent brain damage."

Among the unvaccinated population, Stack said more than one in five measles victims are hospitalized and one in 20 get pneumonia, which is the most common cause of death. 

"The most common age of death is under 5,  those are the individuals hurt the most by this disease if you're unvaccinated," he said. "And for the really unlucky, one in one thousand can get a permanent brain injury from the brain swelling that I talked about." 

Dr. Steven Stack with Gov. Andy Beshear (File photo)

Because measles is a highly contagious virus that is spread through the air, with an incubation period of 10 to 12 days, it is easy to spread it unknowingly. Stack said a person is contagious for four days before the rash and four days after the rash, which is why it is recommended for anyone who has been exposed to measles or who has it to stay at home for 21 days to avoid spreading the disease. 

"Measles is probably the most contagious viral disease on planet Earth at present. The only thing that could maybe compete with it is Covid," he said. "In this room, all of us in this press conference for a period of 40 to 60 minutes, if one person had measles in this room and we were unvaccinated, nine out of 10 of us would become infected with measles in about 10 to 12 days." 

As of Feb. 29, the CDC reported there had been 41 measles cases reported in 16 states, none in Kentucky.  

"This is becoming more common and because people travel a lot and are portable in ways that weren't possible . . . in the prior century, it spreads too easily and can cause too many problems," said Stack. "Everybody please go get yourselves and your children vaccinated if you are not already vaccinated."

Florida, with its many airports and a regular vacation spot for many Kentuckians, is one of the states with a recent outbreak. Of concern to public health officials is a letter issued by the Florida State Health Department that does not urge parents of unvaccinated children at that school to get vaccinated or to quarantine. Instead, it leaves these decisions up to parents.

These recommendations go against well-established public health guidelines that call for unvaccinated people or those with no prior immunity to isolate for 21 days after exposure and for unvaccinated children to get vaccinated within 72 hours of exposure, which allows them to return to school as long as they don't develop symptoms,  Katelyn Jetelina and Dr. Kristen Panthagani, write in their Your Local Epidemiologist newsletter.

Asked about what precautions Kentuckians should take if they are traveling through the Florida airports or spending time in the state, Brice Mitchell, spokesperson for DPH said a person's level of concern should be determined by whether they are vaccinated or not.  

"If you are vaccinated for measles, there are no special precautions necessary. If you are unvaccinated for measles, the Kentucky Department for Public Health urges that you get vaccinated," he said in an email. "For further information, please review the Centers for Disease Control and Prevention guidance." 

Dr. Sean McTigue, interim chief of infectious disease at Kentucky Children's Hospital agreed.

"Anyone who is up to date with this vaccine is protected against measles infection and would not need to take any additional precautions when traveling to Florida or through Florida airports," McTigue said in an email. "If planning a trip to Florida and one or more travelers are not already up to date with MMR vaccine, then now would be an excellent time to be vaccinated." 

Two doses of measles, mumps and rubella (MMR) vaccine are recommended to children starting at 12 months. Adults can also be vaccinated. 

McTigue called this measles outbreak and others a "wake-up call" for those who are not protected and provides an opportunity for parents to protect their children against measles. 

"Because the MMR also protects against mumps and rubella, it is also an excellent way to protect against mumps which can cause testicular infection and sterility in males and against rubella which can cause severe birth defects if a pregnant woman is infected during her pregnancy," he said. 

Stack also pointed to the protections provided by the vaccine, saying in a news release, "Two doses of MMR vaccine are 97% effective at preventing measles and provides lifelong protection if exposed to the virus. Even if exposed to measles, vaccinated persons may continue routine activities.”

The CDC says that while detectable antibodies generally appear within just a few days after getting the measles vaccination, it takes about two or three weeks to be fully protected. Ideally, the CDC says a person should be fully vaccinated at least two weeks before they travel.

More information can be found in a Los Angeles Cedars-Sinai Hospital blog post, "Measles Makes a Comeback: What Parents Need to Know." It says measles cases worldwide increased 79% in 2023, according to the World Health Organization. In 2022, the WHO estimated that measles killed more than 130,000—most of them children.

“Measles is a huge concern and directly related to declining measles vaccination rates,” said Dr. Priya Soni, a pediatric infectious-disease specialist with Cedars-Sinai Guerin Children’s Hospital. “Vaccine hesitancy, fueled during the pandemic by the anti-vaccine movement, has affected vaccination rates nationwide. In addition, because children were quarantined during the pandemic, many missed out on well-child visits and didn’t catch up on their vaccines. That has meant 61 million fewer doses distributed nationwide between 2020 and 2022.”

Although the first dose of the MMR vaccine is traditionally given to infants 12-15 months of age, and the second around a child’s fifth or sixth birthday, Soni said infants as young as 6 months can receive the first vaccine if they are traveling to areas where the measles infection rate is high.

Unvaccinated attendee of big revival has state's third case of measles in 3 months; Ky. ranks very low in measles vaccinations

An unvaccinated Jessamine County resident who attended the large, spontaneous revival at Asbury University has Kentucky's third reported case of measles in three months, the state Department for Public Health said Friday.

“Anyone who attended the revival on Feb. 18 may have been exposed to measles,” Dr. Steven Stack, the state health commissioner, said in a news release. “Attendees who are unvaccinated are encouraged to quarantine for 21 days and to seek immunization with the measles vaccine, which is safe and effective.” Citing privacy, the state said nothing more about the infected person.

Stack added, “If you may have been exposed at Asbury University’s campus and develop any symptoms, whether previously vaccinated or unvaccinated, please isolate yourself from others and call your medical provider, urgent care, or emergency department to seek testing. Please do not arrive at a health-care facility without advance notice, so that others will not be exposed.”

  
Measles is one of the most contagious diseases, and spreads through the air. Early symptoms resemble those of many upper-respiratory illnesses – fever, cough, red eyes and runny nose – "and proceed to the characteristic rash three to five days after symptoms begin," the release said.

The state says it investigates all reported cases. It said the first case in the last three months was in Christian County, and it was linked to an outbreak in Ohio. The second was reported in January in Powell County, and there were no known exposures or connections to the outbreak in Ohio," the release said. "These two previous cases were thoroughly investigated and neither presented a public-health threat."

The vaccine for measles vaccine is given in combination with those for mumps and rubella ("German measles to children at 12 to 15 months of age. A second dose is usually given at 4 to 6 years old, and is required for admission to school. Two doses of the MMR vaccine are about 97% effective at preventing measles if exposed to the virus, the state says.

The state health department is working with local departments to promote MMR vaccination in communities with low vaccine rates, the release said. Recent data released by the Centers for Disease Control and Prevention shows MMR vaccine coverage among Kentucky kindergarteners is one of the nation's lowest.

The CDC reports that the rate could be as low as 86.5 percent, which could rank it sixth lowest among the states. The national average is about 93%. Kentucky's percentage is expressed as "greater than or equal to" because the state counts some or all vaccine doses that are given outside federally recommended age and time intervals, and it does not include vaccinations at certain types of facilities, which could include kindergartens in child-care facilities, online schools, correctional facilities, or military installations.

The CDC report has a graph estimating the gap between MMR vaccination rates and the potential rates in each state, based on the percentage of unvaccinated students without a documented vaccine exemption; Kentucky's gap appears to be larger than any state but Alaska (right-click to download image):

Opinion: Politicians are playing with fire when they erode support for mandatory childhood vaccinations

OPINION
By F. Douglas Scutchfield and Al Cross

Public health is the nexus of science and politics. Unfortunately, the two frequently do not mix well. A recent example involving childhood immunizations prompts real concern for the erosion of science in the name of politics.

State Sen. Ralph Alvarado, physician and lieutenant governor candidate with Gov. Matt Bevin, recently declared: “I think it’s good health policy to administer vaccines, but if people don’t want them, we shouldn’t force people to take them.” This followed the governor’s ill-advised exposure of his own children to kids with chicken pox, a practice discouraged by both public health and physician organizations.

These politicians are playing with fire. The U.S. is currently experiencing the worst measles epidemic since 1992, and nearly 80 percent of this year’s cases occurred in outbreaks in unvaccinated, close-knit communities, such as the Amish.

Many people oppose vaccination for measles, despite recommendations of the World Health Organization, the Centers for Disease Control and Prevention, and major physician and health organizations. Some of this opposition is the result of a fear of autism associated with vaccination, driven by a British physician whose paper on the topic has been retracted as fraudulent by editors of the leading British medical journal, and who has lost his medical license as the result of his claims.

Some people mistakenly think that vaccines contain mercury, but that has not been true for decades. Studies by the CDC, the National Academy of Medicine and the National Institutes of Health have demonstrated, repeatedly, the lack of any linkage between vaccines and autism.

Measles is not an innocuous disease. It can cause encephalitis, pneumonia and even death.

Immunizations protect us in two ways. They keep you from acquiring the disease, and with enough people immunized, a virus cannot spread, giving a population “herd immunity.”

One of the most effective ways to assure freedom from measles is to assure that all susceptible people are vaccinated. The major way of doing that is to require vaccination for enrollment in school, day care centers, kindergarten and summer camps.

All states have such laws, but in some, pressure from anti-vaccine groups watered them down so that parents can easily refuse immunizations for their children. Kentucky made it easier in 2017, by dropping the requirement that a physician sign the exemption form, and the immunization rate dropped below the 95 percent generally thought to guarantee herd immunity.

There are a few children who, because of some immune disease, should not receive live-virus vaccines, but these are rare cases and should be protected legally from immunization rules. Kentucky and some other states allow non-medical exemptions based on personal preference or belief. It is in such states that we are seeing epidemics in close-knit, unvaccinated populations. That has prompted several states to reexamine the vaccine exemptions and tighten them. Kentucky has moved in the opposite direction, and that trend needs to stop.

It is not in Kentuckians’ best interests to water down our immunization requirements; in fact, we should be tightening personal exemptions for vaccinations. This is the policy recommendation of public health agencies and organizations, and of physician organizations.

Comments that erode support for immunization laws that protect us from vaccine-preventable diseases are detrimental to the public’s health. That is especially true of people in public life, and health professionals who know better. Such comments from such sources erode public support for our protection from illness and death. Our political leaders’ statements and actions should be driven by evidence and science.

F. Douglas Scutchfield, M.D., is the Peter P. Bosomworth Professor Emeritus in the Department of Health Management and Policy in the University of Kentucky College of Public Health. Al Cross is a journalism professor at UK, director of its Institute for Rural Journalism and Community Issues, and editor and publisher of Kentucky Health News.

State Sen. Ralph Alvarado, Bevin's running mate and a physician, agrees with him that state shouldn't require kids to be vaccinated

State Sen. Ralph Alvarado and Gov, Matt Bevin bumped fists
as they filed in January. (Photo: Mark Mahan, Lexington Herald-Leader)

Gov. Matt Bevin's running mate for lieutenant governor told a Northern Kentucky Tea Party group June 27 that he agrees with Bevin on immunization policy, that government shouldn't require children to be vaccinated.

State Sen. Ralph Alvarado of Winchester, a physician, said “I think it’s good health policy to administer vaccines, but if people don’t want them, we shouldn’t force people to take them.”

Alvarado was recorded by American Bridge, a group supporting Democratic Attorney General Andy Beshear for governor. The group posted the recording on YouTube. A transcript of his remarks is available here.

Alvarado "was responding to a question about a student in Northern Kentucky who had been pulled out of school for refusing to get the chickenpox vaccine," reports Daniel Desrochers of the Lexington Herald-Leader. "The debate over vaccines has captured national attention as the anti-vaccine movement has contributed to a rise in measles cases in the U.S."

Alvarado said, “I think it’s a very fine balance. I don’t think we should force anybody to do something they don’t want to do to their own bodies. We are seeing outbreaks, you’re seeing measles outbreaks and other things that are happening and a lot of people forget that a lot of these diseases can be fatal.” 

Asked about “all the kids who are dying from vaccines,” Alvarado said, “Again, we could debate a lot of that. That’s been studied . . . but to your question, you should have the right to say no if you don’t want that for your kids.” Desrochers notes that the World Health Organization says “so few deaths can plausibly be attributed to vaccines that it is hard to assess the risk statistically.”

Bevin said in a radio interview in March that he had exposed his children to chicken pox to immunize them. “If you are worried about your child getting chickenpox or whatever else, vaccinate your child,” he said. “But for some people, and for some parents, for some reason they choose otherwise,” he said. “This is America. The federal government should not be forcing this upon people.”

The federal government does not force states to require vaccinations, only recommends that they do. The National Conference of State Legislatures says all 50 states have laws requiring specific vaccines for students; 47 grant religious exemptions and 18 allow philosophical exemptions.

Kentucky only allows medical and religious exemptions. In 2017 the Bevin administration made it easier for parents to invoke the religious exemption. They can now download a form, have it notarized and submit it to their school upon enrollment, instead of having to get a signed form from a health-care provider. Spectrum News reported that the number of Kentucky parents claiming the religious exemption increased 59 percent in the 2017-18 school year.

A Cabinet for Health and Family Services representative told legislators in 2017 that the changes had been in the works for several years, in response to complaints that a medical entity should not have authority over a religious exemption; that a co-payment was often required to get a provider’s signature; and that parents and guardians were having trouble finding providers to sign the forms.

Assertions that governments shouldn’t require vaccinations don’t take into account the principle of “herd immunity,” which occurs when enough people have been immunized against a disease to protect others who are not immunized. Some are not immunized because their immune systems are too weak to allow them to be vaccinated, or because they are too young to be vaccinated.

People with weakened immune systems include those with cancer, especially if they are being treated with an aggressive chemotherapy, people who have had bone-marrow transplants, people who have had an organ transplant, people with auto-immune disorders, like rheumatoid arthritis or Lupus, or people with acquired immunodeficiency syndrome, or AIDS.

“Those people are absolutely reliant upon herd immunity because we can’t immunize them,” Dr. Sean McTigue, an infectious disease specialist at the University of Kentucky, told Kentucky Health News in March. “The only way that we have to protect them is to ensure that everybody around them is immunized so that the chances of them actually coming into contact with somebody who has one of these very infectious viruses or bacteria is very, very low.”

McTigue said herd immunity is vitally important to protect babies, because they can’t be vaccinated for measles, mumps and rubella or chickenpox until they are a year old because these vaccines are made with very weak, but live viruses.

“So, every single baby less than one year old is unvaccinated and unprotected against those conditions,” McTigue said. “And the young babies who cannot yet be immunized against those conditions are exactly the patients that we worry about the most if they get those infections because they are at greatest risk of complications.”

Kentucky schools lack immunization certificates for thousands of children, worry about immuno-compromised students and staff

American Academy of Family Physicians photo

A Louisville Courier Journal analysis found that as of March, the Jefferson County Public Schools had no record of whether 4,300 students had received their shots for measles, mumps and rubella, despite a law that requires students to hand in those documents within two weeks of enrollment.

That's a story that can be told in school districts across the state.

According to the state Department of Education, in the 2017-18 school year, of the 99,113 first and sixth graders who were supposed to have immunization certificates, 7,738 of them had expired certificates, 5,993 were missing, 241 had medical exemptions and 695 had religious exemptions.

The KDE data is broken down by school and grade to show how many students have a current immunization certificate, including whether it is a provisional, standard, medical or religious certificate. The data are not broken down by type of vaccination, and current-year data aren't posted.

Jefferson County school officials told the Courier Journal that many students may have simply not turned in their immunization documents, but they worry about those who haven't been vaccinated.

"We're putting immuno-compromised children, children too young to get immunized — and pregnant teachers and pregnant moms at risk," Troi Cunningham, an immunization nurse with the state, told reporter Allison Ross about the low immunization rates in some areas.

Public health officials say about 95% of students need to be fully immunized in order to protect vulnerable kids and others who are immuno-suppressed from measles, which is highly contagious.

Jefferson County data shows that it's not just the measles, Ross reports; some schools are also missing immunization records for other diseases, like chickenpox and hepatitis A.

It's a challenge to know what to do when students don't turn in their immunization documentation, Dr. Ruth Carrico, an infectious-disease expert at the University of Louisville, told Ross.

"What do we do when a child is not vaccinated? Where do they go?"she asked. "If they get sent home, they miss out on education. If we don't send them home, they may not realize we really mean it that you need that vaccination."

Earlier this year, the Northern Kentucky Health Department barred students who had not been vaccinated against the chickenpox from attending school and all extracurricular activities at a private Catholic school because of an outbreak. One of the students sued the health department over the ban, but the courts ruled in the health department's favor.

Eva Stone, district health coordinator for JCPS, told Ross there are several obstacles to getting children immunized, including a lack of access to medical care; that very few health-care providers will give vaccines to children on Medicaid, which forces parents to take their children somewhere else, like the local health department; and that parents have told her that doctor's offices charge for copies of updated immunization records.

"This is a community issue," Stone said. "How do we make sure children have access to health care?"

Cunningham, the nurse with the health cabinet, told Ross that the state is trying to encourage pediatricians and other health-care providers to use the state's immunization registry to keep track of patients' vaccinations.

Infection-control activist calls for timely outbreak notifications, comprehensive tracking, aggressive containment and vaccines

OPINION By Dr. Kevin Kavanagh

I live in Kentucky, a state with the nation’s largest hepatitis A outbreak, an emerging measles outbreak and a governor who said he exposed his children to chickenpox rather than get them vaccinated. In the past year, two heads of infection control in Kentucky’s Department of Health have left the position. The first one was asked to leave after he expressed the need for an urgent increase in infection control funding.

Dr. Kevin Kavanagh

I am a firm believer that we must learn from history or be doomed to repeat it. Unfortunately, the United States and many other nations appear not to have learned this lesson with regard to public health and are heading down a dangerous path.

The recent book The Pandemic Century by Mark Honigsbaum examines a number of major disease outbreaks around the world and draws lessons about how some of them were mismanaged. But one can see many disturbing parallels in the handling of today’s epidemic of drug-resistant bacteria and viruses.

One of the most important is that when infections spiral out of control, governments worry too much about avoiding accountability, often downplaying the severity of an outbreak until it is too late. In the severe acute respiratory syndrome epidemic of 2002 and 2003, for example, the Chinese government initially withheld information about an outbreak in Guangzhou, which delayed the discovery that the infection was not caused by the flu, but by a more dangerous pathogen.

In the ebola epidemic of 2014, the government of Guinea, a country with very limited health resources, initially insisted that only laboratory-confirmed cases be counted, this led to a drop in reported cases and a false sense of security, delaying the mobilization of resources and fueling the spread of the virus.

And as the 2015 Zika epidemic was taking hold, resulting in the births of babies with the neurological condition microcephaly, the Brazilian Ministry of Health changed the definition of microcephaly from a head circumference of 33 centimeters to 32 centimeters, effectively reducing the numbers of cases.

The United States also falls victim to the practice of mathematical case reduction. Several years ago the Centers for Disease Control and Prevention doubled the amount of bacteria required to be present before a urinary infection must be reported to health officials. Bladder infections associated with a catheter and caused by any type of yeast are no longer reported, which technically includes the deadly superbug Candida auris.

The definition of hospital-acquired methicillin-resistant Staphylococcus aureus (MRSA) infections has been changed from patients who developed an infection after two days of hospitalization to after three days. And the number of “community-acquired” infections occurring in the first three days of hospitalizations are not released to the public.

And instead of fixing a requirement that hospitals keep logs of infectious disease cases, in 2012 the U.S. eliminated this requirement and used our current spotty federal tracking system as justification.

In past epidemics, the cause and mechanism of the spread of infection and even vaccines were desperately sought after, but academic pride and competition often impeded science. No better example was the Spanish flu epidemic, which killed more soldiers in World War I than the war itself. Academic pride perpetuated the myth that the primary cause was a bacteria and not a virus. In the past few decades, other powerful factors, industrial profits and conflicts of interest, have emerged.

Finally, local beliefs, lack of education and mistrust create the breeding ground for pandemics. This was evident in the 2014 ebola outbreak, when the general population believed that the infection was a government plot and that health-care workers were purposely spreading the infection. In addition, they firmly embraced social customs and burial practices that were fueling the epidemic.

In some respects, this type of misinformation and paranoia is held by many who refuse to vaccinate their children. Often standing behind a shield of “religious freedom” or “personal belief,” such parents are allowing their children to act as reservoirs to spread dangerous pathogens. I have a niece who had a heart transplant and is immuno-compromised, and it terrifies me that the anti-vaxxers could jeopardize her life.

Americans over 65 still remember the ravages of epidemics and how vaccines were transformative. I still vividly recall being deathly sick with measles as a young child. I would not wish this on anyone. When the vaccines came out, there was a public rush to get them, and we all stood in long lines. But as memories faded, a suspicion of vaccines grew and dangerous pathogens re-emerged.

The public needs timely notification of infectious disease outbreaks, and epidemics need to be comprehensively tracked and aggressively confronted. All states should mandate vaccinations and eliminate religious exemptions. Our collective health depends on having public policy fully aligned with good science.

Physician Kevin Kavanagh of Somerset is founder and chairman of Health Watch USA, a nonprofit patient-advocacy and health-care policy research organization. Kavanagh wrote this opinion piece for the Los Angeles Times.

Ky. mom says she doesn't vaccinate her kids due to religious belief; meanwhile, number of U.S. measles cases at 25-year high

Centers for Disease Control and Prevention photo

As the number of measles cases in the U.S. reach their highest count in 25 years, a Lexington mom holds firm to her faith-driven belief to no longer vaccinate her children, Mary Meehan reports for WEKU-FM. 

Toni Wilkinson is one of many parents who cite religious reasons for not vaccinating children. She told Meehan she did that after learning that stem-cell tissue from abortions had been used to produce some vaccines.

“That became a big issue for me because we're very pro-life,” she said.

A few vaccines have been developed using human cell cultures derived from two legal abortions in the 1960s and are maintained in laboratories, but no additional fetal tissue has been added since they were originally created, According to the federal Centers for Disease Control and Prevention,

Wilkinson has seven children, all of them home-schooled. She told Meehan that her two oldest children are fully vaccinated, the next two received the required shots only until middle school, and the three youngest are not vaccinated at all.

From Jan. 1 to April 26, the CDC reports there have been 704 cases of measles confirmed in 22 states, including Kentucky. It is the greatest number of cases reported in the U.S. since 1994, and has been blamed on a decline in vaccinations.

"Kentucky is among 47 states that allow some form of religious exemption from vaccination requirements for children to attend public schools," Meehan notes.

West Virginia has no religious exemption, and has a 98% vaccination rate, well above the national median rate of 94.3%, Meehan notes. Kentucky's rate is 92.6%.

In June 2017, Kentucky's health cabinet made it easier for Kentucky adults to get religious based vaccine exemptions for their children by allowing them to get the exemption form online, have it notarized and then simply submit it to their school upon enrollment -- instead of having to obtain it from their health-care provider along with their signature. And it looks like that's not going to change.

“There has not been any talk about eliminating exemptions to vaccines in Kentucky that I'm aware of at this point,” Kentucky Public Health Commissioner Jeffrey Howard told Meehan.

Meehan reports, "Howard said he supports vaccines and that there are a lot of misunderstandings and myths surrounding them. But, he says, Kentucky is a place where people want to protect personal liberties such as whether or not to vaccinate a child."

Meehan reports  that no major American religion explicitly seeks to forbid vaccines and some within the Catholic church even encourage them -- though a subset of church members, like Wilkinson, reject vaccines on moral grounds related to the past use of fetal cells in some of them.

Dr. Scott Gottlieb was commissioner of the federal Food and Drug Administration from 2017 until earlier this month. He is now a resident fellow at the American Enterprise Institute.

Gottlieb told Meehan that he didn't think the federal government should mandate vaccinations, "because I think these are issues that have long been held left to state supervision for a lot of good reasons."

However, he also said that this surge in measles infections is forcing public health officials to make some tough policy decisions. “We're at the point right now where we're starting to see outbreaks of such a scope that we are going to reach a tipping point and perhaps some point soon," he told Meehan.

Toni Wilkinson told Meehan that she and her friends who have made a similar decision have faced backlash, with both family and on social media, but she still stands by her decision.

“God places children in families for a reason,” she told Meehan.

She also told Meehan that she has brief moments of doubt. “I think there was still a little fear of like, what if my child got what is considered a vaccine-preventable disease, what am I going to feel?”

Form for religious exemption from vaccination can now be obtained online, with no role for any health-care provider

By Melissa Patrick
Kentucky Health News

Kentucky parents who don't want their children vaccinated for religious reasons can now get the religious exemption form online, have it notarized and submit it to their school upon enrollment -- instead of having to obtain it from their health-care provider along with their signature.

Laura Begin (pronounced buh-GEEN), health coordinator for the Cabinet for Health and Family Services Office of Policy and Budget, told the legislature's interim joint health committee that the changes had been in the works for several years, in response to complaints that a medical entity should not have authority over a religious exemption; that a co-payment was often required to get a provider's signature; and that parents and guardians were having trouble finding providers to sign the forms.

"It's still not a perfect form. I feel like it still exceeds the law's requirement. The law simply requires a signed, sworn statement to exempt yourself religiously from vaccines -- that's it," said Erika Calihan of Lexington, who said she was a representative for a "whole lot of moms" who believed in religious liberty. "This is like a thousand times more, but it's better and it's improved and that is because of voices in the community speaking out and standing up for religious beliefs."

Begin said that fewer than 2 percent of Kentucky's children have a religious exemption for vaccinations. In 2016, of the 99,805 students enrolled in Kentucky's schools, there were 202 medical exemptions and 521 religious exemptions.

The new form also includes educational information about the symptoms and effects of the communicable diseases that are prevented by immunization.

In response to public comments on the proposal, the cabinet changed the wording on the form to say "according to the CDC and KDPH," when describing the symptoms and effects of each disease, instead of "I acknowledge that there are increased risks associated if exposed to this disease." Those are acronyms for the federal Centers for Disease Control and Prevention and the Kentucky Department of Public Health. 

After the meeting, Eric Clark, legislative director for the cabinet, said the health department  is "compelled under the law" to share this educational information.

"The decision whether or not to immunize a child is a medical decision, with a vested public-health interest at stake. If an individual can make that decision on a form available online, rather than through the consultation and discussion of a health-care provider, it is the role of the Kentucky Department of Public Health to share information with the public on the risk and symptoms associated with diseases," Clark said.

Dr. Patty Swiney, former president of the Kentucky Academy of Family Physicians, told the committee that the religious decision to not immunize a child should be an informed decision based on "good information and evidence" and not on "fears and misinformation."

Research has disproven any relationship between vaccines and autism, a common concern among those who choose not to vaccinate. The 1998 study that claimed there was a link between the measles, mumps and rubella vaccine and autism has been declared fraudulent and been retracted.

"The best way to treat disease is to prevent it and that is what immunizations do," Swiney said. She added that we no longer have smallpox or polio, and that cases of chicken pox, measles and mumps are rare because of immunizations. But she also said, "We do have epidemic of these preventable illnesses because of children and patients that are not vaccinated."

In 2016, there were 70 confirmed cases of measles across the U.S., and most of those who contracted the disease were not vaccinated, according to the CDC. As of June 17, that number is already up to 108, with 78 of the cases in Minnesota, mostly in children who were not vaccinated, according to the Minnesota Department of Health.

Swiney also spoke to the dangers of meningitis, noting that 10 to 15 percent of people who get meningitis will die and of those who do survive, 20 percent will have a permanent disability.

"Your individual right only goes so far as it affects the public rights to health, and that is why I'm here standing up for this immunization policy," she said.

People who aren't eligible for certain vaccines, like infants, pregnant women and immuno-compromised individuals, depend on others to be vaccinated for protection, a concept called "herd immunity."

Calihan told the committee that the amendment wasn't about immunizations, but instead about religious liberty. "If a parent decides that it is against their religious beliefs to vaccinate  their child under state law we have a right and that is all there is to it," she said. "So it doesn't really matter what physicians say at this point because you are going to find physicians on both sides of the issue."

Calihan said many vaccines have "aborted fetal tissue, among other things that I find objectionable morally." However, the Children's Hospital of Philadelphia says: "Fetal cells are used to make five vaccines: rubella, chickenpox, hepatitis A, shingles and rabies. Fetal cells used to grow the vaccine viruses were isolated from two elective abortions performed in Sweden and England in the early 1960s. Further abortions are not necessary as the cells isolated in the 1960s continue to be maintained in laboratory cultures."

The updated immunization regulation requires a meningitis booster before 11th grade and a hepatitis A vaccine; consolidates the immunization certificate and medical exemption form; and requires home-schooled children who participate in school-sponsored activities to attend in-school classes to provide proof of immunization or an exemption.

It also adds meningitis B to the list of recommended, but not required, immunizations. Meningitis B is responsible for nearly 50 percent of all cases of bacterial meningitis.

The cabinet removed a requirement in the proposal that would require health-care providers to use the Kentucky Immunization Registry by July 1, 2018 in response to comments received.

The Interim Joint Committee on Health and Welfare and Family Services approved the religious exemption form as part of the updated immunization regulation June 21. It will go into effect July 1, 2018 for the 2018-2019 school year. The religious exemption form can be downloaded on the Kentucky Department of Education website and the CHFS and DPH websites.

It's time to get school-age children vaccinated; state requirements are in place for kindergartners and rising sixth graders

An editorial in the Bowling Green Daily News about the importance of getting your child vaccinated before school starts is applicable to all communities in Kentucky.

Health.com

State law requires children to be vaccinated upon entering kindergarten, with exemptions given only for medical or religious purposes. Fewer than 1 percent of Kentucky's kindergarteners were exempted during the 2013-14 school year, according to the federal Centers for Disease Control and Prevention.

For years, widespread misinformation about the safety of immunizations has caused some parents to think the mumps-measles-rubella (MMR) vaccine or the mercury-containing preservative thimerosal causes autism. Both of these claims have been proven untrue. The original study that linked the MMR vaccine to autism has since been scientifically discredited and is now considered "fraudulent," and extensive scientific studies have concluded that there is no causal connection between thimerosal and autism. The MMR vaccine does not contain thimerosal.

The editorial notes that this reluctance to vaccinate has shifted since the outbreak of measles earlier this year that resulted in mostly unvaccinated people becoming infected with measles at Disneyland from an infected traveler.

"A University of Michigan poll released this month shows 34 percent of parents think vaccines have more benefit than they did one year ago; 25 percent of parents believe vaccines are safer than they were a year ago; and 35 percent of parents report more support for day care and school vaccine requirements than a year ago," the editorial writes.

So far this year, nearly 200 people have contracted measles. In 2014, there were more than 600 cases, a sharp increase from the less than 200 the year before, according to the CDC.

So, with school about to start in a month, the editorial encourages all of its citizens to get their kids vaccinated.

"The beginning of school will be here before you know it,"says the editorial. "So please take your kids and get the necessary vaccinations they need for their own well being and for the well being of their classmates."

Vaccination schedule:

Before kindergarten, kids need immunizations, a school physical, a vision exam and a dental exam.

Children entering kindergarten receive the DtaP for diphtheria, tetanus and pertussis; a measles-mumps-ruebella vaccine; and a chicken pox vaccine.

Children entering sixth grade receive a booster vaccine for tetanus, diphtheria and pertussis (TDAP), a meningitis vaccine, and a second chicken-pox vaccine.

The HPV vaccine is also recommended, but not required. This vaccine protects against the many cancers caused by the human papillomavirus, including cervical cancer in girls, and anal cancer and genital warts in both girls and boys. HPV vaccines are given in a three-dose series that should be started and finished when the boy or girl is 11 and 12. Pre-teens and teens who have not gotten this vaccine series should ask their primary care provider about getting them.

Flu vaccines are recommended for school-aged children every year as soon as it is available, but not required. This vaccine is especially important for those with chronic conditions like asthma or diabetes.

Belief in bogus studies and stories undermines use of vaccines that have been proven safe, resulting in spread of diseases

UPDATE: Jan. 16, 2014 4:50  Kentucky has not had any reports of measles in the past three years. It has had two cases of mumps in 2013 and two cases of mumps in 2014. Kentucky continues to have a large number of  pertussis, or whooping cough, cases with 666 in 2012; 383 in 2013; and 292 in 2014. The 2014 reports have not been finalized at this time.

The United States has recently seen a significant rise in the number of cases of vaccine-preventable diseases such as measles, mumps and pertussis, commonly called whooping cough.

A recent report blames this on an anti-vaccine movement caused by widespread misinformation about the safety of immunizations, John Wihbey reports for Harvard University's Shorenstein Center on Media, Politics and Public Policy.

"Over the past two decades, a combination of fraudulent scientific studies, irresponsible reporting, and well-meaning but misinformed citizen activists has led to a steady increase in the proportion of parents who have concerns about the recommended childhood vaccine schedule," says a 2014 report from the American Academy of Arts and Sciences.

Many young parents in the United States have no memory of  the time before vaccines and don't realize how important successful vaccination programs are to prevent the reemergence of the diseases they protect us from. In 2014, the United States had 610 confirmed cases of measles and 20 outbreaks, the highest number of cases since measles elimination was documented in the U.S. in 2000, according to the federal Centers for Disease Control and Prevention.

Chart provided by the federal Centers for Disease Control and Prevention

The origin of much of this misinformation is a "fraudulent" 1998 study, published in a well-respected British medical journal, that linked the measles-mumps-rubella (MMR) vaccine to autism. And while the study never claimed a definite link between the vaccine and autism, "sensational media reports ignited a public panic and MMR vaccinations fell dramatically," WebMD reports.

The study has since been discredited and retracted from the journal because it "was proven entirely false and even labeled "fraudulent,"" Wihbey writes. A new study, that updated this 1998 fraudulent study, has also shown that the MMR vaccine is not the cause of autism, Daniel J. DeNoon reports for WebMD.

"We are convinced there is no link between MMR vaccination and autism," study leader W. Ian Lipkin, MD, director of the center for infection and immunity at Columbia University in New York City, said at a news conference, DeNoon reports. Lipkin noted that this study did not address the theory that the mercury-containing preservative thimerosal might cause autism. The MMR vaccine does not contain thimerosal.

As for thimerosal, "A very large number of scientific studies have been carried out, and extensive scientific reviews, that have concluded there is no causal connection between vaccines or the preservative thimerosal and autism," Anne Schuchat, director of the CDC's National Center for Immunization and Respiratory Diseases, told DeNoon in a different article for WebMD.

The rate of vaccination in the United States is 92 percent for measles, mumps and rubella, which is relatively high, Wihbey reports.And only 1 percent of children in the United States do not receive any vaccines, according to the CDC..

But, "if we stop vaccinating, even the few cases we have in this country could very quickly become tens or hundreds of thousands of cases," says the CDC website.

How "herd immunity" protects us all.

National Institute of Allergy and Infectious Diseases

One concern is that as the vaccination rate drops, the United States will loose its "herd immunity," which offers a level of protection across an entire community that protects even the un-vaccinated. This type of noncompliance occurred in 2011, when 15 states saw MMR vaccination levels below the target level of 90 percent, Wihbey reports. Adding to misinformation about immunizations is media coverage of activists and celebrities with anti-vaccine positions.

In an in-depth article about the media's role in spreading misinformation that childhood vaccines cause autism, Curtis Brainard, for Columbia Jouralism Review, writes: "The consequences of this coverage go beyond squandering journalistic resources on a bogus story. There is evidence that fear of a link between vaccines and autism, stoked by press coverage, caused some parents to either delay vaccinations for their children or decline them altogether."

And it looks like many choose to believe unsubstantiated stories rather than public-health campaigns that attempt to address this misinformation, according to a recent study published in the peer-reviewed medical journal Pediatrics.

“None of the pro-vaccine messages created by public health authorities increased intent to vaccinate with MMR among a nationally representative sample of parents who have children age 17 years or younger at home," the study concluded.

The researchers said there should be more careful testing of public health campaign messages, suggesting that pediatricians, rated by parents in the study as the most trusted source of vaccine safety information, could be an "especially persuasive source" for this information.

The vast majority of Kentucky's children have been immunized, possibly because state law requires immunizations for admission to school, with exemptions made only for medical or religious purposes.  The CDC reported that less than 1 percent of Kentucky kindergarten children were exempted from one or more vaccine during the 2013-14 school year.

U.S. measles cases highest in 2 decades; blamed mainly on Americans' foreign travel, but also on opting out of vaccination

By Melissa Patrick
Kentucky Health News

In the wake of the highest number of measles outbreaks in the U.S. in the last 20 years, it is important to make sure you and your children are fully immunized, especially if you are traveling abroad.

"The current increase in measles cases is being driven by unvaccinated people, primarily U.S. residents, who got measles in other countries, brought the virus back to the U.S. and spread (it) to others in communities where many people are not vaccinated," Ann Schuchat, director of the Center for Immunizatons and Respiratory Diseases of the federal Centers for Disease Control and Prevention, said in a press release.

Centers for Disease Control photo

Measles is a virus and is one of the most contagious diseases known. It spreads through the air when an infected person coughs or sneezes and will infect 90 percent of those who are exposed if they are not protected. It starts with a fever, followed by a cough, runny nose and red eyes. Then a rash of tiny, red spots breaks out, which starts at the head and spreads to the rest of the body. It can lead to pneumonia, swelling of the brain and death. Of every 1,000 children who get the disease, one or two will die, the CDC says.

Kentucky requires measles immunizations for children in child care and school, with exemptions made only for medical or religious purposes.

The Kentucky Annual School Immunization Survey for Kindergarten and Sixth Grade reports that for the 2013-2014 school year: 148 kindergarten students (0.3 percent) and 228 sixth graders (0.4 percent) opted out of immunization under the medical exemption, while 359 kindergartners (0.6 percent) and 249 sixth graders (0.5 percent) opted out for religious reasons.

As of May 23, measles cases have been reported in 18 states and New York City, with most reported from Ohio (138), California (60), and New York City (26). Ninety percent have been among people who have not been vaccinated or have unknown vaccination status, according to the CDC. Most of the patients report religious, philosophical or personal reasons for avoiding vaccines. Through May 23, no deaths had been reported.

Measles is still around; rate in 2011 was highest in 15 years

Measles virus (Photo by Scott Camazine/CDC/Getty Images)

In 2000, the Centers for Disease Control and Prevention declared measles had been eliminated in the United States. But last year, the nation had the most cases of the infectious disease since 1997.

A report released last week shows there were 222 cases of measles and 17 measles outbreaks in 2011. In a typical year, there are usually just 50 to 60 cases. This year, there have already been 25 cases.

"Of the 222 reported cases, 50 percent were associated with the 17 outbreaks and 90 percent were associated with importations from foreign countries — 26 percent from U.S. residents traveling abroad and 10 percent from foreign visitors," reports Alexandra Sifferlin for Time magazine.

Each case is treated with intense investigation because of the highly contagious nature of the virus. "You can catch measles just by being in a room where someone with measles has been, even if they left," said Dr. Anne Schuchat, director of the CDC's National Center for Immunization and Respiratory Diesease. "It's serious; one out of three people who got it last year had to be hospitalized." No one died, however.

Of the 196 U.S. residents who contracted the virus last year, 166 had not been or did not know if they had been vaccinated. More than 80 percent of them were eligible for vaccine.

"Many people think diseases like measles are gone and that they do not need to vaccinate themselves or their children," Sifferlin reports. "But the CDC warns measles is still prevalent worldwide. Globally, about 20 million people get measles each year." (Read more)