In November, as rising numbers of RSV, influenza and COVID cases worried parents across the country, parents in Ohio faced another unexpected health threat to their children: measles.
Ohio’s Columbus Public Health (CPH) and Franklin County Public Health (FCPH) announced a week into early November that they were investigating an outbreak of measles – at the time four children, associated with a local daycare. Measles, which is easily transmitted by coughing, talking or being in the same room, is highly contagious. Indeed, it is estimated that measles infects 90% of unvaccinated people who are exposed to it. It is also surprisingly contagious: only one virus, SARS-CoV-2 (which causes COVID-19) is known to be more contagious than measles.
Most adults and older children are vaccinated against measles, but the measles-mumps-rubella (MMR) vaccine is not offered to children under one year of age. This means that infants are often the most vulnerable.
Measles deaths occurred in the thousands during the first two decades of the 20th century. But in 2000, measles was declared eliminated from the United States and no deaths were reported until 2015, when a woman in Washington was the first to die in 12 years from complications from measles.
“It’s certainly bigger than what we’ve seen in years.”
Since then, there has been a significant overall resurgence in the measles incidence rate in the United States – such as the most recent outbreak in Ohio. Initially, more than a dozen unvaccinated children in Ohio were infected, including nine hospitalized. The Centers for Disease Control and Prevention (CDC) responded and deployed a small team to help fight the outbreak. But in December, the number of infected children rose to 59. More recently, as of January 6, the number of measles cases rose to 82; 33 of them were hospitalized.
“Most of the measles outbreaks we’ve had have been very limited to one or two cases,” Dean Blumberg, chief of pediatric infectious diseases and associate professor in the Department of Pediatrics at the University of California, Davis, told Salon. “It’s certainly bigger than what we’ve seen in years.
According to data collected by the Ohio Disease Reporting System, 23 of those infected were under the age of one year and 74 of those infected were not vaccinated against measles. Four of the infected people were partially vaccinated and the vaccination status of the other four infected children was unknown.
Doctors recommend children to be vaccinated against measles in two doses: the first between 12 and 15 months and the second between 4 and 6 years. The figures reported are concerning, as the majority of these children have not been vaccinated at all. One dose of measles vaccine is about 93% effective in preventing measles; two doses are approximately 97% effective.
According to the CDC, approximately 90% of children in the United States are vaccinated against measles. But why are more and more groups of parents choosing not to have their children vaccinated? The main reason is misinformation about vaccines, an issue that predates the COVID-19 pandemic. While parental vaccine hesitancy is generally seen as prevalent in states like California, which infamously experienced a measles outbreak in 2014, the movement is also taking hold in the Midwest.
“Here in Ohio, we have pretty active anti-vaccine groups,” Tara Smith, a professor of epidemiology at Kent State University College of Public Health, told NBC News. “I’m really worried that it’s something that’s taking root more and more here.”
Blumberg told Salon that there are two big false claims surrounding the measles vaccine for children.
“The first is that they’re worried about the adverse effects of the measles vaccine itself, and the most common thing people talk about is autism — and that’s been completely debunked,” Blumberg said.
“Unfortunately, with the way social media is set up these days, the guardrails have been lifted and there is a lot of misinformation out there that is not being checked at all.”
Indeed, research published in 1998 by a British doctor named Andrew Wakefield claimed to find evidence of a correlation between childhood measles vaccines and autism. This study has since been outright discredited. Wakefield was also banned from practicing medicine in the UK.
The Journal of American Medicine recently wrote that “the receipt of MMR [measles, mumps, rubella] the vaccine was not associated with an increased risk of ASD, [Autism spectrum disorder].”
Blumberg said there’s another misinformation that’s become increasingly popular: that measles isn’t particularly dangerous.
“Although most people recover, some children die of measles or may remain blind, brain damaged or have other problems,” Blumberg said. “Measles can lead to pneumonia, weaken the immune system and make children vulnerable to secondary infections, so it can be quite serious.”
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Blumberg said there needs to be consistent public health messaging, but he thinks that’s harder to do with social media these days.
“Unfortunately, with the way social media is set up these days, the guardrails have been lifted and there’s a lot of misinformation out there that’s not controlled at all,” he said. “I really encourage anyone who has questions about vaccination to really trust your health care provider, talk to them – they are an important source of reliable information, not an influencer or a celebrity.”
As for the outbreak in Ohio, it appears to be slowing down — but public health officials fear it’s not a fluke, but may be the new normal, and not just in the United States but around the world. .
“The record number of children who are underimmunized and susceptible to measles shows the profound damage immunization systems have suffered during the COVID-19 pandemic,” said CDC Director Dr. Rochelle P. Walensky. “Measles outbreaks illustrate weaknesses in immunization programs, but public health officials can use outbreak response to identify communities at risk, understand the causes of under-immunization, and help provide locally tailored solutions to ensure that vaccines are available to all.”
on children’s health
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