After more than 12 months of continuous measles spread ― a vaccine-preventable illness ― the United States has officially lost its measles elimination status. The designation was originally awarded in 2000 to mark and celebrate the end of endemic transmission of measles.
The decision was made by a panel of international health and science experts at the Pan American Health Organization, which is an agency within the World Health Organization.
It isn’t shocking. There were measles outbreaks in several states this year, including Pennsylvania and South Carolina, a multistate outbreak that started in West Texas last year, eight measles-related deaths in the country, and a health and human services secretary (Robert F. Kennedy Jr.) who has a history of being anti-vaccine. Even still, the designation loss is a “reputational hit,” “disheartening” and “preventable,” experts told HuffPost.
Ahead, doctors and public health leaders share their honest thoughts on what this all means for you and the rest of the country.
The loss of measles elimination is a ‘stain’ on the reputation of a country that once led the global campaign to end the disease.
“The fact that our measles elimination status is even up for consideration is just a stain on our reputation as a once-proud leader, global leader, in advancing health,” said Dr. Jennifer Nuzzo, the director of the Pandemic Center at Brown University in Rhode Island.
“It’s a black eye for a country that really helped conceive and lead the global campaign to eliminate measles,” Nuzzo said, before adding that the Americas were the first region to achieve measles elimination.
“To return to a time period where measles once again circulates continually ... it’s hard to state how much of a step back that is,” she said.
There had been a focused effort to achieve measles elimination status, through vaccination campaigns and public health programs.
“That we are at risk of losing our elimination status, first of all, puts us into a category that is largely occupied by countries that are not our peers,” Nuzzo said. “They’re countries that have far fewer resources and many more health struggles than the United States has typically had, and it just shows that we are absolutely headed in the wrong direction and losing what was once our point of global pride.”
The U.S. has allowed measles to spread for nearly two years, which does not offer much confidence in the country’s ability to handle disease threats, experts say.
The loss in status is a “reputational hit,” Nuzzo continued. But even if the U.S. didn’t lose its measles elimination status, “I think we already know that the United States has gone backwards in terms of being able to protect its people,” she said.
“We have demonstrated an inability to control deadly diseases, which not only we’re bearing the tolls of each week when there’s hundreds of new measles cases reported, but also it sends a terrible signal about how capable we are to protect ourselves against disease threats,” said Nuzzo.
The U.S. has allowed measles to spread, largely unchecked, for nearly two years. “It’s just an unsustainable path that we’re on, and I think the loss of elimination status should, if anything, be a wake-up call about how we need to change course,” Nuzzo said.
Measles cases and deaths are preventable, but vaccine hesitancy and mixed messages from top officials allowed the spread to continue.
“We’ve always said that in the U.S., as a clinician, you won’t ever ... treat a patient with measles because it’s so rare. But that’s not becoming the case,” said Dr. Nuwan Gunawardhana, an epidemiologist and infectious disease physician at Columbia University Irving Medical Center.
The loss in status is “deeply disheartening,” he said. “Just because all these cases were preventable.”
“We shouldn’t be where we are today ... now, we are at more than 5,000 cases this year,” he continued, which is a 35-year high.
“That is a result of gaps in vaccination and also mixed messages that the families are receiving. ... I think there’s a lot of things that added up to where we are today,” Gunawardhana said.
Vaccination rates were declining for years, but since the pandemic, vaccine hesitancy has increased as confusing messaging comes from leaders of the country and misinformation spreads online.
“I don’t blame the parents because they’re just trying to do what’s best for their child,” said Gunawardhana. “But when you’re getting messages from the top saying that vaccines can cause all types of side effects and things that have been disproven extensively with great evidence-based medicine, and really well-performed studies — it’s really unfortunate.”
“As someone who spends much of my time fighting medical misinformation, watching that progress unravel is frustrating,” said Dr. Joel Bervell, a physician and science communicator.
“It isn’t a failure of science. We’ve had a safe, effective vaccine for decades. It’s a failure to maintain the trust, access and public health infrastructure that made elimination possible,” Bervell added.
The consequences of low vaccination rates and a loss of elimination status won’t be equally shared. “Outbreaks hit hardest where vaccination coverage is low, whether because of barriers to access, misinformation or long-standing distrust of medical institutions,” Bervell added.
Dr. David Higgins, a pediatrician and preventive medicine specialist at the University of Colorado Anschutz Medical Campus, agreed: “It’s an avoidable tragedy. American physicians in my generation were trained at a time when measles was only something we read about in textbooks. That’s where it should have stayed.”
“Now doctors will be learning about it when their patients are ill or suffer life-altering consequences.” Higgins added. “It isn’t an accident. It’s the result of years of growing distrust in vaccines and misguided policy choices. But we know how to fix it, and we’ve known for decades: get vaccinated.”
The resurgence of measles creates a ‘logistical nightmare for infection control.’
The loss of measles elimination status “represents an alarming step backward that drastically alters a doctor’s daily practice and approach to training,” said Dr. Katharine Clouser, a pediatrician at Hackensack Meridian Joseph M. Sanzari Children’s Hospital in New Jersey.
“Physicians must now maintain a high index of suspicion for a disease many have never seen in clinical practice, complicating routine diagnoses of childhood fevers and rashes,” she added.
“This resurgence creates a logistical nightmare for infection control, as the extraordinarily contagious, airborne virus requires strict isolation protocols to prevent devastating waiting-room outbreaks,” Clouser said.
It’s also particularly scary for babies too young to be vaccinated and for immunocompromised people.
Babies under 1 are not eligible for the measles vaccine and some immunocompromised people aren’t able to get the shot, either.
Doctors now carry a “heightened fear for infants and immunocompromised patients who have suddenly lost the lifesaving shield of herd immunity,” Clouser said.
Elisabeth Marnik, a science communicator and the executive director of The Evidence Collective, added that “it didn’t have to be this way.”
“Now we are all more at risk from a disease we know how to prevent, and it’s kids and families who will suffer the most,” Marnik said.
Dr. Mona Amin, a board-certified pediatrician in Florida and face behind the medical social media account @pedsdoctalk, said “I especially think about the babies who are too young to receive their first MMR vaccine and those who cannot be vaccinated for medical reasons.”
“Already this year, at least two infants under the age of 1 have been reported to have died from measles in the United States. These babies rely on those of us who can be vaccinated to help protect them,” Amin added.
Amin stressed that measles is a vaccine-preventable disease. “We shouldn’t have to see more children hospitalized or lives lost to remember why we worked so hard to eliminate it in the first place,” Amin said. “I hope this serves as a wake-up call to rebuild trust in science, improve how we communicate it, and remember that vaccination is about protecting our own children and the communities they grow up in.”