Hello.

The United States is turning back the clock, at least in terms of measles.

In the 1980s and 1990s, before the disease was officially eradicated in this country, cities and towns struggled to contain outbreaks that sickened thousands, even though vaccines were available.

“A lot of children died of measles between 1989 to 1991,” said Anne Schuchat, a former top official at the Centers for Disease Control and Prevention, who began working at the agency in the wake of a large outbreak. More than 45,000 measles cases and hundreds of deaths occurred during those years, with a disproportionate number among Black and Hispanic children. 

The vaccine’s cost turned out to be a major barrier. In California alone, 3,390 people were hospitalized and 75 died of measles from 1988 through 1990, and the cost of medical care and outbreak control exceeded $30 million. 

“We learned that we needed to offer children a second dose, and offer them vaccines earlier,” Schuchat said. “And we learned that kids without insurance were at risk.” 

The agency changed its recommendations to advise two doses before kindergarten, and it helped launch the Vaccines for Children Program, so that anyone under age 18 could get vaccinated.

Vaccination rates went up, forming an invisible shield that protected communities when occasional cases popped up — usually from people infected abroad.  

But vaccination rates have been dropping over the past five years as misinformation flourishes and schools and state officials loosen mandates for shots. In 2011, nearly 95% of kindergartners across the country had received the measles, mumps, and rubella vaccine, a level of coverage required for herd immunity. In the last school year, the rate dropped below 93%. 

Averages obscure wide disparities among U.S. counties. And county averages hide dangerously low levels of vaccination at individual schools. For example, the massive West Texas outbreak earlier this year exploded in Gaines County, which had an already low 82% vaccination rate. Some school rates in the county were as low as 46%. 

The West Texas outbreak spread to at least four states and Mexico, sickening more than 4,500 people and killing at least 16. It also levied enormous costs on hospitals, health departments, and those paying their own medical bills. 

As it diminished this summer, other outbreaks flared. Since August, a measles outbreak along the Utah-Arizona border has sickened more than 120 people.  

In Arizona’s Mohave County, just 78% of children were vaccinated this school year, down from 90% in the 2019-20 school year. In southwestern Utah, vaccination rates were also at about 78%.

“It’s super upsetting to see budget cuts that will make responding to measles harder, and a secretary that fans the flames of suspicion,” Schuchat said, referring to Health and Human Services Secretary Robert F. Kennedy Jr. 

“To see even a single school-age child dying of measles in the U.S. is a tragedy,” she said. “It shouldn’t happen.”

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