A second unvaccinated child died of measles in West Texas last week. U.S. Health and Human Services Secretary Robert F. Kennedy Jr. attended her funeral Sunday and called vaccination “the most effective way to prevent the spread of measles” in a social media post.
Yet, as experts have noted, Kennedy has promoted vaccine skepticism and pitched alternatives such as cod liver oil and vitamin A to prevent measles — neither of which works. A top vaccine expert working under Kennedy resigned in protest.
Abrupt cutoffs in federal funding under President Donald Trump have also crippled some state efforts to vaccinate people against measles and other diseases.
A third death in New Mexico, of an unvaccinated adult who tested positive for measles, remains under investigation. Before vaccination started in 1963, measles caused as many as 500 deaths a year in the United States.
The most important things states can do are providing vaccine clinics, testing quickly for measles, and tracing the contacts of people with identified cases, as well as fighting misinformation on vaccines, said Dr. Susan Kansagra, chief medical officer for the Association of State and Territorial Health Officials.
“Measles is one of the most contagious diseases, so one of the roles of public health is working to identify others that might have been exposed,” Kansagra said of contract tracing.
Despite vaccines’ effectiveness, recent federal funding halts have crippled state and local efforts to vaccinate more people not only for measles but also for this year’s deadly influenza viruses and COVID-19. On April 3, a federal judge in Rhode Island agreed to temporarily block the Trump administration from pulling $11 billion in federal health grants from states after a court challenge by Democratic states.
But in the days before the judge’s order, measles response plans came to a crashing halt in parts of Minnesota, Texas and Washington state when federal health grants were abruptly cut off. Dozens of free vaccination clinics in the Dallas area were canceled overnight. On March 24, Washington state was forced to cancel 104 upcoming “Care-a-Van” mobile clinics that would have provided 2,000 vaccinations against childhood diseases, including measles.
In Minnesota, where $220 million in previously approved federal health funding was cut off, the state announced layoffs April 1, including some positions supporting measles vaccination and other disease response. Minneapolis vaccination clinics were canceled March 26.
“The sudden and unexpected action from the federal government left us with no choice” but to lay off workers, Minnesota health commissioner Dr. Brooke Cunningham said in a statement. “We are working now to figure out how much of this critical public health work we can save and continue.”
Alarm Among Experts
Experts regardless of political affiliation have expressed alarm about federal moves to abandon support for vaccines. They include the nation’s top vaccine expert at the Food and Drug Administration, Dr. Peter Marks, who was appointed to the position in 2016.
In his resignation letter March 28, Marks said the measles outbreak “reminds us of what happens when confidence in well-established science underlying public health and well-being is undermined.” He accused Kennedy of seeking only “subservient confirmation of his misinformation and lies” about vaccines in general.
Measles is so contagious that it can spread to 90 percent of unvaccinated people near an infected person. The virus can linger in the air up to two hours after an infected person has coughed or sneezed. Symptoms of the disease include high fever, cough, runny nose and rash, leading to a severe lung infection. Rare severe cases can cause swelling of the brain and death. Measles is most dangerous for infants, pregnant women and people with weakened immune systems.
In Texas there are already signs that misinformation and vaccine skepticism may be feeding a rise in measles cases. The state had 499 cases as of April 6.
A Lubbock hospital reported that several unvaccinated children were treated for vitamin A toxicity, apparently in response to Kennedy’s recommendations to take vitamin A and cod liver oil.
Dr. Ashish Jha, who worked on COVID-19 vaccine plans under the Biden administration, said vitamin A treatment is appropriate in parts of Africa where vitamin deficiency is a factor, but not often in the United States.
“In Texas and Louisiana and New Mexico and Ohio and Pennsylvania, where we’re seeing a lot of these outbreaks, vitamin A is going to do very little for kids because they already have plenty of vitamin A,” Jha said.
“Really, the only thing that helps is making sure you don’t get measles — and the only way to do that is to be vaccinated,” said Jha, who is now dean of Brown University’s School of Public Health.
State Responses
The current outbreak is on track to surpass 2019, when there were nearly 1,300 cases, and to be the worst year for measles since 1991 when there were more than 9,600 cases.
Local and state health officials in Texas also warned against “measles parties” where people try to expose themselves and their children to the disease hoping to gain immunity. Measles can cause severe complications and death even in otherwise healthy people, state officials warned.
New Mexico has opened 22 free walk-in measles vaccine clinics around the state, including two in Lea County, where most of the cases are located, near the Texas border. The state is also trying to head off more infections in Guadalupe and Valencia counties, where a traveler from Texas may have exposed people to measles in early March at a restaurant, hotel, church and travel center.
Funding cutbacks forced New Mexico to cancel contracts for vaccination outreach to potential clients in underserved communities, but the state has not interrupted its own public service messages or vaccine clinics, said New Mexico Department of Health spokesperson Robert Nott.
Kansas, where there are 24 known cases, recommended early vaccination for children in affected areas — starting at 6 months of age instead of the usual 1 year. The state also put doctors on alert to watch for symptoms such as fever and rash among unvaccinated people and offered expedited testing for suspected measles cases.Kentucky, with only one case, requires doctors to send such tests directly to the state for faster processing.
As in other states, almost all the Kansas cases are among unvaccinated people. Only one person with measles was fully vaccinated, and another case is not clear.
Colorado, where the state’s first case was reported March 31 in an unvaccinated Pueblo resident, state officials were already sending reminder texts and emails about vaccination to parents because of cases in nearby Texas and New Mexico. They also warned residents who may have been exposed at a restaurant and clinic in Pueblo and Pueblo West in March.
In New Mexico, there’s been an encouraging increase in measles vaccinations since the outbreak, said Nott. There were almost 15,000 new vaccinations in February and March, up from about 8,200 in the same period last year, he said.
On April 2, New York state warned residents to get vaccinated before traveling to areas with measles outbreaks. In March, the Pan American Health Organization said measles outbreaks in North and South America could endanger the region’s status as “measles-free.”
Some states are working to locate people who, residents or not, may have exposed others while traveling. New Jersey has three cases among residents, all members of one family, but is seeking people exposed to measles by travelers on an Amtrak train, at Newark Liberty International Airport, in hospitals and at other places in March.
A March editorial in The Lancet, a medical journal, said the recent measles outbreaks “should be taken as a wakeup call” for more vaccinations.
“People should be encouraged to listen to factual scientific evidence and verified sources. Awareness of the safety of the measles vaccine needs to be spread to combat the viral misinformation against it,” the editorial stated.
This article was published by Stateline. Read the original here.
