As Predicted, Measles Returns in Unvaccinated
By Gary Evans
As this report was filed, a measles outbreak was underway at a Florida elementary school, prompting a bizarre letter to parents and guardians by the state Surgeon General Joseph Ladapo, MD, PhD. Ladapo has a history of taking antivaccine positions.
In the letter, Ladapo mentioned the measles, mumps, and rubella (MMR) vaccine but did not advocate it against one of the most infectious viruses on Earth. Instead of urging children susceptible to measles to be immunized, Ladapo said it is “normally recommended that individuals without a history of prior infection or vaccination stay home for up to 21 days [the incubation period for measles].”1 He then undercut this questionable recommendation by noting in the same letter that the state Department of Health “is deferring to parents or guardians to make decisions about school attendance.” Since there already have been measles cases at the school, and the virus can spread several days before symptoms, susceptible children re-entering that environment are at no small risk of acquiring measles.
“There is a general notion out there now that everybody used to get measles and recovered and it was no big deal,” says William Schaffner, MD, a professor of preventive medicine at Vanderbilt University. “Before we had a vaccine, 400 to 500 [children] in the U.S. died of measles and its complications annually. Measles is a nasty virus. There are complications of otitis media and encephalitis. Even those who have an uncomplicated case of measles may be miserable for a week or longer. The answer to all this is stunningly simple — vaccinate those children.”
According to the Centers for Disease Control and Prevention, as of Feb. 22, 2024, 35 measles cases were reported by 15 states: Arizona, California, Florida, Georgia, Indiana, Louisiana, Maryland, Minnesota, Missouri, New Jersey, New York, Ohio, Pennsylvania, Virginia, and Washington.2
If measles begins circulating in the community, employee health professionals should ensure healthcare workers are immune. Evidence of measles immunity for healthcare workers includes taking two doses of MMR vaccine, serologic evidence of immunity, or laboratory confirmation of disease. Birth before 1957 — when immunity by infection was assumed — is no longer acceptable for healthcare workers.
“For healthcare workers born before 1957 who lack evidence of measles immunity, healthcare facilities should consider vaccinating with two doses of MMR vaccine separated by at least 28 days,” recommends the Minnesota Health Department, which has dealt with a fair share of measles outbreaks over the years.3
The measles vaccine can be used as a post-exposure prophylaxis for exposed, non-immune healthcare workers. It is effective at preventing measles when administered to a susceptible employee within 72 hours.
A new book by vaccine scientist Peter Hotez, MD, PhD, warns that the antivax movement is metastasizing and will threaten the uptake of the pediatric immunization schedule. In The Deadly Rise of Anti-Science: A Scientist’s Warning, Hotez traces the roots of the modern antivaccine movement, including the infamous retracted Lancet paper that tried to link the MMR vaccine to autism. Having an adult daughter with autism, Hotez took on this thoroughly debunked notion, writing a book in 2018 explaining that autism is not caused by vaccines.4-6
“This is not going to stop with COVID immunizations,” Hotez says. “It is going to spill over into other aspects of biomedicine. One of them is clearly childhood immunization. We are already starting to see the return of measles in outbreaks in the U.S. Measles is often the first one you see because it is the most highly transmissible of all the viruses.”
On Feb. 1, 2022, Hotez and a colleague were nominated for the Nobel Peace Prize for their efforts to design and distribute a nonproprietary, free COVID-19 vaccine to impoverished nations globally. The next day, he received an email with the subject line: “You will hang for crimes against humanity.”
This was the price Hotez paid for advocating COVID-19 vaccinations, much as he always encouraged other immunizations in his writings, talks, and media appearances as the co-director of the Texas Children’s Center for Vaccine Development. Hotez is a professor of pediatrics, molecular virology, and microbiology, as well as the founding dean of the National School of Tropical Medicine.
Hospital Employee Health asked Hotez whether he was surprised to see so many healthcare workers against the COVID-19 vaccine.
“This is one of the more disheartening aspects of this,” Hotez notes. “It is one thing to have antivaccine activists do this, but [to see it] within the healthcare professions — even among physicians, who are espousing antivaccine [rhetoric]. That’s very demoralizing. I guess it just goes to show you that anyone can go down the rabbit hole — watch [right-wing media] every night and falsely believe that vaccines are something sinister.”
Hotez documented this chaotic and divisive period in his book, estimating that about 200,000 people died of COVID-19 after willfully refusing a widely available vaccine. Some who survived likely developed long COVID.
REFERENCES
- Ladapo, J. Letter to parents/guardians. Feb. 20, 2024. https://www.washingtonpost.com...
- Centers for Disease Control and Prevention. Measles cases and outbreaks. Last reviewed Feb. 23, 2024. https://www.cdc.gov/measles/ca...
- Minnesota Department of Health. Managing measles exposures in health care workers. Feb. 16, 2023. https://www.health.state.mn.us...
- Hotez PJ. The Deadly Rise of Anti-Science: A Scientist’s Warning. Johns Hopkins University Press; 2023.
- [No authors listed]. Retraction — Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet 2010;375:445.
- Hotez PJ. Vaccines Did Not Cause Rachel’s Autism: My Journey as a Vaccine Scientist, Pediatrician, and Autism Dad. Johns Hopkins University Press; 2018.
As this report was filed, a measles outbreak was underway at a Florida elementary school, prompting a bizarre letter to parents and guardians by the state Surgeon General Joseph Ladapo, MD, PhD. Ladapo has a history of taking antivaccine positions.
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