Vaccines prevent diseases in the twenty-first century that routinely killed or crippled people before clever men and women figured out how to make defenses against Mother Nature’s assaults. Fear promoted the development of vaccines targeting bacterial and viral diseases, and fear is being used to frustrate the application of these agents. Unscrupulous physicians and politicians are increasingly attracting attention by insisting that vaccines are actually dangerous or part of a conspiracy to somehow corrupt or enfeeble America. Some religious spokespeople have added credibility to these false claims simply by frequently repeating them and have advised their congregants that their virtue will protect them more effectively than any medical concoction. That faith-based sentiment has been reiterated millions of times over the millennia and was probably the justification for the first religious fundraiser held around a campfire in the Rift Valley of Africa [humanity’s birthplace]. Unfortunately, bacteria and viruses have never demonstrated a willingness to spare the virtuous amongst us or to target the nefarious.
Consequently, measles [aka, rubeola] is re-emerging as a threat to our children and the elderly. Scientists developed highly safe and effective vaccines against this viral disease many decades ago, but unwarranted concerns that the widely available and inexpensive MMR [measles, mumps, and rubella] vaccines might cause damage, including autism in children, has dissuaded many Americans from utilizing this gift from science. Just 24 years ago, measles was declared eliminated from the United States with no cases occurring in our fellow Americans. With carefully applied fear, the rate of MMR vaccination fell, and during 2019 the Centers for Disease Control and Prevention [CDC] reported 1,274 confirmed cases in the U.S. with affected individuals living in 31 of the 50 states. In January and February, 2024, there have already been 41 cases of measles in 16 states. Contact with these infected individuals need not be prolonged or substantial for the disease to spread rapidly to hundreds or thousands of our fellow Americans.
If you were living in the United States in the 1930s, 1940s, or 1950s, you may remember measles as just one of many viral diseases that swept through innumerable communities without causing much death or disability. Indeed, compared to polio, whooping cough, rubella [German measles], scarlet fever and other communicable diseases, measles [rubeola] seemed fairly innocuous. Unfortunately, that was a false impression. Measles caused hearing loss, pneumonia, permanent lung damage, and inflammatory diseases of the brain (encephalitis), as well as fever, convulsions, and rash. It also elicited a potentially lethal ‘multiple-sclerosis-like’ deterioration of the brain, called SSPE [subacute sclerosing panencephalitis] years after the disease victim appeared to have recovered from the measles infection.
An effective vaccine was developed in the 1960s, and the incidence of the disease plummeted as MMR vaccinations became widely available and often mandated for enrollment in schools. Decades before that vaccine was distributed, about 6,000 Americans died each year from complications of measles. Virtually every American contracted measles by the time they were 15 years old before the vaccine was available.
Now that we have had more than 60 years’ experience with this and several other vaccines, one might think that Americans would be comfortable vaccinating their children against this awful disease. One would be wrong.
Americans have complex feelings about their healthcare providers. For many of us, there is distrust of those who seem to hold our very lives in their grip. Pronouncements from people with famous names, like Robert F. Kennedy Jr., feed our distrust. Ambiguous laws, such as religious exemptions allowing people to opt out of medical mandates, further erode our trust. And then there is Florida.
Measles vaccinations are not mandatory for children enrolling in public schools in Florida. The CDC recommends that unvaccinated children exposed to the disease should not attend school for 21 days, an interval during which the disease will become evident if the child did contract the highly communicable virus. Unfortunately, the Florida Surgeon General Joseph Ladapo, the state’s top health official, advised parents to do whatever they were comfortable with, rather than following CDC recommendations. This highly influential physician in effect told parents in Florida that this potentially lethal, highly transmissible but easily preventable [with vaccination] disease was no big deal. The policies of optional and unrecommended vaccinations and unrestricted school participation are likely to cause widespread misery and avoidable deaths. Florida’s and Dr. Ladapo’s relaxed approach to easily transmitted diseases is the same approach that gave us the 2020-2021 Covid epidemic.
Florida’s failure to take action when confronted by a public health emergency is consistent with a disinclination by state and federal policymakers to alarm or even alert its citizens to an imminent health threat. Reassurances that Covid-19 was “something like the flu” and might be managed by just “shining UV lights” into the infected individual’s body facilitated the rapid spread of this virus and the more than one million American deaths that resulted as a consequence of misinformation and delayed action. Measles is less deadly but much more readily spread than Covid-19. A cough from a measles infected person may leave infectious particles in the air for up to 2 hours after the infected person leaves the location where he or she coughed. Minor changes in the measles virus have resulted in epidemics in the past that killed millions. If state and federal officials insist on ignoring the threat posed by the measles virus to the very young, the very old, the unvaccinated, and those with weak immune systems, we may yet get to see how many ‘virtuous’ people are spared by the virus.
Dr. Lechtenberg is an Easton resident who graduated from Tufts University and Tufts Medical School in Massachusetts and subsequently trained at The Mount Sinai Hospital and Columbia-Presbyterian Medical Center in Manhattan. He worked as a neurologist at several New York Hospitals, including Kings County and The Long Island College Hospital, while maintaining a private practice, teaching at SUNY Downstate Medical School, and publishing 15 books on a variety of medical topics. He worked in drug development in the U.S., as well as in England, Germany, and France.
