Measles Outbreaks and Vaccination Debate

South Carolina has reported 789 confirmed measles cases, joining Utah, New Mexico, Arizona, and Texas as states with at least 100 cases since January 2025. Over 150 children have been hospitalized, and three deaths (two children, one adult, all unvaccinated) have occurred.

These fatalities mark the first U.S. measles deaths in a decade.

Background on Measles

Measles, or rubeola, is a highly contagious airborne viral infection. It typically causes fever, cough, runny nose, and a characteristic rash. While most individuals recover within 10 days, severe cases can be fatal, especially for children under five and those with weakened immune systems. The disease was officially declared eliminated in the U.S. in 2000.

The Resurgence of Measles

Recent Trends and U.S. Status

The current outbreaks originated in an unvaccinated Mennonite community in West Texas in January 2025. Texas subsequently reported 762 cases by August 2025, constituting the largest single outbreak in the U.S. since 2000. In 2025, the U.S. confirmed 2,255 measles cases, marking the highest number in over two decades. As of 2026, 416 cases have been confirmed across 14 jurisdictions.

To retain its elimination status, the U.S. must avoid 12 consecutive months of sustained transmission. Currently, several nations, including Spain, the UK, and Canada, have already lost their elimination status.

Official Responses and Recommendations

Leaders within the Department of Health and Human Services (HHS) have characterized the outbreaks as a "cost of doing business," citing porous borders and international travel. This perspective was shared by Ralph Abraham, principal deputy director at the CDC.

Despite this, the American Academy of Pediatrics and the CDC continue to recommend the MMR (measles, mumps, and rubella) vaccine for children. CDC data indicates that 93% of confirmed measles cases in 2025 were in unvaccinated individuals or those with unknown vaccination status.

The Vaccination Debate

Recent outbreaks have intensified discussions over childhood vaccinations. Vaccine skeptics often frame the decision to forgo vaccination as a personal choice. Conversely, proponents emphasize the critical need for at least 95% vaccination coverage to achieve herd immunity, which protects those medically unable to receive vaccines.

Political and Medical Community Responses

Left-leaning Concerns

Some observers on the left express significant concern about the escalating outbreaks and perceive a lack of adequate response from health leaders. Leana S. Wen in The Washington Post described the return of measles as a "public health tragedy." She highlighted legislative efforts to relax vaccine requirements and the influence of figures like Robert F. Kennedy Jr., the newly confirmed HHS secretary, who has not disavowed debunked theories linking MMR to autism.

Dan Vergano in Scientific American criticized what he termed a "brainwashing campaign" of measles misinformation. He cited polls showing public misconceptions about vaccine safety and effectiveness, attributing the spread of such views to political and personal gain.

Right-leaning Concerns and Counterarguments

Some on the right also express concern about the outbreaks but suggest that public health officials may be contributing to vaccine skepticism. The Wall Street Journal editorial board criticized CDC official Ralph Abraham's statement downplaying the outbreaks, noting that outbreaks increase when vaccination rates fall below herd immunity levels. The board further criticized Mr. Kennedy for fueling vaccine distrust and stated that government leaders should educate parents rather than dismiss serious illnesses.

Conversely, David Strom in Hot Air suggested that the severity of the outbreak might be overstated. He compared U.S. measles rates favorably to peer countries like Canada, France, and Germany, and attributed fluctuations to natural variations rather than recent vaccine skepticism.

Medical Expert Views

Medical experts have warned of a potential epidemic without a more effective public health strategy. Dr. Michael Mina, an epidemiologist, stated in The New York Times that measles is highly contagious and can lead to severe complications, including permanent disability and death, especially for vulnerable populations like infants and immunocompromised individuals. He noted that millions of American children are susceptible.

Dr. Mina suggested early MMR vaccination for infants in affected areas and criticized Mr. Kennedy's focus on vaccine-autism links over broader vaccination efforts. Nathaniel Mamo, Dhriti Jagadish, and Arthur Caplan in MedPage Today highlighted that containing infectious diseases is complicated by the independent nature of state health agencies, which can operate against federal guidance, causing public health to become politicized.

Analysis of Common Vaccine Skeptic Claims

An analysis addressed common skeptical claims regarding the MMR vaccine, referencing arguments from Robert F. Kennedy Jr.

Claim: Pre-vaccine Measles Mortality

Robert F. Kennedy Jr. cited CDC data suggesting measles fatalities in the pre-vaccine era were 1 in 500,000 population-wide and 1 in 10,000 among infected individuals. While sources corroborate the pre-vaccine mortality rate of 0.2 per 100,000 people, current general mortality rates for measles have been 0 in most years since 2000.

In 2025, the maximum mortality rate reached 1 in 115,000,000. Among infected people, the mortality rate has remained around 1 in 10,000 in the U.S. since 1962, and approximately 1 in 1,000 for infected children under 10.

Claim: Lack of Scientific Proof for Vaccine Efficacy

Kennedy asserted that no scientific evidence definitively proves that the 70 vaccine doses recommended for American children save more lives than they cost. He suggested this requires studies comparing long-term health outcomes in vaccinated versus unvaccinated populations. The National Academies have indicated that such large-scale studies would be prohibitively time-consuming and difficult to conduct.

Claim: High Injury Rate from MMR

Kennedy stated that Merck's pre-licensure MMR studies found that 40% of children experienced gastrointestinal illnesses and 55% suffered respiratory illnesses within 42 days, suggesting these are "injuries." These reported events are considered common, temporary side effects of a live vaccination, rather than long-term conditions or injuries. Similar side effects, such as a faint rash or mild arthralgia, were also noted.

Claim: Arthritis and Arthralgia Risk

Kennedy claimed 26% of post-pubertal females might develop arthritis and arthralgia from the MMR vaccine. A Johns Hopkins epidemiological review clarified that adult women who received the MMR vaccine developed temporary arthritic and arthralgic symptoms, not actual chronic arthritis.

Claim: Seizures After MMR

Kennedy cited a 2004 JAMA study suggesting an additional 1 in 640 children experience seizures after MMR compared to unvaccinated children, with about 5% progressing to epilepsy. The study concluded that while MMR vaccination was associated with a transient increased rate of febrile seizures, the risk difference was small. Furthermore, the long-term rate of epilepsy was not increased in children who had post-vaccination febrile seizures compared to those with febrile seizures from other causes.

Claim: VAERS Data on Adverse Reactions

Kennedy referenced the VAERS (Vaccine Adverse Event Reporting System) reporting over 89,000 adverse reactions and 445 deaths related to MMR through March 31, 2018. He then applied a 2010 HHS-funded study's estimate that VAERS captures "fewer than 1% of vaccine injuries" to extrapolate numbers of 44,500 deaths and 8,900,000 injuries.

VAERS is a voluntary surveillance system where individuals report events after vaccination, which do not imply causation and are not closely vetted.

VAERS typically captures about 1% of non-serious events, while approximately 25% of serious adverse reactions, such as anaphylaxis and Guillain-Barré syndrome, are reported. Therefore, the multiplication of adverse events by 100 is considered invalid for serious outcomes.

Claim: Bodily Autonomy and Vaccine Coercion

Kennedy's arguments align with the belief that individuals should have sovereignty over their bodies and that the government should not coerce healthy Americans into medical procedures. Historically, leaders like General George Washington ordered mass inoculation against smallpox for the Continental Army between 1777 and 1778 for the common good. This historical context highlights instances where public health measures were prioritized for collective well-being.