"Measles did not come back because the virus got stronger. The virus is the same as it has been. It came back because we let our guard down."
IndigenousNetwork was able to attend this briefing from American Community Media.
Twenty-six years after the United States declared measles eliminated, public health experts say declining vaccination rates, widespread misinformation and weakened public health infrastructure have allowed one of the world's most contagious diseases to regain a foothold.
During an American Community Media briefing, pediatric infectious disease specialists and vaccine experts discussed the resurgence of measles, which has resulted in thousands of reported cases across multiple states over the past 18 months. Speakers emphasized that the virus itself has not changed. Instead, they said, falling vaccination rates have left communities increasingly vulnerable.
Paty Stinchfield, a pediatric nurse practitioner and executive director of the Measles Collaborative, explained that measles was eliminated in the United States in 2000, meaning continuous domestic transmission had stopped, but it was never eradicated worldwide.
"Measles is one of the most contagious pathogens ever identified," she said. "When community coverage drops below that threshold, we lose protection and the disease spreads."
She noted that approximately 95 percent vaccination coverage is needed to prevent outbreaks because a single infected person can spread measles to as many as 18 others.
Stinchfield described measles as far more than a childhood rash. The virus can cause pneumonia, severe dehydration, brain inflammation and long-term damage to the immune system. She recalled treating a nine-month-old infant who contracted measles after international travel and spent 15 days on a ventilator.
"The mom asked me to take photos of her son on the ventilator," Stinchfield said. "She said, 'Please share this with people. I didn't know that measles could be this dangerous.'"
Much of the discussion focused on how misinformation has reduced vaccine confidence. Stinchfield described Minnesota's Somali community, where organized anti-vaccine campaigns falsely linked the MMR vaccine to autism. Vaccination rates among Somali toddlers fell sharply despite previously being among the highest in the state.
"We listened first," she said of outreach efforts. "We answered questions. We addressed fears."
She said rebuilding trust has required partnerships with Somali physicians, faith leaders and community organizations, but acknowledged that misinformation remains difficult to overcome.
"The tsunami of misinformation every day is really, really difficult for health care professionals to overcome."
Dr. Andrew Pavia, chief of pediatric infectious diseases at the University of Utah, said Utah's recent outbreak illustrates how declining vaccination rates, distrust of government and reduced public health resources can combine to accelerate transmission.
He estimated the state's reported cases may represent only a fraction of the true outbreak.
"We estimated that we're undercounting by about two to fourfold," Pavia said, suggesting that hundreds of confirmed cases could represent well over a thousand actual infections.
Pavia also warned that adults now account for a growing share of cases and highlighted the particular risks during pregnancy.
"You can't get the vaccine when you're pregnant," he said. "You have to know whether you need it before you decide to become pregnant."
Texas A&M virologist Dr. Benjamin Neuman explained why the current vaccine continues to provide strong protection despite the virus evolving over time. Unlike influenza or COVID-19, measles changes very slowly in the parts of the virus targeted by the immune system.
"If it ain't broke, don't fix it," Neuman said of updating the vaccine, noting that current vaccines remain highly effective.
Former CDC immunization official Dr. Jose Romero expressed concern about recent changes to the Advisory Committee on Immunization Practices, arguing that previous recommendations were developed through months of scientific review involving independent experts, extensive conflict-of-interest screening and public discussion.
"The ACIP in its former iteration was one of the best institutions for making recommendations," Romero said. "Recommendations that are out there from the ACIP take into account effectiveness of the vaccine and safety of the vaccine."
Throughout the discussion, speakers repeatedly stressed that vaccines remain the safest and most effective way to prevent measles outbreaks. They also emphasized that protecting vulnerable populations depends on maintaining high community vaccination rates.
Closing the briefing, Stinchfield urged families to remember that vaccination protects not only themselves, but also infants, cancer patients and others who cannot safely receive vaccines.
"I vaccinate me and my family to protect them," she said. "But that also protects you. And if you vaccinate you and your family, then we're all protected."
