Measles outbreaks are spreading across the U.S., and the nation is likely to lose its status as a country where the disease is eliminated, something that infectious disease specialists say is directly related to President Trump’s appointment of Robert F. Kennedy Jr. as secretary of the Department of Health and Human Services (HHS).
South Carolina this week quarantined at least 254 people after confirming more than two dozen measles cases in the state. It’s the latest in what has been the worst year for measles in the U.S. in recent history.
An outbreak in West Texas this year saw more than 700 confirmed cases since January and the deaths of two children. According to the Centers for Disease Control and Prevention (CDC), there have been 47 reported outbreaks in the country this year.
“This is a very clear example of the damage that the anti-vaccine movement has done in the United States,” said Fiona Havers, adjunct associate professor at the Emory School of Medicine and a former infectious disease staffer at the CDC.
Kennedy was one of the country’s most well-known anti-vaccine advocates when Trump named him to lead the HHS. Since taking power, Kennedy has moved to remake the nation’s vaccine advisory board and other parts of the government to reflect his vision.
A nation loses its distinction as a country where measles has been eliminated when it sees at least 12 months of sustained transmission.
Measles spiked in Canada and Mexico this year as well, with the former officially losing its measles elimination status last month.
The U.S. declared measles to be eliminated in 2000, but Jan. 20 of next year will mark 12 straight months of uninterrupted measles transmission and reaching that day with continued spread looks all but certain.
Havers called this situation “extremely embarrassing” for the U.S.
“There are a number of things that have made these ongoing outbreaks very difficult to control. One is that the decades of false information about measles vaccines that [Kennedy Jr.] and other people in the anti-vaccine movement have been spreading has led to a decline in vaccination rates,” Havers said.
Haver acknowledged that containing measles outbreaks is becoming more difficult as the vaccination rate continues to decline in the U.S.
“But I do think a different administration — what we would have seen is a CDC director giving weekly updates to the press about the status of the measles outbreaks,” she said. “We would have seen money pumped out to the states, with airwaves and billboards being blanketed about measles vaccination and how that’s the most important way of controlling things.”
After the death of an 8-year-old girl in Texas due to measles, Kennedy publicly stated that the measles, mumps and rubella (MMR) vaccine was the “most effective way to prevent the spread of measles.”
This was a significant admission for Kennedy, who for decades cast doubt on the safety and efficacy of vaccines. The secretary previously claimed that the MMR vaccine has an “unconscionably high injury rate” and causes “all the illnesses that measles itself causes.”
He has long argued there could be a potential connection between the MMR vaccine and autism, though no causal has been found.
At the same time, Kennedy promoted vitamin A supplements, cod liver oil and the steroid budesonide to treat the virus. Infectious disease experts said that while these likely would not cause harm, they didn’t offer any added benefits.
When he was confirmed, Kennedy made it clear he would shift the HHS’s priorities away from infectious disease and focus more on chronic illness.
Strictly speaking, a country losing its measles-elimination status is a technicality that recognizes the spread of measles has gone uninterrupted for at least one year.
According to Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, the imminent deadline isn’t as important when “we can already say the damn house is on fire.”
“We don’t need to wait for one more smoke alarm to go off to know that’s happening,” said Osterholm. “Whether we formally lose that elimination status, to me, isn’t even that important in the sense of we already know we’ve got a terrible, terrible problem on our hands.”
Osterholm noted that in Canada’s population of roughly 41 million people, there have been more than 5,000 cases this year.
“You’re almost 6,000 cases for 40 million people. Do the math for 340 million people, and you can get a sense of just how big this could get,” he said, warning that the next 12 to 18 months could present extreme challenges in terms of fighting infectious diseases.
When Canada lost its measles elimination status, it announced it would be coordinating with the Pan American Health Organization to reverse the development. Regaining measles elimination requires that transmission of the current strain be interrupted for at least 12 months.
Osterholm said the uptick in measles activity would have occurred regardless of who was in office, though he added, “This administration is only pouring more gas on the fire with the kind of comments that are coming out of HHS.”
When asked whether she believes the HHS and CDC under Kennedy’s rule will prioritize regaining measles elimination status, Haver said she was “not optimistic.”
“This administration is far more focused on any risks associated with vaccines, without looking at any of the risks associated with the deadly diseases that they prevent.”
“I do think that this is far worse than it would have been under another administration,” she added. “It is not a coincidence that the first year where we’ve had we will have had 12 months of continuously circulating measles in the first 12 months of this administration.”
When reached for comment, HHS spokesperson Andrew Nixon said, “Elimination status depends on evidence of continuous transmission for 12 months, and our current assessment is that we have not met that criteria.”
“Secretary Kennedy has been very clear that vaccination is the most effective way to prevent measles. Any attempts to spin this are baseless. Individuals should consult with their healthcare provider on what is best for them,” he added.