Measles Surges Across the US: A Public Health Crisis Unfolding

Measles is surging in the U.S., exposing serious flaws in our public health response. There’s a big brouhaha over whether the U.S. will lose its measles elimination status after 25 years. That reflects whether there has been sustained transmission in the country over the past year. Dr. Ralph Abraham, the principal deputy director of the Center for Disease Control and Prevention, suggested that “it’s just the cost of doing business, with our borders being somewhat porous [and] global and international travel.” Dr. Demetre Daskalakis was former director of the CDC's National Center for Immunization and Respiratory Diseases. He and CDC officials Dr. Daniel Jernigan and Dr. Deb Houry all resigned in protest after Dr. Susan Monarez was fired by Robert F. Kennedy Jr. In a webinar sponsored by Protect Our Health, an educational nonprofit, Daskalakis countered that “elimination is already lost, frankly, no matter what any other body says.” He further explained, “The actions of the Secretary of Health so far have already damaged our public health system, potentially beyond repair, and we do not have the capability to actually control measles.” Measles is highly transmissible—each person with measles will infect 12–18 others. Further, the virus can remain infectious in the air for hours after an infected person had been there. To provide immunity for the population, 95% need to be immune. MORE FOR YOU The last time measles cases were this high was 1991. In 2025, there were 2,242 confirmed cases, with 93% of cases among unvaccinated individuals. Actual cases are likely higher as many people can’t or don’t seek medical care. Eleven percent required hospitalization, and three people died. Cost Of Measles Measles epidemics are quite costly. There are always fixed costs, no matter how many cases in an outbreak, including the initial investigation, contact tracing, quarantine, and vaccination. Researchers estimate this at $244,480.40. Beyond that, add $16,197.13 per case, or $36.3 million for the 2242 confirmed 2025 cases. Another review suggests $43,200 per case. This would translate to $96.9 million for the year. Either way, it is considerably more expensive than vaccination. The measles epidemic in South Carolina is expensive to the state in lost tourism, according to Dr. Annie Andrews, a South Carolina pediatrician. She also spoke about how the lack of immunizations has changed practices, such as having to triage patients with a rash outside, in their cars, rather than allowing them into the office and risk infecting others. Andrews also now has to ask every patient “where they are on their vaccine journey,” as so many are unvaccinated. She said the disinformation campaign that led to that is “malpractice that is causing true harm.” She is hopeful that the economic and tourist impact on the state might be the one thing that “moves the needle.” Public Health Response And Misinformation All three speakers at the January 20th webinar stressed the impact of the dismantling of our public health infrastructure beyond measles. Governor Josh Green (D-HI), who is also a physician, said that cutting Medicaid enrollment is “another episode of public health malpractice.” His biggest concern is not measles, but that by undermining confidence in vaccines and slashing research, the next pandemic—be it bird flu or another—will make the COVID-19 pandemic look like “a walk in the park.” Daskalakis echoed the concern about “mis- and disinformation campaigns that undermine the trusted vaccines, discourage immunization and spread myths about vaccine safety.” He added, Kennedy’s “statements and actions have been have reached wide audiences, amplifying skepticism and fueling resistance, particularly in the most vulnerable communities.” An example Daskalakis gave was that of the measles outbreak in an Orthodox Jewish New York community, fueled by such disinformation. Another was that in Texas, Kennedy “was telling people that they should use inhaled steroids and clarithromycin, which is an antibiotic, instead of getting vaccinated for the MMR, stating such crazy things as durability of the vaccine isn't good, and claiming that the vaccine had fetal parts in it.” So the measles elimination status is important as being “a vital sign for our public health system. It reflects our ability to maintain high vaccination coverage, conduct effective surveillance and respond swiftly to outbreaks” of any kind. Green similarly criticized efforts by Kennedy to promote Vitamin A or cod liver oil and the inhaled steroid Butesonide for measles in Texas, and people profiting from selling these unproven supplements. Freedom Abraham added that parents choosing not to vaccinate their children reflects “their personal freedom,” and we should respect them. He’s ignoring that some children who are too young to be vaccinated or who are immunocompromised can die because of the unvaccinated person. Grandparents for Vaccines has a collection of very brief personal stories from grandparents about the impact of infectious diseases such as polio or meningitis on their families before vaccines were widely available. In one, Therese shows photos of her sister, who developed encephalitis (brain inflammation) after measles. Nancy was left permanently intellectually disabled but was able to find a job in a sheltered workshop. She died of dementia in her 60s. Therese also expressed concern that the types of programs that supported her sister are being cut. While Abraham and Kennedy say they endorse the measles/mumps/rubella vaccine to combat epidemics, their support has been tepid, at best. Kennedy has urged separating the shot into the three individual components. This is something pharmaceutical manufacturers are not prepared to do, and would be far more costly for parents, requiring them to take off work three times per immunization rather than once. He has also spread disinformation about vaccine safety. Future Of Vaccine Schedule Many states are choosing to reject the CDC’s new vaccine schedule, which eliminated many vaccines, and urge doctors to follow the recommendations of the American Academy of Pediatrics. Another thing to watch is the course of a lawsuit seeking to block Kennedy’s and the CDC’s recent recommendations. The suit is being brought by a broad array of organizations including the American Public Health Association, the American Academy of Pediatrics, the Infectious Diseases Society of America, the American College of Physicians, the Society for Maternal-Fetal Medicine and the Massachusetts Public Health Alliance. Reflecting on Abraham’s press conference, Daskalakis observed, “If the business is destroying public health then losing measles elimination is the cost of doing that business.”