Measles: Will It Take a Death to Get Kids Vaccinated?

Paul A. Offit, MD


February 05, 2019

Editorial Collaboration

Medscape &

This transcript has been edited for clarity.

Hi. My name is Paul Offit. I'm talking to you today from the Vaccine Education Center at Children's Hospital of Philadelphia.

In the past 2 days, we've read about a state of emergency in Washington State, because now 36 children younger than 10 years have suffered measles, and one has been hospitalized. Almost all of those children were unvaccinated because their parents chose not to vaccinate them. The county in which they live (Clark County, Washington) has a rate of vaccination of about 22% of children, creating fertile ground for measles to spread.

This isn't the first instance of this type of outbreak. To put it into perspective, we eliminated measles in the United States in the year 2000. It has come back because a critical number of parents have decided not to vaccinate their children. As a consequence, we had an outbreak in California in 2014-2015 that started in southern California, spread to 25 states, and involved 189 people—again, mostly children who weren't vaccinated.

We've had outbreaks among the Somali community in Minnesota, where Somali Americans had immunization rates drop from the 90% range down to the 40% range because they were scared that vaccines could cause disorders like autism, which obviously isn't true. We've had outbreaks in ultra-Orthodox Jewish communities in Lakewood, New Jersey, and Brooklyn, New York—again, because pockets of parents have chosen not to vaccinate their children.

What stops this? When do we get to the tipping point where we stand up for children whose parents are making bad decisions that are putting children at unnecessary risk? I think the answer to that question is: when children start to die. With measles, death typically begins to occur when you have about 1000-2000 infections, so that is what will change things. Children will have to die to finally get our attention that we need to stand up for these children. These parents do not have the inalienable right as citizens to allow their children to catch and transmit a potentially fatal infection. Or when diseases like polio and diphtheria come back to the United States, maybe that is what it will take.

But invariably it's children who suffer our ignorance, and it is unconscionable. Thank you.

Follow Medscape on Facebook, Twitter, Instagram, and YouTube