As measles cases rise in the United States and globally, a new book warns that the disease should not be underestimated, especially as vaccine coverage drops.
Adam Ratner, a pediatric infectious disease physician in New York City, is particularly concerned. In his book Booster Shots, Ratner stresses that measles is the most contagious disease known to science, far surpassing flu, COVID-19, polio, and Ebola.
He believes the resurgence of measles is a warning sign about the state of public health. “When vaccination rates decline, measles outbreaks are the first to appear,” he says. “These outbreaks often lead to other vaccine-preventable diseases.” Already in 2023, small outbreaks of measles have been reported in states like Texas, Rhode Island, and Georgia.
Globally, measles caused the deaths of more than 107,000 children in 2023, mostly among those who were unvaccinated or undervaccinated. In the U.S., there were 284 reported cases of measles last year, the highest number in five years. This uptick comes as vaccination rates for measles, mumps, and rubella in U.S. kindergartens have fallen below the 95% threshold necessary to prevent widespread outbreaks.
Though no measles deaths have been reported in the U.S. since 2015, Ratner worries that this could change if cases continue to rise.
Before the measles vaccine became widely available in the 1960s, the disease killed hundreds of children each year in the U.S. Ratner argues that the success of the vaccine is now being threatened by growing vaccine hesitancy, making it crucial to remember how severe the disease once was.
“Measles thrives on being underestimated,” he warns. “We tend to forget how bad it was before vaccines were available.”
Ratner also highlights the role of public policy in controlling measles. He points to a major outbreak in Texarkana in 1970. The area spanned two states: Arkansas, which had a school vaccine mandate, and Texas, which did not. “95% of the cases were in Texas, where kids weren’t getting vaccinated in schools,” Ratner explains.
The physician is deeply concerned about the upcoming confirmation of Robert F. Kennedy Jr. as the U.S. Secretary of Health and Human Services. Kennedy, known for his anti-vaccine stance, has campaigned against vaccines for years. “I am very worried about the future of vaccines and public health, both in the U.S. and globally,” Ratner says.
Ratner concludes that public health successes, such as widespread vaccination, are fragile. He emphasizes that while child mortality and diseases like measles have become rare, this situation is not guaranteed and can easily be reversed if vaccination rates continue to fall.
“Our public health achievements are precious, and we must protect them,” he urges.
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