Measles is making an alarming comeback. Officially declared eliminated from the United States in 2000, the highly contagious virus is again on the rise, fueled by declining vaccination rates and a flood of online misinformation, according to the American Academy of Pediatrics.
Before the 1963 advent of the MMR vaccine (measles, mumps, and rubella), measles sickened nearly 4 million Americans annually; an estimated 48,000 were hospitalized and 500 died.
As of April 17, 785 measles cases have been recorded nationwide — more than twice the total number for all of 2024 — as reported by the Center for Outbreak Response Innovation (a Johns Hopkins University program that monitors epidemics). The CDC said that 11% of infected individuals were hospitalized and three have died, including two children. (The last recorded U.S. measles death since 2003 was in 2015.) The virus has spread across 25 states, with Texas reporting the largest outbreak at 569 cases. New York has seen four confirmed infections, in Suffolk and New York counties.
The state Department of Health warned the public earlier this month that measles is “only a car ride away,” citing an active outbreak in southern Ontario, Canada, which the province’s chief medical officer attributed to “unimmunized individuals” in Mennonite, Amish, and Anabaptist communities.
Nearly all U.S. cases have occurred in people who were unvaccinated or had unknown immunization status, according to the CDC. Measles is virtually 100% preventable with two doses of the MMR vaccine (measles, mumps, and rubella), typically administered at ages 1 and 5.
Measles is more contagious than the flu or COVID-19. A single infected person can spread the virus to nine out of 10 unvaccinated people. Symptoms include a red, blotchy rash and high fever lasting five days, often accompanied by a lingering cough, runny nose, and malaise lasting up to two weeks. In rare cases, measles can lead to pneumonia or encephalitis — brain swelling that may cause permanent neurological damage. About three in 1,000 people with measles die, with young children most at risk.
Vaccine misinformation, especially the false claim that the MMR vaccine causes autism, has fueled hesitancy among parents and driven national immunization rates below the CDC’s 95% target for community protection. The fraudulent theory, first published in a now-retracted 1998 Lancet paper and debunked by more than 25 studies, such as the one published in the April 2015 Journal of the American Medical Association, continues to spread on social media and is fostered by Health and Human Services Secretary Robert F. Kennedy Jr., who refused to deny the link during his Senate confirmation hearing. In 2024, fewer than 93% of public school kindergarteners nationwide were vaccinated against measles. New York was one of three states to surpass the goal, reporting a rate of 97.7%.
Nationwide, MMR vaccination rates are far worse among toddlers (ages 2 and below): Only 84.9% received their first MMR shot in 2024, down from 92.4% in 2020. New York’s rate was just 81%. Pine Plains fell far below the mark at 75%, in part due to additional health care barriers like distance and travel time — problems common to rural areas.
Compounding the issue is a recent wave of false internet claims, sparked by Kennedy’s statements about so-called alternative measles treatments. In a March Fox News interview, Kennedy said that doctors caring for measles patients were “getting very, very good results” from treatments including budesonide (a steroid), clarithromycin (an antibiotic), and cod liver oil. “Cod liver oil,” he said, “has high concentrations of vitamin A and vitamin D.”
A number of online sources have promoted high-dose vitamin A as a substitute for vaccination, leading some parents to unknowingly overdose their children with cod liver oil (rich in the nutrient), and resulting in the hospitalization of nearly 10 Texas pediatric patients with vitamin A toxicity. Earlier this month, America’s Poison Centers reported a 38.7% rise in calls concerning vitamin A poisoning.
But vitamin A deficiency is rare in the U.S., and excess amounts can be harmful. Because it is stored in body fat — not excreted in the urine like vitamins B and C — it is easy to take too much. Excessive vitamin A can cause bone pain, vomiting, and headaches; in some cases it results in permanent liver damage. A tablespoon of cod liver oil contains 4,080 micrograms of retinol, the active form of vitamin A, which is five to 10 times above the average daily allowance.
The CDC recommends prescribed vitamin A to boost the immune system, but only for hospitalized patients with severe measles and only under physician supervision. The other treatments mentioned by Kennedy — the prescribed medications budesonide and clarithromycin— are ineffective against any viral infection, including the measles.
The MMR vaccination is the most effective way to prevent measles, according to the CDC and the World Health Organization. Those born before 1957 are an exception: Nearly all have had the disease, which gives lifelong immunity. Adults vaccinated after 1957 but before 1971 — when the vaccine was less effective — may need to be re-immunized.
If you think you or someone you know has measles, call your healthcare provider immediately. You can also contact your local health department: In Dutchess County, call 845-486-3404, in Columbia County, 518-828-3358.
Dr. Mary Jenkins, a contributor to the Herald and member of its board of directors, retired after nearly 40 years as a family practice physician in New York state.