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Measles is spreading. Here’s how to stay safe.
00:24:07
As measles spreads in the United States, we unpack how to stay safe – and why public health experts are so concerned by the confusing, contradictory federal response.
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- [00:03]
Colby Ikowicz
The United States is experiencing a serious measles outbreak. There have been hundreds of cases. At least two children have died in Texas. Both were otherwise healthy. Neither had been vaccinated. Public health experts say the Trump administration's response is woefully inadequate and even dangerous. But this isn't the first time President Donald Trump has faced a measles Crisis. Back in 2019, there was a significant outbreak and his response was very different. My colleague Lena sun reports on public health and infectious diseases for the post.
- [00:37]
Lena Sun
Back in 2019, you had President Donald Trump coming out and saying very matter of factly, the importance of getting vaccinations and urging parents to get their vaccines. They have to get the shot. The vaccinations are so important. This is really going around now.
- [00:55]
Thanet Naropil
They have to get their shot.
- [00:57]
Lena Sun
And now when he was asked about this outbreak, he downplayed it.
- [01:02]
Thanet Naropil
It's so far a fairly small number of people relative to what we're talking about.
- [01:08]
Lena Sun
That is a stark contrast because in order to stop an outbreak, you have to have strong messaging from the very top. This outbreak will only stop after infects everybody who is vulnerable or people get vaccinated. That's the way the outbreaks stop.
- [01:28]
Colby Ikowicz
What changed for Trump between 2019 and today?
- [01:32]
Lena Sun
We have a new Health and Human Services Secretary, Robert F. Kennedy Jr. Who has a long track record of taking anti vaccination positions and talking dismissively about the importance of vaccination, including the measles vaccine. And since he has become Health and Human Services secretary, his messaging has been consistently inconsistent. What we need to do is give them the best information and encourage them to vaccinate. But if people don't want it, they shouldn't be. The government shouldn't force them to do it. There are adverse events from the vaccine because he will often say something in support of vaccines and then hours later post something that is basically undercutting that message by promoting alternative treatments or by praising people who use alternative treatments that are not based on science or on evidence.
- [02:30]
Colby Ikowicz
Lena also says the measles vaccine has been proven safe and effective for decades. But RFK Jr keeps calling it into question, drawing attention to extremely rare side effects rather than the danger of not vaccinating against a potentially deadly virus. From the newsroom of the Washington Post, this is Post Reports. I'm Colby IKOWICZ. It's Monday, April 14th. Today, the confusing, contradictory federal response to the measles outbreak. We'll break down how to protect your family and whether alternative treatments are a safe option. Lena? Hi, welcome to Post reports.
- [03:17]
Lena Sun
Hi, Colby. It is great to be here.
- [03:19]
Colby Ikowicz
We're so happy to have you. So we're hearing about more and more measles cases lately all across the country. What is going on? Can you walk us through this latest outbreak?
- [03:33]
Lena Sun
This latest outbreak is based in West Texas. The first cases were reported in late January, and since then, the outbreak has spilled over to New Mexico and now also in Kansas. They have cases there that are linked to the Texas outbreak.
- [03:49]
Colby Ikowicz
So let's talk about how measles are actually spread and just how contagious it is.
- [03:55]
Lena Sun
Measles is the most contagious disease on Earth. Wow. Period, Full stop. The virus particles are very small, so they hang in the air for up to two hours. If you're not vaccinated and you walk through the CVS after someone who's had measles has gone through that CVS, 90% chance you're gonna get infected. So it is very, very contagious. And symptoms take a week or two to show up. And initially, the symptoms look like a lot of other things. But when someone is sick with measles, like a kid is sick with measles, their eyes are super red and they are the sickest they have ever been. This is what doctors have told me. But also, a lot of pediatricians in this country now never saw a case of measles. Right. And a lot of parents now don't, you know, they have kids, they never grew up with measles because measles was eliminated in 2000, and that means that there was no longer endemic transmission in the country. Okay, people, you will hear now talk about we are going to lose. Our elimination status means that if you have continuous transmission for 12 months or more, then you are no longer one of the countries that has eliminated measles. In 2019, we came very, very close. But in October of 2019, because New York did a lot to up the vaccination rates, the US did not lose its elimination status. And at that time, the HHS secretary, Alex Azar, came out very strongly to encourage vaccination. So did the CDC director.
- [05:34]
Colby Ikowicz
I mean, this certainly sounds like we're. If we're not already, we're at the precipice of a national public health emergency. How is the government responding to this current outbreak? How seriously are they taking it?
- [05:47]
Lena Sun
The only way to stop a measles outbreak is if you have a coordinated response at the local and state level and also at the federal level. And at the federal level, we are led by someone who is in the top position. At Health and Human Services, who has not come out with a full throated, unequivocal endorsement telling parents to get their kids vaccinated. Also, the Trump administration has put an external pause on all communications from the health agencies, and that was put in place in January, and that has not been lifted. And as a result, the Centers for Disease Control and Prevention, the cdc, which takes the lead in outbreak responses, has not held any briefings for reporters, has not been able to give updates to clinicians about what they should be looking for, and has basically been muzzled.
- [06:41]
Colby Ikowicz
Wow. So in January, the White House just said, you can't communicate anymore about public health.
- [06:48]
Lena Sun
HHS told the health agencies, you cannot do all sorts of external communications unless it's for emergency and outbreak things. So you can still update cases about bird flu, for example.
- [07:02]
Colby Ikowicz
I see.
- [07:02]
Lena Sun
But you could not communicate with reporters unless it was first cleared by hhs. And since then, we are now in April, that was in late January. That has really hampered the ability of the federal agency to be able to communicate. And so what people need to hear is a strong message. But there's a lot of misinformation out there. So there's a lot of confusion about, well, what do we really need to do about vaccination?
- [07:29]
Colby Ikowicz
And they're not considering this an emergency or an outbreak.
- [07:33]
Lena Sun
When the first death was reported, Secretary Kennedy said, so it's not unusual. We have measles outbreaks every year. You know, this is normal. He downplayed the significance, and he has a long record, even before he became Secretary for Health and Human Services, of promoting vaccine conspiracy theories. He's said things about the measles vaccine that are not true, about how harmful they are, that what is the cure for measles? The treatment, vitamin A and chicken soup. And that raises confusion if you're a parent, because you're hearing all of this in the echo chamber as well.
- [08:15]
Colby Ikowicz
Right.
- [08:19]
Lena Sun
After the second death, which was much more recently, that's when Kennedy finally said the most effective way to prevent spread of measles is the MMR vaccine. But that, I believe, was in response to what Senator Bill Cassidy, the Republican from Louisiana, who voted to confirm Kennedy.
- [08:38]
Colby Ikowicz
And is a doctor. Right.
- [08:39]
Lena Sun
And is a doctor, had posted on X saying top health officials should make stronger statements. And then hours after saying vaccine was effective, Kennedy posted on X and he praised, quote, unquote, extraordinary healers who used alternative treatments that infectious disease experts say are not recommended treatments for measles. So an infectious disease doctor who served in West Africa on Ebola and many other Infectious diseases. Craig Spencer said he is talking out of both sides of his mouth and that sows confusion.
- [09:21]
Colby Ikowicz
After the break, what people can do in this moment to keep themselves and their families safe. We also get into alternative treatments like vitamin A, which Lena explains can actually be dangerous if taken in high doses. We'll be right back.
- [09:46]
Thanet Naropil
I'm Thanet Naropil and I'm a health reporter for the Washington Post. My job is to cover public health and that means I'm writing about infectious disease threats like Covid mpox and bird flu. And I'm also holding the federal government and state government officials accountable for how they respond to these disease threats. So when we write about public health issues, we want to serve our readers by going deep into the science and by making sure that what they're reading is authoritative information that's been vetted by experts and written by people who've covered these issues for years. We want to empower people to live their best lives and to protect themselves and their loved ones. And that's what subscriber supported work does, is that it gives me the time and resources to really spend on a story. When you subscribe to the Washington Post, you support this kind of journalism and the people behind it. I'm Fennet Neerpil and I'm one of the people behind the Post.
- [10:49]
Colby Ikowicz
Lena. I'm a mom of a school age child.
- [10:53]
Lena Sun
How old is yours?
- [10:54]
Colby Ikowicz
She's seven and she's in first grade.
- [10:56]
Lena Sun
Oh, that's such a great age. And has she had both? Both doses?
- [11:01]
Colby Ikowicz
Yeah, she's had both doses of the mmr. How worried should I still be? Like, even though she's vaccinated, can she still contract measles if she gets in contact to it?
- [11:12]
Lena Sun
I think that you don't have anything to worry about because she has both. Normally the recommendation is for one dose at one years and that will protect you 93% against measles. That second dose is what they recommend to catch you up, to bring you up to 97%. And they ask that you have that second dose right around the time your kid is in school so that you are protecting yourself but you're more importantly protecting other children.
- [11:41]
Colby Ikowicz
But if you are someone like our executive producer who has a one year old and is still going through, isn't fully vaccinated against measles yet, like how worried should you be to take your child out into the world?
- [11:53]
Lena Sun
So the recommended schedule is to get your first dose between 12 and 15 months and the second dose at four to six years and the Reason is for the first dose is that's when they figure it's the best balance for protection for immune response for the kid. In Texas, they changed the recommendation for their first dose recommendation for children living in or visiting the outbreak area, which now includes 10 counties, to get their first dose at six months. And in many cases, doctors will recommend that you get your child that first dose before one year old. If you're traveling to areas where there's active measles outbreaks. Sure. So in the case of your executive producer, my friend Maggie, I don't think you have much to worry about because the first dose is 93% effective and the only reason they give you a second dose is to pull you up to 97%.
- [12:54]
Colby Ikowicz
Got it.
- [12:54]
Lena Sun
It might not sound like a lot on the individual level, but on the population level for the country, it has a good effect.
- [13:02]
Colby Ikowicz
Yeah. And is the immune response at these younger ages? Like, if you get, if you decide, okay, I have a six month old, I want to get her him vaccinated early, does it have the same immune response as if you wait till you're older?
- [13:15]
Lena Sun
Well, so that's why they don't recommend getting it at six months across the board. Right. That's only if you're gonna be traveling and you're at higher risk. When you get it at an earlier age, the immun response is not as great. If kids in West Texas are getting it at six months, they will still have to get them at one. And at four, it doesn't substitute. It just gives you a little protection. That's why.
- [13:38]
Colby Ikowicz
Got it. Got it.
- [13:39]
Lena Sun
I know people are worried because pediatricians have told me that because of the confusing rhetoric, and parents are worried. They have been going into their pediatrician offices and asking for their kids to get the shots earlier. If you have a child in daycare. Right. Some states don't have requirements for daycare. So then they are going in because if your kid gets sick and you can't go to work, then you need to stay home and isolate for 21 days.
- [14:07]
Colby Ikowicz
Wow. I mean. And I also know that a lot of, you know, a lot of public schools will require, you know, cams will require vaccination before you send your kid. Has the Trump administration said anything about changing that, about, you know, maybe not making that a requirement anymore?
- [14:23]
Lena Sun
So those requirements are all set by the states.
- [14:25]
Colby Ikowicz
Got it.
- [14:26]
Lena Sun
And all states have these requirements definitely for measles, mumps and rubella. There are some states, the legislatures have been trying to do away with that requirement, trying to get schools to say, you know, we don't need this anymore. But those efforts have not become law.
- [14:44]
Colby Ikowicz
So if you're older and you've been vaccinated, there are some people who are vaccinated in Texas that are still. So do you need a booster shot with the measles vaccine? And when should you get that?
- [14:58]
Lena Sun
There are very rare instances where you've been vaccinated and you still get measles. Cause it's, you know, not 100%. And then depending on when you were born, you may need another shot. So people born before 1957, they figure you are most likely exposed naturally, and so you have immunity. If you were born between 1963 and 1967, you may have gotten a less effective version of the vaccine. And you can go, you should maybe get another one. And then people born between 1968 and 1989 only got one dose. That's usually enough for most adults. But if you're planning to go someplace like Texas, New Mexico, and also many parts of Europe where there's active measles outbreaks around the world, you may want to get another shot. I went to cover a measles outbreak in Minnesota several years ago. I got another shot because I was going to be around people probably with lots of measles.
- [16:08]
Colby Ikowicz
So let's talk about these alternative treatments that Secretary Kennedy has been promoting. He said in an editorial for Fox News that studies have found that vitamin A can dramatically reduce measles mortality. What have you reported about the effectiveness of vitamin A as an alternative treatment? And should parents consider vitamin A?
- [16:32]
Lena Sun
So vitamin A people should be clear, and this comes from the American Academy of Pediatrics does not prevent measles. The only thing that prevents measles is vaccination. But in parts of the world where there's severe malnutrition and vitamin A deficiency, getting vitamin A as a supplement can decrease the severity of the disease. Okay, so that's where that is. Secretary Kennedy directed the CDC to add a section on vitamin A to their guidance on measles. And that section did not include the risks of vitamin A. Vitamin A is fat soluble. It can build up in your body. It's in cod liver oil. You're only supposed to be doing vitamin A under the supervision of a clinician who knows what they are doing. Because high levels of vitamin A can cause liver toxicity and all sorts of other damage. So people think, oh, it's a vitamin. I'll just guzzle cod liver oil until I'm blue in the face or whatever color I am in the Face. No, no, no. That is dangerous.
- [17:45]
Colby Ikowicz
And I imagine in children especially.
- [17:48]
Lena Sun
Right. And also we don't have vitamin A deficiency in this country. I checked on this. I think it's less than 1% of the United States has a vitamin A.
- [17:58]
Colby Ikowicz
Deficiency because you're getting it in your.
- [18:00]
Lena Sun
Foods and you're getting in your foods. But vitamin A can be helpful as a supplement in somebody who's really malnourished in a part of the world where your access to healthcare is not great. It can help decrease the severity of the disease.
- [18:14]
Colby Ikowicz
And is there long term effects or damage to having measles?
- [18:18]
Lena Sun
Yeah, that's the part that people think don't realize that it can cause pneumonia, it can cause brain swelling. And there is a rare complication which has a very, very long medical technical name and I am not going to be able to give it to you, but the acronym is sspe. But what it means is if you are a kid who got measles under the age of one, you have a much greater risk of getting this rare complication that shows up not until much later in life. Eight, nine, 10 years old. And it's basically a kind of encephalitis in your brain swelling. It is almost 100% fatal and you cannot treat it.
- [19:02]
Colby Ikowicz
So you're saying you could have a baby that had measles recovers, goes on to live to 8, 9 years old.
- [19:09]
Lena Sun
Or 11, 12, and die of SSPE?
- [19:13]
Colby Ikowicz
Oh, that's horrible.
- [19:14]
Lena Sun
And there's another thing that people don't realize about measles. So the measles virus, when you get, comes in strong and it destroys your immune response to a lot of other diseases that you may have been vaccinated or developed natural immunity against. It's called immune amnesia because it knocks out the rest of your body's ability to fight off these diseases so you become more vulnerable.
- [19:41]
Colby Ikowicz
Selena, where is all of this headed? Are we gonna get it under control in this country?
- [19:48]
Lena Sun
Cases are going up. You know, in order for a measles outbreak to be declared over, they have to wait two incubation periods, 21 plus 21, 42 days. And because measles takes a long time to sort of show up, you are infectious. Four days before and four days after that rash. In Texas, you are seeing people who are reluctant to come forward to be tested and you are hearing misleading and confusing information about the importance of vaccination. We are heading into spring break and summer travel and people don't want to stay home. 21 days. That's a long time to Stay home. So the health experts, especially a local health official in Lubbock, Texas, said that she thought it could be nine months, 10 months, a year, 13 months before this is over. Just think about that. Measles is the most contagious virus on Earth. If an infected person is in a room with 10 people who are not vaccinated, nine of them will get measles. You just do the algorithmic math there. It grows very fast.
- [21:08]
Colby Ikowicz
So, Lina, we've discussed that. There's just a lot of misinformation out there about vaccine safety. And so there are parents that are worried about getting their kids. What would you say to them to maybe allay some of those fears?
- [21:21]
Lena Sun
I would say that you, as a parent, what you want is the best thing for your child. Sorry, I just get really upset when parents don't get their kids vaccinated. Sorry. Here's what I would say to a parent. You know, you want the best thing for your child, so you should talk to your pediatrician. You should talk to a trusted health professional. I would not go online and Google. Does vitamin A work to prevent measles? Because it does not. And the measles vaccine has been around since 1963. The reason you don't see people dying of measles right and left now is because of this vaccine. When you talk to people who are in their 60s and 70s now and they describe what it was like to have measles as a kid or to see their sibling or their children. Children die of measles, it is just heartbreaking. There are still so many measles cases around the world. But what has happened is this doubt about vaccines in general has spilled over into a vaccine that is one of the most effective in preventing disease, especially this disease. And unlike some vaccines, like the flu vaccine, for example, is not nearly as effective as the measles vaccine. But measles also is a virus that is way more contagious than flu. Way more contagious than Covid. Way more contagious than anything. And I know parents want to do the right thing for their kid, and the right thing for their kid is to keep them safe and make sure they don't get this disease. And they should talk to their doctor or a trusted health professional.
- [23:12]
Colby Ikowicz
Melina, thank you so much for your reporting on this and for coming on and walking us through it.
- [23:18]
Lena Sun
I'm glad to be here. Colby.
- [23:23]
Colby Ikowicz
Lena's son reports on public health and infectious diseases for the Post. That's it for Post Reports. Thanks for listening. Today's show was produced by Ilana Gordon. It was mixed by Shawn Carter. It was edited by Maggie Penman. Thank you to Lenny Bernstein. If you're interested in learning more about this big measles outbreak, our producer, Ilana Gordon, actually visited West Texas with health reporter Fennet Neeripil in late February. The episode they put together is really nuanced and insightful, and if you haven't heard it, we'll put a link to it in our show notes. I'm Colby Ikowicz. We'll be back tomorrow with more stories from the Washington Post.