Although COVID-19 continued to garner the bulk of media attention in the U.S. throughout 2023, it was a year of alarming measles resurgence around the globe. Measles outbreaks and deaths worldwide rose for a second year as vaccination rates remained below pre-pandemic levels.
Now, with measles outbreaks in multiple states and vaccination rates at a decade low, anti-vaccine activists are ramping up efforts to roll back school immunization requirements, setting the stage for a repeat of the devastating 2019 outbreak.
Declining measles immunization and rising outbreaks
A CDC and WHO report from November 2023 found an 18 percent increase in measles infections and a 43 percent increase in measles deaths worldwide from 2021 to 2022, as 33 million children missed measles vaccinations. The rise has alarmed public health officials, who warn the disease poses a “relentlessly increasing threat to children.”
As COVID-19 taught us, infectious disease spread anywhere is a threat everywhere.
In the United States, a quarter of a million children missed measles vaccinations in the 2022-2023 school year, and the national measles, mumps, rubella (MMR) vaccination rate stayed at 93 percent, below the 95 percent needed to maintain herd immunity.
In a dozen states, measles vaccination coverage is less than 90 percent, leaving a significant portion of the young populations vulnerable. We’re already seeing the effects of declining measles immunization worldwide.
While the total number of U.S. measles cases was lower in 2023 than in 2022, the number of states affected tripled. Outbreaks were reported in Ohio and Kentucky, and cases were reported in over a dozen states and jurisdictions, including Wisconsin, Illinois, Pennsylvania, Colorado, and Texas. In almost every instance, measles cases were linked to unvaccinated or undervaccinated individuals.
Routine vaccines face public scrutiny and legal challenges
The drop in childhood vaccination coverage—and rise in measles outbreaks—coincides with declining confidence in vaccine safety and growing resistance to vaccine requirements. A Pew survey in 2023 found that 28 percent of Americans think parents should be able to opt out of school immunizations, up from 16 percent in 2019.
Following the trend, school vaccination exemptions reached a record high of 3 percent in 2023, with increases in 41 states. Exemptions from school vaccines have nearly doubled over the last decade, almost entirely fueled by nonmedical exemptions, a strategy by vaccine opponents to skirt school vaccine requirements.
After recent legal success in Mississippi, the same anti-vaccine groups that led the legal opposition to COVID-19 vaccine mandates are now funding lawsuits to reinstate or strengthen nonmedical vaccination exemptions nationwide.
How to protect your child against measles
The CDC recommends that all children receive two doses of the MMR vaccine by age 6. Children who are unvaccinated or not fully vaccinated are at high risk of infection during an outbreak. Adults who are unsure of their vaccination status can receive an MMR vaccine dose.
Measles vaccination provides lifelong immunity. As measles outbreaks continue to spread in the U.S., vaccines are the best way to protect your child against the potentially deadly disease.
For more information, talk to your health care provider.